Friday, August 25, 2017

Baby Story - Part 2: Labor (Graphic Level: Low)

I started to write the labor and delivery story of Baby L and I, and it started to get really long. Instead of a single novella post, I've broken it into 4 parts, each with varying levels of graphic description.

All photos on this blog entry are courtesy of Lacey Sexson Photography!

Part 1: Pre-Labor (Graphic Level:  TMI)
Part 2: Labor (Graphic Level: Low)
Part 3: Delivery (Graphic Level: Eww)
Part 4: Recovery (Graphic Level: TMI)

Part 2

Around 12:30pm on Tuesday, after 39 hours of pre-labor contractions, my water finally broke.  Once the amniotic sac ruptures, the doctor on call assesses cervical dilation, and then the nurses put an adult diaper on the mom.  Now...these aren't like Depends in the USA, these are actual DIAPERS that are adult-sized, which I found hilarious - I didn't even know they existed!  As soon as they put the diaper on me, just like a baby, I had the massive gushing water like you'd see in the movies.  So also like a baby, they had to change my diaper right away.

Doctor assessed me at 3cm, which isn't quite "Labor" but we'll call it labor.  Shortly after the assessment, I had my first post-sac-rupture contraction, and I learned what an actual painful contraction feels like.  I decided at that moment to change my birth plan and get an epidural.  I think I could have actually tolerated the pain if I weren't so exhausted from a long pre-labor. Knowing that I would eventually need the energy to push Baby L out, I decided to conserve my strength - during Part 4, Recovery, I'll talk about why I still struggle with this decision.

The nurses wheeled me up from the maternity ward to a labor suite.  It was much larger than our hospital room, super bright and airy, and had a bath tub for laboring in - I had been so excited to use that tub, but BrightPoint is such a busy hospital that really nobody gets to hang out in the labor ward in a bathtub for hours on end.  Everyone pretty much labors in the maternity ward in a regular hospital room until go-time.

Anyway, once upstairs, I had to do a CTG again to make sure the baby is not in distress before the epidural.  Once the epidural was complete, I had to be strapped to the CTG for monitoring all the way up until it's time to push.  More on why this was awful later.  I went through several painful contractions during this particular CTG, we got a final assessment that I was 4 cm dilated, and we were "officially" in labor and were good to go for the epidural.  Yay!  I still count my water breaking as my official labor start time.

The epidural was inserted without much fanfare, other than I kept asking "when is it going to get here!?!?".  G reminded me that I knew in advance when I said I didn't want one that I would have to wait awhile to get it since the anesthesiologist might be busy.  This is the problem with husbands who pay attention during birthing class. :-)  The anesthesiologist finally came, and I was pain free except for a small section of my belly on my lower right side.  I twitched a little when the needle went into my spine, so I suspect that small section was my fault...and I kind of liked having a spot on my body where I knew what was actually going on, compared to feeling nearly nothing everywhere else and having my legs go numb.

Anyway, now that we were all set up, G called Lacey, our maternity photographer, to let her know.  She came to the hospital to prepare to photograph our birth story.  I thought it would be cool to capture this moment since birthing is chaotic, and a lot of parents don't think to take pictures of various birthing things amidst all the excitement.  By the time Lacey arrived, the epidural had fully kicked in, I was 5 cm dilated, and labor was awesome!  This moment was probably the high point of the experience - my contractions were pretty strong, they were about 4-5 minutes apart, and I only felt the tiniest little bit of them!

All smiles when Lacey arrived!
So obviously of that was the high point, it goes downhill from there.  Epidurals wear off, so when I started experience cramping around the edge of my belly, I notified the anesthesiologist, and they administered more meds.  This happened every 90 minutes or so.  What I didn't fully understand was that the meds were also accumulating in my system and slowing down my labor.  I didn't feel any pain, and the muscles in my body also stopped feeling the urgency to push this baby out!  I got to around 7-8 cm and then my labor stalled for a third time in three days.  It was a looong night. Contractions were getting weaker and further apart.  Sometime after midnight, the staff consulted with my doctor, and we added Pitocin to augment the labor.

At this point several things happened.  I was extremely uncomfortable having been sitting in a birthing chair with limited ability to move for hours.  I'd also had these CTG elastics tied to my belly for hours.  They itched, they were tight, and I was mostly miserable again (but pain free!) The baby's movement came into question because her heart rate was a little too consistent on the CTG monitor. This is the same CTG monitor that kept dropping the heart rate signal and contraction signals altogether.  My epidural started wearing off, and everyone agreed that I should let it wear off so that I could have strength to push, and help move labor along.  We started measuring the location of the baby's head in my pelvis to see if it had dropped far enough for me to start pushing.  I needed Baby L's head to drop about 2 cm, and my cervix to dilate another 2 cm before the push party began.

These probes measure fetal heart rate and contractions - and they are pretty uncomfortable after about an hour.

Cardiotocography (CTG) Machine which records fetal heart rate & uterine contractions.  I loved this machine the first time I heard my baby's heartbeat, but by the end of my labor, I despised it for the inaccuracy of its readings!!!


So tired, upset, uncomfortable.  G tries to encourage me.
The nurses wanted me to lay on my side to see if baby movement would improve.  I tried left side, right side, you name it, with the monitors strapped to my belly, nothing was comfortable and laying on my side only served to slow contractions further with improving baby movement.  I argued to sit up straight, but the nurses said the could get a reading on the baby because her head was too closet o my pelvis.  Every time I sat up, not only was I more comfortable, I could feel Baby L's head dropping and my contractions got stronger.  The nurses believed the baby was in distress, so they never supported my sitting up for more than 20-30 minutes at time.  I was having all kinds of anxiety about whether this delivery would end in a C-Section...which, if that was what was best for the baby, so be it, but it seemed awful to go through all this suffering to still end up with that outcome.

G catches a few Zzzz's throughout the night

The one photo I took all night - G and Lacey try to watch a show while we wait for my cervix to dilate, but I think they kept getting interrupted.  I wasn't entirely sure, since I tried to take as many naps as I could.
This back and forth went on and on for hours.  G and Lacey helped me sneak in a few moments where I leaned way forward in my chair to relieve my lower back - it was heavenly.  Finally, early in the morning, the midwife checked my cervix and it had dilated to 9 cm - moving in the right direction! - and Baby L's head was about 1 cm from where it needed to be.  We asked the midwife if I could sit up straight to allow gravity to help me, and she said, "Sure why not??".  It felt like a miracle!  The midwife and nursing staff called my doctor in from home, and we were ready to get this party started.  Almost.

My doctor was concerned that perhaps the umbilical cord was preventing the baby from descending further, so we looked at the ultrasounds - and the baby was clear of the cord.  I felt a huge sense of relief when she told me that.  Finally, around 4:45 to 5am, my cervix has dilated to 10cm.  Now are we ready??  Not quite.  The nurses started setting up my birthing chair and had me put my feet up - not in the big stirrups yet, but sort of in a squatting position.  My doctor calmly sat in a stool near my chair and instructed me to bear down with each contraction...not too hard, not like pushing, but just bear down to help Baby L's head move downwards.  Don't use up too much strength.  After a few of these, I started to feel the need to urgently push this baby out of me...and that is when the REAL excitement began!

My doc confirms umbilical cord is not wrapped around Baby L

On to Part 3: Delivery (Graphic Level: EEWWWW Gross!) -- DISCLAIMER:  Part 3 gets quite graphic in some places, and may not be 100% "medically correct" since it's told from my perspective. Just a warning, if you're squeamish, or don't like to hear about some of these things, skip to Part 4: Recovery (Graphic Level: TMI).

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