Katie's Birth Story (Part 1)

Today, Katie is one week old! She and Mark are taking a nap in the recliner, and Ben is at the zoo with his grandparents, so it seemed like the right time to try and document this little girl's birth. It took me a while to process it all, particularly since there were a number of "interventions" that I was not thrilled about. But after a few days of thinking about it, and talking about the labor and birth with Mark and Patti (our doula), I am at peace with the whole process and grateful for a beautiful birth (even if the labor part was a bit tough at times). And as our doctor liked to often remind me that his job is to "have a healthy baby and a happy mom. In that order." And Katie is off to a great start, so I have much to be grateful for.

As noted in the previous posts, this pregnancy was pretty standard by most accounts right up to the end. At my 38-week check-up on Friday, Dr. Del thought that the baby seemed transverse (sideways), so ordered an ultrasound the following week to check her positioning. I had a labor prep massage scheduled with Patti the following Monday, and she assured me she could help make room for the baby to move. It did seem that she was able to move her into a more head-down position, and the ultrasound that Wednesday confirmed that she was indeed head down! But as the ultrasound technician was taking additional measurements, she mentioned that the amniotic fluid levels looked a rather low, and that we might be having this baby sooner than we thought. After the ultrasound, Mark and I went to sit in the waiting room for my appointment with Dr. Del (ultrasound lab shares a facility our doctor's office) and wondered what did this mean? Was he going to send us to the hospital right now to be induced? Is this just something to watch? Fortunately, it wasn't a long wait until we saw the doctor. Before examining my cervix, I made him promise not to do anything (ie strip membranes) until we could discuss it. He announced after the exam that the "only nice thing he had to say about my cervix was that it was a bit soft." Still closed up and tight, though. He also told us that we needed to have this baby soon, and that we weren't going to be able to wait until my due date to deliver her. He wanted me on bed rest so that my body was only focused on making more amniotic fluid, and that we needed to schedule an induction for early the next week. We were in a bit of shock for much of this conversation, but Dr. Del showed that he knew us and our desires at this point, and he handled the conversation very well. He assured us that the induction would be slow process, and he understood how much we wanted to just let nature take his course. But he was also serious about getting the baby out, and didn't say anything to scare us, but his seriousness made us understand that this wasn't just an induction for convenience. He wanted to induce on Monday, and said Tuesday would also be okay...but also wanted me to come in on Saturday for a biophysical profile of the baby to see how she was doing. (The appointment we were discussing this on was on a Wednesday). The hospital did not have any room for planned inductions except for Sunday night, so he said we would not need the biophysical profile and could just proceed with the induction on Sunday.

Mark and I headed out to lunch after the appointment (Ben was in school), before heading home to be on bed rest for four days until the induction Sunday night. I had planned to go back to work that afternoon after the appointment, so it was strange to be instead planning Ben's care during our hospital stay and determining what we needed to do to get ready for the induction. I went back and forth between doubt over whether this was really necessary and worry about whether the baby was going to make it okay until Sunday. Had we not had this ultrasound to check positioning, we would not have known about the low amniotic fluid levels, and would have proceeded normally. Would she have been just fine? Was all this unnecessary? Or was it a blessing to know this information so we could ensure that she was delivered before something went wrong?

The next few days of bed rest were very strange. I had a work meeting that afternoon that I decided to still teleconference into (from my laptop on our recliner), and begin the process of notifying my work contacts that I was starting disability leave immediately. I then spent a lot of the next couple of days (Thursday and Friday) wrapping things up on my laptop for work, since Ben was in school. I also took a few naps, watched some movies, etc. And I spent a fair amount of time fretting over the whole situation. I was worried that my bed rest would postpone natural labor, that the baby would turn sideways again, and that my body would become lethargic from not moving for several days and I would have increased difficulty during labor and delivery.

Mark and I had a lot of discussions about whether we should have another ultrasound done before the induction began (maybe the amniotic fluid levels went up?), whether I should really be on bed rest, or should try and move around some to try and kick-start labor myself, etc. But at the end of the day, you have to decide to trust somebody, and we decided that Dr. Del had thus far earned our trust and knew our desires. It was more important to have a healthy baby than to have the labor and delivery experience we were hoping for. So on Saturday, I scheduled another labor induction massage with Patti, and she was encouraging saying that my body looked like it was ready to handle labor.

When Sunday came, it was a relief to be approaching the end of the bed rest, and the beginning of the next stage. It was a fairly leisurely day, and we planned to go to Olive Garden for dinner that night before picking up my dad from the airport. However, the airline information indicated his flight would be in earlier than normal, so we decided to wait for him to arrive so we could all have dinner together. Mark and Ben set off for the airport to pick-up my dad around 6:30, and I settled into the recliner to wait for their return. It was strange to be in such a quiet, empty house knowing how many changes our lives would bring in just mere hours. I decided to turn on the TV (which Mark had just recently set-up so that I could actually figure out how to use it!) and watched part of an episode of "One Minute to Win It" and then part of "Desperate Housewives." I felt very relaxed, and welcomed the distraction of TV for a few minutes.

My dad's flight ended up coming in as scheduled, instead of early, and it was getting pretty late in the evening by this time, so they swung by the house to pick me up for a quick dinner before Mark and I needed to head to the hospital. I chose Taco Bell as my "last meal", so the four of us (me, Mark, dad and Ben) enjoyed a quick dinner together. I was really glad to see that Ben remembered his grandpa, and seemed very comfortable with him and the idea that Grandpa would be taking care of him for the next few days. We then went back home, got Ben and Grandpa settled into decorating a couple of cupcakes, as we had promised a birthday celebration for Ben with Grandpa upon his arrival. We then said our goodbyes, and Mark and I headed for the hospital.

What a different drive it was to the hospital for Katie's birth, than it had been for Ben's. With Ben, I was in labor and very uncomfortable, and we had to get through some traffic to get there. This time, it was about 9:20 pm on Sunday night, and the roads were quiet. We parked in the parking garage so that I could get a chance to stretch my legs a bit on the way to our room. The garage is a pretty good hike from the labor and delivery section of the hospital. The hospital was very quiet, and we headed to triage so that we could check in at the admissions office. The admissions lady was very busy, and we kept getting interrupted by calls and stop-ins, so we didn't actually get to our room until about 11:15 PM. I also had to sign some forms in another office as well, while Mark went to try to find a bottle of water for me to "sneak" sips from until we were assigned a room. After we filled out all our forms, we waited in the lobby with a few other people, who looked like they were friends/family awaiting a first peak at babies in the newborn nursery.

We were finally assigned a room, and were a bit disappointed to find that it was the very smallest room that they have at the hospital. In fact, we had peeked in the very room we would be staying in during our hospital tour, when the nurse showed us the "small" room before escorting us into the bigger room to explain the hospital processes, etc. Our night nurse, Teddy, put in a heplock, drew some blood, and then left us to get settled before returning to insert the Cervidiil (cervix ripener) for the night. We were delighted by a surprise visit from Dr. Del at around 11:15 PM. He had been out of town for the weekend, and just stopped by to see how we were. I was very touched that he came to see us before everything got started.



At about 11:45 PM, Teddy checked my cervix, which was still long and not dilated, and inserted the Cervidiil. After she inserted it, I got a bit nauseous and light headed, so she brought me a bucket in case I needed to throw up. The feeling quickly passed, and Mark and I took a few pictures, and then got settled into bed --- me in the hospital bed, and Mark on the little window seat in the corner of the room. We chatted for a little while, and sort of waited for sleep. But of course, who could sleep with all the excitement ahead of us?! I began to worry a bit that if I started to feel contractions during the night, that I wouldn't be able to sleep and I would be too exhausted for the real labor the next day, so I requested an Ambien at about 12:30 to help me sleep. Teddy had told us it was an option when we first checked in, but as always, I was afraid to do anything "unnatural" and so was hesitant to accept it. The medicine did help me relax and go to sleep, but it also gave me such wild dreams! The first, mentioned in an earlier post, was about a big hole in the room and Mark and I were trying to push all the furniture out the hole. Perhaps symbolic of an approaching birth? The second dream about the furry, winged animals seemed like something out an advertisement for the "wild things" movie that I had seen on TV earlier in the evening.

Around 1 AM, Mark got into my hospital bed to snuggle with me for a little while. It was very comforting, and a good reminder that I wasn't doing this all alone. We enjoyed a few minutes of closeness before he returned to his own "bed" to get some sleep. I remember hearing Teddy come in while he was in my bed, but she didn't say anything, and I wondered if she thought it was sweet or weird that he was in there. We both decided that we didn't care, and that the beds were designed to probably hold very large people, so it could certainly hold the two of us. :)

I woke up a fair amount during the night, but fell quickly back asleep. As the morning light began filtering in the room, I had more and more trouble staying asleep in anticipation for all the excitement that was yet to start. I wasn't expecting to get the pitocin until 11 or 12, so I wanted to sleep for as long as possible, but by 8:30 I just needed to get up. I tried to do so quietly, so Mark could sleep longer, but he also woke up, and we decided to start the "day."

I brushed my teeth and hair, and put in my contacts to feel more like day time. I was REALLY hungry and wished I could have something to eat. Fortunately, Dr. Del allowed me to have apple juice and ice chips throughout the day, so I settled on a glass of apple juice on ice for breakfast. Mark and I took some pictures to document the beginning of the day, and then I posted an update to the blog at around 9 AM while Mark updated our delivery "log" so that we could remember all the details about the labor.







I was getting eager to get started --- or at least to get out of bed, so I asked Paige (our day nurse, and also the daughter-in-law of our doctor, who we had requested per Patti's advice) if we could walk around the halls for a little while. She called Dr. Del to ask him, and he instructed her to remove the cervidiil, and then we could walk around for an hour before starting on the pitocin. Paige removed the medicine, and checked my cervix, which was now soft and dilated to 1 cm. She was very encouraging, and told us that everything was on track to continue progressing the induction.

Around 9:45, we took a few laps around the halls, and then Mark went to get breakfast while I waited in the room. He returned around 10:30, and we made one more lap around the halls.

At 10:45 Paige started the pitocin, and by about 11:45, I was having regular contractions. Like with Benjamin's labor, I felt most of the contraction in my back, but was encouraged to also have some sensation of the labor pains in my abdomen --- hoping that this labor would prove easier than my first. Mark and I really enjoyed these first few hours of labor together, as with Benjamin's labor, I slept through the early labor and was very uncomfortable immediately. This time we were "eased" into it a bit more, and had a chance to try out different positions and Mark worked on massaging my back during the contractions. It was a very intimate time for just the two of us, and we wanted to see how far we could get before calling Patti.

As you can see, the mood was pretty light, and we were still busy documenting and taking pictures. Here I am pretending to be in horrible pain --- it was funny at the time, but little did I know that the real pain really was coming!





By about 2 PM the contractions were getting pretty strong, and Mark's hands were beginning to get tired from all the back massaging, as I need him to press firmly on my lower back for each contraction. We decided to call Patti, and were glad we did, because in the half hour between our call to her and her arrival, Paige turned up the Pitocin twice.

When Patti arrived at 2:30, she took a few pictures of Mark helping me through contractions, and then we sent Mark off to get some lunch and fetch our phone chargers from the car (we had packed them in the overnight bag instead of the delivery bag).





However, to my dismay, shortly after Mark left, Dr. Del came in to check on me. He checked my cervix, which was dilated to between 2-3 cm (I believe he then stretched it to 3) and wanted to break my water. I really wished Mark was there to help me with this decision. I decided to let him break the water, and when he did, he found a lot of meconium in it. He then inserted a tube in my cervix, which continually flushed saline to help clear out the meconium, so there would be less danger for the baby to inhale it during her first breaths after birth.

This is where things started really getting hard for me. To begin the irrigation, they wanted me to stay in bed for an hour, but at this point the contractions were really strong and the most pain was in my back --- but there was not much I could do to counteract the pain while being inclined in bed. Once the hour was up, I was allowed to get out of bed (and I even went to the bathroom), but the sensation of the tube in my cervix bothered me. It didn't hurt, but I could feel it there, and when I moved, I could also feel it moving. I felt so hooked up to so many things, and not really sure how to deal with the pain anymore. I didn't know it, but Mark had snuck out to let the nurse know that I may be asking for an epidural sometime soon, and around 4:30 I asked for an epidural. At this point, my body was shivering involuntarily, which is what happened to me during the transition phase (last few centimeters dilation) during Benjamin's birth, so Patti suggested I get checked to see how far along I was before they inserted the epidural. At 5 PM, the anesthesiologist arrived, and I asked Paige to check my progress before they inserted the epidural. At this point, I was only 3-4 cm dilated, so we decided I should proceed with the epidural. I thought at first that the epidural might be working a little bit, but the pain did not get much better. Still, I was stuck in bed on my back with the worst of the pain in my back and I felt like there was nothing I could do to help myself. They called in the attending (a resident had placed the first epidural), but she was in a C-section so could not come immediately to check on the epidural. She finally arrived at around 6 PM and tried to figure out why I was not receiving relief. She stated that the epidural had "migrated" to a blood vessel, and that I had a lot of vessels, and she wasn't sure that it wouldn't happen again if she re-did the epidural. By this point I was in a state of panic. I asked about Demoral and was ready to tell them to knock me out and cut her out if they could not do another epidural. Fortunately the second epidural worked, and they gave me a stronger, quicker acting drug this time. By 7 PM, I was comfortable again, and at first I could feel some of the contraction, but then I could not feel the contractions at all. I could, however, begin to feel pressure in my bottom, which told me she was moving down, and was encouraged that I would be able to feel some of the birth experience, after all. Patti worked on massaging the baby down into the birth canal (she told me later that Dr. Del had told her that the baby had worked herself partially transverse again), and as she did, I could feel the pressure increasing. Paige, our nurse, was also very encouraging about my decision to have an epidural, and I was again relaxed and excited about the upcoming delivery.

At 7:45 PM our final nurse, Kristin checked my cervix and said I was ready to go! I was 10 cm dialated, and the baby was at a -2 station. She called Dr. Del who arrived within 10 minutes. He was in his street clothes, and was very relaxed and encouraging as he came into the room and dressed in his scrubs and talked about what was going to happen. The baby warming room (which is actually like a large closet in the delivery room) was filled with people as well. Because there was so much meconium in the amniotic fluid, she was going to be taken immediatly to the warming area to be suctioned by the neonatologist before I would get to hold her. Assuming everything went fine, she would then be returned to me within a few minutes.

At this point, my legs were not quite totally functioning from the epidural, but I could still feel them and move them a bit on my own. The nurses dropped down the bottom of the bed and put my feet up in the stirrups. Dr. Del was so wonderful and encouraging in instructing me how to push and the room just felt peaceful and calm, despite all the people who were now there.

I pushed just four times, and then our little Katie was born! I remember grunting as I pushed, but not really trying to make noise and not embarrassed that I was. I felt so present in the moment and watched her head come out of me. I don't remember seeing Benjamin being born, but I had been pushing for an hour and a half with him and was so exhausted. This time, I was so much more aware of the end result --- getting to meet my baby! Dr. Del suctioned her nose and mouth just after her head was delivered, and then instructed me to push the rest of her out. I did, and he clamped and cut her cord and handed her over the nurses ready to rush her into the warming room to be addressed by the neonatalogist. Mark hurried after her to watch and take pictures, and I watched Dr. Del deliver the placenta and begin sewing me up. Just a minor tear this time --- right along the same line where I tore with Benjamin. Within just a few minutes, Katie was returned to me (Apgar scores of 8 and 9!), and we tried breastfeeding. She initially had a bit of trouble latching on, but with some help and guidance from Patti, we got her latched on. Dr. Del took off his scrubs and stayed with us for a while chatting before he and then Patti departed, and we were instructed to order our dinner before the meal service closed at 9 PM. Mark and I ordered hamburgers, and then after a while, Katie was taken to the transition nursery for her initial evaluation and shots.



















Whew, this is turning into quite a long story! I've at least written through her actual birth, but I also want to remember the details about the hospital stay, coming home, recovery, as well as my feelings about labor and birth, in general, now that I've done it two times. But I'll go ahead and post this - what I have so far, and hopefully finish her birth story sometime soon.