Sunday, January 17, 2010

A UNC birth story!

I am borrowing this birth story from Stand and Deliver's post: Failure to progress or reason to be patient? A birth story because it takes place at UNC (my alma mater!) and also because it shows a positive situation where the mother's wishes were respected, her body was believed in, and her use of an epidural went well. Pictures of the baby can be seen at the link!

From the post:

A few highlights from her birth:

  • She was in labor for over 36 hours
  • She was stalled at 8 cms for 12 hours
  • Her birth plan was followed to a T; the only deviations were ones she chose
  • She had a spontaneous vaginal birth, with total support from her midwives, despite the attending physicians wanting to move to cesarean during her long period of "failure to progress." 
Warning: I am going to tell about the details of Isaac's birth, so if you don't feel comfortable with technical birth terms like "mucus plug" or "cervix", you might want to skip the story to the pictures below.

As Kent mentioned, the entire labor period was rather long. Sunday night [I think she meant Saturday night] I was really achy, so I moved to the couch in the study which is a little firmer than our bed. Around 7:30 am, I noticed a little gush of liquid from my vagina. A few hours later I called the midwife and she agreed with me that it was probably the mucus plug (I know it sounds gross, but this is the real technical term used to describe the material that keeps the cervix sealed so that the baby in the uterus is protected during pregnancy) which usually comes out 2-3 days before people start having contractions.

I clearly was NOT having contractions, so Kent and I went to Church. Since I looked like I had a beach ball in my stomach and people know my due date was on the 17th, we got lots of good luck wishes from people. One of my 8 year old students from the church class I taught last year was so excited about the pending birth, she had announced to her class at school that her church teacher was about to have a baby--she is pretty cute. I now teach the 6-year-old class at church and part of the lesson was playing "Follow the Leader" which invariable involved several variations of hopping. Although a little uncomfortable, I joined in with the hopping but still experienced no contractions.

Later that I night, I had the intense urge to tidy the living room, bake chocolate chip cookies, cook a nice/huge stew for dinner, and finish up some research that I had been working on in the past week and was planning on meeting with my adviser to discuss the next day. I ended up staying up until 1 am to get this done, and noticed some irregular twinges of discomfort in my lower abdomen.

Monday 3:00 am to 7:00 am: I only slept for about 2 hours because around 3 am, I began to have constant contractions, about 8 to 10 minutes apart. I moved to the couch in the living room because I didn't want to wake Kent (which I didn't--he sleeps like a rock). The rest of the night was spent pacing around the living room and trying to rest on the couch between contractions. It felt like just as I was about to drift into a real sleep, the next contraction would hit. I mostly remember that the house was very cold, noticing that the high school students waiting on the sidewalk in the dark for the school bus in the freezing cold at what seemed a horribly early hour, and watching the progress of dawn through the curtain cracks.

Monday 7:00 am- 6:30 pm: Kent finally woke up and agreed that I probably was in the early stages of labor and should cancel my meeting. I felt the strong need to go to Target to get a bathrobe and other things so we went early in the morning before the contractions got stronger. The rest of the day was a blur of pacing around our little house, grabbing on to desks/door frames/sinks, and moving my hips like a hula dancer to help with the discomfort. Because of the age of the house, the floorboards are a little unstable and squeaky in parts, so I am sure our neighbors in the other units were wondering why their floors were wobbling so much. I ate a bowl of cereal in the morning and a 1/4 cup of tomato soup around lunch, but mostly just drank tons of water. As the day progressed the time between contraction decreased and by 6:30 pm, they were occurring about 3 minutes apart and I was having a hard time talking through them so we decided to head over to the UNC hospital!

Monday 6:30 p.m. - Tuesday 1:00 a.m: We got the the hospital and found out I was only dilated to 4 centimeters (full dilation is 10 centimeters) and I was a little disappointed because I thought I would be further along that that. As we walked toward our delivery room, we passed a group of people touring the maternity ward. (Of course a guy said, "Get a chair for the lady!" when they noticed I was in the middle of a contraction. Obviously he has never been in labor because it is much worse sitting still -- or at least it was for me). The irony of seeing the tour group was that we had been signed up to take our tour of the maternity ward that night at 7pm, but instead we came in for the real deal.

We got situated in the room, talked to the midwife on duty and meet the wonderful nurse who would be periodically monitoring the baby and helping us through the night. My goal was to have a natural childbirth with no medication. The nurse and midwife were very wonderful and supportive of my goal and allowed me to not have an IV, agreed not to ask me to rate my pain (I wanted to focus on the positive), and agreed not to ask me if I wanted pain medication as I outlined in my Birth Plan. And then I began my pacing and swaying-it involved a lot of movement which probably used up a lot of my energy, but it was the only thing that really helped me. I tried to sit and rest when I could, but it was only for a few minutes at a time. I found vocalization to also be a good way to deal with the pain--singing parts of songs, saying random vowel sounds, etc. I sounded really weird, but I didn't care about anything other than getting through the contractions. As the night progressed, I stopped vocalizing and was just really really intense and quiet as I focused on getting through one more contraction.

Around 1 am, the midwife checked and found I was dilated to an eight. I upchucked after one contraction They were all sure that I would probably have my baby within the next few hours.
WRONG!

Tuesday 1:00 am - 7:00 am: Kent was so amazing in letting me hold his hand in a death grip, helping me get out of the seat and onto my feet when a contraction hit, and giving me constant positive encouragement letting me know that I was doing well, etc.

Tuesday 7:00 am -11:00 am: At 7 am, there was a shift change which brought in two new midwives and a new nurse. They were really nice and helped me a lot in getting through the contractions. Their help was even more appreciated because the past night had been really draining on Kent. I don't think he realized how hard it would be to see me in pain, but he really did a great job. To make sure he kept up his energy, he quickly ran down to the cafeteria for breakfast. Unfortunately, the exhaustion and stress hit him hard and his stomach rebelled around 30 minutes after getting back to the room. Luckily, the midwives were so involved in helping me cope with the contractions that this allowed Kent to rest a little on the couch to make sure his stomach could get settled. Around 9 am, my dilation was checked again and it STILL was only at 8 centimeters. 8 hours and no progress! Grrrrrrrr.

I decided that it was time to try some of our options and decided to get an IV to make sure I had enough fluid in my body and have my bag of waters broken in hopes of strengthening the contractions.

After two hours, we checked again and no progress. At this point, I was literally falling asleep standing up. I still felt relatively optimistic, but I knew I was exhausted and my body was physically drained. I talked to the midwives and I decided that I would get an epidural so I could sleep and then get some pitocin to help strengthen the contractions and get this baby out!

Tuesday 11:00 am- 5:31 pm: Getting the epidural was fine and in 20 minutes, the contractions were numbed, I could still feel the sensations but not to the point of pain. I fell asleep almost instantaneously. Kent also got some sleep on the pull out bed. The nurse and midwife let me sleep for 3 or 4 hours (I think) and I woke up with so much energy and feeling so happy and ready for the next part. We checked and the pitocin had helped me dilate to 9 centimeters--everyone cheered. Everything started moving quickly at this point and the next thing I knew was it was time to push! The epidural allowed me to feel when I needed to push and how much the baby was progressing, but the pain was minimal. It seemed like we had to wait a long time between each push, but after about an hour of pushing, Isaac came out. We did it! It was so miraculous. They let me hold him immediately and I remember thinking that he felt so soft and warm. I can't describe the awe and wonder of the moment.

The midwives told me after that the doctors all thought I wouldn't make it and were really pushing for me to have a c-section, but the midwives knew I didn't want this and backed me up 100 percent. Apparently there are many places that tend to perform a c-section after 2 hours of no progression in dilation and that letting it go 4 hours is considered liberal. During my labor, I knew it was taking a while, but I had no idea how long it was actually taking because I was focused on each contraction. There was no past, no future, just now. So it wasn't too bad and I am glad I didn't have people telling me they thought I was taking "too long." I took just the right amount of time for me and was very happy with how things worked out.

During the whole birth process and after, I have felt great peace and a deep happiness. We love Isaac so much. I have loved spending this past day with him watching his squashed newborn eyes open and peer around with a look of bafflement, his soft dark hair, being able to comfort him when he cries, and all the other many little things that make him special. He has a talent for sneaking his hand out of his swaddle blanket--like a baby Houdini.

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