Friday, April 10, 2009

The story of Audrey's birth

Due date: Friday April 3, 2009

For weeks, I’d been having days where I’d have contractions 5 minutes for hours and hours, but they’d never progress in intensity or frequency. It was very frustrating, never knowing if the contractions were “real” or not, and always waiting on pins and needles to find out. I felt like I’d been walking around for weeks, ducking under everything and peeking around every corner because I was waiting for the other shoe to fall on my head.

And then my due date came and went with no baby. I was shocked and so very tired of being pregnant. Never in a million years did I think I’d actually get to my due date still being pregnant.

Sunday April 5, 2009
Spent the morning at Beth’s for the family birthday party for Elliot (4/8), Anna (4/6), and Sean (4/3). I had been expecting to bring a new baby to the party, not still be pregnant. I was incredibly uncomfortable and grumpy and not very social. But it was a very nice party and in the end I’m really glad I got to be there with Elliot.

I spent the afternoon resting after the party, catching up on email, and watching tv with the boys. I noticed that I kept getting back pains like I’d pinched a nerve going across my hips. It felt kind of like how I remembered labor contractions, but my uterus wasn’t contracting at all so I assumed it was the baby hitting nerves. That had been happening a lot. At this point, I fully believed that I'd be pregnant until my scheduled induction on 4/10.

That evening, I made Elliot's lunch for the next day and got the kids' school things together. That's normally something I'd do in the morning but I had an 8am appointment for a biophysical profile ultrasound, so Brett would be trying to get both kids off to school by himself. I was doing what I could to minimize the morning chaos for him. Around 8pm, my brother Andy arrived after driving up from New York City. He'd spent most of the week down there with my mom (who was still in NYC) helping her deal with Anita's failing health and getting hospice care established.

I set my alarm clock for 6:30am and went to bed around 11pm.

Monday April 6, 2009
I woke up at 4:30am with a contraction (if there were any before that I guess I slept through them, so they couldn't have been very strong). It felt like all the contractions I'd been getting for weeks, but I'd never before been woken from sleep by one. Because of my history of fast labors, I was being very sensitive to any and all contractions and carefully took note of the time and then tried to go back to sleep.

I had another contraction at exactly 4:35am and another at 4:40am. At this point, I got out of bed and started to walk around to see if that slowed or stopped the contractions. It usually had before. At 4:45am there was another contraction, this time with that pinched nerve feeling in my back. I went downstairs and bounced on the birth ball and watched the clock. Another contraction at 4:50am, and the pain in my back was a bit stronger. And another contraction at 4:55am. My gut was now telling me this was real.

I woke Brett at 5am, telling him I was having contractions 5 minutes apart and they were starting to get more uncomfortable. He popped out of bed to get dressed (after confirming that he really didn't have time for a shower). I called the answering service for the midwives and spoke to the nurse on duty. She listened to me describe what was happening and my history, and told me to just go to the hospital and not wait for the midwife to call me back. That's what I expected to hear. Meanwhile, Brett called his mom Sue to come over and get the kids off to school (and I was feeling very glad that I'd already gotten their school things together the night before!). Fortunately, my brother was here so we didn't have to wait for Sue to get here before leaving. I woke my brother to tell him we were leaving and that Sue was on her way over, but we couldn't wait for her.

We left the house at 5:30am. The ride to the hospital was about 30 minutes (though it feel three times as long to me!). By now, the contractions were just a 3-4 minutes apart and lasting well over a minute. Brett was doing a great job staying calm and talking to me to keep me distracted. But I was starting to have to concentrate to stay relaxed through the contractions. I was definitely into back labor, just like with my first two (even though all babies were properly positioned!).

We got to the hospital just after 6am and checked in at the Emergency Room desk, just like we were supposed to. We waited there for about 5 minutes while a nurse from L&D came down to get me, and Brett was rubbing my back to help through the contractions. The contractions were uncomfortable at this point, but very manageable. When the nurse took us into L&D, she completely bypassed the triage rooms and set me up directly into a delivery room. Guess they figured I wasn't kidding! The midwife, Nancy, arrived a few minutes after we did and by the time I was changed and on the monitor she was in the room.

I had my first cervical check at 6:30am. I was about 4cm and was *so* disappointed that I wasn't further along! I'd been 2cm a few days before, so I was sure I'd be further along with all the contractions that morning. I asked the midwife if I still got to stay, and she laughed and said most definitely. I actually felt relieved, though I don't know why I thought I'd be sent home given how I was contracting and my history.

By 7am, the contractions were overwhelmingly intense. I'd had visions of relaxing through the contractions and being able to stay on top of them, just like I did the first two times. But this felt so very different. I was having a very hard time staying on top of the panic and simply could not figure out how to keep from tensing up. I knew I was making it worse on myself, but that knowledge only seemed to make me feel worse - like I was failing somehow. I was on my side in bed (the best of the positions I'd tried), gripping the side rails with all my strength during contractions, and vocalizing a lot - moaning, groaning, chanting. Brett was doing everything I asked him to, but I was feeling so much in both my back and my belly that I didn't know what I needed. Vomiting a couple times didn't help my rising feeling of panic. Nancy was doing what she could to help me relax, too - I think she was noticing that I was losing control.

Around 7:15am, I was at 6cm. At that point, I really started to panic. If I was going to keep on like this for many more hours (that's how slowly I thought I was progressing), I knew I wouldn't be able to do it without pain relief. (Never once, in my first two births, did it even occur to me that I could ask for pain relief. That's how different this one felt.) I told myself to get through just 5 more contractions and then reevaluate.

Around 7:30am, Nancy suggested breaking my water. She warned that it might increase the intensity even more, but it would get things moving faster. I rode through a couple more contractions, and then agreed to let her break it around 7:40am. I was about 8cm.

After another 10 minutes or so, Nancy said she wanted to reach in and help stretch my cervix the last cm or so to get the baby moving down. I'd been starting to feel like pushing at the top of the contractions, so I agreed. (I found out after that the baby's heart rate was dropping much more than they like during contractions - though still rebounding fine after - and she really wanted to get the baby out sooner rather than later.)

Shortly before 8am, I started pushing. For the first pushing contraction, I wasn't really coordinated yet. I pushed out a bunch of poop (which Nancy quickly cleaned) but felt like I didn't do anything for the baby. We were also trying to figure out positioning. I wanted to push on my side, but Nancy wanted me on my back. We finally compromised on me being kinda in between, but it apparently took several nurses to hold me legs apart far enough (I don't really remember that part). For the next contraction, I pushed with everything I had and I felt the baby move down and start to crown. The crowning scared me, so I backed off pushing because I just wasn't ready to go there. Then Nancy told me that with the next push she was going to help stretch me around the baby's head (apparently this little maneuver is called "midwife's forceps"). I barely had time to process what she said when I was pushing again, this time really crowning. I felt the baby's head pop out, and then took a moment to gather courage to push the rest of the baby out. As I started pushing, I heard Nancy say "It's a girl!"

Wait a minute! I thought the rest of the baby was still inside! Nope. She was on my belly, getting rubbed down by 2 or 3 nurses, and I hadn't noticed. Born at 8:09am, just over 3 1/2 hours since I'd woken up. I was completely shocked that I hadn't even realized the baby was born! Then it took a moment for me to process what Nancy had said - we had a daughter! I was honestly surprised! I hadn't realized how deeply I believed I was having a boy until right then, but I was also truly thrilled to have a little girl. She was 8 pounds 10 ounces, 20.5" long and we named her Audrey Celeste.

Brett and the baby nurse took the baby over to the warmer to do the assessment. Nancy waited with me to deliver the placenta. While we waited, she showed me the baby's perfectly formed curly cord and told me it'd been wrapped around the baby's neck and was getting too tight during the contractions - thus the urgency to deliver at the end. And then we waited, and waited, and waited. I one point I commented that it seemed like this was taking a lot longer than I remembered, and Nancy agreed it was taking a long time. After a few more minutes, she checked internally and found that my uterus had already clamped back down and my cervix was back to 2cm dilated. The placenta was pretty well trapped, and was going to need some help to come out.

First, Nancy tried to just reach in and see if she could gently nudge things enough to make the placenta come out. Despite having just been through what I would call a very hard labor, that was worse. They practically had to scrape me off the ceiling after Nancy tried that (unsuccessfully). The next step was to inject Nubain into my IV to see if that would relax me, and my uterus, enough that she could pull out the placenta. But again, I ended up on the ceiling with no progress for the placenta. At that point, Nancy called in the oncall OB, Dr. Merens, (who was in the hospital) for a consult.

After talking together, Nancy and Dr. Merens came to talk to Brett and I. Dr. Marens was very warm and supportive and tried very hard to make sure I was comfortable with everything that was happening. I really appreciated it! At this point, I had a fully retained placenta and my body was not going to do what it should have. It was not a complete emergency, since I was not bleeding. But it needed to be dealt with. They called down the anesthesiologist to do either a spinal or general (needed his consult to decide which).

The anesthesiologist decided he couldn't do general (because I'd had a banana to eat before leaving for the hospital) so we went with the spinal. I was wheeled into the OR around the corner from the delivery room. I'd been told the procedure would have to be done in the OR, in case they needed to use instruments or in case I started bleeding. What I wasn't expecting was a flood of memories as I went through the OR doors - memories going back to the last time I was in an OR 2 1/2 years ago for my skull/brain surgery. Very odd sensation, but it quickly passed. Brett waited back in the delivery room with Audrey.

Nancy and Dr. Marens were great about holding my hands and talking me through getting the spinal (which seemed to take forever!). They were friendly and warm, and distracted me from what was happening in my back. Within a few minutes of getting the spinal, my legs started to go numb and very quickly I could feel nothing. Nancy then went to work trying to manually extract the placenta, and I think I'm really very glad I had a spinal at that point! Unfortunately, she couldn't quite get it. So Dr. Marens took a turn. He worked and worked and was about to give up and get the instruments, when he got the grip he wanted and was able to pull it out successfully. Then he went back and made sure to scrape the uterus really well to ensure everything was out.

Nancy then finished up with a few stitches (I had a shallow 2nd degree tear) and we were done. As I was wheeled back down the hallway, Brett and Audrey joined me and we all went to a recovery room. After an hour of monitoring (and finally getting to nurse Audrey) we went to the post-partum room to begin the full recovery.

And I'm now quite certain that I don't want to do that again!


bcshopping said...

I'm glad you wrote this story down! A little more details than your brother-in-law was expecting to read, but a lovely memory nonetheless. I am sooo looking forward to meeting my beautiful niece. HEHEHE... NEICE *grin*. My love you you, Audrey and the your three guys!!


bcshopping said...

I'm glad you wrote this story down! A little more details than your brother-in-law was expecting to read, but a lovely memory nonetheless. I am sooo looking forward to meeting my beautiful niece. HEHEHE... NEICE *grin*. My love you you, Audrey and the your three guys!!