Wednesday, February 09, 2011

Benjamin's Birth Story

This post is long. And fairly graphic. Consider yourself warned, my dears!

I originally wrote down this account of Benjamin’s birth because I didn’t want to forget the details, or more accurately, the snippets of details that I remember from that day. 

Here is my account of Ben’s birth:

Our official due date was Feb. 5th, a Saturday.

It was the week before, on a Thursday (Jan 27th), that things began: I puttered around the house, went for a swim at the pool, and, in the early evening, started to make dinner. That’s when my water broke.

I initially didn't realize that my water had broken; I'd just gotten out of the shower a few minutes earlier and it was nothing like the "big gush" I was expecting. Frankly, (and I cringe as I say this), it wasn’t like how it happens in the movies. Or how it happened back in 6th grade, when my best friend’s aunt’s water broke on the little train at Remlinger Farms. That was one heck of a gush.

Mine was a tiny trickle that lasted a few seconds and then stopped. As all sorts of weird things happen to your body during pregnancy, I didn’t make much of it, besides mentioning it to Chris that night at dinner.

It wasn't until the next morning (Friday) when I started having pre-labor contractions that we clued in on what had actually occurred. The contractions were very manageable (about 45-60 seconds long, every 5-6 minutes) so we went for a long walk around the neighborhood. I stopped every few minutes to take a few deep breaths and then we’d continue to amble along. No big deal. Chris had stayed home that morning due to the contractions but we both agreed that he should trundle into work later in the afternoon as I didn’t seem to be progressing.
All smiles during our morning walk

 We left the house around 10:30 AM for a previously scheduled midwife appointment at our birth center (Group Health). My contractions had tapered back by the time we got to the appointment but we explained what we were experiencing and our midwife did a quick swab and stuck the sample under the microscope. It came back positive for amniotic fluid, confirming a tear in the sac. We were sent upstairs for a non-stress test (baby was in good shape) and an ultrasound (to measure the amount of fluid remaining). Our midwife theorized that the rip was very small and that baby had probably inadvertently plugged it quickly with his body, hence the absence of a dramatic gush.  Unfortunately, even a very small tear still means that the sac had been breached and was consequently vulnerable to infection, so our birth options became limited in fairly short order.

Because my water had broken around 5 PM the previous day, we had two options: start induction immediately or wait a few hours to see if my natural labor would get going on its own, thereby avoiding the need for an induction. Due to the increased risk of infection, they didn't want to wait much beyond that 24 hour mark.  We elected to go home and see if my labor would progress on its own.

Once home, we finished packing, took a nap, and called family. We got back to the hospital around 6pm on Friday and learned that my labor had progressed, but not enough. We started a pitocin drip after getting checked in and settled into the room. Because my water had broken, our midwife didn't do any internal checks; I had no idea if my cervix was dilated.
Watching (and feeling) my contractions. Still smiling. Notice that we have the blog up on the ipad. I wanted to see who had picked Jan 29th in the baby pool contest (FYI: I’ve yet to announce the winners…give me a few more days)

Chris’ mom Cherie arrived from Anchorage and we were able to say hello to her and my sister-in-law Megan that evening, and check in with both my parents. Our midwife and nurse popped in every once in a while to check our progress and offer encouragement. We settled in for the night around 10 PM.

Things were progressing well and I wasn’t in too much pain; Chris even managed to grab an hour of sleep on the pull-out chair beside me.

The pitocin was begun at a very low level and was initially quite manageable with breathing and counting techniques. As part of our birth plan we had requested no IVs and intermittent monitoring but that was made impossible due to the pitocin. As I'd planned on being fairly mobile during labor, it was a pain to be hooked up to multiple monitors and two IV drips. Going to the bathroom becomes a much bigger deal when you are trailed by an entourage of equipment.

No longer quite so happy
I woke Chris up shortly after midnight. I needed something else besides breathing exercises. We decided that a bath might be in order.

The bath was pure heaven. The warm water seemed to take a bit of the edge off the pain and I splashed around for a few hours, with Chris counting from a chair placed beside the tub.

Around 2 AM, I headed back to the bed for our first measurement: 4.5 centimeters. Ugh. Not very far.

I again headed for the bath.

A few hours later it was back to the bed: 6.5 centimeters. And here I’m convinced that our midwife was fudging, just a bit. She wanted it to be good news, to tell me that I was progressing rapidly.

Not rapidly enough, as far as I was concerned.

I was hurting. Really hurting.  I was tensing up my entire body when I felt a contraction approaching. Dreading its arrival. Throwing up. Shaking uncontrollably. Losing my concentration and mental focus, despite the counting and breathing with Chris.

It was no fun.

My mental focus was shot.

Originally, when I’d told our nurse that we were going to try and avoid an epidural, she’d cautioned us that the pitocin, while good for speeding up labor, also makes the contractions more forceful.

Forceful = painful. Reason #1 why we’d wanted to avoid an induced labor.

Frankly, I wasn’t sure I could get through natural labor without an epidural, never mind my ability to do it while on pitocin .

But it was at this point, when I was hurting so badly, that both our nurse and midwife became my body’s biggest advocates. Our midwife suggested that instead of an epidural, we consider a 1-hour narcotic. It wouldn’t make the pain go away, but it might take the edge off, make me drowsy, and give me a short rest.

Sign me up.

And, frankly, the most important thing the narcotic did was do allow me to regroup, mentally. Once the pain eased, even slightly, I could refocus my efforts from only thinking about the hurt to coping [a little more gracefully] with the pain. [Update: these days they're using Nitrous oxide (laughting gas) in place of the narcotics - wish I'd had that option!]

The narcotics lasted for an hour and I went back for a second round. Around 5 AM I trundled off to the bath, once again. Loved the bath. My mom and mother-in-law had long since arrived and my mom was able to spell Chris for short portions of breathing exercises.

Around 7 AM I decided that it was time.  I didn’t have an overwhelming urges to push yet but I’d decided that I couldn’t last much longer, despite the lingering effects of the narcotics and the bath.

Back to the bed.

And from the midwife? 9.5 centimeters.

Good enough, baby!

Time, indeed.

So I should note here that I was operating under the assumption that the pain was going to cease once I started pushing. In all the accounts I read, pain never really seemed to be a big factor at this stage of the game.

Not the case. Yowza.

I had a small lip that the midwife held back while I did my first push. Big time ouch.

And despite my cheering squad (2 nurses, midwife, mother, mother-in-law, Chris), it wasn’t until they brought the mirror up so I could actually see Benjamin’s head that I actually made much progress. I work best with incentives, clearly.

It helped that either the midwife or one of the nurses said something along the lines of: "Ok, remember that this stage can take up to three hours”.

Three hours?! NO WAY.

Those hospital folk, they make effective uses of both carrots and sticks.

30 seconds old

Benjamin was born at 7:50 AM on Jan 29th, 2011 after about 50 minutes of pushing. Exactly a week early.

I cried. Chris cried. Benjamin cried (but for different reasons than his parents).

Covered in goo, squalling, and still attached to the umbilical cord.

After Chris cut the cord, things were stitched back into place, I was cleaned up a bit, and the rest of the family came in for hellos.
Benjamin with Grandpa Tom
And with his grandmothers

Later, Chris gave Benjamin his first bath, a baby massage (he loved it), and Ben was plopped on the scale for weigh-in.
First bath

Eventually we moved up a floor to the recovery room where we had a chance to look over our new baby, count his toes, and wonder at his existence.
First diaper

Initially, it wasn’t the birth we planned on having, but it turned out fine: healthy baby, happy parents.

Things might have been quite different, had a few factors had been tweaked, just a bit. When I described our birth earlier in the week as a team effort, I was completely serious. My job would have been far more painful if it hadn’t been for our nurses, midwife, family cheerleaders, and most importantly, Chris. He was by my side for just about every minute of labor. Counting, soothing, encouraging, rubbing my back. I couldn’t acknowledge at the time just how much his presence was getting me through those small hours of the night. He was the one that I appealed to when I hurt, when I needed help.

We also loved our birth center. We briefly considered other options but were completely won over by the midwife team at Group Health Unit on Capital Hill in Seattle. It might have helped that I was born into the same program, nearly 30 years ago.

From the very beginning we found the midwives to be helpful, professional, and best of all, very relaxed and not rushed for time. We’d head to our appointments with a laundry list of discussion items and they always took the time to fully discuss the issues and ease our concerns.  Our midwives were continually reminding us that we needed to put together a birth plan so we could discuss our wishes, together, as a team. I am fully convinced that every staff member read the birth plan before coming into our room, because they all commented on the fact that I was a GH midwife baby. They loved that. During labor and delivery, our midwife was focused, attentive, and always accessible. She was truly the unsung hero of the night.

Tired but happy
One thing that was a lovely surprise was the natural high that came immediately after Ben was born. I'd read about the fabled oxytocin rush that occasionally happens with unmediated births but had largely forgotten about it until immediately after his delivery. And then? Holy batman!  I felt like a superhuman. Invincible! Want to climb Mt. Everest this second? I'm in. Need me to figure out world peace? Done. It was quite unlike anything I've ever experienced and I remember thinking: "Now I know why drug users throw their lives away in pursuit of this feeling". I was blissfully euphoric.

In reality, I suppose it's simply the body's way of telling you that, yes, you've survived a grueling labor but that the job isn't finished and that now you must turn your attention to keeping this tiny human alive, despite the sleep deprivation and physical exhaustion. It was exhilarating feeling combined with an unbelievable sense of satisfied accomplishment.  This birth remains one of my proudest personal achievements in terms of mental and physical perseverance. That said, it also serves as a reminder that we all have the same goal: emerge with healthy and happy mother and baby; no matter the process. I am a firm believer that each mother should choose their best birth, to the extent that procedures and circumstances allow. Of course (and as we were so aptly reminded), control is often a luxury and sometimes things go awry and we simply have to roll with the punches and hope for the best.

Update: I never got quite the same rush with Emma, perhaps because her birth was speedy. Interesting, yes?

Going Home

We had a day and half in the hospital, much of it to ourselves. We huddled up in a little cocoon of a room and focused on the task of learning all about our baby. Food was delivered, nurses came in to offer advice on nursing, and Benjamin was checked out by the rounding pediatricians. It was a much needed break.

And then, it was time to go home, also a good thing. We’re slowing adjusting to having a new baby in our midst: seeing him become more alert, keep his eyes open for longer periods, and learn to pick up on hunger and sleep cues. What an adventure we have before us!

And that, my dears, is Benjamin’s Birth Story. Thanks for reading.
Benjamin 7 lbs 1 oz, 19.5 inches

PS: Emma's Birth Story (2014)