The story of
Erik’s birth and the events of our first week together:
Saturday, March 2 promised to be a lovely day. Jake had planned to go golfing with a buddy
from work and I had planned to have lunch with some friends, followed by
pedicures. We figured we should get in
some time with friends before Erik made his appearance. I got up at 5 a.m. for a routine bathroom
trip, accompanied by the routine Braxton Hicks.
After climbing back into bed, however, the contractions (or surges)
didn’t stop as they normally do. I
decided to start timing them. They were
irregular but persistent, coming every 7-10 minutes, but not painful. I let Jake know I was timing them and he
snoozed and I rested and wrote for the next two hours. I finally fell asleep around 7 a.m. and slept
til 8 a.m. The contractions came back
quickly after I woke up, but perhaps they had never left? Jake decided to cancel his golf game but I
said I was still going to lunch with the girls.
We got up, had breakfast and I gave Jake a haircut while having surges
about 5-7 minutes apart. They were
starting to “pinch” at this time and I was making “OW” faces. I left for lunch about 12 and by the time
lunch was over I was squirming in my chair with each surge and feeling slightly
nauseated. We had already agreed to skip
the nail salon J I arrived home at 1:45 and my contractions
were 2-4 minutes apart but only last 30 seconds. I called the nurse triage line around 2:45
and asked what they thought I should do given the short nature of the
contractions. They advised I go to the
hospital. I hung around at home for
another couple of surges because I didn’t want to get to the hospital and only
be 3 or 4 cm. We finally headed out the
door at 3:15. Between the car ride and
the time we spent registering in the ER I had a few surges that brought tears
to my eyes so the ER nurses took me up to OB triage quickly. We did the required 20 minutes of fetal heart
monitoring but I chose to lean over the bed instead of lying down. I was 5 cm when she checked me. We were soon in our labor room and I asked
for the water tub to be filled.
The next many hours were filled with increasing painful
surges, many changes in position and a couple of episodes of vomiting. We had taken the clock off the wall so I
wouldn’t get discouraged by the slow passage of time so I don’t really know the
timing of the rest of the labor. I had
surges on the toilet, in the birth tub, on the birth ball, leaning over the
bed, on hands & knees on the bed, hanging around Jake’s neck, leaning on
his back as he sat on the edge of the bed, lying down (very painful!), and
hanging on the birth bar. After several
hours my midwife agreed to check me but I had told her not to tell me how many
cms I was if I wasn’t at least 8. She
said, “Good job, you made your goal!
You’re 8 cm.” In my estimation it
took another two hours to get to 9 cm and another hour and a half to get to 9.5
cm. My midwife said I had a large bag of
“bulgy forewaters” and offered at 9 cm to break my water. I declined but accepted when she offered
again at 9.5 cm. Erik immediately moved
further down the birth canal and we got to the pushing stage pretty
quickly. But pushing lasted two hours
and was the saddest part for me.
Because I had vomited several times and was unable to keep
anything down for long I lost my energy and my will to keep going by the time I
got to 8 cm. I started saying, “No
more. I don’t want to do this
anymore.” But I knew I didn’t have any
choice. By the time we got to pushing I
had completely lost any desire to keep going and any energy I had left. I kept saying, “I’m so tired. I just want to sleep.” I asked for pain medicine but everyone kept
telling me, “You’re so close! You said
you wanted to do this without medication.”
They were sincerely trying to support my birth plan and I knew that and
I didn’t push the issue because I didn’t want to go through the hassle of an
epidural if I really was “so close”. But
I believe that had I insisted they would have listened to me.
Between my lack of energy and having sort of “given up”
emotionally & mentally, my midwife suggested that I push in a semi-reclined
position. She said, “I know you don’t
like the idea of this position but you’ve said you’re really tired and I think
you should lie down.” I did try pushing
while up on the birth bar but I really was too tired to stay upright. I realized later that I should have had an IV
put in and been given some sugar water long before I got to this point. But somehow none of us, at that time, seemed
to realize that would have been a big help to me. So I pushed, quite ineffectively, for a
while. Then Erik started having variable
decelerations with the pushing. I had
been trying not to hold my breath while pushing but when his decels started the
midwife had the on-call OB notified and the midwife said, “Erik’s ok, but it would
be better to get him out sooner rather than later.” So they had me change to closed-mouth
pushing, which Jake and I are both sad about because we wanted to avoid
that. I don’t know if the closed-mouth
pushing caused Erik to continue with decels, or if it led directly to my
post-birth complications but I didn’t know what else to do. I wasn’t moving him down well at all and felt
like my energy was being diffused rather than directed when pushing. They got the mirror out for me to help me see
what I was doing and that did help some, but I know that over and over in my
head I was saying, “I don’t want to. I
don’t want to.” And I know that that had
a huge impact on how slowly things went.
Finally the midwife had the OB come in because we were beginning to
discuss and episiotomy versus use of the suction. Inside, I was actually relieved to think that
I might get some help, although I did not
want the episiotomy. Well, the OB came
in and assessed the situation and her reaction was, “Oh! She doesn’t need help! She’s got this!” Those words were encouraging in a way because
I assume that all OBs just want to intervene but she was confident in my
ability to birth unaided. In the end,
with a lot of stretching from the OB and the midwife and with a lot of
concentrated pushing and with lots of verbal encouragement from Jake and Kori
(our hypnobirthing instructor who attended the birth) Erik finally came out at
2:03 a.m. on Sunday, 3/3/2013 and Jake cut the cord. I had a 2nd degree tear and was
so, so, so relieved that it was all over and I would never have to re-enact that birth ever again. Erik had his left
hand up beside his head and the midwife doesn’t think that I would have torn if
his hand hadn’t been there. Erik cried
immediately but settled down quickly. He
was very tired and didn’t attempt a crawl to the breast and didn’t want to
nurse for a good while. We did manage to
nurse just before a full hour had passed.
In the meantime I gave him to Jake so I could concentrate on staying
still for the midwife while she sewed me up.
By the time she was finishing I was saying, “Oh, man, I need to get off
my butt! It hurts a lot!” (Jake was busy with helping Erik get weighed
and cleaned up.)
The pain in my buttocks continued to increase after my
midwife had left and within an hour or two I couldn’t move with crying, despite
having taken some Vicodin. Also, every
time I tried to get up my blood pressure would drop and I would get dizzy. The nurse started IV fluids and checked my
bottom but couldn’t see anything amiss.
She knew, however, from my behavior that something was wrong. She called my midwife who immediately
suspected a hematoma (A collection of blood in the tissues created by a
ruptured blood vessel. The growing mass
of blood puts increasing pressure on the tissues and creates pain.) The midwife came back to the hospital and as
soon as she began an internal exam the hematoma, which was just on the other
side of my vaginal wall, partially released.
It made my pain level go down dramatically but it made the midwife say,
“I need a doctor in here. NOW!” So the OB who had been there during the
delivery came back and I got loaded up with some IV pain medicine before being
taken off to the OR for packing of the rupture in the vaginal wall and to provide
pressure to stop the bleed. I was told
later that they took down the original stitches the midwife put in so they
could get a better view of things, put the packing in and re-did the stitching
of the tear. Then I was sent for a CT
scan to see if there was any active bleeding continuing. There was not, but the CT showed why there
wasn’t any external evidence of the hematoma.
The blood, instead of pooling with gravity in my butt, was pooling in my
abdomen.
By the way, Jake did a great job of being my labor partner
and then staying calm throughout the following bit of chaos and taking care of
Erik. This next bit isn’t really funny
because it shows how we medical personnel forget that others don’t always know
what we’re talking about, but it is the most amusing thing of the entire story
and that’s why I share it. Jake thought
when they said “packing” that they were going to use Styrofoam peanuts, like
packing a box!
So, after the OR and CT I was taken back to my room, given
lots of fluids and three units of blood.
I finally got to just hold my little baby and loved snuggling with
him. Erik was discharged on Tuesday but
he and Jake stayed in the hospital with me til I was discharged on
Wednesday. We had to wait for my blood
counts to stabilize.
By Friday morning, after only being home for one and a half
days, my pain level was increasing and I made an early morning trip with Jake
and Erik back to the midwives’ office.
The midwife who saw me was reluctant to examine me for fear that the
hematoma might re-open. She conferred
with the backup OB in the office and they had me go to the ER and told me I
would likely be re-admitted. We spent
most of the day in the ER trying to get my pain under control, doing another CT
scan, realizing that I wasn’t fully emptying my bladder and having a catheter
put in. The full bladder, added to the
hematoma, added to not having had a bowel movement in a week meant that I had
too much matter in a very small space!
That was part of the reason for the increased pain. I was admitted to a room later that evening
and even though my OB saw me in the ER he didn’t examine me. He said he wanted to keep me overnight for
bladder rest and pain control. Right
before I left the ER for my overnight room the tech took my vitals and I was
starting a fever. The temperature
reading was higher when my vital signs were checked later that evening and the
on-call OB was notified. She came and
not only talked to me but did a gentle pelvic exam and said, “Oh, honey. You have an odor. You’re infected!” She put me on three strong IV antibiotics
because she was worried the hematoma might be becoming an abcess and we spent
the next three days discussing whether or not they would and could drain the
hematoma. Finally I was sent home on
oral antibiotics with a decompressed bladder and bowel, feeling much
better. (Thankfully, Jake’s mom was here
over that time and kept Erik for three nights while Jake and I caught up on
sleep.)
So what would I do differently and how have my opinions about
birthing changed?
1.
I should
have had the IV.
2.
I don’t know what I could have done differently
with the pushing but I hope that next time it’s different.
3.
I completely
understand why people get epidurals and I’m not sure I’ll tough it out
“naturally” next time.
Now you know the rest
of the story.