Tuesday, December 21, 2010

Our birth story

Prefaces:
  • A lot of people have asked about our birth story, so here it is
  • It's long
  • It's moderately graphic (not extremely, but if you don't want to know, don't read it)
  • This is our story. We're not trying to judge anyone else's!

Ellie’s birth story


My due date, November 19, came and went with nothing out of the ordinary. I was 1 cm dilated and about 75% effaced, but there hadn’t been any real change in a week. I was definitely having some contractions, especially in the morning, but they weren’t painful and had no consistent pattern.

Ryan and I decided to make use of each “bonus” day we got – we had dinner with Kevin, Laura and Ella Storm on the 19th; went to see Harry Potter: Deathly Hallows Part 1 on Saturday; and Ryan played hockey on Sunday night.

On the 22nd, I had an appointment with my OB/GYN, Dr. Margaret Rempe. She was supportive of our desire to have a natural childbirth, and since the baby’s heartbeat and movement were both great, she didn’t see any reason to induce me.

As part of regular post-date appointments, I had a non-stress test and ultrasound at St. John’s right after my appointment. The non-stress test was normal and they predicted a 9 pound, 4 ounce, baby based on the ultrasound.

Our good friends Andrew and Teresa Yakel were in town from Texas for Thanksgiving, so we went out to lunch while Ryan was at work. When we got home at 2 p.m. or so, I noticed I had missed a call from Dr. Rempe. When I called the office and gave the nurse my name, she said, “Oh, she told me to pull her out of her room when you called.” Not a good sign!

One of the reasons we love Dr. Rempe is that she explains everything thoroughly. She’s also focused on what her patients want, and was very supportive of our birth preferences – so when she makes a recommendation, we generally trust her expertise and opinion.

She cut right to the chase – my amniotic fluid level was on the lowest end of normal, and would almost certainly continue dropping. She said she’d like to induce me when a room opened up at St. Luke’s at 5 p.m. My main concern was starting the “domino” of Pitocin to epidural to C-section. I asked if she thought I’d be able to avoid other interventions. She said she was committed to that as long as the baby and I were both doing well. I agreed that it wasn’t worth putting the baby at risk, and decided to go in. Dr. Rempe also mentioned she was extremely doubtful that I’d be delivering a 9-pound baby!

I called Ryan, then our parents. Andrew and Teresa helped me finish packing for the hospital, and Sarah Laury came to pick up Marah.

I started Pitocin about 7 p.m. after getting checked in and filling out a ton of paperwork. The plan was to start me at 4 mu/minute and increase 2 mu/minute every half an hour. As soon as I established a regular contraction pattern, they would back me off it. My mom, my dad, Bruce and Pam came in around 7:30 or so and stayed for about an hour while my contractions slowly started building.

Soon after our parents left, I decided to stand up and see if that got things going. About 10 p.m., when I still wasn’t having painful contractions, Ryan and I started talking about going to sleep and conserving energy. However, I wasn’t sure I wanted to lie down, worried that would slow things down. But the decision was made for me – the contractions all of a sudden started getting painful enough that I knew I wouldn’t be able to sleep through them. Our awesome nurse Tammy checked me and I was at 3 cm, 75% effaced and 0 station. I was so encouraged that things were progressing, and I was really excited that it wouldn’t be long before we met our little girl!

Around this point, we got the telemetry (wireless) monitor, which would let us walk around (I had to be continually monitored because of the Pitocin, which I think they stopped increasing when we were walking). We started making laps around the floor, with Ryan pulling the IV pole next to me. He kept making me laugh, which screwed up the monitors over and over again! It was a really sweet time of connection for us.

The contractions started getting a lot more painful. From about 11 p.m. to 1 a.m., I alternated between standing, swaying, sitting in a rocking chair, leaning on Ryan and sitting on the toilet (which made no sense to me during the childbirth classes, but felt great!). We were excited for the 1 a.m. check, because the contractions had been progressing so well – but I was only 4 cm, still 75% effaced.

I decided to get in the laboring tub while the Pitocin went up to the max of 20. I could tell the contractions were getting stronger, but the tub worked like an analgesic, and I almost fell asleep. But when Tammy checked me again at 2:13 a.m., there hadn’t been any progress, so I decided to get out of the tub. It was at this point the pain of the level 20 Pitocin started to hit me.

Ryan suggested I try squatting – I was sitting on the edge of the tub, and during a contraction, could squat back into the water, which helped with the pain. About an hour later, we moved out of the bathroom and I started rotating a bunch of different positions. We tried the birthing ball, which I thought I’d love, and it was horrible – same with counterpressure on my hips and back.

Sometime in here, my contractions started coming every 30 seconds or so and lasting for about 25 seconds, so they started easing me off the Pitocin. I started shaking and shivering between contractions. Around 4:30 a.m., the hot flashes during contractions got worse. I threw up once and Tammy thought it might be transition, but there wasn’t a whole lot of change – 5-6 cm, 90% and 0 station. I threw up two more times (Ryan was a champ at catching the basin from the nurse and getting it under me on time!) in about half an hour.

I moved into really painful contractions at this point, basically collapsing into Ryan with each contraction. I considered an epidural briefly, because I had only progressed about 1.5 cm in four hours. But Ryan was really encouraging – telling me (in nicer ways) that an epidural wouldn’t help with the contraction I was having, so let’s focus on getting through that one. In between contractions, I had confidence I could make it through. I felt like my body knew what it was doing, and I just needed to let it keep going!

Before Tammy ended her shift, she checked one more time at 6:34 a.m., and I was at 6-7 cm. We met our new nurse, Karen, and a nurse-in-training, Jeannie. I was starting to lose my focus, closing my eyes and holding my breath or breathing too quickly during contractions.

Karen took charge and gave me three options: lie on my right side, lie on my left side, or get on all fours in the bed. I turned on my left side, and Karen surrounded me with pillows, started massaging my legs and talked me through good breathing. These contractions were the worst yet, but Karen encouraged me that this was a good sign – I was getting pressure on a new part of my cervix and it would help me dilate more quickly.

Half an hour later, I was already at 8 cm! I turned on my right side, which again moved to a new level of pain. During most of the contractions, I was saying I couldn’t do it, but Ryan was amazing and encouraged me through them, supporting me physically and emotionally. In between contractions, I was exhausted but excited that we were getting close. At 7:42 a.m., I suddenly felt my body begin pushing, and told Karen – she checked, and I had progressed to 9 cm, 100% effaced and +1 station. She told me to do little pushes at the peak of contractions, but not try to push the baby out yet. I moved to my knees, facing the back of the bed with my arms on the top of the bed. I shortly hit another level of feeling the need to push – Karen checked, said I was fully dilated and that it was time to call the doctor!

The on-call got a little messed up – Dr. Rempe had asked to be paged, even though she was technically off call at 8 a.m., but they paged Dr. Rockamann instead. While we were waiting for her to come, Karen checked me again and broke my water. Dr. Rockamann arrived at 8:03 a.m.

I decided I wanted to turn back around to push in the typical semi-sitting position. Ryan held my left leg, Jeannie held my right, Karen talked me through good pushing technique and Dr. Rockamann gave me encouraging updates on the progress. I loved not having an epidural, because I got to totally direct my pushing. They let me decide how many pushes to do for each contraction, and I could feel what my body was trying to do. I knew we were getting close, and I wanted that baby out! After my second push on one contraction, Dr. Rockamann said the next push might deliver her head. I pushed hard, but she didn’t quite come out. I was on the tail end of the contraction and knew I could get one more push in before it ended. I almost immediately started to push again and I felt her head slide out!

From Ryan…
Ellie’s blonde hair began to show and Dr. Rockamann commented on the “inch of blonde hair.” Her little head finally crowned and her purple face was suctioned and cleared by the doctor. She was looking to the left, which was the side I was on, when her head came out. Kate then pushed hard one more time on the next contraction and Ellie shot out and turned to her backside in the doctor’s arms. She was beautiful and didn’t cry more than once – just to let us know she was OK. She was about to continue crying and I spoke to her, and she looked right at me and stopped crying right away. They clamped the cord and I cut it. She was placed onto Kate as they began cleaning her off. We kept looking at each other and her and laughing and crying and talking to her. Her eyes were open and she was looking at us.

Back to Kate…
It was totally surreal for me. One second I was in intense pain, focusing on pushing through a contraction, and the next, there was almost no pain and there was a baby being held up and brought to me. I didn’t have an instant “oh my gosh” feeling – I mostly kept looking at Ryan like, “Is this real?” I definitely had an instant connection to her, but not in the way I expected. The sweetest moment for me was when she came out crying, heard Ryan’s voice and quieted immediately. It made me realize this is really OUR baby, the one who’s heard us from my womb for months!

We had decided to donate her cord blood, so they clamped her cord and collected the blood, then delivered the placenta. I had a second-degree tear, even though Dr. Rockamann had been trying massage to avoid it. She stitched me up while the nurses took Ellie to the warmer to check her vitals. Ryan followed her over there and she was holding his fingers and trying to suck them occasionally. Whenever she started to fuss, she immediately calmed down whenever he would speak to her or rub her head. She’d also turn toward me when I would talk to her from my bed.

She was 19.5 inches long and weighed 7 pounds and 9 ounces (glad we didn’t put any stock in the ultrasound prediction!).
As soon as I was stitched up, they brought her back to me. We got to feed her within a few minutes of her being born, and she did great – alert and latched wonderfully.

They left us alone to feed her, hold her and bond with her. After awhile, they came back to take her footprints, do her newborn screenings and give her a bath. Finally (after hating her bath but loving the hair washing), she was done and Ryan came and held her and sat with me. We invited the grandparents to come meet her a short time later.

I am so glad I had support and was able to direct our birth experience, and am so glad I didn’t use pain medication. I loved the feeling of connecting with my body and letting my natural instincts and urges direct me. I also feel like it sped up my labor because I kept moving around. It was a bonding experience for Ryan and me, and I was impressed (but not surprised) by how wonderful he was during the labor, delivery and immediately after. We had a phenomenal birth, and I am so glad we got to welcome Ellie in such a beautiful way!