The obligatory birth story

Happy that hes external
Happy that he's external

When last we left our heroine, she was whining rather vociferously about how she had had a crappy day and was going to be pregnant FOREVER. She was feeling a little crampy after getting her membranes stripped, but nowhere near badly enough to be excited about it.

5 pm — Well, I went to go pick up my eldest son and I brought him back home. We made dinner for our friends, as is our wont on Monday nights. We weren’t role-playing on Monday — instead they brought a game called Agricola. Around dinner time, I started writing down my contractions as I had for about 6 nights in the last fortnight. Unusually, I didn’t stop writing as I got distracted/rested/put Grey to bed/sat down, which had been par for the course. (During false labor I’d get four or five decent regular contractions, and then they’d tail off.) The contractions were mild, but pretty regularly about 5 minutes apart.

They lasted for the whole game. I’d like to say, for the record, that I did much better that game than you could possibly expect from a person in labor, despite the fact the contractions did seem to line up with my turn rather unfairly. Also, Agricola is quite a fun game!

10:30 pm — By the time the game was through it was nowise clear I was in labor, but it was clear that I was closer to in labor than I had been before. We asked our friends to stay in the house while we took a walk to see if that would either calm down or solidify labor. They obliged us.

We had taken a very long walk while I was pregnant with Grey (3 – 4 miles). It had been a lovely, temperate clear night, and we were out walking very late. This time, we walked down to the friendly old graveyard where we’ve previously spotted groundhogs and cotton-tailed rabbits. We walked up the hill and down. I felt unsure — the contractions were getting more intense, but they weren’t speeding up. In fact, they were hard, but further apart.

11:15 pm — When we got home, I sat down to watch my friends play the last two games of Boom Blox. My contractions didn’t come for nearly 10 minutes and I was depressed, but unsure. It was much kinder for us to call the night shift in now if we were going to do so. I figured my friends would forgive me for continuing to cry wolf if it wasn’t labor, and we called him in. Then we worked on all the last minute things, between contractions about 7 minutes apart. The hot shower, the home made bread toast, the last-minute-charging-of-camera, etc.

Midnight — Our work was done. This either was labor or it wasn’t. We went to bed.

3 am — I won’t say it was quite what I was hoping for, but I was woken up by the pain of the contractions. They weren’t nearly as fierce as the contractions that had woken me up when I was in labor with Grey, and they were way too far apart — 10+ minutes. But they were also not contractions that could be ignored. I laid in bed as quietly as I could, knowing it wasn’t time to go yet and hoping to get my husband a bit more sleep before we launched into our ordeal. But you can’t hide strong labor contractions, so basically we’d both be just drifting back to sleep and the next contraction would come, waking both of us up.

4 am — I gave up and got up. What do you do at 4 am when you are in labor and can’t sleep and you know it’s not time to go to the hospital yet? I did the laundry. I started a load of sheets and folded the darks. I believe I will be mentioning this in “I’m tougher than you” arguments for the next 20 or so years.

5 am — we called the dr. The answering service gave us the wrong on-call doctor to call, so he understandably didn’t call us back. Fortunately, I wasn’t going to pay any attention to him anyways. With the contractions 5 – 7 minutes apart and fierce, we got in the car. We noticed the lights in our bedroom were still on and that we’d forgotten to feed the cats. We got out of the car, fixed that, and then got back into the car. My husband says on the drive in, “Gee, if I left for work at this time with this amount of traffic, I’d get there in no time!”

When we got to the hospital (we’d called ahead there too, so they were waiting for us), I once again took the stairs. What can I say, I’m a creature of habit! My husband tells the nurse I’m in transition. She looks at me and say, “She’s still smiling. She can’t be in transition.” Then she does a pelvic exam. If I’m not in transition, explain to me how I’m 5 cm dilated? I take pride in my ability to reel off (increasingly unfunny) quips while in labor.

At this point, I start losing track of the time. It takes way too long to get a strip of the baby — she doesn’t like it because his heart rate is too calm. (To which I say: wha????) Why they didn’t start prepping the tub while they were getting the strip, I do not know. But that is where my complaints about the staff end. They did finally get the heart rates they were looking for, and the tub was finally filled. Can I just say, for the record, that if you’re going to attempt a natural childbirth GET A BIRTHING TUB. I swear it cuts the pain by 30 – 40% … which may not sound like a lot but that is easily the difference between thinking you can make it and grabbing someone by the stethoscope and demanding MORPHINE. Of course, while I was IN the tub I was thinking “Gee, this doesn’t help as much as I remember” because, um, hate to break it to you but labor pains HURT.

8 am? I knew when it was time to get out of the tub and start the business of pushing. So I told my attentive husband, “Tell them it’s time.” He said, “She feels a strong urge to push.” No, I just knew it was time. Totally different. I was 9.5 cm dilated. (10 cm is “all the way — let’s get this show on the road”). I was also really, really, really tired. It’s unfair that you often go into labor after a full day. My waters were also still intact, so I spent a bit of time (maybe 15 minutes?) in this uncomfortable spot between fully dilated and ready to push. My midwife broke my waters, and then things started moving.

I should mention that in my birth plan, as you all read, I explicitly said that students were ok. That’s because, in my experience, a lot of students tend to hang around my midwife and I have no problem with that. I was asked while in the tub if I was ok with a male student observing. At that point I didn’t care if this was going to play to a sold-out crowd in an amphitheater. I had work to do. But my birth was apparently unusual. For one thing, I was later told that there are almost no unmedicated births at that hospital. With a 50% c-section rate, vaginal births aren’t even a majority and most women DO get epidurals or other pain medication. Plus, plenty of women with vaginal births don’t really want spectators there, understandably. So EVERYONE in the area was very interested in watching an unmedicated, vaginal birth. By the time it came to push, I believe there were 7 – 9 people in the room other than my husband or I, most of them watching with great interest the, ahem, area highlighted by the BIG OLD SPOTLIGHT. I didn’t really care — I just thought it was funny. They were all very, very grateful to get to watch. Actually, as I came out of the tub naked as a jay-bird into this room full of people, my midwife sort of said, “Are you sure you don’t want a johnny” in a voice that indicated that maybe I should consider some pretense at modest. I believe I told her that there was a time and place for modesty, and the delivery room was not it.

9 am — Anyway, pushing really sucks. I think I did worse at it this time than last time, because I was tireder and knew how much it hurt and knew how far I had to go. Experience is a mixed blessing in giving birth. I was sort of watching the clock knowing based on where it was that I wasn’t really almost there. At the beginning of each contraction, I would make increasingly less-funny comments to the effect of, “In case you are unaware, labor is painful!” I really struggled with the pushing phase this time. It actually lasted longer (40 minutes instead of 30) than it had with Grey, and frankly I think that’s because of what I was bringing to the game. I also had full bowels, which was physically actually quite difficult to deal with. It was intensely uncomfortable when he crowned and then didn’t go backwards after the contraction was over — I was just stuck there for what felt like an eternity until I realized that the only way to make the pain stop was to just push him out. And I did.

9:27 am — It’s funny how the world just totally spins around like someone smacked a globe when you give birth. One minute I was completely absorbed by how incredibly uncomfortable I was. The next minute, there was this vernix-covered person on my lower abdomen, still connected to me, and I was crying and trying to tell him how much I loved him. They wiped off a bit of the vernix (he really was completely covered — he came out white!) and pulled him up to my chest. I watched them cut the umbilical cord. (They let one of the students do it — A. didn’t want to. I remember listening to them teaching him: “It’s tougher than you think it will be.”) And there was this perfect, amazing, wonderful, precious person. He started nursing not 5 minutes after he was born. They let me hold him for nearly 40 minutes afterwards. I actually called a bunch of people to tell them of his birth before they’d gotten a weight on him or done the fingers/toes check or anything — with him sitting joyfully there on my chest.

Eventually I relinquished him. Birth was over and recovery had begun.

There are a bunch of notes to this….

First, I hardly tore at all. I had one tiny tear. Right now, I feel unexpectedly great down there. The funny thing is that this time I felt the tear. The first time, I wasn’t aware of tearing at all.

Second, there were actually two serious issues with Thane’s placenta/umbilical cord.

The first is Velamentous Insertion of Umbilical Cord, which basically means that the placenta wasn’t in the right spot and was therefore unsupported. This could’ve caused problems if the placenta had been damaged because it was more vulnerable. In fact, it’s probably a really good thing that my water was broken on the delivery table instead of at home, because vasa previa (when the umbilical cord gets in the birth canal ahead of the baby — which can be really bad!) is a particular problem with this. This wasn’t a huge deal — actually, it was more of a risk than a deal at all. This apparently happens with 1% of singleton pregnancies, and more often with twins.

The second issue I didn’t catch a name for, and I understand that they only suspect this issue and that pathology will need to report back before it’s for sure. But there’s some kind of issue that happens once every 2500 pregnancies (my midwife had never seen one before) where instead of one big umbilical cord, there are many smaller cords. This can result in extremely small babies (not enough nutrients get through) or fetal death. Much of this was explained to me 20 minutes after I’d given birth, so I’m a bit fuzzy — I’ll ask for more information at my next checkup. But the takeaway is twofold: 1) Thane is likely smaller than his genetics would’ve had him be at birth, and at least a tiny bit growth-restricted because of his uterine environment. 2) We are very, very, very lucky that he made it.

Neither one of these conditions has the slightest bearing on his health going forward. His pediatrician and my midwife chatted yesterday morning before we were released from the hospital and she asked him if he’d heard about it and he sort of waved it off as now-unimportant (which it is).

There is probably much more to say — it’s a momentous few hours. Already some of it is fading away in the rush of things that have happened since. But it was a very good experience. I was treated extremely well and had the birth I was hoping to have. I know I’m a lucky woman to have gotten to give birth the way I chose not once, but twice. But mostly, I’m lucky to have Thane and Grey.

Photographic evidence of a second son

I was less ruthless than normal in my weeding out process, in part because I’m short on time and in part because… well, what the heck. He’s a beautiful kid and so is his big brother!

(Note that you can click on the image to see a higher resolution/larger version of the picture.)

http://tiltedworld.com/brenda/pictures/ThaneBorn/index.html

We’re home now and doing really, really well. At least, until I have to pull a second night like last night!

Insanity

A popular definition of insanity is doing the same thing over and over and expecting a different outcome.

According to this definition, I really will be pregnant forever.

I’ve had lots and lots of contractions this pregnancy. I swear the contractions started before I started feeling fetal movement. I get contractions nearly every time I stand up. Walking up or down stairs (and I live in a 3 stairway house) is almost guaranteed to initiate contractions. Pretty much every afternoon I start getting contractions, and they are worst while I’m getting dinner on the table. By the time I sit down for dinner (nearly every day this week) I’m mentally packing my hospital bag. 

Then they go away. I go to sleep. I wake up the next morning, still very very pregnant and feeling slightly foolish about the night before.

You see where I’m going with this?

SOMETIME in the next, uh, 18 days those contractions will actually be for real. And they will be going somewhere. And I just know that by then I’ll have subconsciously learned my lesson and completely stopped paying attention to the damn things. By the time labor pains get truly unambiguous, it’s really pretty late in the process. With Grey, labor was only for-darn-sure maybe 3 – 4 hours before he was actually born. And second babies come sooner. And this time around, we have to get someone to be with Grey while we’re gallavanting off to the hospital, so we NEED the time more.

So every night, when I get the contractions, I think of saying, “Oh, here we go again.” And then I think, “But what if this IS the night?”

Insanity.

In other pressing, important, critically interesting news, I decided yesterday that something had to give. Something simply HAD to change.

My hair was pregnancy-thick and just past shoulder length. It was heavy enough to laugh off most barrettes and hair bands, but too short to braid.

Now, it is much shorter and rather more layered. I don’t think this is my Platonic Ideal of a haircut. I dare say it looks a touch too mommyish. (What? Just because I have a 3 year old and am 18 months pregnant doesn’t mean I have to THINK of myself as mommyish.) But it is also a vast improvement over what came before.

And yes. I am still pregnant. Yes. Still.

39 and a half weeks pregnant, but who’s counting?

I once again got through an exam ungroped. Next exam will make up for it.

My belly has apparently gotten smaller — I measure 34 cm. So basically, I look 7 months pregnant, not nearly 10. This seems true — I really don’t look nearly as pregnant as I am, and not as pregnant as I did a few weeks ago. I think this is because my son is SO LOW that he’s not actually all the way IN my belly. I would be more worried if we didn’t have a recent ultrasound pointing to a very reasonable size.

His heartbeat was 160. This is high for him (he likes 144) and the high end of normal. I would be more worried if I hadn’t eaten 3 cookies on my way to the doctor’s office.

He’s moving less than he used to. I’m pretty sure this is because he’s so low/engaged (his head is stuck, so he can’t do the wild gyrations he was doing a few weeks ago). Also, moving LESS than he used to still more than meets the criteria for moving several times an hour. It’s just less vigorous. And he still loves his 11 pm workout.

As far as future planning goes, at my next appointment on Monday I’ll be officially post-due. We’re planning on having her strip my membranes then. (No, still not going to explain what that is. You can look it up.) She is operating on the assumption that it’s likely to work. I’m operating on the assumption that I’ll be going nuts and happy to try relatively non-interventionist methods of inducing labor. (See also: lobster bisque, chocolate, marital relations, raspberry tea). I’ll probably go in for a non-stress test on Monday too, just to make sure everything’s ok.

Turns out she’s going on vacation November 4th. ARGH! NO PRESSURE!

I also negotiated ahead of time for getting to wait until the 10th before being induced (instead of the 7th). She says that as long as the non-stress tests are ok, and given the family history I’ve harped on constantly (she complains about their computer systems, I never pass up an opportunity to point out how late I’m likely to go), that should be ok. (But she won’t be here so I’ll have to argue with her OB.)

Yeah, so I guess I should actually write out my birth preferences.

What the heck, you’re all fascinated, right?

I would like:

  • To have as few interventions as possible
  • To labor in the tub as long as possible
  • To retain my mobility during labor, and possibly use alternate birthing positions (squatting, etc.)
  • To eat and drink during labor if I feel like it
  • To push when I feel I am ready to push
  • The umbilical cord to stay intact for as long as blood is being transferred
  • To try to nurse right away
  • To exclusively breastfeed my baby, and have him in the room with me as much as possible
  • For any tears to be stitched using a crown stitch, if possible
  • My husband to speak for me in the case that I am not able to communicate my wishes

 

I would not like:

  • To be offered pain medication — I will ask if I think I need it
  • To have an episiotomy unless medically indicated
  • To have labor-intensifying/inducing drugs unless medically required
  • A C-section except when medically required
  • To be constantly monitored
  • To have an IV
  • To force my husband to cut the umbilical cord

 

I am ok with:

  • Trainees or students being present during the labor/birth
  • Participating in very low risk studies regarding birth/post birth care
  • Standard newborn treatments (vitamins in the eyes, blood test from the heel)

 

Am I missing anything?

 

Does this woman look 9 months pregnant to you?
Does this woman look 9 months pregnant to you?

Fun with false labor

So last night I was experiencing pain, as though all my muscles had knotted up and I was short of breath and a little panicky, and the pain seemed to be coming on a regular basis. Yeah, the first 7 innings or so of the Red Sox game downright hurt.

Oh, and I was having strong contractions that seemed, at least for a while, to be coming in five minute intervals.

When I was pregnant the first time around, this wouldn’t have caused much angst. I was in labor or I wasn’t. Time would tell. Maybe we’d have gone for a walk to see if exercise would solidify the contractions or diminish them. Maybe I’d just take a hot shower, pack the bag and go to bed, and see what I felt like in the morning.

But the second time around, there’s an additional complication. Yes, the product of the FIRST pregnancy needs to have a grownup around at all times. (Funny how that works.) So the question of whether I was in labor or not took on added importance. Did we need to call backup or not? I texted a friend in the middle of a date to let him know that he was on call. I watched Dice-K give up another homer. I attempted to watch the baseball game, gchat with my mom, text message with my friend, read some blogs, check the contents of my hospital bag and have my husband read to me about the difference between false labor and real labor simultaneously.

I felt slightly distracted and as though I had difficult focusing. Clearly, it was labor.

My frenetecism was rewarded. My mom told me that my baby brother was actually on his was New Englandward a day earlier than I thought he was going to be. I called him and asked him to please come spend the night in our house just in case. The great thing about family is that you can inconvenience them and only feel a little badly about it. A few more contractions while I showered, two more runs given up by Papelbon, and I was ready for bed. I figured that the Sox season was over, and that even if my labor progressed while I slept my son would be taken care of.

That was, of course, just the wrong time to turn off the Sox game. But it wasn’t labor. It was just practice. I’m really, really, really hoping that I don’t have too many more ambiguous labor-like periods, or my friends’ love-lives may seriously suffer from ill-timed text messages. But hey, at least I’ll have one more Sox game this season.

On another note, I uploaded all my latest pictures a week or two ago, and got stymied at a near-final step and never got around to, you know, letting people know. So here, a few weeks late, are some pictures, including my birthday, my husband’s surprise concert for me, some apple picking, and Grey playing with Jefferson.

http://tiltedworld.com/brenda/pictures/October08/

38 weeks pregnant and needs more coffee

So I had my 38 week checkup today. Of course, I’m at the point in the pregnancy where I’m like, “I’m 38 weeks and TWO DAYS” as if those two days were critically important to understanding just how damn LONG I’ve been PREGNANT ALREADY.

I swear that the first time around I had weekly pelvic exams starting at about 32 weeks and every week I’d find out that I was exactly the same as last week and I got sort of in the habit of getting nekkid etc. I can’t say I’m disappointed, but apparently my memory sucks or things have changed. Not only did I get to keep my clothes on again this week, but apparently I don’t have to doff them until 40 weeks. Oh, and we rescheduled my 41 week appointment so that it happens on a day where she’s on call that evening.

I think she is wildly optimistic. She stripped my membranes (and no, I’m not going to explain what that means, but yes it’s just as much fun as it sounds) TWICE last time to NO AVAIL. But hey. It’s not like I have other big plans for that Monday. Except Linens ‘n Things is apparently going out of business and they’re totally right across the street. So this might all work out in my favor.

I confess — I’m not really sure why they want to see me so often when all they do is take my weight (don’t wanna talk about it), check my pee, take my blood pressure and measure my fundus. (I think that’s the right word. But it seems like the sort of word that it would be _BAD_ if I was close but not quite on in my usage.) Pretty much all of that could be done from the comfort of my own home, if I got someone else to look at the scale because I can’t see it because my belly is too big but I’m not sure this is a bad thing.

Ahem.

On the “my memory sucks” part of the argument, I was attempting to reassure a friend last night that although I am a figurative ticking time bomb, the “ticks” go on for long enough to run for cover. He brought up the quintessential scene of water breaking and I said that while that was a valid fear, I didn’t actually remember my water breaking with Grey.

At this point my husband pipes up to tell me that my water was broken while I was in labor. I totally and completely remember absolutely NONE of this. I mean, I thought I remembered labor pretty well: refusing to take the elevator to labor and delivery because I’d always taken the stairs, the skeptical look on the nurses face when a first time mom claims she’s in transition, the stuff they were storing in the tub where I wanted to labor, the unfair period where they wanted to take a “strip” to measure how the baby was doing, how they couldn’t get the remote monitors to work, how I fell asleep between contractions in the tub, how one simple request on my part clued them in that I was ready to push, the jokes I made between pushing, how my midwife appeared at the nick of time, the very unreasonable things I was asked to do at that point, the bit where my husband kept TOUCHING ME, both of us refusing to look at what was going on, Grey’s actual birth, the part where I had to bully A. into taking pictures of his newborn son which he didn’t want to do it was all “gross”, and the rather unpleasant few minutes that followed. I remember all of this. I do not remember anyone at any point breaking my water. Did they ask me? Did they need to? Don’t you think that’s the sort of thing that would, you know, make an impression? How long between when they broke my water and when I gave birth? It HAS to have been after I got out of the tub, but I was like pushing at that point. Doesn’t your water sort of need to break before you push?

The mind boggles.

I’ve thought of having some sort of countdown, but it’s rather too depressing. It’s not so bad with my due date — B minus 12 days! But then when you add in the 14 days I’ll agitate to go past due, well… let’s just say that I’m not sure I can maintain my sang froid (or my permanent wave — only family members will get that allusion) for another 26 days. TWENTY SIX DAYS. That’s like, forever. That’s like as many days as there are between December 1st and Boxing Day. People write novels in less time.

My husband said to me last night, as he worked the levers on the crane to lower me into bed, “I’m really looking forward to when you’re not pregnant anymore.” I shot him the look of doom and he hurried on, “I mean, I feel badly for your discomfort and how you hurt all the time and how difficult it seems.” I looked skeptical. “Also, I really hate your belly pillow and want to sleep on my right side again.” Light was shed. See, people? It’s not just me who’s sick of it all. Think of A. and how much of the bed the body pillow takes up. It’s all just unfair. Should he really be asked to put up with the bed interloper for 26 more days?