Sunday, October 28, 2012

Ezra's {Almost Unmedicated} Birth Day

At my 40 week appointment, my blood pressure was much higher than it had been.  My feet were swollen, everything was sore, but I wasn't quite ready for an induction, yet.  I wanted him to come when he was ready.  At my 41 week appointment, everything was worse, and I was just ready to be done.  My midwife said I could hold off until Wednesday evening to give little dude a chance to come on his own, and I agreed to that.  She said they would use Cytotec, which I had researched during pregnancy.  I was very concerned about using it, but I was assured that most of the negative outcomes were due to overdosing and that we would only use 1/4 of a tablet, and MIGHT need a second 1/4 tablet 4 hours after the first.  

We got to the hospital at 7pm on Wednesday, October 24th.  I was 3cm, 80% effaced, and contracting on my own every 7 minutes, before anything was given.  At 8pm, ¼ tablet of cytotec was placed.  My midwife was convinced that was all I would need to kick start labor.  I wasn’t so convinced, though, for whatever reason.  Fletcher and I watched TV and just…waited.  Around 11pm, I could tell the contractions were getting more intense and asked him to turn the TV off and plug my computer in so we could listen to a playlist of instrumental Hymns.  I asked for a birth ball and sat in front of Fletcher’s chair so he could apply counter pressure to my back and hips during contractions. 

At 1am, I asked to get in the tub.  The hot water and the jets on my back felt good, but I just couldn’t find a comfortable position to work through the contractions.  Leaning back into the jets made them worse, and my legs were so swollen that getting on hands and knees just wasn’t working, either.  My contractions were coupling for two minutes every 2 ½ to 3 minutes, so I had maybe 30 seconds of a break between them during transition.  All of the pain was in my lower back.  I don’t even know how to describe the intensity.  

A little after 3am, my nurse asked if I could get out so she could do a 20 minute strip on baby and then my midwife would break my water.  I was 8-9cm with a bulging bag.  Someone told me once that cervical checks during labor didn’t phase them at all.  BOLOGNA.  Holy cow, they hurt.  I thought maybe laying on my back was making them worse, so I asked if I could lay on my side once…nope…not cool.  Next time, they said I could leave the bed raised and put my feet on the squat bar.  That didn’t help, either.  I had Fletcher in a bear hug with my head in his shoulder every time.  

A little before 4am, my midwife broke my water, which felt…weird.  There was a little meconium staining, so she called the pediatrician on call to give her a heads up that she might need to head in soon.  Everyone thought it would be just a couple hours before Ezra was here.

With the hymns playing and a lavender block in the hospital-provided Scentsy burner, my midwife and nurse both said it was the most relaxing labor they can remember attending.  And, it kind of was relaxing at that point.  I felt in control, I was still able to smile and laugh (which shocked them) but I knew it wasn't going to be that way for long.

At 8am, I was still at 9cm, with a lip.  For those 4 hours, my midwife and our L&D nurse had been right there.  Helping apply counter pressure, giving Fletcher bottles of warm saline to hold on my back, helping me get on hands and knees to help Ezra get in the right position.  I got back in the tub for a while, but I can’t remember what time it was.  

At 9am, having been stuck at 9-9.5cm for over 4 hours, I looked at Fletcher and said, “I just need…something.  I don’t even know what they can give me now, but I just need a break.”  My nurse had stepped outside for a minute, and when she came back she said, “Deann just called and said that she doesn’t want to offend you and knows how badly you want to get through without medication, but she was wondering if we could just offer you something to help you rest for a few hours so you have the energy to push, and it’ll probably relax your body enough to finish dilating.”  It was just perfect timing.  No one had said a word about medications before this, but everyone, including me, knew I just needed a break.  

I got back in the bed and the nurse brought the Dilauded in.  I had a heplock in place (that bugged the tar out of me, by the way) and she pushed half a dose during the first contraction, waiting for the second to push the rest.  That stuff stung.  Just a few contractions later, I could tell it didn’t hurt nearly as badly.  Fletcher was sitting in a chair next to the bed, dozed off, and almost fell out of the chair.  I was getting sleepy, too.  Both of us had been up for over 24 hours.  The nurse looked at him and said, “Go lay on the couch for a little bit.  I’ll sit with her.”  He looked at me and I said, “Go lay down.  This stuff is about to knock me out, anyway.”  I drifted in and out.  I could still tell when contractions were happening, but I didn’t feel them.  The nurse said she could tell the intensity was getting higher, though, because I was curling my toes more and more with each one. 

Around 11, Fletcher woke up.  The Dilauded was starting to wear off and contractions were hurting again.  Our midwife had gone up to the clinic for a few hours to get some of her appointments in.  She came back down around 11:30 and checked me.  I just had a little lip of a cervix left, so she held it back to see if pushing a little would make it go away.  Um…that hurt.

At 12:15, I felt his head just drop. I screamed.  I had been telling myself for months that I would NOT scream, grunt, say “Ow,” or get mad at anyone.  I was choosing to do this without medication and just needed to suck it up and deal. 

They broke the bed down, called everyone who needed to be there back in the room, and we thought we were going to have a baby pretty quickly.  I didn’t like my feet being in the low stirrups (bed was sitting straight up because I did not want to lean back for anything) so they pulled the high stirrups out.  I never thought I would deliver like that, and my midwife was really surprised that’s what I wanted, but it worked. 

I started pushing at 12:15.  I have no recollection of time between then and 3:02, when Ezra was born.  I remember Fletcher saying, “I know, I know,” during the contractions, just trying to be sympathetic.  It got to the point where I just wanted to grab his face and say, “NO, YOU DON’T!!!!!!” but I didn’t.  I remember one nurse (not the one who was with us the entire time) coming in for a few minutes and saying, “Honey, don’t just breathe in and out.  You need to be pushing,” and my midwife saying, “She is pushing.  This is the best open glottis pushing I’ve ever seen.”  Heh…I was just doing what my body told me to do.  Amazing that I didn’t need to hold my breath and have someone there counting to ten over and over.

I remember hitting a point where I was just done.  It felt like he was never coming.  I just knew he was stuck and I was going to end up with a c-section.  But, no one else in that room was going to let that happen.  At one point, the fetal monitor started picking up my heart rate, which caused a bit of a panic.  The nurse put a pulse ox on my finger to see if that is what happened, and then she just left it there.  I wanted to throw that stupid thing across the room.  After a few contractions, I remembered that I COULD just ask if she would take it off and not risk hitting someone with it.  And she did. 

I remember my midwife saying, “You’re tired.  Baby’s getting tired.  You need to push him out.”  So, I pushed…and screamed…and grunted…and yelled, “Ow!”  I said “I can’t,” several times.  The contractions spaced out at one point, which was super frustrating.  Like my body just decided it didn’t want to do this anymore.  They picked up again, still coupling, still in my back.  Precious.  My midwife said, “One more contraction, and we’ll have a baby.”  I thought, “Yeah, right.”  I thought maybe 3 or 4…but 1????  She was right.  One more contraction and he just slid out with 2 pushes.  Granted, it took 3 hours of pushing to get to that point, but still.  I had closed my eyes and had no idea he was out until I heard him crying.  Fletcher was looking at me and didn’t know it, either.  But, there he was. 

She placed him on my chest so she could clamp and Fletcher could cut the cord.  They let him stay there for a few minutes before the pediatrician and respiratory tech wanted to look at him to make sure he didn’t aspirate any meconium.  Just a few minutes later, they handed him back and we did skin-to-skin for about 3 hours.  20 hours after my admission, after 17 hours of back labor and 3 hours of pushing, we had our 8 pound, 8.8 ounces, 20 ½ inches of chunky baby.  Who, even though we tried to evict him, decided to still keep his own timetable.

Our nurse came in before she left at the end of her shift and told me I had made her feel like a nurse.  That she was grateful she had been able to use her skills and help a mom and baby through labor.  She and every other nurse and physician in the hospital was absolutely phenomenal.  Almost enough to make me say that I can’t wait for it again… ;-)

UPDATE: I'm not about to say that unmedicated labor and birth didn't did...a lot.  But weeks 2 and 3 of nursing hurt so much worse.  I didn't cry at all during labor...I bawled like a baby those 2 weeks every time he nursed.  But, we pushed through it, the pain eventually went away, and we're still exclusively nursing and hoping to keep going until he's 2.  Now I know that child birth actually isn't the most painful thing on the planet and I can get through it next time like it's nothing.  :)

The huge bruise on his head is from being malpositioned while I was pushing.
Stubborn, stubborn child.

My husband's thoughts about Ezra's birth day can be found here.