Friday, July 20

a birth story, part i.


The week that ended up being my last week of work before maternity leave was a very busy one as usual. I was helping the middle school administrators make scheduling decisions for the next school year, coaching a student as she prepared to give an Ignite talk at the state superintendents' conference the next week, and helping teachers prepare for state standardized testing. That Wednesday I had my scheduled weekly OB/GYN appointment  - one of the quick, routine visits that consist of not much more than a weigh-in and blood pressure check - and everything was normal. My doctor asked me if I wanted her to check my cervix and I refused once again - members of my online May moms' group had posted about how painful those checks were and everything I'd read said they weren't medically necessary. The only real sign that I was nearing the end of my third trimester was how swollen my feet and legs were - so much that my ankles had disappeared and a coworker was joking that I had developed "flegs" instead of cankles. My nurse had ruled out preeclampsia in a previous appointment and my doctor had declared that I was "just a sweller." I was moving more slowly, parking in front of my school to save steps instead of in the teachers' parking lot, taking the elevator when I had to go between floors, and asking kids to surrender the most comfortable seats in their classrooms to me when I did observations (and help me out of those seats when I needed to stand up again). 

That Thursday, I attended the annual educators' banquet to support a friend who was nominated for Teacher of the Year and my student who was delivering her speech as a test run. When my name was called to honor my ten years of service to the district, it took me a while to waddle up to the front of the auditorium to collect my certificate. On Friday, I chaperoned the eighth grade dance after school, and my coworker made me put my "flegs" up on a Rubbermaid tub that held photobooth props. I stayed, along with a few of the other chaperones, until every student had been picked up. That night as I was going to bed I felt a few contractions, different than the Braxton-Hicks ones I'd experienced after going on a too-strenuous hike in the winter. Though strong, these contractions were irregular and ended after two hours or so.

The next day was May 5th, which was the day of the Kentucky Derby this year in addition to being Cinco de Mayo. I had to get out of bed to throw up that morning, which my brain mentally cataloged as a potential sign of labor. Then mucus plug made an appearance, but I told myself that I could still have a week to go. Being a group of people who can never resist a celebration, our Bible study friends had planned a Cinco de Derby party at the lake, and we had planned to go. Since I still felt good and the party wasn't too far away from our packed hospital bags, we decided we'd still go. 

One of my dad's favorite songs was Creedence Clearwater Revival's "Have You Ever Seen the Rain?" and since he passed away my mom and I have liked to think of cloudbursts as a little hello from him. On the drive toward the lake, it started raining, but the sun still shone brightly. I felt such a sense of peace and that everything was going to be okay, and excitement in the knowledge that my baby would be on the way soon. I didn't have much of an appetite for the tacos my friend Jessi had made, but I parked myself in a rocking chair with a stool and enjoyed the conversation and picking a horse to root for. One of my best friends remarked on how uncomfortable I looked, and actually asked me if I was in labor. When I got too tired and achy, I let Josh know we needed to leave.

At about 11:00 that night, I started to have contractions again. I opened the tracker in my Ovia pregnancy app and started recording them. They were all about 40 seconds to one minute in length, but very irregular - anywhere from three minutes to 15 minutes apart. To deal with the pain, I tried bringing the yoga ball upstairs into our bedroom. My favorite strategy we'd learned in our Prepared Childbirth class was getting on all fours, but that wasn't bringing much relief either. My contractions started out in the depth of my belly and felt like period cramps, then circled my body and ended in my back - what's called back labor. At around 1 a.m. I asked Josh to call the hospital. The doctor on call said my contractions were too irregular for her to tell us to come there yet, and for me to try to get some rest. It's probably a good thing I wasn't the one on the phone.

I went downstairs to labor for a while so Josh could try to sleep. After another hour of contractions, I told Josh that I just wanted to be at the hospital even though my contractions were still irregular. Lying down and sitting were incredibly uncomfortable - I felt best either pacing the floor or pushing against a wall while lunging and peddling my feet the way my yoga teacher tells us to do in downward dog. I had figured out that I would have about six contractions between our house and the hospital and felt like I could handle that. On the drive, I leaned the seat all the way back, gripped the seat and arm rest, and screamed a lot. The good thing about being in labor in the middle of the night was that there was no traffic on the way to Roanoke. When we got to the hospital, a security guard met us at the door and helped me out of the car. I couldn't wait to stand up, so I rejected the wheelchair he offered and hobbled to the elevator as Josh went to park the car. Our hospital has an express elevator that only goes to the Labor/Delivery and Mother/Baby floors. A lady getting into an elevator on the other side of the hallway saw me clutching my belly and rocking from side to side and said, "It'll all be worth it."

To get into the L&D unit, I had to pick up a phone beside a locked door and identify myself. It felt strange, alone and in pain, limping toward a dark triage room. "In here," the nurse called. I had to undress and get on an exam table, and anticipating the pain of lying down made me want to cry. The nurse checked me in and paged the OB/GYN on call. I was 100% effaced, four centimeters dilated, and the portable ultrasound machine showed that the baby was head down, ready to be delivered. I got a hospital bracelet and was taken to my room. Josh called our parents and his sister to let them know it was happening.

The doula who taught our Prepared Childbirth class had recommended requesting a nurse who liked supporting natural birth, but we didn't have to - the nurse assigned to us asked about my pain management preferences, and when I told her I wanted to avoid medication as much as possible, she went to get a yoga ball and peanut ball. She arranged my monitors so that I was able to still get up and down from the bed, bounce on the ball, and stand up as needed. As the pain from my contractions got more intense, she helped me get on all fours or lie on my side with the peanut ball between my legs. There was a shift change at 7 a.m., and the new OB/GYN on call was my own doctor, which I felt very lucky about. My new nurse was very motherly and sweet. When the pain got too much for me to handle, and I had thrown up several times, I asked for IV pain medication, still wanting to avoid an epidural if I could because I wanted to be able to move around as much as possible.

The L&D floor was very busy on May 6th. There was a set of twins and a set of triplets being delivered via Cesarean section, and eight other mamas in labor. My father-in-law went to the waiting room for a while and ran into one of my coworkers' mother-in-laws - it turned out that she was in the room next to mine. Her due date had been May 10th and mine had been May 16th, so both of us would be starting maternity leave earlier than planned! Our nurse was happy to relay messages back and forth between the rooms about how we were doing.

Though the IV pain medicine helped, I could still feel my contractions, and since the ward was so crowded, my nurse had told me that if I decided on an epidural I should let her know sooner rather than later because the anesthesiologist could be busy with another patient. She reminded me that I hadn't slept, and might be too tired to push if I spent all my energy on managing the pain of labor. On one of my cervical checks, my doctor accidentally broke my bag of waters. I had learned that after the water breaks, contractions become more intense and painful, and since I was already at my threshold for pain, I asked for the epidural.

The anesthesiologist looked like someone who would be cast as a caring, fatherly doctor on a show like E.R. and was the nicest person we'd met in a hospital full of nice people. I had been scared of getting a shot in my back, but the worst part of the process was the numbing shot before the epidural. I laid down to let the medicine do its work. Unfortunately, the next thing I knew I was coming back to consciousness with my bed angled so my head was down. There was an oxygen mask on my face. There were four nurses in my room, talking fast, which really alarmed me. I could see Josh and asked him what was happening. My blood pressure had dropped, which is the most common side effect of an epidural, and the nurses got me back on track.

After the epidural, my nurse wanted to help me change my position fairly often so I didn't develop a blood clot or anything like that. However, the baby's heart rate would drop in some of the positions she tried. I got an internal monitor for the baby, and spent most of the time in "throne pose," which is being almost vertical in the hospital bed with pillows under each leg. My sister and her fiancée alternated sitting in front of the monitors, watching the baby's heart rate and letting me know when I was having a contraction - which was really strange since I couldn't actually feel the pain, just a sensation that something was happening in my body. My doctor came by to let me know her shift was ending and she was disappointed that she wouldn't get to deliver my baby. The doctor who had admitted me and my original nurse came back on duty.

The doctor was starting to get worried because the baby's heart rate kept dropping and I wasn't progressing past 8 centimeters of dilation. At about 8 p.m., she told me that I needed to make a decision: I could have a C-section right away, be awake for the procedure, and have Josh in the operating room with me. Or I could continue to wait to try to do a natural birth, with the risk that the baby's heart rate could drop further and I would need an emergency c-section, for which I would have to go under general anesthesia and no one would be allowed in the room. It wasn't much of a choice, and I asked for time to talk to my family. I burst into tears pretty much as soon as the doctor left the room - I was tired, I was scared by the prospect of major surgery, and I was worried about my baby. We knew what I needed to do, and my father-in-law led us in prayer. Everyone except Josh had to leave, and we talked about potential baby names in the time we were alone together - even though some of our friends thought we were just keeping it a secret, we really hadn't chosen one yet. My nurse came to explain the preparations we would have to undergo and to get me ready. Josh still wanted to be able to cut the baby's umbilical cord, and if there was anything wrong with the baby I wanted Josh to stay with him instead of me. She had seen our family prayer and said that my anesthesiologist liked to pray with patients if they wanted. He and my nurse prayed with us and it made me feel so much more safe and secure with what was about to happen.

To be continued...




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