Pregnancy Retrospective: A Birth Day

Sunday, October 9, 2016

Now that our darling girl is 3 months old (WHAT?), I suppose it's time to write her actual birth story. It makes me smile that almost exactly a year to the day that I found out that I was pregnant, I'm writing the birth story of that same baby. Here we go.

June 19th came and went without so much as a real contraction. Ken and I had plans to go to Ocean City that day, but I was just too tired to walk more than 5 minutes at a time, and it was HOT. Instead, we opted to do what any sane adults on the cusp of parenthood do; go see a Pixar movie. Obviously. After I obtained my required popcorn with extra "butter", we settled into our cushy, reclining, seats in the most deliciously air conditioned theater and prepared to watch Finding Dory.

(Note to self and all pregnant ladies, Finding Dory is very emotional and has lots of parent-related feelings and I cried... so you might cry, too. Ken only made fun of me a LITTLE bit, so at least there's that.)

In the days leading up to THE BIG DAY, I kept people updated on Facebook with the following statuses:

June 13th - Still pregnant. Send popsicles. Or watermelon. I will accept either.

June 14th - State of the Alison: Still pregnant

June 15th -
Returns shipped ✔ License plates acquired ✔ Health insurance BS sorted 
 Still pregnant ✔ Next: Grocery shopping, Old Navy returns, maybe a pedicure?

June 16th - Late-breaking update: Still pregnant. Have attempted acupuncture as a way to possibly get things going. No signs yet. Contemplating making a key lime pie

June 17th - Captain's Log, Day 278: Still no sign of Baby Girl. Have eaten copious amounts of ice cream. That second part isn't really related, but it happened.

June 18th - State of #TheNotoriousBGB: Still contentedly hanging out in her uterine lodging.
State of the Womb-Haver: Very hot. Have made a trip to Lowe's and a thrift store for kids' stuff. May acquire water ice.

June 20th - For those playing the home game, still pregnant. The #NotoriousBGB is clearly on her own schedule. Eventually, she'll be evicted, but not today. Until that time, lots of Netflix, walking, and ice cream.

On June 20th, I had a scheduled OB check-up, during which I had my doctor attempt a membrane sweep. (TMI WARNING). "But Alison, what is a membrane sweep?" you may be asking. Well. It's when your doctor (midwife, nurse, whoever), inserts a finger through your cervix (ow) and sweeps it around (ow ow) to attempt to separate the amniotic membranes from the side of the uterus (ow ow ow). This causes a local release of hormones that can often induce labor. I knew it wasn't going to be fun, but hearing my OB tell me that he wasn't going to stop until I said "STOP," and would be ignoring all other sounds or words I said during the procedure did not inspire in me a feeling of calm. He ended up only being able to do the sweep for less than 30 seconds because I was going to crush Ken's hand, but the good news is that I was almost 2 cm dilated. The bad news is that I was 0% effaced. (Effacement is when your cervix shortens and thins out to prepare for labor. 0% effaced means no change, 50% effaced means the cervix is half of its normal thickness, 100% means the cervix has thinned out completely and just the uterine opening is there. Being 10 cm dilated and 100% effaced means you are "complete" and THINGS ARE HAPPENING.) After that, I scheduled an induction for June 27th, silently prayed that I would not still be pregnant by then, and away we went.

The rest of the day was uneventful. Lots of walks were taken. Lots of ice cream was eaten. Lots of sitting on the couch, talking to the bump, telling her it was time to come out. Finally around midnight, I started having some semi-regular contractions, and by 1 am, I was definitely sure that things were happening. My contractions were 12-15 minutes apart, and only about 30-60 seconds long, so I knew it would be awhile before we would have to head anywhere. I was having a lot of back labor since Baby Girl was still "sunny side up", so lying down was extremely painful. I told Ken to sleep and spent the next 5 hours on the sofa, half-sitting, half-lying down, sometimes walking, sleeping in between contractions. I hung out with the cats, texted my mom, and talked to Baby Girl. At 6:30, I woke Ken and said that it was probably going to be time to go in a few hours. At 7 am, I called Lee (our doula) and she talked me through a few contractions. Since they were still about 10 minutes apart, she told me to eat, shower, stay hydrated, and let her know when we were heading to the hospital. At 8:30, Ken decided it was time to go since he was worried about traffic, and so we packed up the car and started on our journey to Pennsylvania Hospital.

The commute to Pennsy takes about 45 minutes on average. I think that morning, it took 93 days. Every bump made me want to cry. I squeezed Ken's hand the entire ride, so major props to him for driving to Philly with one hand on the wheel for 95% of the time. By 9:30, we were upstairs in the triage waiting area. The nurses made me fill out some paperwork (note to self: FILL OUT THE DAMN PAPERWORK BEFOREHAND NEXT TIME), and I was shocked that I could even sign my name because I was so tired and not focused on the task at hand. Our nurse got me into a hospital gown and hooked me up to the monitor, and then a resident came in to check me to see where we were. I was still only 2 cm, but I was 70% effaced. Active labor is considered to be after 6 cm, so I was nowhere near that, and my contractions were only 5 minutes apart. I think they were about 27 seconds away from sending me home, but then Baby Girl decided to give us some excitement and her heart rate dropped... so they admitted me because they wanted to induce me.

Pause: I hadn't written out a "birth plan," per se, because I kind of believe that writing out a birth plan immediately guarantees you a c-section. Also, my plans were so generic. They were, "Avoid being induced, avoid c-section, labor as long as I can without an epidural, get an epidural when I wanted it, have a healthy baby." So, right away, less than 24 hours into this extravaganza, I was having to give up on my "avoid induction" plan. Could I have refused the induction? Sure. But then they would have sent me home and since BG was showing some signs of distress, I would have been freaking out. I agreed to the foley bulb insertion (to get me to 4 cm) and to be started on pitocin (synthetic labor hormone), with the idea that hopefully, my body would get the memo and we could remove the interventions once things got going.

(Ha, I'm adorable.)

By the time I got over to Labor and Delivery, I had gone from 2 cm to 4 cm, so no foley bulb (yay!), but they started an IV for a low dose of pitocin. I called Lee to let her know what was going on and that she didn't need to come over yet because I wasn't even in active labor. She was in the neighborhood, so she said she would stop by and see how I was doing. She got there around 11 and ended up staying because my contractions were getting stronger and I needed support. Because I was on pitocin, I had to stayed hooked up to the monitor, which meant no wandering the halls or getting in the shower, which made me sad. (Cross those off of my labor plans/desires...). Fortunately, I was allowed to get out of bed, walk around my room, and sit on the labor ball, all of which helped a lot. I labored with Lee and Ken until 3:30 or so, and it was rough, but manageable. Breathing, counter-pressure and massage, heat, and walking helped me get through each contraction, which were about a minute long and 5 minutes apart. Without Lee and Ken, I would have been a disaster.

At 3:30, my nurse and a resident came back to check me again, and I was 4 cm and 100%. BG's heart rate was still not ideal, so my OB wanted to break my water to move things along. I went back and forth on this, but in the end, decided that it was a good idea, since my body didn't seem to be getting with the program by itself. The actual rupturing of membranes didn't hurt at all; it was just messy. We also found out at that point that BG had gotten a little over-excited and pooped, as there was meconium (baby's first poop) in the amniotic fluid. As you can imagine, this is not ideal, as baby is still "breathing" amniotic fluid, so breathing poop isn't great. And so, do not pass go, do not collect $200, the NICU team was now invited to our delivery in case any poop was aspirated during the birth.

After my water broke, shit got REAL. My contractions were more intense, about 3 minutes apart, and almost 2 minutes long. There was yelling. There was crying. There was a lot of, "I can't do this, I can't do this, I can't do this," while I rocked back and forth on the labor ball, bent over into Lee's lap, while Ken rubbed my back and pressed warm compresses into my sacrum. Around 6:30, I asked for an epidural. Knowing that I had wanted to labor for as long as possible without an epidural, Lee reminded me, and asked if I wanted to have the doctor check my cervix again to see if I was close. We all figured that since labor had been so intense for the last three hours that I must be close to transition.

... I wasn't. I was still only 5 centimeters.

I couldn't even contemplate continuing what I had been doing for the last three hours, knowing it could be hours and hours more until I was ready to push. I needed the epidural, and I wanted it NOW. Of course, I had to wait about 20 minutes to get more IV fluids and for the anesthesiologist to arrive. I wasn't allowed to get out of bed and walk around or get on the ball at this point because my nurse was having trouble keeping the baby on the monitor, so I had to lie in bed, which was torture. I was having a lot of back labor, and every contraction felt like it lasted forever. They came on, one after another, with barely time to breathe between them. While we were waiting, I ended up getting sick and throwing up all over the floor, and then thought I had peed everywhere, but it was just amniotic fluid. Never in my life have I cared less about my dignity as when I was sitting, nude on the bed, soaking wet, crying, apologizing to the nurse (who kept saying that I didn't have to apologize), trying to get into a hospital gown, trying not to throw up. (This is the part where I tell you that pregnancy and birth are so magical and glamorous and you simply must cherish every moment, and then I laugh maniacally.)

Once the anesthesiologist arrived, things happened quickly. I swear that she had me prepped and had that epidural in within 5 minutes, but Ken maintains it was longer than that. I didn't care; I would have proposed marriage to this beautiful, amazing, pain-relieving angel if I wasn't already married (And if that wouldn't have been totally weird and also unethical for her. Details.) I feel bad, because I forget the name of the nurse who was taking care of me at that point (we had a few throughout our stay in labor and delivery), but without her, I would not have been able to sit still and get my epidural. I was starting to freak out and she basically grabbed me by the shoulders and said, "LOOK AT ME. LOOK RIGHT HERE. You are amazing! You are determined! You are strong!" and she coached me through contractions while I sat as still as I possibly could, knowing there was a giant needle in my spine.

And then... relief. Magical, wonderful, blissful, pain relief. I sat and watched the monitors as my body handled contraction after contraction, but now I could sit still and not scream and know where I was in space and time. It was odd. After a couple of hours, Ken went to get dinner and when he got back, we told Lee to go home and rest and that we'd call her when I was closer to pushing. That was around 9:30. Ken took a nap, and I tried to nap. Instead, I started having incredibly bad breakthrough pain, and the anesthesiologist had to come back to my room twice to bolus me with pain meds. Then, I spiked a fever. And the baby's heart rate was too high. And then I threw up again. I was having so much pain and pressure that I couldn't get away from, it was torturous. One of the OB residents came back to check me again since I was feeling a lot of pressure, so the team thought I must be getting close to pushing.

I was barely 6 centimeters.

At this point, things are a little fuzzy. It was 1 am. I had been in labor for 25 hours and my water had been broken for 9 hours. I had a fever. My OB was actually the physician on call that night, which was nice, because there were at least 17 different doctors who could have been on call. He came into my room and asked how I was doing, and then told me that he had been trying to give me as much space as possible to have this baby with as few interventions as possible, since he knew that was what I wanted. But... the time had come. Her heart rate was too high, I had a fever, and now there was some blood in the amniotic fluid, so he was concerned about a placental abruption or an infection. He suggested it was time for a c-section. I immediately consented, because I just wanted our baby to be okay. I woke Ken and told him what was happening, and then I called Lee and told her I would be heading back to the OR shortly. By 1:30, I was being wheeled back, and Lee met Ken in our room.

As I lay on the table while the OR nurses prepped me and the room, I tried not to think about the fact that in mere moments, my abdomen would be incised and stretched open to accommodate removing a human from my body. I chatted with the anesthesiologist and waited for Ken to be brought back to the OR. My doctor and a resident came in and made sure I was numb, and then it was go time. There was a lot of pulling and pushing and pressure, and I listened as my OB talked to the resident, pointing out anatomy and guiding technique. It was kind of surreal, knowing that right now, I was a patient, but in a few months, I could be standing on the other side of the drape, assisting in the same surgery I was undergoing.

They had told us before they started that our baby wouldn't cry right away because they wanted to suction her fully to make sure she didn't aspirate any meconium. The neonatalogy team was there to check her out, just in case, too. Before she was born, my doctor announced that it was time, and that she looked like a pretty big baby! Then, they took her out, and the first thing someone said on the other side of the drape was, "You're covered in poo!" We all laughed, and they held her up over the drape so we could see her. She was, in fact, covered in a greenish-brown sheen, and she had a look on her face like she knew she was covered in her own poop, too. She was quickly whisked away to the warmer, and even though it was just a few seconds, it felt like an eternity until her tiny wails filled the room. I exclaimed, "Happy birthday, baby!" and tears filled my eyes. I kept craning my neck to see if I could catch a glimpse of her on the warmer, and I started to get really anxious because she was suddenly quiet. I asked if everything was okay, and the pediatrician replied, "Yup! She's just checking everything out!" Ken went over to take some pictures, and he showed them to me on his phone when he got back. Once she was cleaned up a bit, they swaddled her up and handed her to Ken. I wanted so badly to hold her, but as my abdomen was still open for the world to see, I had to wait. Meanwhile, Baby Girl was busily trying to nurse on Ken's "bunny suit" scrubs (no actual bunny ears or tail, just a pull-on "clean suit" for the OR). Honestly, I don't really remember what happened after this or how long it took to get back to recovery. All I knew is that our baby was here and healthy and just like that, we went from being Ken and Alison, to Mama and Daddy.

First family portrait!
In recovery, I got to hold our baby for the first time. I looked into her chubby little face, and marveled at her tiny hands and feet. Her eyes, large and blue, were open and she seemed to be taking it all in. She also was hungry. VERY hungry. With the help of Lee and my recovery room nurse, I was able to nurse her, and she latched on right away. I really, really, really wanted water and ice chips, but they had to wait to make sure I wasn't going to have to emergently go back to the OR for any reason. By the time we were taken up to our room, it was 4:30 in the morning. I was exhausted and thirsty and sweaty and gross, and I just wanted to sleep. As the sun came up over Philadelphia, we stared at this tiny, new, human and picked out her name. And then, for the first time as a family of three, we slept.

Aviva Jane, our Rainbow Baby
7 lbs, 8 oz, 20 inches long
100% perfect

From Facebook:

Final state of the womb address for this term: Aviva Jane is here! Born via emergency c-section on 6/22 at 2:26 am. Ken and I are overflowing with love, and we can't believe this tiny miracle is ours. Thank you to EVERYONE who has called, emailed, texted, visited, sent congratulations and good vibes... you are all the best. We can't wait for Aviva to meet the people who have been waiting for her and loving her since day 1!! 

Pure bliss

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