Wednesday, October 9, 2013

Ada’s Birth Story


We welcomed Ada Rose Hitchcock Chaney into our lives on Wednesday, August 14, at 8:30PM. She weighed 7 pounds, 7 ounces, and was 19.75 inches long. She gets her first name from Ed’s great-grandmother, and her first middle name partly from some other relatives of Ed’s, but largely in memory of her big sister, who also had a flower for a middle name. This is the story of her birth.

The weeks and days leading up to Ada’s birth were long. They are long ones for any pregnant mom nearing her due date, feeling big and swollen and sleepless, but they felt especially long for me. Although I’d been able to stave off most of the anxiety that had plagued me all during my pregnancy with Jackson, the last weeks of my pregnancy with Ada brought many of those fears roaring back. I dreaded the possibility that she might not arrive by her due date, because I feared that my anxiety would just skyrocket at that point. I talked with the doctor about when they’d want to induce, and she said they would probably not let me go past 41 weeks, given my age. But I wasn’t sure I’d be able to make it to 41 weeks. We went ahead and scheduled an induction for the day after my due date, but I knew that I could change my mind if I decided I didn’t want to go through with it, and I was just hoping that this baby would follow in her big sister’s steps and come several days early rather than following her big brother, who arrived right on his due date.

I was nesting like a madwoman during those last three weeks. I baked, I cooked meals for the freezer, I organized the basement, I organized the baby’s room (some more), I knitted—you name it, and I was probably doing it. I think I was hoping that all the activity would bring on labor. I know I was hoping that all the activity was a sign of impending labor. At my 38-week appointment, I was about 1 cm dilated, and the doctor went ahead and stripped my membranes in hopes of helping get things going. This, of course, did nothing. At 39 weeks, I was about 2-3 cm. I saw a different provider that week, a nurse practitioner, and because I didn’t know her and she didn’t offer, I didn’t ask her to strip my membranes again. As that week went on, I felt the induction looming large in my mind—I really didn’t want to go through with it, because I was committed to another drug-free delivery and I was concerned that Pitocin would make that difficult. I had acupuncture for the first time the day before the due date. The due date, August 13, arrived, with no sign of the onset of labor, except that I was dilated even more, to 3-4 cm at this point. I told the doctor to go ahead and cancel the induction, that I was feeling OK anxiety-wise and really didn’t want to induce unless the anxiety got unbearable. We scheduled a non-stress test for the baby for a few days later. And although the doctor stripped my membranes again that morning, the due date came and went with no excitement.

Early the next morning, around 2AM, I woke up for no reason, as I had a tendency to do during that last month or so. I lay awake in the bed for a while, trying to decide if the contractions I was feeling were real contractions or just Braxton-Hicks, which I’d been having off and on for a few weeks. I was also counting the baby’s movements, and by 4AM, I felt like I hadn’t felt her moving enough and decided to go into the hospital to get her checked out. This kind of anxiety and overreaction was just exactly what I’d been hoping to avoid, but there it was just the same, just as soon as the due date passed. I went to labor and delivery and they hooked me up to the monitors. The first 20-30 minutes really didn’t look that great—Ada was moving occasionally but not showing any real accelerations of her heart rate during the movements. The nurse said to me, “How do you feel about staying here and having a baby, because in about five minutes, that’s what they’re going to come in here and suggest that you do.” I called Ed (he had stayed home with Jackson because I didn’t want to wake up my sister-in-law and have her come over for no reason—I imagined I would get the baby checked out and be back home in a couple of hours) and asked him to come to the hospital so that we could talk to the doctors and make a decision. Of course, after I called him, the nurse gave me some juice, and I went to the bathroom, and within a few minutes, Ada was bouncing all over the place. During all of this time, I had been having what I was pretty sure were real contractions at this point, although they were still only mildly painful and were very irregular, and I’d also had a fair amount of bloody show. The resident checked me and said I was still about 3-4 cm. She talked to the chief resident and they decided to send me home since it still did not appear that I was in active labor. I asked if it were possible for me to just stay and see if the labor started to progress more, and she said the only way they would let me stay is if I agreed to go ahead and let them do some kind of artificial augmentation of labor. We started planning to go home, and then there was a shift change. A new attending came in to see me and he said that not only was it fine for me to stay if I wanted to, he’d actually prefer it—he said that OBs are anal and conservative and that they’d have preferred for me to have delivered before the due date. Ed and I thought I’d probably be more comfortable laboring at home until things seemed to actually be progressing. The new doctor, who was really very nice, said that if we went home, he would be on shift until 5:30 that day, so if we changed our minds and wanted to come back in, we could do so, and at point, we could talk about some other options besides Pitocin to get labor started, including breaking my water. This seemed like a good compromise to me, so home we went.

I remembered the advice my very first doula gave me, which was to rest as much as possible, so that’s what I tried to do. I laid down in bed and tried to sleep, but the contractions I was having were getting more painful, even though they weren’t getting any more regular. They were anywhere from seven to fifteen minutes apart, and I was still not convinced that I was really in labor.

Finally, close to 4:00 in the afternoon, I was getting frustrated and anxious. Several Facebook friends suggested that perhaps the labor wouldn’t really start to progress unless and until I felt safe and confident that that baby would be OK. I was also worried that once things really did get going, they might go very fast, and I did not want to be faced with the prospect of having a baby in the car. While most women feel more comfortable at home, it seemed like perhaps I would feel more comfortable at the hospital, where I knew we could monitor Ada and get help immediately if we needed it. I also wanted to get back there before the attending I’d seen that morning left his shift, so that we could talk about some things and anyone who took over for him would know about any plan we came up with. So we decided to go back in, even though the contractions were still not regular.

I called our doula to let her know that we’d decided to head in to the hospital. UNC has a volunteer doula program that provides labor doulas for free to anyone who wants one. I decided to go with the volunteer program because I wasn’t totally sure that we needed a doula on the third time around, but I still thought it would be nice to have one there just in case. I’d met her twice already, and Ed had met her once. She was . . . odd, to say the least, and I wasn’t sure I was totally down with her approach to being a doula, but I tried not to let this get in the way. I knew that I had not really connected with her, but she was a volunteer, and I didn’t really feel like I could call up the volunteer coordinator and say, “I’m sorry. I don’t like this volunteer that you are providing to me for free. Could you please provide me with someone else for free?” You know, it just felt like a looking-the-gift-horse-in-the-mouth kind of thing. She seemed like she knew her stuff, and I just tried to ignore her quirks and the fact that I didn’t really like her approach. That was a mistake. When I called her to let her know that we were heading in to the hospital even though the contractions weren’t 4 minutes apart yet, she immediately started trying to talk me out of it. I explained to her that my instinct was just telling me that I should go on in, that I would feel safer and more comfortable at the hospital, but she proposed several doom-and-gloom scenarios and basically suggested that if I went to the hospital now, my chances of being able to stick to my birth plan would go out the window. I mouthed silently to Ed, “SHE’S DRIVING ME CRAZY!” as I simultaneously made arrangements with her to meet us at the hospital later. What I was thinking, I have no idea.

The human body is an amazing thing, though. It seemed that almost as soon as I made the decision to head to the hospital, the contractions started getting more intense and started coming much closer together, well under four minutes. We got to labor and delivery, and thankfully, because I’d already been in that morning and they’d wanted to keep me there in the first place, they skipped triaging me and put me right into a labor room. The resident checked me, and I was already to 6 cm. I was really hoping that the rest of the way would go really quickly, but alas, it was not quite as fast as I’d hoped. Fortunately, UNC had wireless heartrate monitors, which made it much easier for us to keep an eye on Ada while I was laboring.

It was about 5:00 PM at this point. I talked to our nurse while Ed put Hudson’s pictures around the room. Our nurse was fantastic—she was totally on board with drug-free delivery, and she actually sat and read our birth plan through, asking us questions as she went. I was amazed. One of our requests on the birth plan was to have a nurse who was enthusiastic about unmedicated birth, and she assured us that she was a and that when the shift changed again, she’d make sure the next nurse would be as well. She brought me a birthing ball, which I sat on for much of the rest of the evening. The same doctor I’d seen earlier in the morning checked in with us, and since he could see that I was in active labor, he left us in the nurse’s hands.

This is when we fired the doula. The volunteer doula. Yes, we fired our volunteer doula. After we’d gotten settled in, I texted her to let her know they’d admitted me and how far along I was. She texted back that she’d already left and was going to stop and get something to eat along the way. I started explaining the situation to the nurse about how I didn’t really like the doula much, and she immediately said, “You need to tell her not to come.” Ed agreed right away. I hemmed and hawed, saying that I couldn’t fire a volunteer, and I certainly couldn’t fire her on the way to the hospital, but the nurse persisted, reminding me that labor is very psychological and that I didn’t need any stressors or distractions in the room. If the doula was going to be more of a burden than an aid, then she needed to stay home. I relented, and Ed so kindly agreed to call her for me. I was both too embarrassed and also having to concentrate pretty hard through contractions at that point, making a phone call difficult.  I was so relieved once it was done, and I was glad to have two people thinking smarter than I could at the time.

The contractions were getting worse and closer together. A few different times, I went into the bathroom and straddled the toilet backwards for a while, hoping to get my water to break (this position had done the trick with Jackson), but to no avail. We talked about the possibility of having the doctor break my water, and the nurse was really great about explaining the pros and cons of this procedure. I was still frightened enough of scary things like prolapsed cords that I decided to wait it out. Ed was a champ this entire time, massaging my shoulders and back and cheerleading me through the contractions.

At the shift change, two wonderful things happened. First, the attending who came on to the service was one of the two doctors I saw through most of the pregnancy, and I loved her. We were both really excited that she happened to be on call that night and would be delivering my baby. And second, the new nurse was an unexpected gift from the universe. She had recently received her midwifery certification, of all things. We fire our volunteer doula, and suddenly, we get a midwife. And she was fantastic. She sat down on the couch in the room while I labored on the ball and just talked with us for a good half-hour. She was visibly moved when we told her about Hudson, and by the time it was all over, she felt like our friend. Where she really proved her worth was about an hour later, at the very end, when I hit transition. During the last hour or so, I had been in the bathroom again, hoping desperately that my water would break. I was starting to fall apart emotionally, feeling like I couldn’t hang on much longer (a sure sign of transition, but I wasn’t convinced of that), and my legs were beginning to get tired from supporting my body as I straddled the toilet. They were starting to shake, and the nurse suggested that I try lying down on the bed. This idea terrified me a little bit (the pain you know is better than the pain you don’t know), but she made a good case that I needed to give my muscles a break. I lay down on my left side and by this time, my whole body was trembling. I could not stop shaking. I didn’t realize that this is a sign of transition—I’d never had the shakes before—but the nurse did and she paged the doctor to come check me. Meanwhile, she placed one hand firmly on my hip and slid the other hand firmly down the outside of my thigh, a gentle massage that slowly helped my body calm down and stop shaking. It was absolutely amazing, and I told her so.

The doctor that I loved so much came in to check me, and lo and behold, I was fully dilated. I couldn’t believe it. For the last half-hour or so, I hadn’t wanted the doctor to check me because I was sure that I was only 7 or 8 cm along, and I just couldn’t take knowing how much longer I might have to go. So when she said I was complete, I was so relieved. She asked me if I wanted her to break my water, and at that point, I didn’t care anymore, so I said, “YES!” (Hudson’s delivery was similar to this—the doctor didn’t break my water until I was already pushing, and hardly anything came out because Hudson was already in the birth canal). The doctor broke the bag, and I felt the warm whoosh of water and said, “You broke it!” She laughed and said, “I did!”

And then, out of nowhere, I had this incredible urge to push. It was like the doctor broke my water and all of a sudden, the baby was ready to just ride the wave out. I screamed that I needed to push, and both the nurse and the doctor said to go ahead. I pushed once, but I was scared and thought I heard one of them saying something about holding up for a second. I remember thinking that I was going to tear like crazy. I looked up at the doctor and screamed her first name (I was embarrassed about this later), feeling like I needed someone to give me some instructions. But like with Jackson, there was no waiting on this baby. My body was in total control, and I pushed once more and she was out. It took about 20 seconds altogether.

And then, there she was, little Ada, tiny and screaming on my chest. The relief I felt was immense—even having done this twice before, the dread of the unknown can weigh so heavily, and I was just so glad that the delivery was over and that Ada was safe and sound. (Funny—I just went back and read Jackson’s birth story and saw that I wrote almost this exact same sentence at the end of his.) I held her close and spoke softly to soothe her, and I started crying almost immediately, thanking everyone in the room and letting the euphoria wash over me. UNC is wonderful about not taking babies from moms for at least an hour after birth, so Ada stayed right on me for a long time and was nursing within twenty minutes. She looked pretty small to me—her limbs didn’t have much chub on them at all—but her official birth weight was one ounce heavier than her big sister’s. But to no one’s surprise, she looked just exactly like her big sister and brother, as if they were all popped out of the same mold.

So much was different about this labor and delivery. It was so much less loaded and emotionally fraught. This time, I already knew that I could love another child as much as I loved Hudson. I already knew that I could love another child and still love Hudson. Hudson was still present in the room with us, but in a way that felt much more integrated than when Jackson was born, when there was still the very strong sense of a giant hole just waiting to swallow me up. Later, I felt badly that I hadn’t spent much time thinking just about Hudson in those moments after the delivery, but as the time has gone on, I realize that that is what it really means for her to still be a part of our family. She is right there with us, whether we are thinking directly about her or not. And that is a blessing.

In a lovely twist of fate, Ada was born on the one-year anniversary of my last chemo treatment. It’s almost hard to believe that is a coincidence.

And so we keep moving forward, now a family of five, a baby sister, a big/little brother, a big sister, a cancer-surviving mommy, and a daddy who somehow helps us keep it all together every day.






12 comments:

  1. She is so beautiful, Mandy! I just love the shot of Ada and Jackson. What a beautiful family you have.

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  2. I do marvel at how they all look so much alike. I'm also glad you were able to deliver the way you wanted, that you have such steadfast support all around you. (Two pushes is pretty cool too.)

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  3. Congratulations! She's beautiful & you are amazing!

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  4. Congratulations! You are such a strong person and you have a beautiful family.

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  5. I love you all, sight unseen.
    Claire

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  6. Congratulations! Such beautiful children you have, and it is uncanny how similar they all look.

    I was cheering for you as I read Ada's birth story and am so happy that you had such supportive people there with you. It truly does make a difference.

    Kris

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  7. congratulations Mandy. I was anxiously awaiting word from you about Ada's birth. I was so hoping that everything went well. Thank you for sharing her birth story.

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  8. I am sobbing over here at this news. I have been waiting for this post for some time. Welcome, Ada! You are a wise and wonderful mother. Much love to your family as you carry the joy of adding Ada with the sadness of missing Hudson.

    XO
    Meg

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  9. What a little beauty. I love that your babies look like they popped out of the same mould- love it.

    I think it's insanely amazing to know she arrived a year to the date of your last treatment. xox

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  10. I wanted to echo the thank you - have been thinking of you, and hoping you would feel like writing, as your words are soulful in a way few others are. I also couldn't help but take a look at your beautiful photos on Facebook, and I felt that the family photo was particularly beautiful, and somehow - perhaps the expression on your face, or the space between you and Ed - I also felt Hudson's presence there, and saw you all as you are, a family of five.

    Meira

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  11. A late welcome to beautiful Ada! She looks a great deal like her big sister.

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