Monday, August 31, 2015

Butternut: A Birth Story

Greta was born on Friday, July 3, but her birth story actually starts two days earlier.

TL;DR - I had a successful VBAC.

I knew before I was even pregnant that I wanted to try for a VBAC (vaginal birth after caesarean). My doctor had already told me I was a good candidate for a VBAC because my c section was due to Willa being breech and not because my body didn't progress with labor. During my prenatal appointments for Greta, my doctor again confirmed that if I wanted, I could try for a VBAC. Even with the risks, I had to try. I wanted a vaginal birth if I could have it. It was an experience I yearned for.

It was about three o'clock in the morning on Wednesday, July 1, when I woke up because of some cramping. It took me 30 seconds or so to rise up into consciousness and realize that the pain I was feeling were contractions. And not the Braxton-Hicks contractions I had been feeling for a while. These were strong and much lower than the Braxton-Hicks. Stronger than the true contractions that had been irregular for a couple weeks up until then.

The wave of the contraction passed, and I tried to go back to sleep. Twelve minutes later, another came crashing over me. About this time I realized I was alone in bed as John had sought the quiet of the guest room that night. (Apparently I snore at the end of my pregnancies. It has happened both times.)

For the next several hours, the contractions continued to come every 10-12 minutes. With the regularity and intensity, I knew these weren't practice contractions. That this was the beginning of labor. But my doctor told me not to go to the hospital until contractions were 5-7 minutes apart. So I breathed through each contraction as it came and waited. They never got closer together and eventually I managed to get out of bed and take a shower.

When the hour became more decent, I woke up John and told him I thought today might be the day. We talked about what to do and made a plan to get Willa up and to daycare and see if the contractions continued. We made calls to all our family members to let them know it would be soon. But by the time we got Willa to daycare, the contractions had slowed down and lessened in intensity. I decided to call my doctor and get her opinion. She agreed that it wasn't time to go to the hospital yet.

The bigger decision to be made... do I go into work or stay at home? Spoiler alert: I went to work. I knew if I stayed at home and labor did not progress that I would feel guilty and lazy for that decision. I also had a couple final things I wanted to get done at work before I left on maternity leave. I know. I should have stayed home to rest. I took it easy at work, and instead of going to book club that night, I went home instead.

That evening the contractions started coming harder and faster again. Still not fast enough to go to the hospital. I listened to some good advice and took a warm bubble bath before I tried to go to sleep. It was relaxing, and I was able to sleep for an hour or so before a contraction woke me up. That night the contractions were intense, but they were irregular with intervals that were 15-30 minutes. I would sit up in bed and sometimes rock back and forth while focusing on breathing to get through each one. I didn't get much sleep.

Once again, when the morning came the contractions grew even further apart. However, the intensity was still there. Since my contractions were still pretty intense, and I was exhausted from not really sleeping, I decided to stay home. I did a little bit of work in the morning and then tried to relax. I had my 39 week prenatal appointment that afternoon. Before John left for work, I told him he would need to come home at lunch so he could drive me. There was no way I wanted to drive myself. Since my contractions were strong, I didn't want to have one while driving.

Lucky for me, my mom was in Dallas that day for a work meeting. We met her for lunch before my appointment. And since she was as anxious as we were to find out if the show was really getting started, and she didn't want to be back in Fort Worth in case my doctor declared at my appointment the baby was coming that day, she came to the doctor's office with us.

The doctor confirmed I was a couple centimeters dilated and mostly effaced, further proof that this show was warming up. We talked strategy of what to do should contractions progress enough to go to the hospital over the holiday weekend. We made plans for an appointment on Monday in the (extremely unlikely) case that I didn't have her over the weekend. As we walked out, I was partly relieved that I didn't have high blood pressure or any other complication that would have resulted in induction and/or a caesarean section and partly disappointed that I had no more clues as to when this was going to happen.

On the way to our cars, my mom suggested she play hooky that afternoon, and we go get pedicures. (It's an old wives tale that getting your feet rubbed can induce labor. I must say the evidence from many women I know suggest its plausibility. It certainly couldn't hurt, and I'd have pretty toes.) We sat in the massage chairs and talked about different scenarios and plans for what we'd do with Willa when it came time. After pedicures, we picked up Willa from daycare, and my mom took us home.

That evening with just the three of us, I tried to relax. But the contractions were already getting stronger. I called my sister-in-law Jen who is a doula to ask her advice on how to deal with the pain until it was time to go to the hospital where I planned to have an epidural. She suggested several positions that were good for relieving pain in the lower back where I was feeling it mostly. She also suggested I create my own hot compress with a sock and rice. (That thing was the best.)

Once again I took a warm bath to relax before trying to go to bed. I wasn't asleep long before the contractions woke me up shortly after 10. This time I couldn't even sit up in bed. I somehow managed to slide off the side of the bed and tried several positions to see if it felt any better. What I finally found to work for me was hugging my exercise ball and rolling on it back and forth. After the contraction passed, I crawled back into bed to try to sleep only 10 minutes later to be back on the floor hugging that ball.

This happened a few more times before John made the decision to call his parents to come over to be in the house with Willa while we went to the hospital. I then called my parents to let them know we had called John's parents to come over and would likely be on the way to the hospital soon. After I hung up with my mom, I called my doctor who said she'd let the hospital know we were on our way and gave me instructions on which entrance to use since it was late in the evening.

I actually contemplated taking a shower while we waited for John's parents. But then another contraction came, and I wasn't confident in my ability to stand for the duration of a shower. I reasoned I had taken a bath right before bed so I was probably okay. We got dressed, and John got his stuff in the car as my bag had already been there for a couple weeks.

(Poor Cooper. He was confused as to what was going on. The evening started like normal and then we started turning lights back on and walking around the house and packing things. He didn't know what to think.)

My in laws arrived. We gave them some instructions and talked tentative plans for us to call when it would be a good time to bring Willa to the hospital. I did my best to be my usual gregarious self while contractions kept coming, and I couldn't help but wish I was already at the hospital with the epidural administered. After a few minutes, we were finally on our way.

The drive was uneventful. John didn't break any speed records, and we arrived within 15 minutes pulling up in front of the entrance for after hours labor and delivery arrivals. I'm amazed they let us in after John told the nurse on the intercom "We need to come in." I thought for sure they would think we were crazy or something. But when I mentioned my name and my doctor's name, they opened the doors for us.

I wasn't able to walk at my normal pace so we slowly made our way into the hospital and up to labor and delivery where I checked in and tried to remain standing while John filled out the paperwork. After walking gradually to my room, I changed into a hospital gown and crawled into bed hoping that the check in process would be quick. At this point it was about 12:30 a.m.

I got settled in bed and started answering the nurse's questions. John went to get the rest of our stuff out of the car and move it into an actual parking spot. But before he left, the nurse asked him if he wanted to wait and see if labor had really started and I would be staying. "Oh. It's started. We're not leaving." was his reply.

The nurse took my information and checked to see how much I had dilated. It was enough that the doctor confirmed I should be admitted and wouldn't be leaving. This was a relief because it meant as soon as my IV was inserted, I could get an epidural.

My contractions were coming stronger and faster. I started squeezing John's hand every time one came to help me focus on something else besides the pain. Finally. Finally, an hour and a half after arriving, the nurse anesthetist came to administer the epidural. She warned me about how it may be hard to sit still, but I wasn't worried. I was prepared to do whatever I needed to do so the pain would be numbed.

She had said it may take up to 30 minutes to be completely numb, but I started relaxing almost immediately and chatting more with the nurses. I hadn't been especially chatty up to til then. My legs felt warm and tingly. I was so happy to be at this point... Labor started and progressing naturally. I didn't have to be induced. Epidural administered. (My doctor and I had talked about the epidural a couple weeks prior and agreed that getting an epidural was the best call in case there was an emergency situation. Then the epidural would already be in place, and I wouldn't have to be completely put under and could be awake for a c section if needed.)

At some point during the admitting process, my parents had arrived. After the epidural was confirmed to be successful, they were allowed back in. This was about 2 a.m. so we were all instructed to try and get some sleep while we could. I still had several centimeters to go before it was time to push.

John and my parents slept on the pull out couch and chair in the room. I tried to sleep. Honest I did. But I had so much adrenaline flowing through me that I couldn't turn my brain off so I didn't get much sleep. I did doze a bit. It didn't help that the nurse had me in a position on my side with a leg raised to try and encourage my progress. The nurse came in a few times over the next several hours to change my position.

Sometime around 5ish I was feeling pain in my lower pelvis and even though I had pushed the button for more medicine, it wasn't helping much. I was starting to feel contractions again. So I mentioned it to my nurse and after discussing it decided to order a bolus. It felt like cool water had been poured down my back and once again, I couldn't feel the contractions.

The nurse shift change happened at 7 a.m., and my doctor arrived at the hospital. John and my dad went to get breakfast while I got checked again. I had progressed but still wasn't at the magic number of 10 centimeters. We did discover at this time that Greta was sunny side up aka face up. Luckily, this didn't mean a c section. Just meant that delivery may be a little bit tougher. So once again it was time to get into different positions to encourage not only cervical dilation but also see if Greta would flip over.

The doctor broke my water and noticed something to be concerned about... meconium came out with the amniotic fluid. It meant Greta already had her first bowel movement. The concern was that she may have breathed some of the meconium in. It meant that she would have to be looked at immediately following birth to make sure she hadn't swallowed any of it and that her breathing was clear. Once again, it didn't mean an automatic c section (thank goodness).

I was starting to feel pain in my lower pelvis again around 8ish so I rang for the nurse to ask for another bolus. My nurse was busy so the charge nurse came in to help me. While she was there, she checked to see how much I was dilated. It was about 8 centimeters. The nurse said something about pitocin. I told her I had no pitocin, that the progress was all me. She was surprised and encouraged me to keep going.

The rest of the morning was spent in various positions trying to use gravity for Greta to put more pressure on my cervix so it would finish dilating and also in the hopes that maybe she would turn on her stomach.

My sister arrived and sat with me for a while. It was during this time that my nurse had me on my hands and knees in the hospital bed. Conversation with my sister was interesting seeing as my butt was in the air. This was by far the most uncomfortable of all the positions she had me in, but I didn't care. Whatever I needed to do to deliver that baby vaginally, I was going to do.

After about 30 minutes on my hands and knees, I had had enough and asked to be repositioned. I was at 9 centimeters, and my doctor suggested we try a little bit of pitocin to get me the rest of the way. I was a little disappointed to be using pitocin at all. But considering how I got to 9 all on my own, it didn't really bother me that much.

At about noon, my doctor declared it time. Nurses started prepping, and there was a lot of activity in the room. My doctor gave me instructions for pushing. It felt so surreal. Like I was watching it instead of experiencing it.

The pain in my lower pelvis was becoming more pronounced again, so I asked if I could have a bolus. They wouldn't let me have it because they wanted me to have enough feeling to be able to push. This did not help my anxiety.

I had started trembling an hour or so before this even though I wasn't cold. It was partly my hormones and partly anxiety. I remembered how I trembled being wheeled into the operating room to have Willa. As the morning went on and my labor progressed, I got more and more nervous about the job I had to do. Even though this was my second baby, because of the c section, my body was responding to this birth as if it were my first. I had no idea what to expect, and I was scared. Scared of the pain, scared of a potential second c section after all that work I had already done. But dammit I was determined. I took strength from John and my mom who were both there with me and from the rest of my family who were in the waiting room.

My legs went into the stirrups, and as a contraction came, I pushed. I wish I could say I pushed a few times, and she was born, but this was not a movie. It did not happen that fast. Despite my epidural I felt a lot of pressure and some pain. My doctor gave me a local anesthetic, but I don't know how much it actually helped. 

I closed my eyes to try and remove myself from the pain I was experiencing. I was getting tired, and my doctor noticed. She gave me three options: 1. Continue pushing as I had been. 2. Try the vacuum to see if that would help. 3. C section. I absolutely did NOT want the c section. I had not just been through all that labor pain to end this thing in a c section. So I gave her permission to try the vacuum.

Three attempts with the vacuum didn't do much to get Greta to budge, but it was successful in another way. I realized if I wanted to avoid the c section, I was going to have to dig deep. That it didn't matter how tired I felt, I was going to have to find the energy from somewhere to get across that VBAC finish line.

My delivery nurse was a petite woman who was an obstetrician in China. During labor she knew which positions would work to get my cervix to open up and Greta to move into position. During the pushing she encouraged me to grab my legs rather than the handles on the bed. And I hate to admit it, but she was right. Grabbing behind my knees worked much better than the handles did even if it did hurt more. 

At some point my doctor needed to step out, and the nurse moved into her position so I could continue pushing. She was really good at encouraging me, but whenever the nurse touched me to try and stretch the birth canal, the pain became much worse. It was so bad that I envisioned what it would be like to kick her in the head. My legs were in a good position. I could say it just slipped  during a contraction while I was pushing. I didn't do it, but it felt good to dream about it and gave me something else to think about.

The pain and the pressure were getting more intense. I thought back to my swimming days and remembered something my coach would tell me... swim through the wall. Don't stop before you get there. Put all your energy, all your power into those final strokes, and hit the wall strong. I found the energy I needed and put all I had left into pushing. 

Finally, almost two hours since I had started, at 1:43 p.m. Greta was here. The pressure was gone, and my beautiful girl was here. It was an emotional moment. I was elated, relieved. There was so much joy. I had to wait until the doctor was done stitching me up before I got to hold her. When we finally got a chance to go skin-to-skin, I whispered to her and told her I was proud of her. Together we accomplished something beautiful and miraculous.

I knew what we had accomplished was great, but I didn't fully realize it until later when I was in my postpartum room. Every nurse we had would express surprise and admiration when she learned I had a VBAC, especially given Greta's size (8 lb 10 oz). That's when I started to understand what we had done. Not every woman can attempt a VBAC, and not every doctor does them. Even the women who try for a VBAC often have a repeat c section. I feel lucky that I had a doctor who encouraged me to try and not give up.

The lesson I took from this was not the first time I had learned it, but it was the most glorious version I've ever experienced... that I can accomplish great things when I am determined. Sure it may not be pretty and it may hurt, but the result can be beautiful... just like my sweet Greta.

Picture taken by Sassypants Photography

Monday, August 3, 2015

Butternut Month 1

Dear Greta,

It's been one month since you joined us. You have slid into your place in this family as if you've been here all along. All of us are enamored with you. Your sister runs into the house in the evening squealing, and the first thing she does is look for you. You are too young yet to react to her kisses and hugs though I look forward to the day when you are just as smitten with her as she is with you.

So far you've been an easy baby. You're easy to soothe. It usually just takes a paci and some cuddles, and you settle right down. Unless you're hangry. Then you make sure the whole neighborhood knows how mad you are.

Except for the second and third nights you spent on this earth when you were up every 1-2 hours, you've been a good sleeper at night. For a couple weeks now, you've only been waking up once to nurse, usually around 3 or 4. Though a couple times you've gone all the way til 5. You've been sleeping in our room this month. I'm planning to move you to your room this week so we'll see how that affects things.

Picture taken by Sassypants Photography

Your favorite game is Let's Poop in the Fresh Diaper Mom Just Put On Me. You're really good at it, having reached master status already.

When your sister was a baby, I was too nervous to leave the house with her by myself. So I spent the majority of those first couple months at home. With you I have had no such anxiety. We run errands a couple days a week together. Some trips are better than others, but it is always good to get out of the house. And I no longer stress if you start to fuss in a store. I pull out the sling, and you're much happier hanging out there as I finish up.

I've already called you by your sister's name more than once. I'm afraid that's something you're just going to have to get used to. If it makes you feel any better, Omy still calls me Laura on occasion.

Welcome to the world, baby girl. We are so happy you're here.


Picture taken by Sassypants Photography