N’s arrival, pt. 2

So, where did I leave off?  Ah, yea.  3am.  Pants soaked through.

This is really happening…

Actually, I spent a lot of time silently reiterating that.  “This is really happening.”  It didn’t seem real.  After months of Braxton-Hicks contractions that frequently worried my non-stress test nurses but never amounted to anything, I found it hard to believe that early labor was so contraction-free.  We were soon settled into our rooms, wrist bands applied, IV access inserted, and consent forms signed.  Now what?  I decided to sleep, and encouraged the mister to do the same.  I was quickly snoring in my cushy bed, as the mister tossed and turned in his straight-backed chair.  You see, the nurses casually mentioned during our birthing classes that the L&D floor had fewer reclining “dad chairbeds” than they did birthing rooms, but we foolishly assumed that it would be highly unlikely that we’d miss out on said chairbed.  Trouble is, when you come rolling in to the hospital at 3am you’re arriving after the rest of the floor has been tucked in for the night.  No chairs to be had for the mister, and, as a result, barely any sleep as well.  (This will become a recurring theme through the remainder of this tale!  Stay tuned for future posts!)

4am: 2cm dilated, 60% effaced, -3 station

And, so I slept.  Finally at around 7am the contractions started rolling in at a level that, while not all that bad, did make it impossible to sleep anymore.  I do think the poor mister was grateful to have me awake as he had long ago given up on sleeping.  The nursing staff changed over at 7am and we met our new nurse, Liz.  When we first met she said, “Well, my shift is over at 7pm, so you better have this baby before then cause I want to meet him!”  It sounded somewhat optimistic to me at the time (“I’m a first time mom, isn’t this supposed to take FOREVER!?”), but little did I know then that Liz would prove right.  The nurse encouraged me to eat something before labor really started going, so I called up and ordered oatmeal, grape juice, and a piece of turkey sausage!  Certainly one of my weirder breakfasts, but I was unsure about eating too much before labor, but wanted to throw that sausage protein in there for good measure.  This would not be the last time I ridiculously overthought my meals while at the hospital!  In retrospect I wish I had ordered A LOT more.  Note to self: Eat while they’re letting you eat because you don’t know where or when your next meal will come!

10am: 3cm dilated, 60% effaced, -2 station

This is when the decision-making started.  I wasn’t all that surprised that little had changed in 6 hours as I was still comfortably talking through most of my contractions, but it was discouraging none-the-less.  Not the least of which because this meant Liz had to talk to the resident-on-call about beginning augmentation.

As a bit of a refresher: I was hell-bent on a drug-free birth.  (I hate the phrase “natural birth,” don’t you?  It just reeks of smugness like the women who use pain management, who have c-sections, who do what’s best for their babies are somehow “unnatural.”  But, I digress.)  My reasons were many, but I’m finding them hard to articulate now, after-the-fact.  The reasons are there through the anger of my resentment post, but they range from a desire to turn the pain of labor to joy after laboring to deliver 3 prior miscarriages, my wish to experience the same type of labor my (long-dead) mother felt, my fear of drugs increasing the risk of the c-section I’d fought tooth and nail to avoid, my worries that another abdominal surgery would further impair my fertility and/or take more control away from me regarding my reproductive choices, my need to be fully alert and engaged in the process I’d fought so hard to experience, my hard-earned knowledge that my body responds negatively to analgesics, and a healthy dose of stubbornness and commitment to proving how “tough” I was.

So, it was hard not to panic once the discussions of augmentation began.  While I had nothing against pitocin, I worried that allowing a little pitocin would be a slippery slope into pain meds.  At the same time, I had to balance that fear with the knowledge that 1. without pitocin the labor could drag on endlessly and result in my becoming so tired that, again, labor would go differently than I’d hoped, and, 2. that I was working on a hospital-mandated clock because my waters broke at home.  We had 24 hours from when my water broke (11:30pm the prior night) to get the baby out the way I wanted before hospital policy (stemming from a fear of infection) stepped in.

In an odd way, the decision-making was made even harder by the fact that my experiences with my nurse and the resident were completely different from what I’d expected.  Throughout IF and my many other medical (mis)adventures, I’ve gotten serious mileage out of stubbornly pushing my wants/needs/expectations onto less-than-thrilled/less-than-receptive medical professionals.  Given the stories you hear about hospital births in modern America I expected much the same.  I’d have to fight to see my wishes through, I’d have to constantly remind myself to consult the BRAN acronym (What are the Benefits, Risks, Alternatives, and results if we do Nothing?) when having options forced on me.  My actual experience was quite different.  The doctors and nurses were completely hands-off with all decisions, almost to the point of causing me extreme frustration.  If they expressed no preference, then how was I going to battle them?  How would I know if I was winning?  The pitocin decision was just the first of many that went this way.

11am: Started low and slow pitocin drip

Somehow, I expected all hell to break loose once the “nasty” pitocin started.  And, yes, it definitely got worse, but, no, it was still nothing like I expected.  I was giving my longstanding IF-friends-in-the-computer Facebook play-by-plays through it all (have you wondered how I have this all memorized down to the hour?  I don’t – I’m going through old Facebook posts!), and when I mentioned that the nurse was off to get the pitocin one good friendly kindly offered, “Well, I don’t know how you feel about epidurals, but my advice with pitocin is to take the f****** epidural before you think you need it. I was so stuck on having a natural Hypnobabies no-pain-meds birth and… I wish someone had said, hey, pit contractions really are different and it’s OK.”  Not gonna lie, that concerned me.  I was beyond grateful for her advice (and for the fact that before she offered said advice she asked, “Can I offer my unsolicited advice about pitocin?” first… always a good plan!), but my experience was different.  I know I have a high pain tolerance, but I’m also not arrogant enough to think it’s that high.  Namely, I think the reason pitocin and I got along so well was because the nurse agreed to use a teeny-tiny dose and slowly step it up each half hour.  So while the pitocin definitely got things rocking and rolling a little faster, it didn’t lead me to want to break out the drugs immediately.  And when the contractions started picking up in frequency and intensity, and subsequent pelvic checks showed progress, the nurse happily stopped upping the pit and left it at my happy sweet spot.  So far, so good.

That’s not to say that I loved the pitocin or even, in retrospect, think it was entirely necessary.  I grew to have a LOT of angst over the fact that pitocin meant an IV drip and constant contraction and fetal heart rate monitoring.  Those requirements meant I could no longer do my laps around the L&D floor unencumbered, but now was chained to an IV pole.  And, in the beginning, even that wasn’t an option.  Our long string of “good luck” continued.  (I’m not even counting IF, here, but more things like, oh, the fact that the fertility clinic’s entire computer system was down on the day of my embryo transfer so, after years of waiting and knowing what was “normal” for an ET day, we left without seeing or receiving a single picture of any of our blasts…)  Turns out the hospital’s only high quality, portable heart rate/contraction monitor was out of batteries.  And the nurse couldn’t find the charger.  Hilarity ensued over the course of an hour as every L&D nurse scoured the floor looking for the missing battery pack.  It would have been comical if it weren’t for the fact that I was, as a result, left with only about a 5-foot tether between me and the monitor.  I paced that same 5 feet of hospital room continuously for nearly 2 hours before a battery pack was found.  That made me happy for, oh, about 20 minutes until I’d passed the point where leaving the comforts of my room (and bathroom… all those IV fluids!) seemed reasonable.  When pacing went out the window, all I wanted was a birthing ball.  You know, the birthing balls the childbirth class instructors promised us they had in spades?  Yea, turns out they didn’t have any clean balls available either.  So I paced for another hour while I waited for a ball.  The nurse reassured me we were just “lucky” (no chair for hubs, no battery pack, no ball…), but I told her that wasn’t much solace.  I mean, it’s not like I’d be back in next week to see whether the service was better or not.  But, yes, I do think it helped that I maintained my sense of humor through it all.  😉

4pm: 4cm dilated, 90% effaced, -2 station

This is when discouragement started.  Even after all the pep talks, all the knowledge that – especially in first timers – effacement matters more than dilation, all the visualization I’d done while swaying on my long-awaited birthing ball, hearing “4, 90, minus 2” shouted out made my heart sink.  The pain had started in earnest.  After hours of saying, “I thought it’d be worse!” it was now getting worse.  The hubs tried to chat with me as he clocked my contractions on an app on my phone, and in the lull between contractions I repeatedly shouted, “I can’t f-ing talk right now.  Just time the damn things!”

At around 5pm I got off my birthing ball for the last time and instinctually got on my hands and knees on the bed.  Sweat started pouring, tears streaming, groans constant.  I repeatedly had to remind myself to breathe.  I shouted to the mister with the start of a new contraction and sunk into the deepest, rawest pain I’ve ever felt.  Time stopped.

My contraction timing app promised me that in transition contractions could last up to 60 to 90 seconds.  To that I call, “bullshit!”  The contraction that came as I rested on all fours lasted a full 6 minutes without stopping.  By the third minute I was begging for it to end, by the fourth the nurse had entered the room and asked if I needed pain management, by the fifth I’d consented to an epidural and she’d left.  When it subsided I turned over and looked at the mister.  He stroked my brow with a cold cloth, held my hand, and said,

“Are you SURE?”

When the nurse reentered a few minutes later with the epidural supplies I told her I’d changed my mind.  The contraction had passed and, as long as I knew that they’d pass, I’d survive.  It was the fear that derailed me.  The worry that the new pain I was feeling was the pain I’d be feeling constantly until he was in my arms.  As long as I knew I’d have even a few seconds to recover in between, I could manage.  Despite my worries that the nurse would be frustrated with me (what silly things we worry about!), she gladly consented and informed everyone there’d be no need for an epidural.  She went back to checking my monitors without skipping a beat.

Now, many women would probably strangle their husband’s for doing what the mister did, but I’m so grateful he did it.  Many might see his words as questioning my decision, as a failure to support me, but I saw the opposite.  He knew how much a med-free birth mattered to me, he truly believed I could do it, and, as we made the decision to forego the epidural together, he kept saying over and over, “I know you can do this!  I know you’re further than they think you are!  I know how high your pain tolerance is and I wholeheartedly believe that was transition and the worst is behind us!  I know it will be easier from here on out!  I know you can do this!”  And, sure enough, he was right.  It was exactly the support I needed at exactly the moment I needed it.  And, as odd as it may sound, I’m so thankful to IF for his support and my receptiveness to it.  Those moments in that delivery room would have gone quite differently if we hadn’t already had 5 years of supporting one another through the worst under our belts, had we not had the ability to communicate volumes in one look or one hand on the forehead.

At around 5:30pm (the timing gets blurry here!) I told the nurse I REALLY needed to push.  She was beyond skeptical and reminded me I was only 4cm and -2 just over an hour earlier.  She patted my hand, said, “Let’s see if you can have a few more good contractions before I call in the doctor to check you,” and left the room to go back to the nurses station.  A definite hint of panic spread across the mister’s face when he realized he was left all alone in a room with a wife screaming,

“I NEED TO PUSH!”

He held my hand, tried to soothe me, and reassured me it wasn’t time just yet; I squeezed his hand, told him to stop being so patronizing, and bitched about the moron nurse who’d leave a laboring woman alone in a room.  By about 5:45pm I told him, “Screw this, I’m pushing.  I don’t care whether she thinks I’m ‘ready’ or not!”  By 5:50pm I’d pushed through 3 contractions and hubs pressed the panic button and screamed, “Can you please come check her!  She’s pushing!”  Half of me was frustrated my husband had “tattled” on me, the other half was thinking, “About f-ing time you stood up for me!”

The nurse sauntered in, calmly reassuring me that it wasn’t time yet, but she’d gladly call the doctor to come check and give me a progress update.  As she walked by the bed to get to the intercom I think she saw a little more than she was planning on.  The next thing I heard was,

“Get the resident in here NOW!”

Even through the pain I was impressed by the well choreographed dance that played out next.  The bed was broken into a birthing table, more nurses and doctors appeared like magic, each person knew their place, each person filled their role.  Oil was rubbed on the peritoneum, the bassinet was warmed, the spotlight was on, and I couldn’t stop praying that the window that looked out into the neighboring office building was, as I’d hoped, composed of one-way glass.  The resident arrived at 6:05pm and finally gave me formal permission to push.  The on-call attending (amazingly, the same compassionate OB that referred me to the high risk center in the first place!) arrived at 6:20pm.

And our beautiful son was born at 6:25pm on June 12, 2014.

Pushing was a relief after being denied permission to push for so long.  It felt right, it felt natural, it felt like progress.  But the nurse and resident had so convinced me that I had a long road ahead of me, that I couldn’t accept that my pushing was going to be over anytime soon.  As the resident said, “Just a few more and you’re there,” I looked at my husband and said, “She must be kidding, we just started!”  With eyes the size of saucers he looked back at me and said, “No, she’s not.  I see a head.  And LOTS AND LOTS of hair!  Push!”  At that point I realized that he must have been swept up in the grand plan to fool me into being more compliant and motivated for the long road ahead.  I made a note to myself to punish him for his deceit later.  Yet, a few moments later, a wave of relief rushed over me as I felt the head be born.

Still in shock, I reminded myself that that was the worst part and the rest of the body should just easily slip out.  It was over.  I’d done it.  Except, why was there still so much pressure?  Why wasn’t he crying?  Why wasn’t I holding him?  The resident calmly explained that, yes, the head was out, but he’d crossed his arms and was giving himself a big bear hug.  I mean, that would be heart-meltingly cute, right, if it weren’t for the fact that that meant his upper body was now even bigger than his head.  Little stinker!  Despite delivering the head without major trouble, delivering the upper body took the resident a few agonizing minutes longer and resulted in second degree tearing and many, many stitches.  (And probably set the stage for the lovely hemorrhoid I’m still nursing as I type this!)  Nevertheless, he made his quiet appearance into the world.  I only vaguely remember the cord being cut, but I remember each breath, sound, sight, and smell as they placed him on my chest for the first time.  Despite my expectations I didn’t cry, I just held him.  And in that moment I realized he wasn’t crying either…  His eyes were open, and, though he was blue, I knew that was normal.

So why wasn’t he crying?

He was swept away by the nurses and immediately under the care of the NICU staff that they’d called down at some unknown point during the struggle to free him.  My heart stopped for a few moments and it was all I could do not to jump off the table (even as the resident delivered the placenta and began stitching me up – two events I barely remember).  The NICU nurse calmly explained that babies usually spend a little longer than 20 minutes in the birth canal, and that that time is important as it’s when a lot of free fluid is pushed out of the baby’s lungs.  (I knew this fact quite well since it was one of the worries I had should we have had to have a section.)  I couldn’t stop thinking that my quick labor caused it.  The mommy guilt started within 30 seconds of his birth!  After a few (very scary looking) go’s with a long suction tube we started hearing little chirps, then bigger wails, and I knew all was right.  Despite the worry, he wouldn’t need to leave our room, and he never spent any time in the NICU.  He was ours and he was healthy.

He is our dream come true.

NCD ~ June 12, 2014 ~ 6:25pm ~ 7lbs6oz ~ 21in

NCD ~ June 12, 2014 ~ 6:25pm ~ 7lbs6oz ~ 21in

N’s arrival, pt. 1

I’ve sat down to write this post several times.  Writer’s block, sleep deprivation, a continuous string of visitors, and the needs of our little man have intervened.  And, as much as this blog has been my savior over the past year, that’s exactly how it should be.  Life first, blog second.

In many ways I feel like I’m slowly moving back to the land of the living.  A land where acquiring the basic human needs – food, sleep, love – has assumed so much of my time that I haven’t had much left to think about the world I’ve occupied for the past five years.  The one where wants were front and center.  The one where no joy could be found thanks to the constant hole that was felt.  I’ve done both now, and can say confidently that I’d much rather go without sleep than go without hope.  Even through glassy eyes this life lives better.

June 23 was my due date.  June 19 was my scheduled c-section date.  June 16 was my induction date.  June 12 was my baby boy’s self-selected birthday.  What a sense of humor this little man has already.

I should have learned long ago thanks to IF that planning is pointless.  Yet, with a stubborn breech baby who only turned at the 11th hour, with a rare clotting disorder that threatened my placenta, with a history of repeat losses, infertility, and IVF, so much of my pregnancy was planned.  It seemed so unlikely after all the appointments, all the difficult decisions, all the warning signs, that this little guy would catch the mister and I off guard.  But, that’s exactly what he did.

I’ve mentioned several times before that the mister and I are die-hard trivia buffs.  We attend (well, attended!), a weekly Wednesday night game at our local watering hole.  So, there we sat playing away on Wednesday June 11 surrounded by friends, co-workers, and the majority of who’s who in our tiny town.  Looking back now I realize I came within 60 minutes of being a Wednesday night trivia legend.  We left the game a little after 10pm, walked the three blocks home, and settled in for bed and work the next morning.  Just before 11:30pm I felt a substantial trickle.  For one mortifying moment I thought I’d lost control of my bladder, then realized that was unlikely.  I poked the mister, who’d probably only gone to sleep less than ten minutes earlier, and said:

“Um, I think my water just broke?”

One thing that you hear repeatedly – from your birth classes, from pregnancy books, from random strangers – is that labor is not like it is in the movies.  It does not start with a woman walking down the produce aisle at the grocery store and experiencing an unexpected gush of amniotic fluid in front of the peaches.  Except, it seems, when it does.  I was so convinced my labor would not start with my waters breaking, that I spent the next several minutes in disbelief.  I went to the bathroom and looked and smelled and consulted Dr. Google on my phone.  Was I absolutely sure I hadn’t peed myself?  I changed my underwear, grabbed a giant bath towel, and waddled back to bed.  “I guess I’m supposed to call the doctor, right?” I asked the mister.  “I guess,” he answered.  We were both oddly calm.  I called, left a message with the triage nurse, and waited for a call back.  Of course, this is the moment that my cell phone decided it didn’t feel like connecting to the cell tower any longer, so when the on-call resident finally did call back all I could hear was about every fifth or sixth word he uttered through a thick, unidentifiable accent.  I got the gist, though.  Watchful waiting.  If I wasn’t sure sure it was my waters, then there was no reason to panic.  I should only plan on coming in if it happened again.  Get some sleep.

And, that’s what I did.  On my giant bath towel wearing a super pad.  Until 12:45am when the flood gates opened.  I was on my hands and knees in bed pouring forth like Niagara Falls when I shook the mister again.

“Er, yea, no doubt.  <Nervous laughter.>  My water is totally broken.”

Through this all the awkward calm continued.  I was having no contractions, and knew full well that there were no perks to getting to the hospital early.  Just a lot more sitting around in an uncomfortable environment.  I got up, changed my pad/underwear for what felt like the hundredth time, took a shower, did a load of laundry (all those soaked bath towels and undergarments weren’t going to wash themselves), ate a granola bar, kept the mister company as he made himself coffee and a breakfast sandwich (half as fuel for the night ahead, half to soak up what remained of that double scotch he’d had at trivia!), grabbed the car seat, fed the cats, and prepared to leave for the hospital.  As I walked around the house with another bath towel between my legs I kept thinking:

“Am I seriously about to have a baby?”

After moving to this rural village 2 years ago I sought out excellent doctors no matter the distances I had to travel.  That is, for all but obstetrical care.  We moved here fresh from my second miscarriage, and I still had hope that some day my body would get it right.  Some day we’d be doing that midnight drive to labor & delivery.  Some day I’d be happy I’d picked the closest OB I could find.  When that closest OB botched my third miscarriage, I succumbed to the lure of the talented professionals in the nearest city, and prepared myself for an hour drive in labor.  As news of our pregnancy spread, friends and family alike looked puzzled as I explained that I’d be delivering fairly far from home, and I came to embrace the, “Well, I had no choice in hospital,” line once that wonderful city OB transferred me to an equally wonderful high-risk practice that only delivered at the wonderful hospital an hour away.  After 9 months of hearing and internalizing, “How are you going to manage that drive in labor?” it was wonderful to embrace my 10% status as me and my soggy bottoms made the hour drive covered in amniotic fluid, but totally without contractions.

When we did our hospital tour a couple months earlier, a highlight was learning of the valet service that would remove the “What do we do with our car?” confusion from what we were sure would be a confusing and tense time.  Those giving the tour, however, failed the inform us that said valet service comes with limited hours of operation.  As we rolled up to the hospital at 2:45am we were greeted by a sign noting that valet parking begins at 6am.  Sure, I could have gotten out and either waited for the hubs in the lobby or informed the desk attendant that he’d be by behind me, but I didn’t really feel like having to stand about flooding out public spaces without my husband by my side to share in the mortification.  So, I did what came naturally.  I rode with my husband to the nearest parking garage, helped him find a spot on the far end of the 3rd floor, delicately extricated myself from the passenger seat of our (NEW!) car that I had carefully wrapped in plastic and covered in bath towels, waddled down three flights of concrete steps (“No, I’m fine, I don’t feel like using the elevator!”), and shuffled the few blocks uphill toward the hospital in the cool 3am air.

There was one other thing the nurses had gotten wrong during our birthing class/hospital tour.  As we wandered around the labor and delivery floor, they let us – especially the “first timers” – know that we shouldn’t take it personally when the labor and delivery nurses treated our arrival to the 8th floor with a fair bit of skepticism.  “You may feel excited, you may be screaming inside, ‘THIS IS IT!’, but your labor and delivery nurses will still almost certainly send you to triage where you’ll wait to be evaluated before being given a room, or told to go home.  Don’t get discouraged, this is all a normal part of the process!”  So, while the lack of a valet caught me off guard, I wasn’t going to let anything else catch me off guard.  I mean, I was so prepared for this wait that I’d actually, you know, done two loads of laundry before driving the hour to the hospital!  But, sure enough, when the nurses of floor eight saw the very pregnant lady waddle in sporting jeans that looked like they’d just gone for a swim in a backyard swimming pool, their response was a jovial,

“Well, we don’t need to triage you!  You’re in the right spot!  Let’s get you a room!”

The large digital clock above the nurses station glowed red with “3:00:00” (why does that stick out in my mind?) as we were ushered off to room 8020 for the foreseeable future.  And, with that, it’s time to feed the little man whose kitty binky just isn’t cutting it anymore!  Hopefully it doesn’t take another month to write the final installments of this journey!  Until next time…