On Wednesday AJ was a week old (!!!). Hard to believe that only a week ago I had just met her. We have learned so much together in the first week. She is a great feeder and was over her birth weight at this week's checkup. We were given the OK to feed her on demand instead of every 3 hours. AJ likes napping during the day, feeding, chewing on her fingers, staring, car rides and being rocked or swung and mommy's terrible singing. Doesn't like having diaper changed, medical tests, and she hasn't made up her mind about tummy time. She tends to have a fussy period in the evening where she cries and does this panting thing like she's hyperventilating. She also wants to feed more often in the evening. Sometimes it's hard for her to go to sleep at night although once she's settled she's been doing pretty good and waking up every 3 hours or so to feed.
Today we gave her a bath at home which bugged her a bit but she was happy afterwards.
Mr. Turtle has been at home with me most of the week which is great. It is a little intimidating to think about what I will do when he isn't here as he is so great with AJ, and he also helps keep me emotionally calm. I've also had the support of MIL and my mom, so that has helped a lot.
The birth story is quite long and detailed, but I wanted to record it for myself before the details slip away - they are paradoxically both blurry and very vivid.
In one of our Birthing From Within classes, everybody made a piece of art. We were each given a piece of poster paper divided into quadrants. For each quadrant, we had about a minute to draw a picture based on a prompt. The prompts were:
"Draw yourself being strong during labour."
"Draw yourself being strong after twenty hours of labour."
"Draw yourself being strong after you have received an epidural."
"Draw yourself being strong when you are having a Caesarean birth."
The first prompt was probably the easiest one to draw. The next ones were not so easy, and everyone was crying by the time they drew their fourth piece. But I found this a very profound experience.
As I drew, I realized that I did indeed have elements of strength in each of my drawings. Into each drawing I put rain (life giving) and lightning (energy). By the end I understood that regardless of the situation I find myself in, I could bring strength and energy and life into it. As I look back on my birth experience, I think this drawing sums it up the best.
Ember's due date was October 21st, 2014. In the weeks leading up to the due date we scrambled to get everything ready, always with the thought that I could go into labour before 40 weeks. That didn't happen though. Every night I'd go to bed wondering "if this was it" and would analyze my sensations and Braxton-Hicks contractions. But I would go peacefully to sleep and wake up in the morning as pregnant as ever. Mr. Turtle was both anxious for baby to be born but also wanting to finish his graduate assignments. Meanwhile Ember was very active and seemed to be more aware of the outside world. I found this reassuring and felt like she was getting ready to come out.
By the weekend of October 25 and 26 we were getting a bit anxious for things to move along. At our Birth and Babies class the previous week there was very low attendance, implying that most of the 12 couples were having their babies! there were two couples present with babies who were born early, and one other overdue couple. So the topic of natural labour induction came up. We took a few notes. Mr. Turtle was enamoured with the two baby girls at the class. "They were awesome! Best babies ever....until ours is born, of course..."
I wanted to try to induce labour from Saturday, but Mr. Turtle wanted to finish assignments. My view was that it might take a few tries! We went for a long-ish walk by a local lake on Saturday. It was a beautiful sunny day with a light breeze. We walked for about an hour and by the end of it my hips were aching. However, we stayed out and about and did some shopping. My hands got a bit swollen at one point and I had to use spit to get my rings off.
Saturday night and Sunday, still nothing. Sunday Mr. Turtle says: "Tonight we'll try something". So, we spent a relaxing evening eating dinner (pasta) in front of the TV and watching Star Trek Deep Space Nine on DVD. At about 11pm we tried sex to see if that would start labour. It had been a while and it took lot of experimenting to figure out what would work. We went to bed after but I had to get up several times to go to the bathroom. At one point I saw bloody show. Of course this freaked me out as I knew it would. So although I was not in any physical discomfort I huddled in bed with a roll of TP and monitored it. After a few minutes I started to feel contractions, which were just a bit uncomfortable. Mr. Turtle had gone to sleep without a care in the world, so I waited a while to see if they would stick around. When they seemed to be coming regularly I woke him up and told him.
This would have been a good time to relax and sleep, but I wasn't really capable of doing that, especially since I was continuing to have some bleeding and blood is an anxiety trigger for me, even if it is supposed to be normal. I tried to distract myself by reading a book. The contractions continued to intensify to the point where I wasn't progressing much in the book, and I started using some of my breathing techniques. When a more intense contraction hit, one that needed all my focus, I said "Call J" (our doula). It was about 3am. Mr. Turtle talked to her on the phone. J reassured me that it was early labour, and the best thing to do was to try and sleep. I found I was able to do so and stayed in bed the rest of the night and till early afternoon Monday. Sometimes if the contractions were more intense I would get on the birth ball and rock, but overall tried to rest. Mr. Turtle and J stayed in touch throughout the day. The contractions continued to average 7-10 minutes apart.
At 5:30 J called Mr. Turtle to say we needed a plan to combat exhaustion and to try to speed up the labour, as I was facing the second night of labour. J arrived at our house at about 7:45 and I got out of bed and started using the birth ball. J was also worried that I had not eaten much all day and so she coaxed some banana and yoghurt into me. J and Mr. Turtle used heat packs on my back and my lower pelvis and talked me through each contraction. J explained what might be happening with labour, either A) just a long early labour or B) baby is OP position (back to back) and therefore long labour without much progression. After the birth ball we tried walking. The contractions seemed to be coming a little closer together, but still 5-7 minutes apart. I got nauseated and threw up.
At 9:15 J made the recommendation to go to the hospital for assessment as I had been active for 3 hours and contractions were still 5-7 minutes apart. The drive to the hospital wasn't too bad - I had 2 contractions in the car. In triage at the hospital I felt nauseous again and threw up. Baby's heartrate was great. My cervix was 1 cm dilated and thinning out. Because it was still "early labour" (ironic term as it had been going on so long) I was not admitted and the doctor on call did not see me. I chose to have a shot of Gravol and morphine, and to go home and try to rest and see if labour would progress. Augmenting labour (i.e. Pitocin) was not an option at this point.
I spent the night in a dopey haze and was able to sleep although the contractions kept coming, maybe about every 10 minutes. Mr. Turtle kept using the heating pad which made the bed reek like burnt popcorn. Tuesday morning I did feel better and more rested, and was able to eat a bit and keep it down. With J's advice, we decided to call my maternity clinic for an appointment, to discuss what to do next. I saw the doctor at about noon. In the 13 and a half hours since the cervical check at the hospital, my cervix had opened 1 more centimetre. The doctor was quite optimistic, but it was still very slow progress. (In her notes J has made a note at this point: "From Monday 2am to Tuesday noon is 34 hours that Turtle has been at this. She's amazing!")
We had an ultrasound scheduled for the afternoon, the standard one at 41 weeks. The doctor wanted me to go to it as depending on the results they might be able to get me on the induction list. The ultrasound showed baby healthy and well, as J had predicted it would. It was early Tuesday afternoon at this point and Mr. Turtle needed to go out to get some lunch and pick up a few things. I went to bed to see if I could rest some more while he was out.
At this point things started to get surreal. I did manage to sleep, but the contractions started coming closer together and more intense, although I was not in a mental state to analyze intellectually what was going on. I had to apply my own heating pad as I was alone, and when Mr. Turtle came home he found me leaning against the wall with the heat pack balanced and groaning. Mr. Turtle observed that the contractions were coming about 3 minutes apart now. He called J again, who told him there was no rush, no need to panic: if I was 2 cm dilated at noon I was likely only about 3 now. At her suggestion I got into the bath to try to calm things down a bit before the car ride to the hospital. We did that and it did help me to be more comfortable. The contractions were quite intense at this point and I was working hard to stay ahead of them. I focused on my breathing and making deep vocalizations. At one point I was going "MOOOOOOOOOO" like a cow. Apparently Mr. Turtle found this really hilarious and he had to try very hard not to laugh.
The ride to the hospital was OK. I put a hot water bottle behind my back and hung off of the handle at the top of the car window. That helped. There were also some driving rock songs on the car radio which felt really good and helped me to focus. The one I remember in particular was "Hot Stuff" by Donna Summer.
Recommended labour music!
4:40pm - back in triage at the hospital! I noticed that this time around staff reacted to me very differently than the first time. People seemed to take one look at me and decide: she means business. The nurse who cared for me in triage was a bit of a battleaxe with a no-nonsense manner. While she was assessing me the contractions were coming quite hard and she brought me laughing gas. The gas helped although I also got quite loopy, either from inhaling it or from hyperventilating. That made me even more out of it. When the nurse put my IV in (antibiotics) my blood sprayed everywhere but I had only a vague idea what was happening. Mr. Turtle impressed the nursing staff by having a cool head throughout the whole thing and not reacting to the blood or anything else. The nurse was a bit surprised to see that I was still just 3 centimetres dilated, but she said that she did not think I would be going home. She did a sweep on the membranes as well. A few minutes later, my water broke. At that point I was definitely admitted which was a relief.
Shortly after that we went to a birthing room. I vaguely registered a beautiful picture window with mountains before I had to focus on the contractions again. Now that my waters had broken the pain started to become more intense. The nursing staff gave me the option to walk or sit up, but I felt too tired and just wanted to lie down. At this point we talked options. Since I was only 3 centimetres dilated, I was still facing a long night of labour. My concern was to not slow down the contractions because they had taken so long to get going. Attending physician Dr. V-E said that morphine would slow them down, but an epidural should not. We decided to go with the epidural so that I could rest for when I had to push the baby out. Now, I had hoped to birth without any drugs, but I was exhausted and so the decision was quite easy. As J pointed out, it was the compassionate choice. I was really grateful for the all the learning and research we had done into labour and birth because I felt I understood the situation and was able to make a good decision.
The epidural took a while to place since apparently the spaces in between my vertebrae are very small! however the staff was very gentle and calm so I was able to stay still (which was hard because of the contractions) so the anesthesiologist could do his thing. He was quite joky and told a story about being bit by a rabid bat. I thought about telling my bat story but decided against it. After the epidural was placed I did not feel any pain although I could feel the contractions a little. I was now attached to a lot of monitors, but since all I really wanted was to lie on the bed, I didn't care. I was able to get up and go to the bathroom on my own. I also listened to Moya Brennan on my iPod which helped me to relax a little.
A few hours went by. Unfortunately my contractions started to space out again, so Dr. V.E. recommended augmenting with Pitocin starting at 9:30pm. As per usual they started with the lowest dose and slowly raised it. At some point there was concern over baby's heartrate, and the dose was lowered again. Although I was not in any pain the constant fetal monitoring did make me anxious because I was always listening to it. Usually it was reassuring but as the night went on, there were more frequent dips in the heart rate.
As the contractions came closer together, I started to have sensation and pain again in my back. Now, this was the one point in the labour where I could almost wish I had done things differently. Because of the increased pain I asked for the epidural to be topped up. However, the side effect was that I lost all sensation in my lower body - I could not feel or move my legs anymore. This bothered me a bit because I liked to feel I still had some control, and it may have had repercussions for the rest of the labour.
At 1:50 am, Dr. VE examined me and said that I was 10 centimetres dilated and ready to push! That was 6 and 1/2 hours from admission. I was almost surprised as I could not physically feel any difference. This was probably the weirdest part of labour because it was so anti-climactic. In our labour classes we talked a lot about the time of "transition" and what a huge emotional and physical moment it is. But I was not even aware of mine and had to be told by someone else it was happening. However, I was happy because I thought the baby would be here soon, and I was glad that my cervix had finally cooperated!
Now, for some reason I had got it into my head that the pushing part of labour would last about 10 minutes, or at most half an hour. I'm not sure where I got this idea. But I assumed I was almost done! I felt disappointed because J was not in the room. She lives a 30 minute drive away and I thought she would miss the birth. Mr. Turtle was trying to reach her on the phone and I called to him to hurry up and get to my bedside before the baby was born and he missed it too!
Well, I need not have worried about that. I continued pushing for two hours! Both Mr. Turtle and J. had plenty of time to get to me. Dr. VE continued to drop in due to continuing dips in the baby's heart rate. Overall they thought she was doing well but needed close monitoring. At 3:30 Dr. VE says "Lots of hair on this baby" and I said "So we are at the point of hair are we?" I was hoping this meant significant labour progress but unfortunately not! Dr. VE said to me "Your pushing effort is fantastic. You know how to push, where to push." This was encouraging as I had very little sensation to help me push due to the epidural. However, as it started to wear off and I tuned into my body I was able to find some sense in it: I could feel my uterus go hard if I put my hand on it, and I could again feel some of labour in my back. I continued to try very hard to push during contractions, and the team around me including Mr. Turtle and J. were very helpful and encouraging. In between contractions I felt incredibly tired and would almost doze off.
3:50am marked two hours of pushing. There was some descent but not a lot. A change in position may have helped, but because of the strength of the epidural I was only able to labour on my back or on my side. This was the point where I regretted topping up the epidural: perhaps if I had chosen to work through the pain I could have had more mobility and helped the baby to move down. Things being what they were, Dr. VE suggested an OB consult. Dr. C then assessed me. He gave his opinion that it was time for the baby to be delivered one way or another. He thought forceps might work but was not completely sure. He explained the situation very well, and we agreed that we needed our baby here now! This did mean we had to leave the birthing room for the OR. The plan was to try forceps, and if it did not work, to do a C-section.
From here things moved very quickly. I was calm and felt confident we were doing the best thing for our baby. Mr. Turtle was able to come to the OR with me, although J was not. In the OR, Dr. C used one contraction to rotate the baby. When he did this he became a lot more optimistic that the forceps would work. He got into position. I knew when the next contraction came that this was it, so I gave it all my focus! I had the strangest sensation like my pregnancy bump was moving away between my legs. And it was our baby being born! I saw her come out all baby-shaped and then I heard her cry. At that moment I had no words, no thoughts but my heart burst open and I cried.
They took her to the scale and warmer immediately, and I followed her with my eyes and Mr. Turtle also went to be with her. The first thing that came into my head to ask was "Is she really a girl?" (Yes she was.)
She was weighed: 6lbs and 7oz. Then they brought her for skin to skin. She was so strong already and kept crawling up my chest. She also had her little mouth open and tongue out like she wanted to eat.
My cup runneth over.
After the birth J helped us to breastfeed right away, which was great. We then had a mostly uneventful stay at the hospital. Because AJ was considered small for her gestational age, she had to do a variety of tests over two days, but she did great on them and has been doing great since.
Other details: (that's really all they are to me, a few details, but others might find helpful)
- 3rd degree tear (from vagina to anus) Obviously with the anesthetic I didn't feel the tear or the stitching afterwards. For a couple of weeks the stitches made it feel like I had moss growing down there, which was a rather icky sensation (I chose to not ever look at the stitches!) I was glad not to have an episiotomy, which is harder to recover from than a tear.
- The umbilical cord was wrapped several times around AJ, and apparently it was thin and scrawny-looking. This might have impacted on her heart rate during labour but didn't seem to affect her overall prenatal health as all her ultrasound checkups showed her doing fine.
- After birth the umbilical cord separated from the placenta, and I think that had to scrape the placenta out of the uterus (I was otherwise occupied at the time so didn't pay a lot of attention to the details)
- Other things that were weird/awkward about post-partum:
- Being attached to an IV pole for a day (seriously annoying!) Hard to learn how to hold and care for a baby when I had to pull that thing around after me. Eventually I learned to just ask for help more often from the nurses.
- having to re-learn how to pee. My nurse told me that blowing bubbles in a cup of water would help, and it did...eventually. I managed to empty my bladder enough that I didn't require a catheter. I was pretty happy about that!
- Sweating. So gross! The first week I would wake up soaked and shivering uncontrollably.
- Things I'm grateful for:
- How professional all the doctors and nurses were, and the help and support we received at all stages. So glad that J was able to help AJ and I to nurse immediately. For all the nursing tips I received in the days following. which helped build my confidence that I could feed AJ. That was huge.
Of course birth was just the beginning of the journey we have started. This is such a strange and amazing time because there is so much to process: the end of pregnancy, the birth, AJ's new life, and the rest of our lives together! With so much living to do, I don't know how I will ever catch up. But I do hope to continue to share some of the stories on this blog, as we learn how to be a family of 3.
And as always, thank you for reading (or for skimming this extremely long entry). LOL