Tuesday, November 30, 2010

Hudson's Birth Story

It is hard to believe that at this moment two years ago, I was in pretty active labor, working on my Lamaze exercises, and finally notifying everybody that the baby was probably coming in the next 24 hours. It is incredible that it was only two short years ago, and even more incredible that we’ve been without our amazing Hudson for more than a quarter of that time. How is that even possible?

There will be lots and lots of writing tomorrow, so for now, I want share Hudson’s birth story, for those of you who have never read it on the Tarheel Turtle blog, which I started during my pregnancy with Hudson and kept, rather halfheartedly, until she was about 2 months old. It seems appropriate to recall those moments today, and, as one of my friends suggested, to try to draw on the same strength that helped me through a drug-free labor and delivery with my precious Hudson as I figure out how to labor through tomorrow, and too many tomorrows after that, without her.


Our little one is three weeks old today, and while I have a quiet moment between feeding, changing, soothing, cuddling, playing with, and gazing at that amazing creature, I wanted to capture my memories of how she came into the world before they escape me forever. There are a few mildly gory details, so consider yourself warned.

On November 17, Ed and I went in for what had by then become weekly obstetrician appointments. I was just turning 37 weeks and so was considered to be full-term. Much to our complete surprise, the doctor checked me and told me I was already 2 cm dilated and about 70% effaced. Ed and I were both in shock-- just five days before, my cervix was totally closed. If anything, we were preparing for the baby to be born late, as many, if not most, first babies are. The doctor said the dilation and effacement didn't really mean anything-- many women walked around for several more weeks in that condition. Nonetheless, as first time parents who had not yet even gotten around to purchasing a CAR SEAT yet, we were totally freaked out. And I had several projects that I needed to finish up at work before I would feel comfortable going out on leave. I worked furiously the next few days, and we took an uncharacteristic weeknight trip to Babies R Us to buy the car seat two nights later. We then went on a shopping spree for all the remaining baby stuff we "needed" that weekend. The whole time, I was just hoping the baby would not come too soon! One of my colleagues at work just laughed at me, saying I was the only 37-week pregnant woman she'd ever known who was trying to keep the baby IN instead of trying to get it OUT. When I went in for my next appointment on November 24, nothing had changed, but the doctor immediately said, "Whoa, the baby's head is low!" Once again, I could not believe that she could already feel the baby's head. But she said I could still easily go another two weeks or even beyond the due date before delivery.

But I had a feeling-- I don't know if it was just a hunch or, by this point (since we were finally prepared with all our baby stuff), wishful thinking -- but I was starting to feel like the baby was definitely not going to wait until the due date to arrive. On the Wednesday before Thanksgiving (about 4 days before Hudson was born), I started having Braxton Hicks contractions, which are basically fake contractions that are simply getting your body prepared for the real thing. They were totally painless, but a little uncomfortable, as they made me feel like my abdomen was kind of being squeezed momentarily in a vise. The weird thing about them was they were extremely regular-- they were coming about 4 minutes apart for most of the day. I called the doula and we agreed that it was probably nothing (she was planning to go out of town for Thanksgiving weekend, an arrangement we'd already totally agreed upon, but she was going to feel awful if the baby came early and we had to use her backup instead). But still, I had this feeling. Before I left work on Wednesday, I cleaned up my desk, threw out the food in the fridge, sent wrap up emails to people about the status of my projects, put in my final time entries, and left, thinking it was unlikely I would be coming back until the spring. Turned out I was right.

The next few days passed uneventfully. Ed and I had a nice Thanksgiving dinner with friends here in D.C., drove out to a farm in Maryland that Friday to cut down a Christmas tree, got the car seat inspected and finished putting together the Turtle's room and other stuff on Saturday. We went to sleep Saturday night and by this point, I had reconciled myself to the fact that the baby was NOT coming that weekend and that I was going to have to go back to the office Monday.

I woke up about 4AM to go to the bathroom. It was dark in the bathroom and I was groggy, but I just happened to look down at the toilet before I flushed and realized I had passed a lot of what they call "bloody show" (I won't get any more detailed than that-- if you want to know more, you can look it up!), which is among the signs that labor really may be imminent (although again, it's never a sure thing). As I went back to bed, I felt what I thought might really be a contraction-- the same tensing/squeezing feeling as I had gotten with the Braxton Hicks contractions, but this time accompanied by what felt like mild to moderate menstrual cramps. Our doula, Sarah, had stressed over and over that if you wake up feeling contractions, you should immediately try to go back to sleep because the business of labor is long and hard and the more rest you can get ahead of time, the better. So I didn't wake up Ed, and while I tried to go back to sleep, but while I dozed, I kept feeling the contractions and for at least an hour, kept checking the clock to see if they were coming regularly. They seemed to be about 10 minutes or so apart at that point. I did catch a few extra hours of sleep finally, and when Ed and I both woke up around 7:30, I told him I thought the baby might be ready to come that day, but I wasn't sure. The contractions were still so mild, and having never had another baby before, and having friends who had gone for a week or more with regular mild contractions but no baby, I was convinced it wasn't the real thing.

I kept timing them and they were coming anywhere from 4 to 6 minutes apart, fairly regularly, although sometimes they would stretch for longer periods and sometimes would come even more frequently. But they didn't appear to be getting much worse, which would have been a sure sign that I was really in labor. I called Sarah around 10:30 and told her what was happening and we agreed to check back in periodically throughout the day. In the meantime, Ed and I both spent a few hours doing some work in hopes we could wrap up anything critical in case this really was the real thing. Most of the day passed that way-- I didn't really want to call anyone just yet because I just wasn't sure if I was really in labor and didn't want to get anyone excited for nothing. So I got busy decorating the house, hoping to have it all done in case the baby was on its way.

Finally, around 7 or so, the contractions seemed to be getting worse, but they still weren't coming like clockwork. They were bad enough that I could no longer talk during them, and during several phone calls (because by this time I figured I should start putting people on the baby alert), I had to put the phone down for a minute so I could do my Lamaze breathing through the contractions. It was so wild. I called my dad, and, believing there was no way the baby was going to come before the next afternoon, told him he could probably wait and come up first thing in the morning-- his goal had been to be at the hospital when the baby arrived, and given that first babies usually take a LONG time to actually come once they've made their intentions known to do so, I figured he was safe arriving around 10AM or so. Little did I know. . .

I checked in with Sarah around 10PM and she could tell that something had changed when I could not talk through the contractions anymore. We agreed that Ed and I would spend an hour of quiet time at home focusing on our exercises to see if we could manage without her for a while longer-- we'd both been so busy calling people, etc., we hadn't really been doing our breathing or other comfort measures, so we figured we'd try them before having Sarah come over to help. But by 10:45 or so, the contractions were getting worse and were regularly coming about 4 minutes apart. We started to get worried that we'd need to go to the hospital sooner rather than later (I had been advised by the doctor to come in when they were 5 minutes apart, but had already told the doctor I was going to try to labor at home as long as I could and would probably not come in until they were 3-4 minutes apart), so we decided to have Sarah come on over.

In the meantime, I got in the shower, which helped tremendously, as I was able to direct the shower head massager straight to my back and belly, where things were getting seriously painful. The shower also helped to relax me in general-- I had spent the last several days wondering why, exactly, I had decided to go for a natural birth. While I had made the decision early on to try, I couldn’t really articulate my reasons why—it just seemed like the right thing for me. But as the contractions got worse, my resolve began to weaken—what was really the big deal about getting the epidural? More than 50% of women having babies use them. I hardly knew a single person who hadn’t had one. So anyway, the shower helped calm me somewhat, and I got into a zone with my slow breathing while we waited for Sarah.

Sarah arrived sometime between 11 and midnight. She sat quietly with us for a while, and encouraged Ed to take a nap for a bit. He tried, but couldn’t do much more than doze. Sarah had brought her rice bag—a large sock filled with rice that she heated up to apply to my belly or back—and it was awesome. Her saying was always that while you can’t take away the pain, you can change the sensation of the pain, and the rice bag was great at that.

At some point, I remembered that she had told us that keeping your bladder and bowels empty was also a good way to relieve some pain, as it would remove some pressure and keep making room for the baby to come down. So I went ahead to the bathroom and “emptied” both—not really emptied, but definitely moved some things around. (And having contractions while sitting on the toilet is really just not fun). Lo and behold, the contractions really kicked up afterwards and were coming 2 minutes apart or closer. My water still had not broken by this point, but we decided with the contractions that close together, we should probably go ahead and head for the hospital. Ed started loading up the car while I labored through the worst of the contractions I’d had so far (but little did I know how much worse they would get). I was in a lot of pain and definitely starting to doubt my decision to deliver naturally. Once the car was loaded up, I got in (hot rice bag on my belly the whole time, mind you) and we headed for the hospital. It was about 2AM at this point.

We arrived at the hospital and Ed and Sarah both needed to park, so Ed dropped me at the front entrance. I felt a little weird going into the lobby alone (and having serious contractions at this point), so I sat down on the bench outside and breathed in the cold air. About 5 minutes later, Ed and Sarah walk up, carrying a dizzying array of things I’d decided I would need in the hospital, the most conspicuous of which were the big red exercise/birthing ball and a huge trash bag carrying pillows for Ed and me, and a quilt for Ed in case he needed it to sleep. After the front desk made Ed and Sarah both sign in and get photo badges, we headed up to labor and delivery. When the charge nurse saw us and all our stuff, she said, “I sure hope you are getting admitted.” Here I was, leaning over the counter and moaning softly in pain as contraction after contraction hit me and she’s doubting whether I’m going to get admitted? It should have been obvious to anyone that this was neither a false alarm nor the very early stages of labor where they would likely send me back home to wait it out.

Anyway, they put me in a triage/assessment room and hooked me up to two monitors, one for the baby’s heartbeat and one for contractions. They would only let one person in the triage room at first, so Ed stayed in there and Sarah sat in the waiting area. I went to the bathroom and passed a lot more “show,” which freaked me out, but led me to believe that I was pretty far along. The stupid bed in the triage room would not incline and there was no way I could lie flat on my back, so I kind of turned on my side and was terribly uncomfortable. I was in a LOT of pain at this point and my resolve was really weakening. I was hoping a doctor would come in and check me and tell me that I was 7 or 8 cm dilated—then I might have felt like I could make it. Instead, the resident came in to check me and said I was dilated 5 cm. I immediately gasped, “No!” She said, “Is that good?” (she definitely thought it was), and I said, “No!” I totally lost it and burst into tears. Ed says I curled into fetal position. I remember telling Ed tearfully, “I have to get the drugs—I can’t do this. I can’t. I can’t.” He said he would support whatever I wanted to do, but asked me if I wanted him to get Sarah and I said yes. Fortunately, they let her in to the triage room along with Ed (I think they were a little shell-shocked seeing a woman in active labor who had not had an epidural—I don’t think they were used to seeing women in the kind of pain I was in). She talked me off the ledge a bit at that point, and told me that I was way more than halfway there—more like 2/3 to ¾ of the way there, and that once they broke my water, I would “cruise” the rest of the way. I was still skeptical and was really considering throwing in the towel. To make matters worse, another nurse kept asking me if I wanted anything for pain, that it was too late for Demerol, but that I could still get an epidural. She continued to ask this even after being told, more than once, that I was trying to do this without drugs. Again, it was almost like they couldn’t even understand the concept of a woman who wanted no pain relief. After about the fourth time she asked, I finally said, rather desperately, “Do I have to decide this right now?” I was on the brink and knew I should at least wait until I got to a labor and delivery suite and into a more comfortable position where I could focus on my exercises. And part of me didn’t want to let Sarah down. I knew she would support whatever decision I made, but I also knew that she wanted to help me achieve my goal of delivering naturally, and that she would feel like she had failed if I didn’t. The nurses told me I wouldn’t get any drugs until I got to the L&D room anyway, so I had a momentary reprieve from my self-preservation instinct, which was telling me to GET THE DRUGS! NOW!

Finally, after about 45 minutes in the triage room (with very little explanation as to why it was taking so long for them to prepare an L&D room for me), they were finally ready to move me to and L&D room. I was so out of it, I did not realize until later that the nurse had me walk down the hallway in nothing but a hospital gown—I was terrified of having a contraction while standing, and of course, had two on my way to the room and had to lean over and hold onto the handrail on the wall for about a minute each time, trying to breathe my way through the pain. The nurse, Barbara (who would be our nurse for most of the rest of the labor), asked which childbirth classes I had taken, and when I said Lamaze, she started reminding me about breathing tips: “Did you take your cleansing breath?” and so on. A little annoying, but I was glad she at least seemed to know something about it.

At last, we reached the L&D room, and I asked if I could get in the shower before they hooked me up to the monitors again, and Barbara agreed. Sarah put the exercise ball into the shower for me to sit on and I got in, and used the shower massager head to try to “change the sensation” of the terrible pain I was experiencing in both my belly and my back. I was also starting to experience a lot of pressure, feeling like the baby was really pushing down, and it was awful. It was a different sensation from the pain of the contractions, but it was equally uncomfortable (to put it very, very mildly). And because I had to support myself on the ball, I couldn’t get into a very comfortable position—the shower was pretty small, and I tried to lean my head against the wall, but it was cold, hard tile. I stayed in the shower for about 45 minutes (so I was told—I was past the point of having any sense of time whatsoever at this point) and was convinced that it was not helping. At one point, I clearly remember saying to Ed, “I am completely miserable.” I don’t really remember getting out of the shower, except I recall wanting to get to the bed as fast as possible— I remember Sarah had to stop me and tell me to let her dry me off.

Most of the rest of the labor is a blur, with a few moments of clarity. Ed would probably be able to correct some details and the order in which things happened, but this is how I remember it. Sometime after I got into the bed, I remember we started talking about the possibility of getting a doctor to break my water to make the process go faster—again, I was already feeling a lot of terrible pressure, like I wanted to push, but they couldn’t let me push until I was fully dilated. I remember we got Barbara to come in and check me, and I was already up to 8-9 cm dilated. At that point, I basically gave up on the idea of the epidural—I figured either that it was too late to get it (not the case, I later learned) or that I had made it this far, so I might as well suck it up. I think it was then that we asked if there was any way they could go ahead and break my water, but Barbara said she could feel the membranes of the amniotic sac right on the baby’s head, so there was really no point in breaking my water yet (at least I think that’s what she was trying to say). I was desperate at this point—somehow, the breaking of my water had become my only hope, the holy grail, and I wanted it DONE. Barbara said something like, “You know, when I was in labor, I was 9cm dilated and they broke my water and it didn’t make any difference.” Even in my haze, I was with it enough to say to her, “That is NOT helping!” I guess she left the room then, because I remember that at some point, I was wailing that I really felt like I needed to push, so Sarah buzzed the nurse’s station. Barbara came in and checked me again, and told me to push down on her fingers with the next contraction. That did the trick and I dilated the rest of the way. After that, I started pushing with each contraction, and it felt great.

Finally, we were all desperate to get my water broken. Somehow, a resident came in to check me and she said of course we could break the water, and that it was probably only the amniotic sac that was keeping the baby from dropping the rest of the way into the birth canal. But apparently, my doctor had given instructions to wait until she arrived before they broke my water. The nurse had been telling us for a while that they had paged my doctor and she was on her way in—but they had been saying this for a long time, it seemed, and she still hadn’t shown up. Finally, the resident decided they shouldn’t wait on the doctor anymore, but she had to find my nurse before she could break my water. My nurse had apparently gone on break (while I was 8-9 cm dilated, mind you) – a different nurse stopped in but told us she couldn’t do anything, because she had her own patients to attend to.

At last, the resident and the nurse were in the room at the same time, and they broke my water—very little came out. After that, I don’t remember a whole lot except the pushing. Sarah was holding up my right leg and Ed was holding up my left, and I was grabbing my thighs and pushing forward with all my strength. Sarah and the nurse kept trying to instruct me to push with my stomach and diaphragm and not with my head, but it was really hard to figure out how to do it right! I remember I kept worrying about bursting a blood vessel in my head or cutting off oxygen to the baby, but I couldn’t figure out how not to make the blood rush to my head. I did three full pushes with each contraction, rested a little, and then let everyone know another contraction was coming, and we’d go again. I recall beginning to feel very faint at some points and wondering how much longer I could sustain this. I remember Sarah kept looking down between my legs, and I asked her what she was looking at. She said she wouldn’t if I didn’t want her to, and I almost laughed—I was not concerned about that at all. I just wanted to know what we were looking for, and was hoping we were looking for the baby crowning, because I hoped that would mean I would be finished soon! But I didn’t need any help to know when the baby was crowning—I remember that moment with absolute clarity-- although it hurt like hell (there is a reason they call it “the ring of fire”), I remember being amazed that I could actually feel it. It was hard to believe it was really happening at that point.

Then, at some point, I was aware of a lot of commotion in the room, and I could tell they were breaking down the end of the bed, meaning they were getting ready to deliver the baby. But I was really in another world by then, so all of this was happening only at the very edges of my consciousness. I was told later that I only pushed for 30-40 minutes—again, I have no concept of this at all. I have a vague recollection of people telling me to push, and then suddenly, they were holding this baby up in front of me. I don’t remember if it was screaming (Ed said yes) and I don’t remember anyone telling me whether it was a boy or a girl (I’m sure they did). I looked myself and immediately turned to Ed and said, “It’s a girl!” and started crying (that is, I started crying happy tears, rather than tears of pain). Even though I never really admitted it and would, of course, have been just as thrilled to have a boy, some part of me really wanted a girl, and I was so happy. The next thing I remember is that I started struggling to get out of my hospital gown, which Ed had tied pretty snugly in the bag—I was trying to rip it off, because they were going to give Hudson (she had her name long before she was born) to me and I had read how skin-to-skin contact during these first few moments was really important to successful breastfeeding. I finally got the gown off, with help, and they placed that precious creature on my chest—all of a sudden, it was as if the previous 12 or so hours had not even happened. I didn’t notice that she was covered in blood and goop (I saw this only later in the photos of these first moments)—all I saw was an amazing little person whose life was now entrusted to me. I was overwhelmed and overjoyed. They left her there for a long while—pretty much the entire time the doctor was stitching some minor tears (my doctor had finally arrived about 10 minutes after Hudson was born, so all she got to do was stitch me up—a not-so-nice job since the lidocaine kept failing on her, or more importantly, ON ME!). Then they took her for a few minutes to weigh her, etc., and then brought her back so we could try breastfeeding. After a few tries in a few different positions, we figured it out. It was not as easy as I had expected it to be (and as it later became), and I was both relieved and astounded when she finally latched on.


Finally, all the doctors and nurses left the room for a few minutes and Ed and I were suddenly alone with this creature we had made. She was swaddled in a hospital receiving blanket and a little hat, and was completely asleep. She had apparently worked as hard as I had and was ready to rest. We were tired, too, obviously (I had been awake for 27 hours at this point, and had labored hard through about 12 of them), but were filled with such love and joy, we could hardly breathe, let alone think about sleeping. We were beginning a new path on our journey together with our beautiful daughter, so we just took a deep breath and enjoyed the moment.

7 comments:

  1. Mandy, I read this when it was posted on the Tarheel Turtle and was amazed then, and I'm amazed now. It's just a beautiful birth story, and you'll always remember it, I'm sure. I also want you to know that you inspired me to go the natural birth route with my second child. Thinking of you.

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  2. I went through Bradley Classes and ended up with a C-section. I absolutely love hearing of successful natural births, and I am so glad you stuck it out. Way to go! I can't wait to hear of penguin's arrival.

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  3. Mandy - looking at the photo of your beautiful family, I'd never know what you'd been through the previous 27 hours. You look GORGEOUS! When my one and only son, Christoph Eli Gelfand, was born 34+ years ago, I immediately wanted a shower, a coffee frappe (or milkshake as it was called in NY) and to call my mother! Although I too chose natural childbirth, throughout it I was thinking, "Morphine, heroine, WHATEVER a woman needs to get through this she should have!" No longer was I the self-righteousness young woman who knew the only 'right' way to give birth.
    Rebecca

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  4. Gorgeous family portrait! Beautiful, Mandy, just beautiful.
    Claire

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  5. Im so glad you posted this-- I remember reading it before and have thought of it many times - thank you!!!
    -janet

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  6. What a beautiful birth story Mandy. (My water didn't break till I was pushing too...my husband said it sort of shot across the room and sprayed people on the way, haha).

    Thank you for sharing this. I'm thinking of you.

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  7. I love reading birth stories. There is a big part of me that longs to be a doula or midwife. Thank you so much for blessing us with the gift of Hudson's birth. It makes me want to pull mine out and take another look at it. Believe it or not, I absolutely loved giving birth. It was the most powerful experience of my life; just like yours. Loving you four so much...Renee P.

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