Part 2 - Labor and Delivery.

Labor
I was scheduled for an induction on May 31^st, since I was going on 42 weeks and generally healthcare providers prefer that the baby is born by then. The reasoning being that the placenta starts to deteriorate and the baby starts losing oxygen. I had it in my head that Autumn would not be arriving until my induction date and tried not to think about going into labor on my own. Although I was afraid that labor would be much harder if I were to be induced, I didn’t want to get my hopes up about things starting naturally. Fortunately, however, we didn’t make it to May 31^st. Contractions started on their own on Thursday night, May 27^th, 2011.

They started as weak menstrual cramps and lasted about 30 seconds each. They were mostly sporadic, every 10 to 30 minutes, and didn’t ever get progressively closer together. They did start getting more intense, but stopped the next morning around 7 am. At around 4 pm, contractions started again. Doctors and Midwives tell you not to be a clock watcher, but I wrote down the time and intensity of every single contraction. They still never got closer together, but, like before, they started getting more and more intense. At midnight, Dan and I decided to go to sleep, just in case that was the night. I woke up at 1 am with a pretty painful contraction. I wrote down the time and intensity and fell back asleep. 10 minutes later I woke up again with another painful contraction and felt like I needed to go to the bathroom. As soon as I got there, my water broke. What a strange feeling! I woke up Dan to let him know and then called the Midwife. She told me to come into the hospital as soon as possible just to make sure that my water had actually ruptured and then if I wanted to I could return home to labor as long as possible and then go back to the hospital. We hadn’t packed our bags yet, so Dan hurried to get that done as I took my last shower before the baby arrived. We thought we would have hours to pack our bags, since I had been expecting to labor at home for as long as possible and didn’t’ think my water would break first. I was getting super excited. Dan was still tired and probably didn’t realize what was happening just yet. He typically doesn’t function well with little sleep. We got in the car around 2:15, stopped by Dan’s parent’s house to print out a couple copies of my birth plan, and headed for the hospital. Dan’s mother insisted that they accompany us to the hospital since his dad is a doctor and in the event that I had the baby in the car, at least we would have had medical assistance. She was very adamant that babies can arrive at any time after the water had broken. We told them to stay put since the baby was surely not going to be coming out that soon (good thing, too!).

We arrived at the hospital at 3 am and headed straight for labor and delivery. They hooked me up to the monitors to check the baby’s heart rate against my contractions and everything looked great. The Midwife eventually came in and made sure that my water had broken. She also checked to see if I was dilated at all – I wasn’t. I was at 0 centimeters with a broken bag of waters and increasingly painful contractions. I came to the realization that we were in for a very long night and I was okay with that.

We were admitted and moved to the labor room at 4:15. Meredith arrived shortly after that. Things were still feeling pretty manageable at that point so we decided to play some Rummy. We got through 2 hands before contractions really started picking up. We went for a walk around the labor floor and contractions went from every 5-10 minutes apart to every 1-3 minutes apart and started getting worse and worse. At first I was breathing and swaying through them, holding on to the wall or Dan. Within half an hour I was moaning and groaning, holding onto to Dan with every ounce of energy while Meredith rubbed my lower back.

Around 8 am, things started going downhill very quickly. I was so exhausted since I had only had 1 hour of sleep in the past 24 hours and had been having contractions for longer than that – albeit they weren’t all painful until that morning, they were still exhausting. I couldn’t stand up because I didn’t have leg strength. I couldn’t lay down because the contractions weren’t manageable in that position, and I couldn’t get in the bathtub because it hurt too bad to sit down (not to mention getting in and out of a tub when 41+ weeks pregnant is seriously impossible). Eventually I settled for standing in the shower while holding on to the railing with all of the strength left in me so I wouldn’t fall over. The shower was very soothing for about an hour, but eventually started to not work for me at all. I went from moaning through contractions to nearly screaming. Contractions at this point were happening much closer together. Most of the time, I would only get a 10-30 second break between them, and they were extremely intense. I thought for sure that I was in transition. I even started feeling like I needed to push. But, when the midwife checked me, I was only 5 cm dilated.

That was when my “breakdown” started. The thought of going through another 10 hours of labor unable to be in any position that would allow me to manage the pain and having horrible contractions without at least a minute break between them was horrifying. Pain management and exhaustion do not bode well together, at all. That was when I started talking to Dan about getting some kind of medicine. I was so exhausted that all I wanted was to sleep. I felt that if I could just have 2 hours to recover that I would be able to go through the rest of labor. Dan remembered that I pressured him a lot before labor to not allow me to get medication and he reminded me of that a few times. But after about 10 minutes of asking for medicine and Dan reminding me that I didn’t want it, I started crying and begging for it. He told me that it was ultimately my decision, but that he felt he needed to remind me of what I had said I wanted before labor began. He wasn’t pressuring me to not get pain relief, but doing exactly what I’d demanded of him in the weeks leading up to this point. Eventually we talked to the Midwife and she told me about an option to have some medicine to help me sleep, but I would still be very aware of the pain. I was so scared of more pain at that moment that I turned that option down and we started talking about the epidural.

Deciding whether or not to get the epidural was a huge decision. I have always been very, very scared of needles. In fact, when I had to get the meningitis shot before attending college, I brought along my teddy bear to hold onto. Yep, at the age of 18, I brought my teddy bear along for moral support when a tiny needle was going to be quickly poked into my arm. So, imagine my anxiety about a giant needle going in between my vertebrae. But, again, more than my fear of needles was my need to prove that I could give birth “naturally”. For years I’ve been convinced that I could complete the task of childbirth without any help whatsoever. I was overwhelmingly egotistical about it. Any time someone mentioned an epidural I would brush it off and swear I could do without it. I felt like I had to prove to myself and everyone I’d discussed my birth plan with, that I could go through the entire process without assistance. Eventually I had to put my pride and fear aside when I decided to receive the epidural.

The anesthesiologist was fantastic. He had the calmest voice and seemed very confident in his work. I wasn’t scared of the needle like I thought I would be since I never even saw it. The first step was getting the area numb. That was the only time I felt any pain from needles. It felt like a bee sting and then I couldn’t feel anything. After that they inserted the needle, followed by the catheter, and then they taped the catheter tube down across my entire back all the way up to my shoulders. The hardest part was sitting still through each contraction with my back arched. I was just waiting and waiting for it to take affect because it hurt so much. 20 minutes after they finished, I was pain free.

This was a wonderful break. Meredith, Dan, and I each got an hour of sleep. We also got to watch the end of Father of the Bride Part 2. When we turned on the movie it was at the part when the family was headed to the hospital for the birth of the Steve Martin’s grandchild. Meredith, Dan, and I were all a little peeved (to say the least) with the outrageous portrayal of childbirth. Not only did she go from her first contraction to being wheeled to the delivery room in five screen minutes, she pushed out a baby in less than that! Not to mention that the child came out looking like a 3 month old! I mean, honestly, the way movies and television portray births are simply ridiculous.

When I first got the epidural I was at 6 centimeters. An hour or so later I was at 7 centimeters, just about to an eight. At 4:30 I noticed that I was having a little more feeling in my abdomen and called the nurse to come check it out. When I leaned forward off of the pillow for her to check the site, we noticed that there was a 4” circle of blood that had collected behind me, right by where my epidural had been placed. Apparently the catheter had slipped half of the way out, which is why I had more sensation. We discussed having to redo the site, but decided against it. I wasn’t in too much pain and it was all localized to my left side anyhow, so it didn’t really bother me. At 6 pm, 5 hours after they last checked my progress, I was still stalled at 7 centimeters. That’s when they decided to start the Pitocin drip. Contractions started becoming more noticeable and painful at that point, but still localized to my left side. After about an hour on Pitocin it began feeling like the baby was digging a screw driver into my left hip bone every time I had a contraction. Around 9:30 I felt a serious urge to start pushing. The Midwife came in, checked my cervix, confirmed I was at 10 centimeters and at 9:40, I started the very long delivery process.

Delivery

At 9:40 the Midwife and nurse got me into the standard, on your back, pushing position and had me try a couple “test” pushes. They were teaching me how to push so that the real pushes would be more effective. I was pumped up and so were Dan and Meredith. Dan had this cute smile on his face, knowing that within a short time (probably thought it would only be about an hour) he would have a daughter. My test pushes were successful and I began pushing harder and longer. They tell you to push exactly like you’re having a bowel movement, so that’s exactly what I did – I pushed like I was passing the biggest bowel movement I’ve ever passed in my life.

The Midwife and nurse were incredibly encouraging. I kept moving the baby a little farther down each time for the first hour or so, but then progress stopped. Even though I was pushing “perfectly”, she just wouldn’t come down any farther. I was so determined to get her out without having a c-section that I started pushing even harder and even longer. Instead of stopping pushing when the contraction was dying out, I would push again. Some of the contractions lasted for over a minute and I pushed for the entire time, taking only a few short breaths to gather strength.

I tried pushing in the standard position, on my knees leaning forward against the bed, on all fours, on my left side, and on my right side. Eventually we realized that the standard position was best for me – even though I swore up and down before labor that I wouldn’t be caught dead in that position when it was time to push!

Before the pushing process began I told the nurse that I wanted to have the baby before midnight, because that would mean our baby would share a birthday with a good friend from high school. When 11:30 rolled around and her head was still in the same place, I knew the chances were slim. Still, I kept pushing, staying positive and determined the entire time.

Around 1:30 the Midwife mentioned that my water had been broken for 24 hours and I had been pushing for nearly 4 hours and because of that she needed to call in a doctor. The doctor came in to talk to me about my options for the rest of the delivery process. He examined how the baby’s head was situated to see if it would still be possible to have a vaginal delivery. Thank goodness he said yes! The problem with her position was that she was completely sideways and didn’t seem like she had any intention of rotating through the pelvic bone and out the birth canal. He was exceedingly calm and reassuring and gave me three options. The first option was to have the vacuum assisted delivery started immediately. The second was to push for another 30 minutes on my own to see if she decided to rotate and then have the vacuum. The third was to go in for the c-section. He explained the risks of the vacuum, which included swelling and bruising and very, very, very rarely, a bleed underneath the bones of the skull. He also said my likelihood of tearing was much greater with the vacuum and I could end up with a fourth degree tear. I knew I couldn’t handle having a c-section because I had sensation in my left side and I would have been able to feel the procedure, which ultimately meant they would have had to put me completely under. After having slept for only 2 hours out of the previous 40, I just couldn’t imagine having to go through that recovery process. And, besides, I wanted to be awake when my daughter was born!

Dan and I sent everyone out of the room to discuss our options and we agreed to push for another 30 minutes unassisted, and then start the vacuum delivery. With every contraction for those next 30 minutes I pushed with every ounce of energy that I had, sleeping in between each one. She didn’t budge. She was still stuck behind my pubic bone and seemed very content with being there.

At 2:10, 3 delivery doctors, the midwife, the labor nurse, about 4 other nurses, and a pediatrician were all in the room when they attached the vacuum to her head and told me to push whenever a contraction started. I pushed through 2 contractions, and even with the help of the vacuum she didn’t move. So, with the next contraction, I made sure that I was pushing with every teeny bit of strength left. Dan had my left foot pulled all the way back and Meredith had my right foot. I curled my chin all the way down to my chest and leaned my torso forward as far as it would go and I tightened my abdominal muscles and pushed without a sound. Everyone around me started getting excited and telling me to keep pushing – she was finally moving downward! I was so relieved. With the next contraction I tried to push even harder and everyone cheered even harder. After 3 more pushes, when I barely had any strength to continue, I heard people shouting that she was going to come out. Dan was by my side saying, “Push, push, push!” and Meredith was on my other side saying, “This is it!!” I kept pushing for 3 seconds longer when I felt a relief of pressure and my head fell backwards out of sheer exhaustion. They told me to look to see my baby come out, but I felt so drugged and tired that I couldn’t focus and my head just swung up, my eyes opened briefly, I saw her giant bloody body, and I fell backwards again.

I didn’t hear her cry until about 5 seconds after she came out – and those were the longest 5 seconds of my life. When they suctioned out her nose and mouth, she let out a powerful scream, and that’s when I started crying. I looked at Dan, with a serious amount of tears pouring out of me, and saw that he was crying, too. I laughed a little and said, “I thought you were going to high-five me, not cry!” He swore the entire pregnancy that he knew he wouldn’t cry when she came out, especially since he’s never cried from being happy before. He stood next to me, holding my hand, looking in my eyes, and we just cried together for a few moments. Finally the Midwife said, “Hey, Dad! Go see your baby!” and he went over to visit her on the exam table and held her hand while they did some tests.

She was perfect. There weren’t any complications, whatsoever. It was truly a miracle. Actually, throughout the entire labor process her heart rate was completely steady. It never dropped drastically during any contractions and she seemed completely unfazed by the pushing and the vacuum. This was such a blessing because if her heart rate had done anything differently, we would not have been able to have a vaginal delivery and I would have had to have an emergency c-section. She did, however, come out sideways! She never rotated at all!

They weighed her and everyone in the room nearly fainted when they announced that she was 10 pounds 5 ounces! I just couldn’t help but laugh. A few weeks before at one of my appointments, a midwife told me she was pretty average size and she’d probably be between 7 and 8 pounds! Ha! Dan even posited that she would be exactly 8 pounds on the dot. He swore by it. When I told Meredith the midwife’s prediction she seemed a little jealous because she had a 10 pounder and a 9.5 pounder herself. I guess all those people who told me I looked like I was having twins were right, since twins typically amount to 10 pounds anyway!

A few minutes after delivery, the doctor that had talked to me about the potential problems with the vacuum came over to inform me that I had nearly had a fourth degree tear. Basically, this meant that I ripped from the vagina all the way down into the anal sphincter, but not all the way through the sphincter. I also had a tear on the other side as well. They put a lot of stitches in me and explained what I needed to do for the next couple of weeks to take care of them. But at that point I was so tired I don’t even remember what was being said.

Finally, after what seemed like an eternity, they brought her over to me and laid her on my chest. She was so beautiful! She kept crying and crying with her awesome lungs and at one point even opened her eyes and looked at me. It all seemed very surreal. I couldn’t believe that the alien moving inside of my stomach was now out and had transformed into the beautiful, perfect, little girl.

It took an hour for them to finish stitching me and up and to get the room clean for visitors. Dan’s parents came to see her first. I cried when I saw them hold her for the first time, because I knew she had two more people in her life that would love her unconditionally. What more can a mom ask for? At one point Autumn even opened her eyes and looked at her grandmother. This made them comment that she seemed more like a 3 month old than a newborn which made us remember Father of the Bride Part 2 and we all started laughing.

My brother Jared came in next. He was so proud and that made me so happy! I was glad he got to hold his niece so close to the time she was born. He seemed so in love with her from the start and, of course, that made me cry, too! How wonderful that she got to come into the world surrounded by so many people that already adore her!

When all the visitors left, the labor nurse came back in and tried to help me to the bathroom. When I stood up I couldn’t keep my eyes open, my blood pressure dropped really low, and I nearly fainted. They laid me down on the bed, pumped me full of fluids, gave me a catheter to empty my bladder, and let me sleep for an hour before taking us up to the recovery room.

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The recovery story is saved for next time.

Until then,

Amy