Saturday, August 13, 2016

Zeke's Birth Story - 4 hours of "sigh," "hmm, that hurts," and "AAAAAHHHH!!!!!"

...or "It's pretty clear you're not a fan of being in labor," and other things that happened or were said on and around December 5, 2015.

Let's start from the very beginning -
a very good place
to start.
- Julie Andrews as Maria Von Trapp, The Sound of Music

I have started the body of this story for the third 10th time, trying to sort out what is and isn't important to remember, or, as my mind actually works these days, how much energy I want to put into the documenting of stuff that wasn't actually happening on the day of Zeke's entry into our lives. 

Update: see one of my more recent posts, where I started my postpartum anxiety recovery journey, and you'll see one reason among many reasons and excuses why I haven't finished this yet!

And also, I wrote my last birth story for a variety of reasons but in particular because I wanted the world to know that good births happen.  I am writing this birth story for many reasons but also so that the world can know that very rough and awful births do happen, and incredibly beautiful things come from that, too.

So, with that said, here we go:
We moved from Iowa to Pennsylvania when I was about 24 weeks pregnant. I needed a place to do check-ups and deliver this boy, and I needed it fast.

What I realized upon searching for and securing a place is that things work a little differently here - a bit slower, a bit more casual, and a bit...different. I needed a place where I could get in at such a late point in my pregnancy. The place I chose had midwives, which I wanted to have for my pregnancy so I could hopefully achieve an easier and potentially more natural birth.  At this hospital, midwives would definitely deliver my baby as long as I was healthy, but first they'd have me seen by a nurse practitioner until I reached the third trimester, then I'd be seen by OB/GYNs who very likely wouldn't deliver my baby, and then I'd be seen by midwives who would deliver my baby but only could consult with me (or any other pregnant woman) if they were available, which wasn't very regularly. 

At this hospital, midwives delivered the babies in all non-high risk pregnancies. I liked the midwives I got to see, and I appreciated their willingness to spend more time with me than what the OBs had available. That said, I naturally enjoyed some personalities more than others, which went for both the OBs and the midwives alike, and there was a very good chance I wouldn't know the person delivering my baby on the day he would come since my time there was so short.  Perhaps if I had been at this hospital the entire time, I'd have known the midwives a bit more, but that wasn't exactly likely.  

Along with all of this, we have no family out here and only a few friends, so it was my hope that this guy would come right around when John's mom would arrive, which was just after his due date, December 1.  As I went through my appointments and met up with the third trimester at 28 weeks, things seemed alright physically.  Unfortunately, emotionally, I hit depression very hard with this pregnancy, similar to my last one, and I was able to get through that in time.  I didn't go on medication because I was concerned about the potential side effects (which my OB at the time didn't go over...a whole other story for a whole other day), but with better sleep and better eating and some essential oils to help (Joy and peppermint from Young Living), I got through and felt a ton better at about the 34th, 35th week.  Overall, things were ok and we were getting ready for this baby boy to make his entrance!  

If you remember from Suzy's birth story, she was 10 days late. When I got checked up by the OB at week 38 and 39 with Zeke, I was 4+ cm dilated, so I thought I surely wouldn't be as late with him as I was with her. In fact, I thought this kid was going to be here on Thanksgiving!!!  

With that surety and the preceding time that elapsed since learning such a thing, I discovered this:
  1. The hormones that make a woman dilate prior to contractions is completely different than that which makes the contractions happen, so one could get to 3 or 4 centimeters without a contraction.
  2. Stripping the membranes as a way to get labor going is not guaranteed to work, and you could feel totally normal afterward, which is a great way to deflate any hope of labor happening!
  3. Breaking the bag of waters may or may not cause contractions to start.
  4. One can possibly not feel contractions in the early stages of labor.
  5. If one doesn't see the same doctor throughout one's pregnancy, an accurate prediction of baby's size is difficult for any attending midwife or physician.
  6. Getting drugged up the same way for two different pregnancies does not mean said drugs will work the same way on the person being drugged.

Long and short, week 38, 39, and 40 went by without a single seismic shift to speak of. Because of that, I had my membranes stripped on December 2 with the hopes that my labor would start right around John's mom's arrival on the same day. I went home with all sorts of discomfort similar to but far achier than any kind of stomach cramps I had had before in my life.

That next day I was mystified: I felt completely normal. Where was this labor that was supposed to start? The day after that was the 4th, and I again felt nothing abnormal happening at all, let alone a contraction. I called the doctor's office, and the OB who had both stripped my membranes and had seen me for the last few weeks said that if noting had gotten started, I likely would need to be induced to get things going. We scheduled an induction for the next morning, December 5th, and went to bed with the plan to head to the hospital in the morning.

I was bummed; I was hoping that things would get started on their own this time instead of having to go on pitocin again. For anyone who doesn't know: pitocin is, in my book, the definition of the phrase "necessary evil." I also wanted to see if I could handle contractions without an epidural, but I knew that pitocin would make things so horrible that I probably would need the meds.
So on Thursday and Friday night I did every conceivable-thing-to-Google-and-Pintrest I could do to get things going, and it all made me realize that my body wasn't going to make enough oxytocin to get this train a movin'.

Saturday morning came like just about any other day. We loaded our goods in the car, gave one last super-big hug to Suzy while she was still our baby and our only child, thanked John's mom again for being here, and headed through the Lancaster County hills to have this child. Morning was cool and not in anyways snowy, so the green fields and barren forests were covered with a light layer of frost. The sun shown upon this landscape, and it was a much calmer and more pleasant ride to the hospital than when my water broke in the middle of the night with Suzy.

We arrived at the hospital and were given our room in a delivery center that had literally only one other pregnant woman there. My room had a lot of great natural light, and it was big and simply decorated and furnished.

The midwife on duty was one I had before, and our communication styles didn't mesh well. She tried empathizing (in a whiny tone) instead of sympathizing (i.e. being comforting yet professional), and that lead me to feel compelled to reassure her and (constantly) readjust what I was saying. That said, initially anyway, our interaction was amicable, and I was able to relax and EAT (!!!!) due to my very inactive labor and likely course of action for induction.

So my the midwife broke my water and I tried to walk around. Nothing was happening as far as I could tell, you know, aside from the general effects of one's water being broken. We did what we could to make things go naturally - walking, sitting on a ball, other stuff that the midwives and nurses knew to do (they had about every trick there). We had the option to wait around for a while, but with John's help, I came to the conclusion that I'd just go for the pitocin after lunch and wait it out. It took a whole 9 hours from pitocin to delivery last time, and I figured I might as well get this train rolling. Besides, it'd be great to have both kids on the 5th of the month, so we might as well move things along. 

And move along they did. Lunch was average...maybe below average for a hospital, but whatever - I was eating! This never happens in a regular place, as far as I knew. I finished up the food and the midwife and nurse came in to get the drugs in me. Amazingly, I was having contractions but I couldn't even feel them. That was enough for us to move forward with the IV drip and wait for the earth to start shaking within me. 

I started with a low dose, and that was manageable. The contractions started light and I was able to breath through them really well and keep my brain in check with what was going on - physically and emotionally. We watched some NCAA football on the TV in the room, which was my jam, and John and I kind of hung out while my body hummed along. Sounds peachy, huh? 

Well, my nurse and midwife decided to up my pitocin levels a bit to keep the contractions coming. I realized, in retrospect, that this is what happened last time. Please refer to last time to see how I described it. Note that I was able to get an epidural right when I requested it. Have that in the back of your mind as I go on to what's next. 

So my contractions did, indeed, keep coming. I kept feeling a pressure to go to the bathroom (#2), but nothing came of that, and while I kept trying to go to the bathroom and having John help me from my bed across the room and back when I needed to, I would experience no less than 3 contractions in that time. Most of them were breathable for the first hour or so, so much so that my midwife decided to pop in to chat because I think she was bored!!! She talked with us about all sorts of things, most memorably our shared affection for Garrison Keillor and how she does not like football, (to which she said "Wow, we really don't have much in common!" How...odd of you to say, midwife of mine!). Toward the end of our social pow-wow, I couldn't talk through my contractions anymore, my dilation was a little over 6 centimeters apart, and let me tell you, that was the end of the end. 

Trips to the bathroom became incredibly compulsory yet physically impossible, sitting on the ball was trecherous, sitting up at all was torture, and with all that I had to wait an HOUR to get my epidural. 

An hour! Why was that? Because I didn't have the bag of saline fluid in my system yet! It's needed to keep blood pressure at a healthy level with the epidural knocking your lower half out. This was given to me early on at my last hospital because I expected to get the epidural. Also, with my last labor and delivery, it took at least 3 hours for the pitocin to really get going. Here?! I was 3 hours in and BEGGING FOR MERCY. 

Actually, I was groaning, wailing, and gnashing my teeth for mercy. The only thing I could do is sob and sob heavily when each contraction came. The problem with pitocin is that the contractions do NOT take a break. You get done with one 60-second contraction and the next one comes in right on top of it. Sometimes the contractions were 90-seconds. One time I sobbed to John, telling him he had to count the seconds because I couldn't rationalize that they weren't going to last forever (note that I'm explaining that now but encompassed all of that into about 4 words of "WHY'D YOU STOP COUNTING?!"). All of this happened so suddenly - a 5/6 pain-scale contraction turned into a 9/10 pain within about 20 minutes. I begged again and again for the epidural, and finally they got the thing going. 

Per last time, they took me off pitocin completely to let my body stop contracting and help the anesthesiologist get the epidural in me via the most safe way. Completely unlike last time, the contractions did not stop in any way, shape, or form. They kept ragin' on and on and had me in fits of despair mixed with disbelief! "They're not stopping," I cried to my husband and anyone else who'd listen! Heck, I'd quit listening to my wailing if I could! But here I was, the most still-pregnant mess ever. 

Thank God for two people in particular: my nurse, whose name I can't remember, and Dr. Kim, who was the anesthesiologist. The nurse had three kids, and she needed pitocin with her last one. She told me the pitocin contractions are significantly worse than the natural ones, and with that she gave me great comfort simply because I felt like way less of a wimp for suffering so bad. 

The contractions kept coming and coming, so I couldn't get the full epidural yet because I was so unstable.  Dr. Kim heard me sing his praises the minute that spinal block started working. It gave nearly instant relief and let me BREATHE again. I was so elated with the relief and so vocal about my thankfulness that it made my husband nervous! ;-) I looked to John with a sleepy, delerious smile on my face and told him that he was my favorite person ever. He told me he was concerned that Dr. Kim was! I held his hand and said, "Ah, no way!" 

Then I got checked out again. Oh my lanta, I had gone from 6 to 10 centimeters in an HOUR! My entire body felt like seismic shifts in the earth's techtonic plates, and seismic shifting is what apparently happened! 

So, per my last pregnancy and per generally recommended health practices (!!!), I was supposed to relax for a while, maybe even an hour or two, to let my baby get his head in the right place and make pushing easier and faster. A lot of women in the past have been told to push right when they get to 10 cm, but that can result in hours of pushing if the baby isn't ready. Unfortunately, I heard a similar lack of beeping like last time, and the midwife told us that "Baby is telling her something. It's time to get him out of here." 

Baby's telling us what, you may ask? Heck if I knew!!! But after a few deft moves that I will be vague about here, my midwife both got the baby into the canal and got his umbilical chord unwrapped from around his neck. I eventually figured out that the contractions were contracting the chord around his neck, which were making his heart slow in beating until the contraction was over, so we needed to get him out because of that. 

Now, on to the pushing. Many, many women told me during my first pregnancy that pushing was the easy part - it's just pressure. Since I got the epidural earlier with Suzy and didn't feel a thing when I pushed with her, I figured that - hey, I've got this.  So, as I started pushing, I realized that all those people were crazy.  Pushing was NOT just pressure, but pressure and paaaaaain!!! 
You may ask right here, "Laura, I thought you had an epidural?" I thought I did, too! But no, I had only a spinal block, and that did not knock out anything south of my lower back. I felt every single thing happen down there, and I was determined to get this flipping show over with and get my baby out of there! 

My midwife was determined to let this ordeal take it's course now that baby's chord wasn't causing a vice grip, and she was cracking jokes with the nurses! I literally yelled, "you need to stop laughing! This is not ok! I feel everything!!!!" I think they quieted down a big and helped me push forward and onward and upward and whatnot. 

John was there with me the whole time and helped coach me along (Nurse Mednic from Suzy's birth class would have been so proud!). Pushing was going pretty well, actually - it didn't feel so awful at first and I so glad to have John there to be my sanity.  Eventually he pulled over a chair to watch the entire thing finish up - yep, he gets a birth memory all to his own, because frankly, I didn't care for a visual. The midwife actually told him, "you don't have to watch if you think you can't handle it." It was good advice for someone who is squeamish, but John said "I'm ok," and was ready to see his son burst forth into glorious day. 

I was suddenly not ready for my son to burst forth at all because I felt a searingly painful rip and immediately stopped pushing. "NO NO, IT HURTS, I CAN'T DO IT!! PULL HIM OUT OF ME!! YOU JUST DO IT!!" Seriously, I thought that maybe they should do a c-section so I wouldn't be torn apart.
"Laura, you can do this, his head is right here. Laura, you have to do this."
"You've got this babe; he's right there. Just one more push."
"Just one more push!"
"Just one more push!"
"He's here! Keep pushing!" 

And there, after just 20 minutes, was my baby boy. The nurses actually confirmed it was a boy by making sure to lift up his legs and check him out. "Oh yeah, that's a boy!" they said. And there he was, all TEN POUNDS, SEVEN OUNCES OF HIM! The midwife guessed he'd probably be right around 8, maybe 8.5 pounds. Nope - he was two pounds more than Suzy plus a few more ounces, and no wonder he pushed me around like the waves of the ocean for the last trimester. 

Frustratingly, my placenta didn't want to budge. I barely got any pain meds for my labor, but I had to get all sorts of drugs in order to move this now incredibly unnecessary (and, very soon, quite harmful) organ out of my body. I'll sum up this entire experience like this: manual removal of the placenta. That's all I'm going to say about that process, and...for some reason, my midwife showed me what I was now missing. There were reasons for that, but I'll leave this part of the story here.
There I was, now officially high on about 6 different medications to get my entire delivery over with, my husband now holding our son because I was too dang drugged up to feel comfortable holding him, and my midwife gave me the line that's at the top of this post plus one more thing:
"It's pretty clear you're not a fan of being in labor, so you should just get an epidural as soon as you get to the hospital if you have another baby."

Why did she say that? Were there other "super moms" who are able to muscle out a new babe without a single drop of any kind of drug? Are there moms out there who can crack jokes while their muscles split and don't blink an eye with any of the pain? Sure. And hey, maybe they love labor and delivery. Maybe they actually hate it and want it just to be done. But maybe, most likely, that statement just should have never been said, especially after all that happened and in a tone that was not at all...helpful. 

But with all her faults, my midwife did deliver that 10 lb, 7 ounce, 21.5 inch lug, she unwrapped the chord from around his neck and prevented me from having a c-section, she sewed me up in a way that helped my cuts heal quickly, and she got that placenta out of me when it simply did not want to do so and, therefore, prevented a surgery for a second time. So for those things, I am truly thankful.
What I was not thankful for was the nausea and vomitting that came from all the drugs I was on. Gratefully I was in my recovery room and had a plastic bag ready to go. Also gratefully, I got some nausea meds that allowed me to eat all that my soon-to-be-lactating body would need. And my son was grateful, too, to be snuggled by mom and dad. He slept amazingly well that first night and not so great the second. Being a huge boy, he needed his foot pricked to check his gluclose every 3 hours. Also, being a huge boy, he got really hungry and wailed his incredibly tough cry until we finally caved and gave him formula on day 3 (in retrospect, an excellent decision and maybe should have made a day earlier). And, being a huge boy, he was blissful when my milk came in on day 4. The  pediatrician said that 

My last night in the hospital, John and I had a nice meal provided by the kitchen. We sat there, knowing what our son's first name would be, but the middle name was tough. Ultimately, I decided that this may be the only son we have, so I'd let John choose the name. He decided that, since this could possibly be the only son we have, that I should get my choice in the name and have it pay homage to my dad. We both ended up getting what we wanted, and that's how Zeke got his name. 

I'm immeasurably thankful for my son.  He is a true delight and has me wrapped around his finger.  I do hope I never have to go through such an ordeal again, though Zeke is well worth more to me than all the pain of labor and delivery and all I'm dealing with today.

Ezekiel Michael Bazal, you were well worth all the physical, mental, and emotional pain. You were the biggest, cuddliest boy and still are 8 months later. You are a gift to each one of us- a gift in the truest sense of the word. We love you to bits, and we are so glad you are here!

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