Tuesday, August 09, 2011

Jace Ephriam's Birth Story!

Friday July8th
I was one day past my due date (but 4 days according to the midwife’s office). I had a non-stress test and amniotic fluid level check that morning, which that baby passed just great.

I went in at 2:00 for my appointment. All looked good, and I was told I could easily go to 41 weeks and they were not concerned, but would want another NST next week were that the case. Charlene (my midwife) told me she was going out of town midnight Tuesday. This would mean if I went into labor (or was still in labor) after that point, I would be delivering with Angela, the other office’s midwife. I felt concerned – I really liked Charlene and had never met Angela! While they spoke highly of her, I really did not want to deliver with someone I hadn’t met nor knew my birth preference (other than what I had on my birth plan). All the months of going to Charlene I did not want to see “wasted”. I was given a few options , from doing nothing to trying to jump-start labor with stripping my membranes to even trying some pitocin. While I wasn’t going the pitocin route, I was actually comfortable with having her strip my membranes and see if I was “ready.” Since stripping the membranes releases the prostaglandins, the same way “other” activities do, it will not start labor if your body isn’t ready. The evening before, I had half hour of 30-45 second contractions every 6 minutes from those attempts, but then they’d stopped. So I was confident this was not preemptive. (Also, let me say here I had been Group-B Strep positive, so my midwife had told me to plan to arrive at the hospital with at least 4 hours of labor, because they needed to administer 2 doses of IV antibiotics to me for the baby, and they had to be that far apart. I had laughed and told her there was no way I’d plan to cut it that close, that my expectation was to be there somewhere around 12 hours prior to birth.)

I left her office near 2:40 and went grocery shopping. It is a rare trip I’m without Elyana, so I was making the most of it and trying to stock up if the baby were going to come. While in the store, I had strong contractions, every 10 minutes and less than 30 seconds long. I did have to stop, breathe and concentrate through them, but then went happily on my way.

At home, they continued. We decided to go to the mall and Disney store once Elyana woke up. I was still having steady contractions, and I hoped this would be the night. In the mall, I had to give them attention, but they stayed about 10 minutes apart (not really sure, I wasn’t timing them so I wouldn’t be too absorbed with if they were getting closer or not). After about an hour, we went to eat (well, J and E did, I just had water). Jonathan, having learned from the first long labor, was trying to stock up his energy so he wouldn’t be too hungry.

Once we got home and got Elyana put to bed, while I lay on her bed all my contractions stopped – for almost 20 minutes! I had to stay sitting or standing to keep them going, but once I would lie down, they would stop. I tried running up and down the stairs to increase their intensity. I thought it was ironic that the main position the Bradley book tells you to labor in was not feasible. I was concerned the contractions would stop, and I really wanted to have the baby, so since my husband didn't want to “help” (haha), I decided to take a small dose of castor oil (1 TBSP) about now. (Hindsight, all that seemed to do was make contractions more intense, without speeding up anything.)

I started timing my contractions at 9pm. For that first hour, they averaged 45 seconds long, 5 minutes apart.  While I had to give them my attention and they were hard, I was still in doubt whether this would be “the night”. I labored best sitting on the couch on my knees or in the bath. The next hour (10 to 11) things ramped up in intensity and pain and my contractions averaged a minute long and 2:45 apart. Close to 11, I started a text to my family saying, “I think this is it, the baby probably will be born tomorrow (Saturday) afternoon.” But I did not hit “send” because there was still the niggling doubt that my labor would go close to 36 hours again, which in this case would mean nothing until Sunday early morning. I know when we told everyone the first time, they were very anxious to know what was going on, and Jonathan just continued having to send updates about how slow it all was. I guess I didn’t want to worry them. And I suppose, even when you’ve experienced labor already, you as a woman are prone to doubt yourself about when it’s REALLY time (especially if there has been prodromal labor).

For that next hour, from 11:30 to 12:30, I have huge gaps in my timing of the contractions – a 30 minute gap and a 20 minute gap… so that leaves only 10 minutes really timed. This was due to a lot of intensity and my inability to find a good way to labor without a lot of pain. These averaged 1 minute long, 2:13 apart. So, they were a good 30 seconds closer than the previous hour, but the same duration.  Understand, the application I downloaded on my iPhone to track these did not give averages. I only know now by exporting them to Excel. At the time, I would look and see some 45 seconds, some 1:15, and that’s what really caused me to doubt myself. I was reading the Bradley book on labor in between contractions and I had clearly read that contractions that weren’t longer than 45 seconds just were not effective in opening the cervix (dilation).  So this contributed to my lack of surety.

I labored a lot in the tub. I kept the water hot and would just drape myself over the edge. I got my clothes all wet and didn't care. I thougtht of all the things I needed to do (like put my daily makeup, and some more comfortable clothes in my hospital suitcase). I had much done ahead of time, but a few things had escaped me. I knew I could never make it upstairs and get it all done without having a few contractions, and I just did not want to have them take me by surprise. Somewhere here I did manage to grab what I could, and throw it on the couch downstairs. I told Jonathan he needed to get all that stuff when it was time. He encouraged me, but mostly he was just staying occupied but in very close proximity to me, as we both were really thought this was the beginning of a long ~24 hour event. I had wanted to look “pretty” going to the hospital, but at this point all I could do was wash my face and keep laboring - Hard.

Close to midnight, I started having occasional contractions that were 1:15 to 1:30 long. They were odd, because they were like two rolled into one. The wave of a contraction would start: a gripping of the uterine muscles that works its way tighter and tighter and then the loosening and gradual subsiding that occurs. But these would have the gradual subsiding eclipsed by an oncoming wave of a follow-up contraction! These were incredibly hard to manage concerning the intensity, because there was not a rest for my body.  I remember telling Jonathan how incredibly hard these were to endure.

From 12:30 to 1:30 I had 5 of these “double contractions”.  At this point, my labor was so intense, I was crying out very loudly at some of them (things like, “God, help me!”).  I told onathan a little after midnight that I felt this was serious and I needed to go – and I begging for his input. He told me he really didn’t think it was time. He felt it would be good if we could hold off until 5-6am, when Elyana got up, and we could take her to our friend Stacy’s house. I saw the wisdom in this, and thought, “If I can just make it until 6…” With Elyana’s birth, I told him I thought it was time, and he continued to tell me it wasn’t – and sure enough we went too early. So I was really trying to listen to him. After some of these double contractions, and how much pain I felt, I begged him not to even leave the room where I was.  I felt I needed him right there as I labored in the tub, and I needed him to do the timing for me, as pressing the iPhone’s timer once a contraction started was now too much distraction for the amount of intense concentration I needed. I was seeing bright red blood at this point, which I never ever had with Elyana. Honestly, it scared me. I didn’t know for sure what it was from. I wanted the safety and assurance of the hospital.

I went back on the couch maybe 1:00 am and told Jonathan I really thought this was time to go. He then suggested turning on music or watching something on tv. I was so angry and snapped at him, “If you think I’m at the point where I need distraction, that just shows how disconnected you are from what I’m feeling!” (Something like that.) I was really upset that he was not more in tune with the stage of labor I was in… my emotional signpost was SERIOUSNESS, not excitement.  I left to retreat to the bathroom, somehow just sure I’d have to labor this intensely, but I shouldn’t be here. In fact, soon afterward I reached the self-doubt and told Jonathan I couldn’t do this. In fact, from 1 to 2am, my contractions continued to be 1 minute long, but 1:50 apart.

At this point, Jonathan must have been watching me, and I was really, really struggling with the pain (yes, I’m using that word). I honestly felt overwhelmed with how very intense this all was – very unlike my experience with Elyana. At 2:19, which is my last timed contraction on my iPhone, Jonathan said, “We’re calling Stacy, it’s time to go.” I felt relief! Finally, finally. I told him, “And when we get there, I can get drugs. I can have something. Right?” I remember thinking it sounded silly, and almost that I just was asking so I didn’t feel like I didn’t have a choice. But I also know I felt like I was going to die if it got much worse. I felt so, so much pain. I think it may have taken Stacy 15 minutes to get to the house, and in that time Jonathan scurried around loading up the car. I pulled out the exercise ball to try to labor on, just for something different. It helped, some. Things were very serious – I was crying out a lot, and using all my might to grab onto things (like the couch, towel-bar rack, etc). Stacy came in, and I had been closing my eyes for each contraction for a while, and I couldn’t look at her. I couldn’t even hold myself back (which with Elyana’s labor, I was in control the whole time)! I felt everything was greater than I was – the pressure, the unrelenting feeling of it all. I felt just barely in control at the peak of contractions. I snapped at Jonathan things like, “I want THIS pillow…” and at his grabbing the wrong one 2 times I was undaunted in my fervency.
We left for the hospital, only 10 minutes away. I opened my eyes what felt like 30 minutes into the drive and saw we were only halfway there. I was so discouraged. Laboring in the car, at this point, felt unbearable. When Jonathan pulled up, I wanted to scream at the idea that I’d have to either walk the whole way (and up one flight of stairs) or else take a wheelchair. Both seemed horrible. As we pulled under the awning, I told him, “I am feeling a pushing urge.” It was not a true I-Can’t-Not-Push  urge, but just feeling the urge let me know the seriousness of where I was in my labor. Even if I had the 3 hours of pushing like I did with Elyana, I would still see this baby before the sun came up!

The wheelchair ride was awful. The nurse taking me seemed to not care when I was contracting (“Get in, Get Out.”) I went to assessment and was commanded to put on a gown. I had cleared it ahead of time that I could labor in my own clothes, and this first “bump” was aggravating to say that least! And in the midst of such serious contractions, the last thing I needed was to worry about undressing/dressing and fighting some nurses! I refused and rolled my eyes at them – and then finally agreeing very begrudgingly. I was so irritated but just wanted to get out of there! Sure enough, I was 7 cm. They were asking all kinds of horribly annoying and ridiculous questions. Jonathan blanked on the name of my midwife!! I walked to my room, which was only across the way, but it was a horrible walk, and I stopped just feet from the bed with a contraction. I didn’t care that I was contracting on the floor, but the nurse seemed jolly-well-unhappy with it, and intent on getting me in the bed ASAP. I knew I’d need the penicillin in the IV, but then could walk around. The nurses couldn’t understand that I had permission from my midwife to just get the IV for that, and then not be hooked up to it for fluids or anything. I was  so irritated they were so confused. I couldn’t wait for Charlene to come. At this point they also asked Jonathan for my papers from my midwife. They were in the car. I panicked at his leaving me, as he’d been holding my hand at my side since we arrived. I felt he was the ONLY one protecting me and looking out for me, since Charlene wasn’t there yet. It was a very vulnerable feeling, because being in the deepest intensity of the contractions, I had no idea what was really happening around me, nor much of a voice to use. He reassured me he’d fly.

They called my midwife at 3:09. I’d probably been there 10 minutes. Angela, the midwife from my office that was on-call, came over and started to coach me through breathing through these hard contractions. She told me to look at her and instructed my breathing. Just having to focus on her face and my breathing helped those next few contractions. Jonathan took over her place, and I was clawing into him and grabbing him. He said, “Don’t use your nails” and I said, “If I can stand this, you can stand a little scratching!” (To be fair, there was blood being drawn as well. He did suffer.) I was incredibly vocal and aggressive (in my opinion). This was drastically different than my labor with Elyana. I had been calm and controlled the whole 35 hours and here I felt unable to restrain my tone of voice or aggression. I felt like I writhed with each contraction. A nurse was placing the monitors on my belly during a contraction, and I roughly said, “You’re hurting me!” to which she said it wasn’t her it was the contraction. (Not appreciated at the time.)

Thankfully, Charlene arrived soon; her presence was most welcome and reassuring. She checked me and I was a 9. I told her I felt I needed to push and she told me to hold off for another 5 minutes to get the last of the IV in me. I knew I could. After that, with the impending birth obviously not 4 hours away, I was fully dilated and she asked if I wanted my water broken – and at this point I was ready to get the contractions done and the baby out! She told me it could help with some of the pressure I was experiencing and perhaps speed along baby’s entrance. I readily agreed. It was a relief!

Then began the pushing. Sure enough, like my first time, I would start a strong push, but then fight the follow-through. While in the 45 degree position, I was using my feet to push down to bear the pain – basically thwarting my true pushing progress. I knew this, I felt this. So I got into a full squat on the bed position (bless Charlene for telling me I could do what I wanted!). This at least helped me truly push, but it seemed more painful, so I reverted to the 45 degree sit/lay. Charlene pointed out how I was pushing with my feet, and that it was putting me out of reach of her and not helping. I begged for guidance and this is the only part I felt I wish she’d been more instructive on, because I don’t think she said much except not to use my feet.

It finally got to the point of a contraction that I pushed hard enough that the baby’s head must have been crowning – because I got what’s called the “Eject Reflex”. This was the most revealing and surprising thing about my whole labor. I didn’t know what I should do, but I was too involved to even ask. I knew my pushing contraction was over, but the eject reflex basically makes you want to push out whatever is causing such discomfort. I did not experience this my first time, and I didn’t know whether I should trust this and just respond, or if I needed to wait as much as possible until my next contraction. I just went with what was natural – which was to “get it out”. I cried out, “Charlene, help me!” to which she said, “You have to do this yourself, I need your help.” (or something like that) As basic as it sounded, having her tell me I was in control was exactly what I required. I think since I reverted to vacuum assistance with Elyana’s birth, I had residual ideas of an inability to do this on my own. How I needed her words!

So, I pushed through, and asked, “is the baby crowning” to which I got a YES. I was surprised I hadn’t been given more “progress” stats, feeling like that would have encouraged me. (Side note: I’d wanted to deliver with a mirror, and just forgot to ask, but I don’t know how I’d have seen it since the midwife was right where it would go.) Jonathan was still at my right side, coaching and encouraging. I talked to him and leaned heavily on him physically through every contraction and push. He was so excited and encouraging – exactly what I needed to see in order to continue with energy. It's exactly what the Bradley book tells the coach to do - to be very careful to be encouraging and eager with their words/face so that the laboring woman can see through what she is feeling to how close she really is (in the big picture).

As I got the “eject reflex” and pushed through it, I pushed and pushed and I knew “this is it”. You get a knowing that there is no turning back, your body feels it. But the difficult part is not knowing how long you’ll be in that state, or how painful it will be. I could feel the stretching and a bit of tearing (very tiny) but I just kept pushing, but I screamed. Yes, I did. I’m horrified now. It wasn’t bloodcurdling, but I was so controlled and polite and “normal” through my first delivery, I didn’t even recognize myself at this point (ok, Jonathan says it was bloodcurdling). With only maybe 10 minutes pushing (I have no idea), I finally pushed my beautiful son’s body out: oh the relief! That’s the most amazing thing: the intensity, the violence if you will, the pain, it’s all over and there in front of you is a human being! I cannot describe the emotion. Overwhelming. It was 3:55. I’d been there maybe an hour. Wow. (With Elyana, I was there 19 hours.)

The cord was cut, my son wiped and swaddled and placed on me. I held my son. Jace Ephraim. I loved him, but I was exhausted. I handed him to his daddy after a few minutes, as they were delivering the placenta and that had some pain accompanying it. When I got our son back, I tried to get him to nurse, but he was not very interested (unlike Elyana!). Jonathan accompanied him to get his vitamin K shot and vitals taken. I will say I felt strange, I was ashamed at how I’d lost my controlled self. I apologized many times, because I just felt the person who came in just an hour before was not me. I was disappointed in myself. I also felt dumbstruck that this was “over.” Mentally and emotionally I was not prepared to be done with labor. It was a hard thing to grasp. I felt sad actually at the overarching hospital experience (the labor at home was fine). I was overjoyed to have my son here, but it just took time for my emotions to catch up. I also said, “I never want to do this again!” whereas with Elyana, as soon as she was out, I told Jonathan I would love to birth more children! I also learned that I would have to stay 2 days automatically since the baby did not get 2 doses of antibiotic. This contributed a lot to my feelings of having not done well – I felt I’d failed the baby by not coming soon enough. My midwife visited with me for what felt like 30 minutes (I don’t know how long), and talking to her helped some, as I shared how conflicted I was feeling. Charlene offered a lot of encouragement and told me there wasn’t any way I’d have come that early (sure enough, thinking back to 11pm, I wasn’t even sure the labor was here to stay).

Jonathan stayed with me for a few hours, sleeping in the bed next to me, and I slept a little off and on. A little sleep, nursing and holding my precious baby, and getting a shower turned everything around. In just a few hours, I had dealt with those feelings and was enjoying my son and what I’d accomplished to bring him in! I was ready to say, “I can do this again and I want to.” I was seeing the beauty of his labor in its own light, no matter how it surprised me. I was elated at his life! I had my little Elyana visit me and having all 4 of us together was a very sweet time. Welcome to the world, my Beloved, Precious Jace Ephraim! I delight in your life and your arrival.


Herb of Grace said...

I loved reading this :) Wish I had a chance to sit down with you and hear you tell it yourself! I have all these questions ans comments that pop into my head as I'm reading, which I then promptly forget when I sit down in front of an empty com box... :P

I think my main thought was how similar our labors are and how AWFUL all the prodromal stuff is. Particularly the way it makes you DOUBT so much. With all three labors, I couldn't be convinced I was really in labor till within an HOUR of crowning. Seriously. It sucks.

kiwicpk said...

wow you guys.....big congrats to you all, can't wait to see a few photos of you all, well done Denise :-)