Thursday, October 7, 2010

Joel's Birth Story

Sunday--40 weeks GA

 We had been planning on a homebirth with our midwife Susan, but she told us at our prenatal the Sunday before Joel's birth, that her brother who had cancer was unexpectedly having surgery this week in Texas. They didn't know if he was going to make it, and she was leaving on Wednesday to see him and would be coming back the following Monday. I had been having regular, but false contractions that woke me up almost every night for about two weeks, so we hoped I would go into labor before she left. She stripped my membranes and used evening primrose. Contractions picked up about an hour later and became painful, but by Monday things had calmed down.

Susan had two backups: Dr Tami and Yolanda (a CPM who lived about an hour away). We decided to go with Tami...I had met her before, she lived nearby, had delivered a few of her own kids at home with a midwife, and she reminded me of Ate Elai (a well loved supervisor in the Philippines)...calm and quiet but with a strong sense of authority...someone who would know what to do in an emergency.

Tuesday went by uneventfully. Wednesday I woke up with a gush of fluid. "Sigh...of course...the day Susan leaves," I thought. I called Tami later that day when contractions weren't starting, and asked her what she wanted to do. We agreed to wait 24 hours and see if labor would start on its own. Thursday came...no labor. So we went and saw Tami at the hospital. She did an nst and ultrasound. Everything looked fine, and the ultrasound showed there was fluid still around Joel. Probably just a high leak, so we went home.

Friday, I woke up around 1am with contractions. I told myself it was probably just the false stuff again, grabbed my heating pad (Joel was OP so my back was giving me a lot of trouble), and went back to sleep. At 3am, I woke up with a contraction that HURT. Five minutes later, I had another, and another. Around 6, I asked Nate to call Tami. She said she'd be to our house around 7. I started vomiting between most of my contractions. I called my mom and started crying. I didn't think I could do it, and I couldn't stop throwing up. She told me I should call Kim, Nate's mom, and have her come over and help. I said I'd think about it.

When Tami arrived, contractions were still coming every 4-5 minutes, so painful I couldn't talk through them, and I threw up between nearly every one. I was really hoping I was at least 7cm...I thought surely I must be near transition with all the throwing up. Tami checked me: 3cm, 90% effaced. Great. I was one of those women who acts like she is in transition when she's still in early labor. It was going to be a VERY long day.

Tami recommended I get in the tub. She had to go check on a patient in the hospital, and she said to call her if anything changed. We called Kim and had her come over. She helped so much, talking me through it and calming me down. The water helped too, and around 8am, Joel moved out of the OP position...thank goodness. But, by 9am things were getting bad again. Throwing up was the worst part at this point. I would never get a break between contractions, so it felt like I was in pain all the time. We called Tami again, and she let us know that she couldn't leave the patient at the hospital, so we needed to either come to the hospital, or call Yolanda, the midwife I'd never even met.

I felt so angry at everything. Angry at the pain, angry at the throwing up, angry at the situation. This wasn't what we had planned. Tami said she would try to make everything as much like a homebirth as possible, we could leave the hospital at any time if we weren't happy, and she would make sure we had the nurse who had had all her births at home so she would understand. We decided the hospital was the best option at that point.

As I waddled through the hospital doors, I could almost hear the guard (the free parking valet in this case) yell "labor". Everything felt so unreal.

I assessed the hospital room. It didn't seem so bad...a bed, a sofa, a birth ball in the corner, and a big tub. No scary wires or tubing and no one rushing at me with IVs and needles. Our labor and delivery nurse, Monica, seemed really nice too. She had helped Kim with one of her deliveries years before. She checked me: 5cm. Tami came in and we talked about options for the vomiting. I was getting desperate for it to stop. We decided to start with an IM injection of Zofran, no IV for now. I got in the tub...the water helped so much! Monica gave me the injection.

A couple hours went by. So much pain. Sometimes a contraction wouldn't completely go away before another one started. In and out of the tub, standing, sidelying, walking. One minute, I would be shivering with cold, wrapped in warm blankets. The next minute, I would be ripping off my gown, drenched in sweat. Sometimes it helped when people rubbed my back, sometimes I pushed their hands away saying "don't touch! don't touch!" The Zofran didn't help at all. I was SO thirsty, but every time I drank anything, I would throw it up, leaving my mouth dryer than before.

At 11am, Monica checked me again. Still 5cm. I mentioned an epidural, and Kim reminded me that I did not want one. At that point though, I was almost ready for anything to stop the pain. Tami recommended we try something else to stop the vomiting. Maybe if we could stop that, then I could deal with the contractions better. I got another injection, this time Phenergan. It didn't help either. Just made me really tired.

Around 1:00 after an especially horrible contraction that had me yelling at the top of my lungs, I told Kim that if I wasn't 6cm or more at the next check, then I was getting the epidural, and she WAS going to help me get it. She agreed. Monica checked me again about half an hour later: 7cm. We had a deal...no epidural.

More time in the tub, more walking, more pain. I started praying out loud that God would help me through this...I had nothing left to give. I remember looking into Nate's eyes, then Monica's, then Kim's. There was nothing else that they could do for me...nothing they could possibly do would help. I felt very alone.

2:30...8cm. 5:00....still 8cm. I was yelling for a c-section, but I don't really remember that part. I stood facing Nate, bracing myself against him during each contraction. Nate says I tried biting his stomach, but again, I don't really remember much of this part. Just lots and lots of pain. All I could think was "just kiay kiay....kiay kiay.....kiay kiay lang..." For some reason, I had to think in the words that I had told nearly every woman I had ever helped in labor.  Little did I know then how hard it actually is in labor just to rock your hips.

6:30. 9+cm with a lip. I remember moaning “No not a lip. Lord…I just want to be 10…make me 10” Monica asked if I wanted to keep going through contractions and wait for the lip to go away or if I wanted her to push the lip over the baby’s head. “Just get this baby out!!” She pushed the lip up through a couple contractions then suggested I try pushing a little. BOW bulging with the next contraction and Monica broke my water. I tried squatting to push but CRAMP. My whole hip cramped….it hurt just as bad as the contraction, and I couldn’t push.

After a few contractions with the cramping, Tami came in and had me get on my hands and knees so she could push on my hips during contractions and try to stop the cramping. It wasn’t helping. I reached inside and felt Joel’s head. He was right there…so close to coming out. I felt hair, and his head molding…..and the lip! It was still there! “Noooooo” I moaned. “The lip is still there…the baby won’t come out….the baby won’t come out,” I said over and over. I moved to sidelying…that helped the cramping some. Tami got some evening primrose and pushed the lip up some more. After a few more contractions, it was finally gone.

I tried pushing some while sidelying, but I wasn’t really progressing. Finally, I rolled onto my back. I was shocked…this was the best! No more cramping, and I could finally feel what I was doing to push. I didn’t have much of an urge to push, but pushing helped the pain of the contractions. About 30 minutes went by. 2cm head visible. Then there was SO much pressure and it scared me. I stopped pushing and started breathing through contractions. They told me I needed to keep pushing, but I couldn’t….I was too scared. Finally Monica said “Jordan…get angry at the pain. Get angry at it and push through it.” That helped. I WAS angry at the pain, and I really wanted it to be gone. I started pushing again.

Another 30 minutes or so and head was almost crowning. It felt like fire, but I was so happy to be almost done.  I reached down and slowly eased the head out myself. No tear. But then his shoulders wouldn’t rotate and got stuck. I found out later that Joel also had a nuchal hand. Tami had Nate hyperflex my legs. 30 seconds went by. Tami and Monica were telling me very urgently to push. This hurt WAY more than the head. After what seemed like forever but was only a little over a minute, I felt a little pop and even more burning, and then he was born!

The minute his feet were born, I felt amazing! No more pain at all. It was like the “runner’s high” only a thousand times better. And I was holding the most perfect squirmy baby in my arms. He didn’t really cry, but he was very ready to eat! Nate told me he was a boy. I was so incredibly happy!

Tami waited about half an hour to cut the cord. She was really patient about everything. Everyone was guessing his weight…we all thought about 8lb something and couldn’t believe it when the scale said 9lb 13oz! I had only gained 24 lb with the pregnancy and measured small the whole time, so I’m not sure where he was hiding.

Tami sutured the 2nd degree perineal tear that Joel’s shoulders gave me right after the birth while I was breastfeeding. I was glad she sutured right away because nothing hurt for the first half hour, but everything hurt a LOT later. After about an hour, the placenta still hadn’t come. Tami tried cct…nothing. So she injected some pitocin into the cord vein. It was really fascinating. I had never seen that done before. I breastfed almost this entire time, but nothing happened with the placenta. I went to the toilet, but still nothing. My uterus was getting very uncomfortable. After more than an hour and a half, Tami said she might have to explore and see what was going on. I started to cry. I was so traumatized (left the room crying and nearly passed out) the first time I had ever seen this done on a woman. Tami said they would give me morphine first, but that wasn’t very reassuring. I started to pray that God would get the placenta out on its own. Tami tried cct one more time, and a couple minutes later, the placenta finally came.



Nate's dad (he was planting squash and had just come from the field)

Next day....aunts and uncles meeting Joel



Finally done! Nate and I were/are so incredibly happy….I can’t even describe the feeling. Nate is such a great dad! He changes all the diapers when he’s home and is so good at calming Joel down. Joel has been such an awesome baby too….breastfeeds so well and doesn’t cry much. Now if he would only sleep more at night….