Addie’s Birth Story- December 19, 2011

Although I did live updates via my husband’s facebook page, I didn’t write Addie’s birth story until about two weeks later. Of course time being limited in terms of getting online these days (aside from my iphone to facebook during nursing marathons!) I am just posting it here now.

We went in on the thursday for cervidil induction. No contractions, spent a few hours on monitor. Repeat cervidil Friday with overnight admission for monitoring- no contractions. Surprisingly hard to sleep on my own without Jack; I remember feeling very lonely. Foley catheter insertion Saturday with pass to go home for the night (I think this was against protocol but my OB took pity on me/figured I’d come in if any worrisome signs presented), had contractions x 1 minute every 12 minutes down to every 8 minutes from 1630 to 2230 then tapered off to nothing. Was so happy to be in my own bed cuddling my husband. This all set the stage for "real" labour. The following is as detail oriented as I could recall (I wanted to remember as much as I could so its not written in a prettier style):

Sunday was admission for pitocin induction, 1cm dilated on admission (same as 2 weeks prior on exam during stretch and sweep at 40weeks). Pitocin very comfortable to max dose 24 units; 2cm and thinned after 4hours with mild contractions (I’ve had worse menstrual cramps).  Smiling and watching Christmas movies on tv. Still fully believing baby would be born vaginally, hoping before midnight (1cm at noon, OB said 1cm per hour dilatation so I figured Dec18 before midnight baby should arrive). AROM around 4pm? We celebrated clear amniotic fluid and baby looking good on the monitors. AROM was followed by intense totally occupying contractions every 2-4 minutes for 1 minute each. Tried swaying, ball and toilet positions for comfort. Was told pitocin would be doubled to 40units after 2 hours still at 2cm. Began to think I couldn’t handle 8 more hours to do 1cm/hour with drugs making more intense contractions, asked for epidural. Said I couldn’t cope with pitocin making things stronger if they turned it up past the max dose. Asked about risks of exceeding max pitocin dose: small risk uterine rupture, neonatal hypoxia… Luckily baby looked excellent on monitors (constant monitor due to pitocin, half the time they didnt pick up during a contraction and the nurse would readjust, I found this very distracting from my swaying/rocking to cope with pain). Given morphine injection to last until epidural which didn’t do much for pain but I relaxed more between contractions. 3 unsuccessful placement attempts for epidural while crouched on side of bed and wait, doctors change their minds it’s too soon for epidural. Back to position changes for pain relief. Another few hours and epidural offered- first attempt good and numbing to T8 region (mid rib cage). Hubs tries to get some sleep on a cot, doula in a chair while I’m too excited about meeting my baby but I do try to rest a little. Doula and nurse both reassure me that epidural is good choice as labour is augmented by pitocin and not progressing normally; I am fearful of signing onto more intervention. Epidural starts wearing off around 3am, feeling contractions. Dose increased for epidural. 4-5am feeling contractions, epidural dose increased and bolus dose given. 5-8am no pain relief from epidural and contractions are stacked one on top of another so no breaks to rest in between, felt like a three hour contraction. I remember saying this isn’t normal, I’m supposed to get 30seconds of pain relief. Anesthetist comes to assess epidural- I ask her to re-site it as it’s not working. I throw up everything I’ve ever eaten all over her as I called for a basin but it didn’t come fast enough. She doesn’t re-site epidural. I’m checked and told I’m 6cm after ~8 hours of double dose pitocin with some bloody show. I get excited by throwing up and show, thinking "I’m in transition maybe baby will come soon". Baby tolerating well per monitors (this was a big concern of mine). Using 3D u/s photo taped to bedrail to keep focused on bringing baby down. After I threw up I asked JAck to move it so it wouldn’t get wrecked, so glad he saved it for me in his book. 

Constant pain doesn’t abate, I ask nurse if my uterus is rupturing. Am terrified this pain is because I’m going to rupture and die. Nobody seems to be able to say what the constant pain is. Given 1L fluid bolus after two catheters show I’m not making much urine despite ~300cc/HR IV fluid maintenance/meds for the past 8 hours. At this point I start crying asking why nobody is helping me- we asked for epidural resite hours ago but no relief and no resite offered, no additional morphine offered. OB comes at ?7:00 am, asks about the pain and apologized as she was asleep and senior resident didn’t update her re:constant pain. This was one of the few times I opened my eyes after 4am, asked her if i was going to die from uterine rupture. OB feels babe is not positioned well for vaginal birth and tells me is stuck at -3 station. Am in so much pain and just want to either make cervical dilation progress or c section decision. Decision made for c section non emergency for failure to progress. I dont really recall this discussion and wonder for days in hindsight if it was made too soon.

To OR, told plan is for spinal analgesia, trying to hold still while having ongoing sustained uterine contractions. I cried silent tears the entire way to delivery, I remember consciously thinking "Just try and leave your body for a minute to escape the pain". They give me sodium citrate which I throw up, second attempt it stays down. In OR, they do four attempts at spinal anesthesia, I cry out only on one attempt when they hit bone. The nurse told me to calm my breathing down to cope with pain- I remember in my mind begging my grandmother to help me (she was the matriarch of our family; passed away when I was 12 from cancer after living with us for a year- I see her as a protector of sorts). Later my Mom tells me that she saw sunbeams through the clouds on the day Addie was born; that since her mother (my grandmother) died she always saw this on days when she needed/wanted her mother to be close- I take it as a sign that my grandmother heard my pleas for strength and was there for me (of course I bawl when my mother tells me this via phone days later while I’m still in the maternity ward).

I felt very traumatized and exhausted after 4 day induction and labour ending in surgery which was my biggest fear. Was more terrified than I’d ever been in my life. As prepped for surgery memories of conscious D&E experience 1 year ago are mirrored to some extent. I am still having quiet tears stream down my face into my ears. Jack arrives, he looks happy/excited/scared. I tell him I think I am having PTSD and can’t stop crying. He hugs me (strapped down on the table) and I feel better. I tell him I might need therapy, he laughs and says we’ll figure it all out.

I insist that Jack announce baby’s gender as last grasp onto "birth plan" wishes. I notice to myself that the room is filled with women- nurses, doctors, technicians- all working to help me bring a baby into this world. I’m reminded of the words from the naturopath I saw- that I can choose what I give meaning to, and so in hindsight I try to remember these aspects over the more upsetting memories.

Finally, the painless C section delivers a successful, crying right at birth, 9’9 Apgar baby Addie (Adelaide Loraina) whose Daddy got to announce the arrival of our daughter to me when she was delivered. I will forever remember the joy in his eyes in that moment. I remember hearing her gurgled first cry the instant she was pulled out, (I heard her before Jack even saw her) and knowing that she was okay, she was breathing and very much alive. She was cleaned up, held by daddy first then by mommy en route to recovery. Breastfed within 1 hour (I think, time is blurry here but she was certainly hungry right away and not drowsy at all) successfully and was so beautiful, I was in love. I kept saying to Jack "Look at her hair!" it was a light brown/blond, long and spiky with blonde eyebrows and eyelashes. Jack kept saying "Look at her tongue!" she was rooting and hungry! I was still surprised she was a girl as up until 41 weeks I swore my "Critter" was a boy (though I did think maybe a girl when I saw 3D u/s of her face during NST at 41 weeks).

The nights alone with her in the hospital maternity ward were hard but good for me to heal. We’d purposely asked visitors not to come while I was in hospital, even without c-section to work through I just knew I needed space and security to become a Mom on my own terms (emotional baggage of in laws and family can be a lot to handle on a good day let alone sleep deprived). I was raw, I cried easily and often, but I had this little naked baby with me always and I could see the forest for the trees in her eyes. It took me a while but I eventually began to process and mourn the labour and delivery I had hoped for, with the help of others who were there to try and work through feeling like I failed at birthing. This was surprisingly a strong theme for me to face/work through. My OB visited me twice in hospital, she was off call for my c section so really didn’t need to come but always visits "her" patients; one senior resident (who I’d seen but not seen eye to eye with during the past four days) said not all OBs do that and I was lucky my OB was that conscientious.

I’ve had a bit of baby blues but mostly overjoyed and loving my baby girl is helping to heal my heart. I felt my heart break for her cries when she had to have 7 venipunctures (including a scalp poke) and 4 heel pokes for various tests (bili, blood sugar protocol, genetics), but as her bruises heal I have perspective that we are so lucky she is a healthy baby. I’m so glad that we still brought her into the world safely even if not how I’d originally envisioned. She never showed any signs of stress during the augmented labour, it was for my pain and lack of progress that the csection was done.

I didn’t understand this at the time, but I feel like before her birth it was about me, my husband and the pregnancy; now I see her as part of the story too and I’m not as central of a character in the experience somehow. What it meant for me isn’t the only thing to consider anymore. I’m becoming okay with what it was- for I can’t change it, and really in this world a lot happens that you dont expect and can’t control, so maybe her coming this way is that lesson for me to appreciate, in a sense. I hang onto the words of others when I have moments of wondering what if I’d tried harder- held out longer for the epidural, tried hands and knees positioning to have her present better (I had tried for one contraction but couldn’t manage the pain)- but I realize with my OBs feedback that there wasn’t much more I could have done. During the visits my OB said medically there was no doubt, that this baby was not coming vaginally. That the decision was clear, not dilating past 6cm for four hours meant not even a forceps delivery was possible. She says I did everything I could to have her naturally and that I didn’t fail even though it’s understandable to feel that way. She also said she’s worried that I might get depression from the trauma of the birth experience. She really opened up about how having a baby after being a professional can change your life, how sometimes you wonder why you decided to have a baby since your life was pretty good before baby but that these things will settle over time and it’s just a transition to adjust to. She also wished us well and asked if we’d be back for baby #2 before we have to move again- and if we are (we have to wait 12 months min before trying so my uterine scar can heal) I will definitely have the same OB team in my corner again.

These days, I’m physically healing well and optimistic that our next baby will be an easy VBAC. I worry a bit about how the internal sutures are healing as I still feel sore and lumpy (the skin incision is smooth and flawless; its the deeper internal repair that feels a bit knit together less smoothly) but I’m hoping with some ab work and a healthy course of bio-oil application over the next few months that I’ll regain most of my body pride. I do feel like my body has done a good thing- I grew and nurtured a healthy beautiful baby girl who shares smiles and cuddles, who has the world of opportunity at her feet. I both can’t wait to see her grow and want her to stay small all in the same moment. I love my husband more than ever after the pregnancy and birth experiences we’ve had, and its a joy to see him adore his role as father to our baby girl. I’m also feeling like a bit of a champ for surviving both labour and c section. I am grateful for all Addie and I went through for her to be born Monday December 19, 2011 at 9:11am- all 8lbs 13oz of her fuzzy headed love.

Update: Genetics came back, we have a perfect 46XX karyotype. Breastfeeding has been challenging to say the least, Addie is gaining weight but only 15-20g/day when they’d like her at 25+g/day. We are working on getting my supply in check and spending a lot of time nursing and cuddling away the early winter days of 2012.