July 26, 2010

A Baby is Born

Be warned - this is insanely long. Get a snack before you start; this blog is not responsible for death by starvation of any readers.

On Thursday morning, we got up early and drove through Boston traffic to the hospital, so we could pay $17 for valet parking. Oh, and so that I could get a dose of cytotech to get me ready for induction on Friday.

After an hour of monitoring, they said to return in three hours for more monitoring and a possible second dose. We didn't want to go home because there just wasn't THAT much time, and I was dying to visit the Flour Bakery before we leave Boston, so we walked the two plus miles and enjoyed the AC and a giant sticky bun. Afterwards, we walked up to the Prudential Center and grabbed a little lunch, before hurrying back to the hospital. We hadn't intended to walk so much, but it ended up being over five miles.

When we got back and I was hooked back up the monitor, it became apparent that I was having regular contractions about every 3-5 minutes, although they really weren't painful at all. I hadn't dilated anymore (I'd been a two for about ten days), but I was now effaced to a 75%, so there was some progress.

The midwife came in and said she didn't want to give me a second dose, but I was welcome to either go home or to walk around for an hour and see if things progressed. My feet were hurting quite a bit after all the walking and I was sick of being at the hospital, so we went home.

Bart and I both took a nap, ran some errands, and I made dinner. We played some Yahtzee and Greed (Bart won every game except a single round of Yahtzee, which may have slightly peeved me), and we went to bed around eleven. All during this time, I continued to have pretty painless contractions that stayed 3-5 minutes apart.

I slept a little restlessly until about three a.m. and then I woke up, feeling like my water might possibly have broken. Bart convinced me to call the midwife, so I did and when she returned my call she said it sounded like my water had broken, but that if I could still sleep, I was welcome to stay home and come in later after breakfast and a shower, but I no longer needed to wait for my 1:30 p.m. induction time.

After my water broke, my contractions got stronger and a little more painful, although I was able to fall back asleep between each one for about 7-12 minutes. Finally, around six a.m., they were getting quite uncomfortable, and I got up, took a shower, and got dressed.

The contractions were now coming more quickly - like every two minutes apart - and I was in a fairly significant amount of pain. I had to change from the maternity jeans I was wearing into a skirt, because the jeans were making me feel nauseous.

The night before, I had assembled some Creme Brulee French Toast, and Bart stuck it in the oven to cook while we got ready. I was feeling a little too ill to eat it, but I did have about half a yogurt. I felt pretty ridiculously pleased with myself that I'd made an actual hot breakfast on the morning I went into labor. Blue ribbon for me, please.

We ran around gathering last minute things to take with us to the hospital, with me stopping about every couple of minutes to hunch over and tell Bart how much these contractions were starting to hurt. Finally, about seven fifteen, we left the apartment, called the midwife to tell her we were on our way in, and started the drive into the city.

Fortunately, traffic wasn't bad and by eight a.m., we were dropping the car off at valet and checking in.

We'd found out the day before that my midwife, Sarah, was on call at the hospital from seven thirty a.m. to seven thirty p.m. that day, so by not waiting until the induction time, it was a good possibility that, assuming the baby didn't take forever to arrive, she'd be there from beginning to end, which thrilled me.

By the time they took me to the triage waiting room, where Sarah met us, I was feeling pretty horrible and after watching me through one contraction, Sarah said there was no need to send me through triage - I was obviously far enough along to send straight to a labor and delivery room.

She asked me what my pain management plans were and I told her I wanted an epidural. I'd expected to have to wait a few hours to get one, but she said the anesthesiologist would be in my room in a few minutes to talk me through it and then I'd have one shortly after that. I was. . . as delighted as it is possible to feel when you're in that much pain.

Bart and I went to the room, unloaded all our stuff, and I changed into a lovely hospital gown. By this time, I was feeling just truly truly awful. In the bathroom, I started feeling incredibly scared about the epidural and the IV and the whole delivery thing in general. Bart gave me a quick blessing, and I went back out to the room.

Sarah had said she'd wait to check me until after the epidural, but after watching me get my IV in and struggling through a few more contractions, she said she could check me right then to see how far along I was if that would change my decision about the epidural. I told her it wouldn't and the anesthesiologist inserted the catheter for my epidural. We'd been at the hospital less than forty-five minutes.

I started to feel extremely sick and the nurse grabbed me a bucket and I threw up. I felt just terrible.

I had a few more bad contractions and then the pain started to ease off - I could still feel the contractions, but they were very brief and more like pressure than pain. Once I was more comfortable, Sarah checked me and announced that I was dilated to a ten and likely had been when I arrived. I was shocked that I'd progressed so much, so fast without any pain medication.

Sarah said she'd give me about an hour to let the contractions continue to push the baby down and then we'd start pushing. By the time she returned an hour later, my contractions were starting to hurt more and more, to the point where I couldn't really talk through them anymore, and I increased my epidural drip. Within about ten minutes, I felt better than I had since the night before. I couldn't even feel the contractions and I felt basically like my normal self - I could talk and I felt strong.

We started pushing and Sarah commented that the baby was quite close. It took me a few contractions to get the hang of pushing with my stomach muscles (which I could feel just fine), and things started progressing, but quite slowly. They told me they could see her head and she had some hair.

My stomach was pretty empty after having thrown up, and every time I pushed, you could hear my stomach growling loudly. Bart and the nurse and I talked about food and she told me to be sure to order one of the famous milkshakes from the hospital cafeteria once the baby was born.

The midwife suggested that they give me a tiny dose of pitocin to make my contractions a little stronger and speed up the pushing, since I just wasn't making a lot of progress.

About ninety minutes into pushing, my left leg started to feel sore (as if I'd been lifting weights or doing crunches or something). Within thirty minutes that feeling escalated into full-on pain, and it hurt to move it at all. I was starting to feel the contractions again in a big way, and after another dose of the epidural that did nothing for them and REALLY nothing for my intense leg pain, I was feeling like I might die. I threw up again, amazed there was anything LEFT for me to throw up.

The resident anesthesiologist came in, along with another anesthesiologist who appeared to be the head of the department (the resident anesthesiologist referred to him as a "legend" after he'd left), and they gave me a couple of other drugs. I had laid back down, clutching the bed rail with my eyes closed, while they worked - I felt like I was in a complete haze. Bart rubbed my back, and within about five minutes, my leg pain had disappeared completely and the contractions had subsided again.

Sarah said they'd give me about thirty minutes to recover before we started pushing again. The doctor came in and looked at the baby's readouts (which they do if you've pushed for more than two hours), and said everything looked great.

I was worried that the thirty minute break would have caused the baby to retreat back a little, but when I started pushing again, she was even closer than she'd been before.

Before I had started pushing, Sarah had asked if I wanted a mirror. I said I didn't want it, but she said it could be very motivating, so she'd brought it in and turned it around so that it if I changed my mind, it was ready. When we started pushing again, I asked them to turn the mirror around and I could see a small sliver of her head too. It was covered with dark hair.

I continued to push, this time making some real progress in the course of about forty-five minutes. The midwife and nurse started using the minutes between contractions to get things ready for the birth, which they were sure was just minutes away.

Then, when the baby was getting really close, her heart rate stopped recovering between contractions, meaning it wasn't going back up to the healthy base line. Sarah called in the OB-GYN and pediatrician to stand by. Then the team from the NICU was there too, and I suddenly had an audience of about a dozen people. I was getting really nervous by all of this preparation.

On the next contraction, her head came completely out, and the rest of her body came out right away; Sarah unwrapped the cord, which was loosely wrapped around her neck, cut it and handed her to the NICU team. I found out later that they had to breathe for her for the first three minutes. Her Apgar score at one minute was only a 3. It was an incredibly frightening few minutes.

But within five minutes, her score was a 6, and by ten minutes, she was at an 8. They let me hold her for about ten minutes, and then they took her up to triage for observation to determine if she needed to go to the NICU or not. Bart went with her and after about thirty minutes, he called me to say that everything was good and that they wouldn't be sending her to the NICU.

The nurse took this photo while Bart stood at Ella's side in triage:

They both returned within another thirty minutes while the midwife and doctor finished stitching me up. After that, they left us alone with Ella for an hour or so before taking us up to the post-partum wing.

They needed to put her under the warming lamps, since she was having trouble maintaining a good temperature on her own, and I ordered dinner.

I can't say enough good things about Bart during this whole thing. He was a little nervous because he has a history of passing out in the hospital, but he was such a rock star. He was right there the whole time, so helpful and so encouraging. I had worried that the pain would make me angry and that I'd feel angry at him, but I never once felt anything but deep gratitude to have him there - several of the nurses and the midwife commented on how terrific he was from start to finish.

And now, watching him with our baby, I could just die of joy. He is so sweet with her, anxious to hold her and have her with us as much as possible (although we did send her to the nursery for most of the first two nights and enjoyed a total of about eight hours of sleep, with a little break in between for changing and feeding).

Welcome to the world, Ella. We couldn't be more thrilled to have you here.


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