Friday, July 18, 2014

Lucy Emeline

11:15 in the morning. Eight hours into a 13-hour labor. This is me "smiling" through my monitoring.

I woke up at 3:15 AM in labor. I got Mike up an hour later. It was a long day for both of us.

It's hard for me to believe that I was thrashing and screaming just minutes before this picture was taken.

Lucy's due date was June 24. Charlie was born five days before his due date, so in my head I had prepared for Lucy to arrive on a similar timetable. 39 weeks came and went. Then my due date passed. When I dragged myself into my doctor's office 40 weeks and six days pregnant, I was starting to feel a little frantic. I had expected a baby by mid-June. Suddenly, it was July, and I was still very pregnant.

I chose my doctor because he isn't induction-happy. We had the common goal of letting my baby come on her own, assuming all was well with both of us medically. When my water broke with Charlie, my body didn't go into labor. After twelve hours of trying to get labor going on my own, I eventually accepted Pitocin, and after six hours of Pitocin (that stuff is wicked), I finally asked for an epidural. The epidural was hard to place because of a vein that runs over my epidural space. The many attempts to place the line caused a spinal fluid leak, and I was flat on my back with the most excruciating headache for five days before returning to the hospital for a blood patch. It was a terrible way to start life with a newborn. This time around, I wanted to experience my body going into labor on its own and, if possible, I wanted to avoid an epidural.

My doctor and I hadn't really talked induction because we both felt pretty sure that Lucy would come on her own around my due date, give or take a few days, because I had been in prodromal labor since 38 weeks. But at my last appointment almost a week after my due date, I saw the possibility of another induction on my horizon. I sat in our minivan and shed a few tears and prayed that I would have some sort of confirmation that whatever plan we devised in this appointment, I would know it would be the right thing to do.

After checking my cervix (which was dilated 2-3 cm, the same state as it had been the last two weeks), my doctor talked with me about the pros and cons of going all the way to 42 weeks, the generally accepted absolute maximum time to allow a pregnancy to continue without a medical induction. My doctor expressed his concern with allowing the pregnancy to go on much longer; in my heart, I knew he was right. Friday was the Fourth of July, and I didn't want to purposely have a baby that day, and for some reason the weekend didn't feel right, and past the weekend was too long to wait, so I suggested Thursday, July 3, nine days after my original due date. My doctor looked me in the eyes and said, "This is the right thing to do." I said a little prayer of thanks in my heart. I had gotten my confirmation that we should move forward with this plan. Tender mercy much?

In the end, the induction was unnecessary. When I told Mike about the induction plan, I said, "Watch, I'll wake up at 4:00 in the morning the day of our appointment in labor."

I was almost right. I woke up at 3:15 in the morning on July 3 to painful contractions. I got up and turned on some low light in the living room, turned on the TV for some white noise, and started pacing and timing contractions. I walked around until about 4:15. My contractions were about 40 seconds long, 4 minutes apart. And they hurt. Ouch. I woke Mike up and we decided to drop Charlie off with some friends about half an hour ahead of schedule, in case my labor picked up suddenly. Mike loaded the van with our bags and I carried Charlie to the living room. I held him an extra minute, thinking about how much all our lives were about to change, hoping he would fare the adjustment well.

We settled Charlie in with our friends (thanks, Nicole!) and headed to the hospital. Sitting in the van, my contractions pretty much stopped. That worried me a little bit. But as we walked into the hospital, they started up again. This became a recurring theme for most of the day: walk around, have contractions; sit down, lose them.

I was admitted to labor and delivery for my scheduled induction at 6:00, and the nurses placed my IV and had me finish some last minute paperwork. They checked my cervix; I was dilated to 4-5 cm. I stayed on my feet as much as possible to keep those contractions coming. My doctor came in a little while later while I was hanging with my arms around Mike's neck and breathing through a contraction, sat himself down in a chair, and asked, "So, are you in labor?" I sort of laugh-shout-grimaced, "YES!" He cancelled the Cytotec, wished me well in my labor, and said to have the nurses call when I was ready to push. I was so ecstatic! All I had wanted was to be allowed to labor in peace. I couldn't believe I was actually getting my wish! Dr. B left for his office, and Mike and I set about keeping this labor progressing nicely.

We spent the next hours walking around the labor and delivery wing. While I walked, I had a contraction every four or five minutes. Painful, but not agonizing. We continued to chat and walk, say hi to the nurses, and loop back around to our room. That took about 20 minutes. Then I'd lean against my bed or rock on a birthing ball (they make them oblong now, so smart!) and rest for about 20 minutes. Then my sweet nurse Cindi would hook me up to the monitors for about 15 minutes or so to check on the baby. I totally understood the need for monitoring, and was glad we were able to check on the baby at regular intervals, but I hated having to sit in the bed. My contractions slowed down, which made me worry about my progress, and the contractions were much harder to manage sitting down. The pain was the same, but I wasn't able to diffuse it at all unless I was standing and swaying or walking. For an hour or two, I ended up dozing off in bed, waking up for contractions, but I was only have two or three an hour while in bed, so I was able to get a little rest.

Even with my contractions spaced apart, each check showed more progress. By 2:00 PM I was at a "stretchy" 9 cm, and another check at 3:00 PM revealed I was still at 9 cm. My energy was seriously flagging at this point. I had had a granola bar and some milk at 4:00 AM and two popsicles during the labor. I brought snacks but I really didn't want to eat anything, to my surprise. I had been on my feet for most of the last 12 hours. I was tired. I asked my nurse if Dr. B could come in to talk about breaking my water. She paged him and said he would be in at 4:00 PM.

Mike helped me stand in the room while I worked through a few more contractions. When Dr. B came, I was moaning and starting to get a little bovine in the corner of our L&D room. Hah! It was interesting to feel my mind turn my body over to its pure instincts. I breathlessly asked our doctor what he thought about breaking my water, going over my lack of dilation in the last few hours. He checked me and agreed that I wasn't at a 10 but was very close and that breaking my water would probably be just the thing to get me fully dilated.

As he broke my water, another nurse came in with a cart of tools and supplies for delivery, and the room was suddenly a little chaotic. At least, that's how it felt to me. Mike and Cindi helped me sit up, and suddenly I was screaming. Shrill, uncontrolled screaming. Not yelling. Screaming. Nice, buzzy resonance at the back of my pallet and into my nose type of screaming.

I started to shout, "I want to push!" Did I mention that even at this point we hadn't picked a name for the baby? After announcing my desire to push, I told Mike I wanted to name the baby Lucy. He agreed. I think at that point I could have asked him for a Mercedes or an emerald necklace or an island in the Caribbean and he would have consented. Anyway.

Dr. B was dressed and positioned at the edge of my bed, but the bed wasn't totally prepped and the large overhead light wasn't on. I'm sure other things weren't quite ready, either. Dr. B suggested a few practice pushes but my body was just going for it. The nurses dropped part of the bed down and pulled some handles up at the side of the bed for me to use. I'm not really sure exactly how I was supposed to use them, but I pushed up on them sort of like a pommel horse. I was so weak though that I couldn't support my weight long. I was really uncomfortable in that position. I remember squeezing out the words, "I need a different position after this!" I had hoped to use the squat bar to hang down and push but my brain wasn't able to process that request in time. I eased out of my pommel horse position. Mike tells me I pulled myself back up again the next time I started to push. I don't really remember this but I was in a state of losing my mind and letting my body do whatever felt okay. And, strangely enough, though everyone says it is the least comfortable position for a woman in labor, I ended up throwing myself back into the bed, tossing my own legs in the stirrups, and letting Mike and Cindi hold me up in a semi-seated position so I could push. After I think two pushes (and still at a stretchy 9 cm), the baby's head was delivered. I pushed one more time, within just a few seconds of my last push, and out she came! 15 minutes after Dr. B broke my water, I had a baby on my chest.

Even though I was hooked up to the monitors during delivery, which showed when I was having contractions, no one tried to coach my pushing. I was allowed to push when I wanted. I have no idea if they matched up with the contractions, but it was really nice to let my body do its thing. I didn't tear, and I was on my feet and feeling pretty dandy after an hour of skin-on-skin contact.

I remember thinking, after my water was broken, that I was crazy for trying to get through this labor without any pain medication. I knew that, at 9 cm, it was too late for an epidural, but I remember asking myself why in the world I didn't get one before it was too late! The pain got intense there at the end. I even said, "I don't think I can do this anymore!" I didn't really want an epidural, but my brain was feeling like some pain management might have been a good idea. My doctor said, "Well, I think it's probably too late for an epidural." I'm not sure if he said this as a response to what seemed like my request for an epidural, or if he was cheering me on to the end by telling me it was almost over. I think it was the latter.

Being packed up and ready to leave at 10:00 AM the next day, I felt glad that I hadn't risked another spinal headache. (The anesthesiologist came by during my labor to have me sign consent forms just in case, and when I explained my history with a previous epidural, he conceded that it was possible to likely that I would have a hard time getting an epidural placed again. He was very kind and didn't pressure me either way, just offered his services if I chose to get some help with the pain.) We had to spend three nights in the hospital when I had Charlie because my headaches needed to be monitored. We had to wait 24 hours before Lucy could be discharged, but it was nice to be ready sooner because I felt that good.

Having experienced both an induction with an epidural and a totally unmedicated birth, I'm not sure that either one is "better." Charlie's birth was peaceful, reverent. The room was dimly lit and quiet, interrupted only by soft prompts from my midwife and encouragement from Mike on my left side and our nurse Rosa on my right. I was alert and calm and rested. I even watched Charlie enter the world with the help of a mirror. Lucy's birth was chaotic and, to be honest, I don't remember all of it. It sure wasn't peaceful because I was screaming nonstop for 10 or 15 minutes. I felt like I could bond equally well with the baby in both scenarios. I felt closer to Mike after each delivery, but for totally different reasons. I don't know that I can really recommend one type of labor and delivery over the other. They are just different. Avoiding any complications with an epidural made an unmedicated birth absolutely worth it for me, but this isn't the case with every woman. I'll leave it at that.

In the end, I had hoped for a hands-off, unmedicated hospital birth, and that's what I got. I'm very grateful to my doctor and the staff at UMC for making it happen! And to Mike, who let me practically strangle him on and off for the better part of a day. He's my hero. (Our doctor commented that Mike was one of the best if not the best dad he's ever seen during labor and delivery. I don't think he really believed me when I told him that Mike was all the doula I'd ever need.) And my body. Thank you for cooperating.

Back to the baby: Lucy Emeline was born at 4:17 PM on Thursday, July 3. She weighed 7 lbs 7 oz and was 20 inches long. I'm glad we didn't rush her out. She was smaller at birth than Charlie was even though she had two weeks extra to gestate. She has red hair and brown eyes, for now. She is calm and sweet and pretty tolerant of Charlie's boisterous demonstrations of affection. He, by the way, has been a wonderful big brother. He's been acting out a bit, because his life is different and he feels a little neglected, but he doesn't yet realize that Lucy is the change in his life. I'm grateful for this. I've tried to focus on him any chance I get, and Mike and I have tried to spend one-on-one time with Charlie when possible, even if it is just running out to the store.

We are in love with our little girl. And I'm so happy I'm not pregnant anymore. I started to wonder if I would ever get to be not-pregnant again!