What I remember about giving birth… Part II

Oh, sorry to leave you dangling!

So the epidural.  I asked Diana for the epidural, and before I had even completed the second syllable of “epidural” she ran into the hall to register my request.  The anesthesiologist, it turns out, was on the floor – Right Then! – and Diana wanted to grab her.  This means that I was getting my epidural almost immediately from Dr. Sarassa.  (I’m sure that’s not really her name; the contractions had me pretty distracted by this point.)  Dr. Sarassa told me just what she was doing during every second of the process, but you know what?  I wasn’t interested.  I just wanted it to work!  I was an easy stick and the process went very smoothly.

After the epidural started to take effect, my legs felt weak and numb.  It was exactly how a limb feels when it falls asleep.  Now we were only waiting for my contractions to dilate me to a 10 so I could start pushing.  The epidural didn’t seem to slow my contractions, though they weren’t as strong as before (this is according to the monitor; I felt none of it).

In addition to numbing agents, the epidural also contained some amount of narcotic in it, because my mood improved but my concentration worsened and I began to think rather silly thoughts.  I only shared the loopiness once, thankfully, when just Andrew and Mom were in the room.  Here was the thought: the blood pressure cuff made a little “ho-hum” noise every time it registered my stats, and for reasons I can’t explain it reminded me of Mr. Snuffleupagus.  And I tried to relate this to Mom and Andrew by saying simply, “I feel like Mr. Snuffleupagus is coming to take my blood pressure.”  There was a pause, and then Andrew said, “You’re kinda drunk!”  So after that I tried to be more judicious about the things that popped into my head.

This part of the process – feeling not much at all while I dilated to a 10 – was just a little bit boring.  I couldn’t concentrate on much because of the narcotic and my general excitement, but I was certainly lucid enough not to try, for example, to take a nap.  (One of our friends suggested via text that I try to rest during this stage.)

Around 12:30, Dr. Cleary examined me and announced that I was at an 8, and that in a half hour I’d be ready to start pushing.  Whoo-hoo!

It wasn’t until 1:30 that Dr. Cleary and Diana returned to get the room push-ready.  The delivery bed on which I’d been lying dismantled at the foot so that it fell away basically at the end of my tailbone.  Then came the “stirrups,” which were longer than those on a gynecologist’s table so that I could rest not just the heels of my feet in them but my entire calf.  I’m sure there were other preparations that they made to the room, but I don’t remember.  Dr. Cleary and Diana scrubbed up and asked me to get ready.

I was convinced that I had the wrong idea about pushing.  Was it just bearing down on my netherworld?  Dr. Cleary made it sound like that when he gave me instructions.  He said I would take a big breath at the beginning of a contraction, hold it while I pushed and he counted a slow 10, and then exhale quickly and repeat that twice for the remainder of the contraction.  And that’s what we did started doing around 1:45.  Dr. Cleary was all up in my business while Andrew and Diana each helped hold one of my legs.  Mom stood over Dr. Cleary’s shoulder.

And we all pushed!  I guess technically I did the pushing while everyone else did the cheerleading and internal grimacing.  But we were all in it together.  The contractions were one or two minutes apart, with the rare rest of a 3-minute interval.  And every time I pushed she came down farther, but then when I stopped pushing she receded some like a drop at the tip of an eyedropper.  (This is, of course, according to Andrew and Dr. Cleary, not first-hand knowledge.  My sensation wasn’t very precise down there at this point.)  After half an hour she had crowned and I was getting pretty tired. My muscles had figured out what to do, but the breaks between contractions just weren’t long enough to get my breath.

But I was still pushing, and everyone was cheering me on and telling me to push harder and harder.  With each contraction I felt we were on the brink of delivering her head, but it kept not happening.  Still the contractions came – and at last Dr. Cleary announced he would be making an episiotomy.   I felt the cut but not the pain and saw the utter distress on Andrew’s face as he watched.  (He told me today it’s the one image he wishes he could forget.)  I pushed and pushed, not caring at all (because I couldn’t feel at all) that I was now pushing through a surgically enhanced vagina.  Diana found a way to make clear to all of us that Dr. Cleary was meant to go off-shift at 2pm but was staying on to deliver Louise.  I felt vaguely annoyed at her for making this a big deal.  Dr. Cleary extended the length of my episiotomy and announced we were getting very close.

Dr. Cleary had me push past a contraction a couple of times (as in, four pushes instead of three) and I knew it was about to happen.  Then her head came out!  Andrew or someone told me her head came out!  I paused to let Dr. Cleary make sure the cord wasn’t wrapped around her neck.  I knew we still had the shoulders, and that they would be a challenge too.  So more pushing was in order.  I pushed.  Dr. Cleary told me to look down, and I tucked my chin to my chest and prepared to push with all my might.  But then he said, “No, down here; look down here at her!”  And there she was!  There she was!  She was all out!  She squawked and Diana took her over to the birthing tray in the corner of our room.

The sequence of things here gets a little fuzzy.  I guess at this point I pushed out the placenta while Diana and another nurse did some initial checks on Louise.  Dr. Cleary started to stitch me up.  Dr. D, newly arrived to begin his shift on the floor after Dr. Cleary’s, stood at my shoulder and congratulated me.  I thought it very discreet of him not to watch Dr. Cleary’s work.  But he did comment that I was fortunate to have Dr. Cleary stitching me up, calling him the best in the practice.

After wiping her off a little, weighing her, and suctioning some gunk off her, Diana brought her back to me.  Andrew followed.   Louise lay on my bare torso and tried to breastfeed a little bit.  We gazed at her.  Beautiful.  Her warm little body consumed me.  Her eyes were open and she was alert (despite the epidural).  She didn’t cry but looked back toward Andrew and me serenely with her giant, deep blue irises.  She curled her fingers around my thumb.  I was flooded with amazement at her presence and relief at the end of labor.  Time must have stood still, because I don’t know what happened next.

Oh yeah.  They took her to the nursery for her real cleaning and warming while I started the recovery process.  I finally got to order some food!  I drank some juice!  It was lovely.

The rest of my stay there was exactly what you’d expect of a hospital stay.  I slept poorly and hated my outfit.  People came to check on me just when I fell asleep.  Andrew stayed overnight with me, thank God.  He was so wonderful throughout this.  But of course I felt a wreck physically.  I was amazed at the pain in my netherworld but was (and am) utterly un-curious to learn more about the state of things down there.  I bled onto these industrial-sized maxi pads that the hospital gave me (we’re talking 8″ x 16″) and sat on my hips in the hospital bed to spare my tender stitches.  At the doctor’s recommendation I took a stool softener and then immediately wondered why because nothing sounded worse to me than having to go #2.  (When I did, it was scary, but not the worse pain I’d felt.)

Breastfeeding in the hospital went well, with the help of the lactation staff.  Louise latched onto my nipple better than I expected yet with some typical newborn difficulty.  A couple of times she seemed to forget completely how to latch, but we got through it.  At night she slept in the nursery until she was hungry, at which point she was delivered to our room.  When she finished nursing Andrew called the nursery and asked them to take her back – which felt very Victorian-era-parent to me.  But it let us rest!  During the day she stayed with us.  We adored her and she made faces at us.

We were so relieved to go home Saturday.  This is just the beginning of that journey, of course, but to conclude the blog I want to note that our birth was just what I wanted it to be: medically unremarkable.  How grateful I am for that.  I wish that every woman who chooses a hospital birth and an epidural could have my experience.  And I’m not trying to congratulate myself here!!  My own preparation and efforts had very little to do with this.  I was lucky to respond well to Pitocin and to the epidural, and Louise had the good sense not to wrap the cord around her neck or anything funny like that.  How lucky I am.  How blessed.  And how very hormonal, emotional, and in love.

What I remember about giving birth… Part I

I’m not going to proofread these entries.

Thursday morning Andrew, Mom, and I woke early and went as planned to the hospital (after I ate a bowl of Wheaties).  By 6:30 I was sitting in my hospital gown in the birthing room, getting an IV.  They started with fluid alone because I was planning on getting an epidural.

Let me introduce the players in the delivery room.  You know Andrew, and you know Mom.  They were there with phones and cameras charged and at-the-ready.  There was the nurse, Diana, who has a daughter Navy pilot currently in training at Corpus Christi.  There was my practice doctor, Dr. Cleary.  I called him Dr. O’Malley at first and will forever be embarrassed about that.  And I learned a new term, “pit doctor,” which seemed to me to be the doctor that the nurses consulted when Dr. Cleary wasn’t on the Labor & Delivery floor.  Our pit doctor’s name was long and I’m afraid I called him Dr. Tartar Sauce in my head because I couldn’t remember it.

So after I’d taken about a half-bag of the IV fluid (whatever it is), Dr. Tartar Sauce came in, shook my hand, and examined me.  Isn’t it nice that he shook my hand first?  He declared me 2-3 cm dilated and 80% effaced.  He also said I was “posterior” which sounded like bad news.  Then Diana explained that “posterior” referred to my cervix being sort of back toward my spine, and that it would rise naturally as I became more dilated.  It just might take a while.

So they broke my water!  It was pretty painless.  And it didn’t happen all at once; after the initial stream came out on the bed pad (which Diana changed promptly), fluid continued to trickle out – especially when Louise moved.  Makes sense, right?

Then they started me on the Pitocin drip – at the lowest setting, 2 mL/hr.  The highest setting is usually 30 mL/hr.

At this point I had several monitors on me.  They included a blood pressure cuff, a belly sensor that picked up when my uterus contracted, and a fetal heart rate monitor.  But that’s not all!  Dr. Cleary also inserted a kind of probe that attached to my uterus and picked up not only when my uterine contractions were, but how strong they were.  At rest my uterus was contracted to about a 20 (I don’t know the units at all).  And for a contraction to be productive – that is, for it to help dilate my cervix – the contraction should be 60 units higher, so around 80.

I need to say that the insertion of this uterine probe wasn’t comfortable at all.  And when I realized how uncomfortable just that little probe’s insertion was, I realized that I am a pain wimp.

Around 10am I started feeling painful contractions.  They were 5 or so minutes apart and they lasted 30-45 seconds.  For me, they were painful like very topical menstrual cramps… I envisioned a band of red burning three inches below my navel.  Andrew saw when my contractions started by watching the monitor, and he came to my side so I could squeeze his hand.  This is when I learned that squeezing someone’s hand doesn’t do much to reduce my own pain perception.  And these contractions only took me from 20 to 50 or 60!  I began to wonder how wimpy it would be to ask for an epidural before I even started having “productive” contractions.

Dr. Cleary informed us around 10:30 that I had increased to a 5 dilation, despite the lack of powerful contractions.  So that was good news!  The contractions were coming much closer together – some with only a minute of rest between.  And then sister-in-law Katie texted Mom to remind me that when I tell people I want the epidural it might still be 45 minutes before the anesthesiologist can get to me.  These things together convinced me to ask for the epidural…

A day of lasts

Early tomorrow morning I’m scheduled to be induced.  Assuming things go as planned, then, today is it… the last day of rest and relative non-worry.  But, being myself, I’m actually already filled with anxiety about tomorrow.  I am confident in the plan to induce, in Louise’s readiness to join us all, in my doctors’ knowledge and experience, and in the support and love of all of my family…  Yet I’m worried.  Every bit of having a baby seems difficult, and I don’t know how it will go for me personally.

But I’m ready to meet Louise.  We’ve been ready for quite some time now.  And we will get to meet her.  Even if I whimper through every contraction and require three dozen stitches, I will meet Louise tomorrow.  I am ready for that.

I’m also quite ready not to be pregnant anymore.  I’m ready not to have to sleep with a body pillow every night.  Body pillows are fine solutions to the discomfort that can accompany sleeping one one’s side all night long.  But for a fully pregnant woman, they present their own problems.  With these extra 30+ pounds of weight on my belly, I have a hard time turning over from my right side to my left (I honsetly have the grace of a beached sea manatee these days).  And if you add to that moving an entire body pillow from one side of the bed to the other… well, it’s like a wrestling match.  Anyway, tonight will be the last night with that particular problem for a while, and I welcome that.  I also welcome the departure of the extra fluid in my fingers and toes.  My hands are swollen along with my feet now, and it’s actually so bad that my fingers (mostly pinkies) fall asleep if I keep my wrist rotated for any length of time.  For example, if I practice my cello my bow-hand fingers start to tingle after 15 minutes.  I understand that it may take some time for that fluid to drain… but tomorrow begins the process of its exit, and that is fine with me.

And today will be the last day I have to grunt to put on my underwear, pants, socks, and shoes.  It will also be the last day I can take a leisurely shower.  I expect it to be the last day I get out of breath climbing the stairs, and the last day I feel any degree of boredom whatsoever.  The last day of fish oil pills (and fishy burps 90 minutes later) and the last day without diaper changes.  *sigh*  So many lasts that I won’t even notice today… and starting tomorrow, so very many firsts for Andrew, Louise, and me.

How do you buy groceries for a week like this?

Still pregnant!  We’ve tried every piece of advice we’ve received!  And there are some interesting ideas out there about how to trigger labor… I will not go into detail.

It’s hard to distract myself from the fact that I’m just waiting to have a baby.  I feel like the most interesting thing I could possibly do at any given moment is have a real contraction.  And that just isn’t happening.  My body feels so entirely normal that it’s hard to imagine having a contraction.  So I sorta think that it may just never happen after all.  Yet everyone is waiting…  Or it seems like that.  Meanwhile, Louise hiccups and shifts around in me as if it’s just another day, never giving the slightest hint that she’s thinking of making a change.

Last Thursday in Dr. Cleary’s office we learned that Louise’s head is at station zero in my pelvis now.  Every time I’m examined the doctor comments, “Oh yeah, she’s way down here.”  So I suppose station zero is pretty low.   And my cervix is thoroughly ripe and effaced.  (Somehow acknowledging the ripeness of my cervix is slightly embarrassing.)  Furthermore, I’m dilated to a 3 now.  Get out your ruler… yes, you’re welcome for that image as well.  So Dr. Cleary concluded from all of this that I’m about as ready to go into labor as possible.  But I haven’t yet.  This calls for a plan.

The Plan: As long as I don’t “blow” before then (oh goodness), on Tuesday afternoon at 2pm I’ll go in for 2 tests.  One is a non-stress test, checking Louise’s cardiac activity as she moves around in me.  The other test will use sonograph to estimate how much amniotic fluid I have left.  If anything looks slightly abby-normal, the doctor most likely will induce me.  But if everything looks fine we’ll continue waiting.  And then if I still haven’t blown by early in the day on Thursday the 29th, I’ll be induced then (as long as there’s room for me in Labor & Delivery).

I really hope I don’t need to be induced.  My doctors have all my trust and I’m happy with our plan.  But there is a part of me – aside from my apprehension regarding Pitocin – that just wants to experience things without induction.  I want to be sitting on the couch one morning and feel a contraction and to have the thrill of wondering, “Is that what it’s like?  I think that’s it!”  Of course, I’m sure a Pitocin-created contraction will feel thrilling in its own way.  And at the end of all of this we will get Louise, which is the point.  I know there’s no trophy in the Labor & Delivery floor for Best Birth.  But I need to acknowledge the hope I have that things happen of their own accord.  I’d really like to know what that’s like.

Due dates are jokes

Right, so this is our due date.  Ever since we found out we were pregnant today has been the pivotal day of 2011, like one’s graduation day or wedding day.  But really, it doesn’t mean much.  Only, what, 10% of women give birth on their due date?  So there’s not much reason to expect that this is an especially important day.  Mom and I are doing household chores this morning (er, she’s vacuuming and I’m typing), and later this afternoon we’ll go to my OB visit.

It’s just like any other day in Pregnancy Land!

But I’ll feel a little let down if the day passes and I don’t feel a real contraction.  There’s no reason to feel let down, but the build up of the last 40 weeks has focused on this one day… and it looks like it’s just going to be a normal day.  I want Louise to arrive soon so Mom can have as much time with her as possible before Mom has to go back home!  But of course, Louise knows what’s good for her.  We’re putting on our patience hats, ordering Buffalo wings, and reading historical novels until the real excitement starts.

Begin baby watch 2011 (just the pre-game!)

No, nothing is “happening” that would get you excited.  But Mom did arrive last Thursday, so that means Baby Watch 2011 has officially begun.  She and I are at home; my maternity leave has begun; we’re trying to find things to do while I twiddle my gestational thumbs.

Yesterday and last Friday we saw to some very important things, like making sure we have enough newborn, 3-month, and 6-month onesies for Louise.  We also installed the car seat to Andrew’s car.

Today it is more challenging.  I’m realizing my life, sans work, is actually much more boring than Mom’s.  We’re going to have to find her some good books to read!

Also, a big challenge I’m finding is truly being on leave from work.  I check my work email throughout the day… but I’m not supposed to!  I should have tied these loose ends up when I had the chance, or better yet, never let the little ends come loose at all.  There are some high school students who want to know about my lab specifically, whom I promised I would help out despite being on leave (WHY DID I DO THAT?).  I’m supposed to teleconference with them today but it isn’t working out – yet here I am at the computer, waiting with my chat window open in case someone contacts me.  And even though most of my committee work has been given to other faculty in my department, I know they’ll need things from me between now and December.  And then there are the undergrads who want a letter of rec from me for their grad school applications.  They’ve just started emailing me about it.  This is bad timing for them!  How do I decide which ones really need MY letter and which can ask someone else?

The answer is most likely simpler than it would seem.   Work has become my default setting, but right now is just not the time for that.  People are amazingly easy to put off when I say I’m on maternity leave.  They back away as if I were in quarantine.  Other faculty can do what I can!  I’m not THAT special!  So I should use this weapon of maternity leave while I can.  Even though I’m just as capable of working now as I was a week ago, I am officially on leave now and so I should establish non-work as my default setting.  I’m going to start doing just that.  Starting… after this teleconference… for real, really, I will.

Any Day Now Land

So Dr. D checked me out again this afternoon.  The bottom line is: Louise could be coming very soon… or in 2 weeks… but probably she will not be late.

According to Dr. D, if Louise’s head descended any more she would be crowning, and it would be very hard for me to walk.  He didn’t put it in terms of a number, and I didn’t manage to sneak a peak at my chart.  But she’s down – despite what many observers say about how high I’m carrying her.

I am also still 80% effaced, and am 2 cm dilated.  (I always spell that dialated first by mistake.)

So enough stuff is happening that Dr. D didn’t think I’ll get to our due date without going into labor first.

And I also am apparently having Braxton-Hicks contractions just all over the place.  I didn’t realize this.  They feel like something is pushing out on my uterus from the inside, so I’ve attributed that feeling to Louise stretching out her perfect little limbs.  But no, those sensations are really my uterus doing some calisthenics.  And I guess I’ve been feeling these contractions for 2 or so months, so hopefully my uterus is in shape by now.

But I am trying to convince Louise not to select September 8 for her birthday.  There are a couple of reasons for this.  First of all, Mom’s plane arrives early this evening, and I don’t want her to have to ride to the hospital in a taxi.  And secondly, speaking of getting to the hospital, you might have heard of the rain that eastern PA has been receiving.  Well it has swollen the Neshaminy Creek quite impressively, and that’s important because the 2 fastest routes to our hospital are now flooded as a consequence.  So until those roads reopen, dearest Louise, please stay in your dark and noisy nest.

37 weeks

Can you believe it?  Already 37 weeks!  Well, I guess I can believe it… it definitely feels like I’ve been pregnant all year.

Yesterday I woke up with swollen feet and this morning brought the same.  This is a milestone of sorts, because although I’ve had some swelling before it has always gotten worse over the day but slackened overnight.  But not this week!  Tides have turned.  We’re swollen from the moment I step out of bed.  My fingers and toes are full of water.  It feels like I’m walking on 10 tiny hot sausages bursting in their casings.  Or, I don’t know, let’s try for a more feminine image?  I’m walking on 10… queen termites, bloated with their unborn worker termites.  Ugh.  That isn’t much better.  Anyway, the swelling has begun.  I knew it would.

I continue to carry Louise, as Dr. D put it, like a bullet.  She is undeniably protrusive.  People refuse to let me open doors for them now.  The typical utterance is something like, “I should be opening that for you!“  Sometimes, if I feel like I can put my voice in the right tone of cheer, I mention over my shoulder as I shuffle by these helpful souls that my doctor hasn’t yet told me to stop opening doors.  (I mean really, if I can manage still to shave my legs in the shower, I can pull open a door.)  But usually I’m met with looks of confusion when I say something ungrateful in a happy voice.   So I don’t say that often.

This morning I met with Dr. D.   I don’t know why I’m obsessed with how male gynecologists go about pelvic exams, but I find it very interesting.  Last week, Dr. O had me in the stirrups but barely even leaned over when he checked me for effacement.  I think if he hadn’t needed to look at my lady parts, he might have even turned his head throughout the process.  And today, Dr. D (who remembers my job and calls me Professor when he sees me) had a female assistant come in the room just for the pelvic exam.  I tried not to notice and continued to chatter toward the ceiling about how I’m still going to work but I don’t really have much to do there.

But perhaps the results of the exam are more interesting than that.  Louise is definitely presenting head first.  Her position in my pelvis is -1… that’s on a scale of -5 to +5, with -5 being up higher and +5 being the equivalent to crowning.  Last week Louise was -5, so she’s been doing some work.  As has my cervix… last week there was no effacement to speak of, and now we’re at 80%.  (“We” being… my cervix and I?)  And no real dilation.  Dr. D emphasized that he cannot predict for me, as an individual, how much longer it will be until I get some good real contractions.  But I’ll go back in a week and see what has happened since today!

I continue to be frustrated by how little physical labor I can do before my back starts to hurt.  Earlier this week my grandmother’s dining room set arrived at our house, along with several other boxes of miscellaneous things from her house, my mother’s house, and my brother and sister-in-law’s house.  I was so excited about all of this that I unpacked it all immediately, and I unpacked our china to put in Grandmother’s hutch.  The unpacking was lovely and bittersweet and… God, it made my back ache!  Just an hour of reaching into boxes and carrying things to shelves!  It’s a good thing I had just eaten a snack, because if I combine physical labor with low blood sugar I end up sobbing for no good reason.  Oh, doesn’t this sound like fun?  I am a lovely housemate these days. 

Her head’s down

According to this week’s gynecologist (Dr. O), I am neither effaced nor dilated.  And that’s fine – except that I’ve been making up in my head this past week that I could feel changes in my cervix.  But that was just things getting made up in my head, and now we know.  Louise hasn’t descended into my pelvis or anything, but I already knew that just from looking at the giant yet still-perky balloon-shaped thing under my shirt.  (See below for the shirt-free version of said balloon.)  But the good news is that Louise’s head is down.  So there’s that!  I like that!  Good job, Louise!

Also, here is a very funny post about the often-feared experience of pooping in front of everyone in the delivery room.

Andrew and I have picked out a daycare place.  We looked at three well-rated ones near our house, and one of them – the farthest of the three of course – had an especially good feeling about it.  The director has been there for over 25 years, and the main woman in the infant room has been there for 20 years.  So I will perhaps not be terrified and guilt ridden by leaving Louise there.  Oh, who am I kidding?  I’m way too good at feeling guilty to avoid that.  But Louise will be in good hands.

Photo shoot

A couple of Saturdays ago Andrew asked me to pose for a photo shoot he had in mind… You’ll just have to take a look below.  I fully consented to this ridiculous concept, by the way.  He is not in trouble for it.  In fact, I embrace any excuse to rat my hair and wear 700% more makeup than usual.