Jubaluba Jabbers: October 2012

Here’s the short version of my labor and Sapphire’s delivery:

Monday October 1, 2012

10:20AM Arrived at the hospital for scheduled induction.

11:00AM 3 cm dilated, 70% effaced. IV in and pitocin started.

12:40PM No real contractions yet. 3 cm dilated, 90% effaced. Doctor broke waters.

1:00PM Started to feel contractions steadily, but very much under control using relaxing and breathing techniques I practiced during pregnancy.

1:40PM Bathroom break removed pressure in pelvic area. More intense contractions.

2:00PM Nurse turned off the pitocin, then checked me. Baby was on its way down and out. Backup help and doctor called.

2:14PM Baby out and in my arms.

Tuesday October 2, 2012

12:00PM Left the hospital and headed home.

For some of you, the above will suffice. Others will want more details—especially if you’re like me and LOVE to hear/read birth stories.

The story really starts with Winston's birth. Ever since he was born, I have been almost euphoric about my next labor and delivery. Sometimes I worried, but mostly I have been excited (it sounds strange, yes) for my next labor and delivery. Perhaps it can be related to a runner’s next marathon? Perhaps?

For better-safe-than-sorry-sake, I kind of planned my work and life schedule around this little baby coming about 3 weeks early, like Winston did. However, at our checkup around that time it was obvious it would not be so. The doctor still thought I’d come early, though. Days turned into weeks and there was little progress. At my 38 (almost 39 week) checkup, I was dilated to 1 ½ and 50-60% effaced, but I had felt little contractions. I had also been measuring small for the last month or so, but each time there was at least some growth—until the last checkup; my uterus measured the same (35 cm when I should have been almost 39). The doctor offered to schedule an induction anytime after 39 weeks. I have very mixed feelings about inductions, and thought I would say “No!” right away, but something caused me to pause and consider the situation. Sam and I decided to think about it. The doctor was in no hurry to make a decision or to bring the baby, though he did say he would not allow me to go beyond 41 weeks, and thought I’d go into labor any day by myself anyway.

That night was a night of much prayer, concern and discussion. The next morning I called the doctor with more questions and concerns. In the end, Sam and I felt the best thing to do was to schedule an induction. We both still held firmly to the hope that I’d go into labor on my own before then. But alas.

Photo taken just before we got in the car to drive to the hospital.
39 weeks 3 days pregnant.

We arrived at the hospital about 10:20 AM. I was dilated to a 3 and 70% effaced. After computer and paperwork, it was 11:00am by the time I had an IV and pitocin started. They can only start the pitocin at a small amount—4 (whatever the units of measurement are)—and increase by 4 every 30 minutes until it is up to 20. Because they had me on pitocin, I had to stay on monitors for both the baby’s heart rate and my contractions. Lucky for me, they had a monitor that I could walk around with. But after a little while, the nurse figured out it was working fine on monitoring the baby, but it wasn’t picking up any contractions. “You’ve got to be having some contractions by now,” she said at one point, but all I felt were some small back pains and occasionally some slight lower-abdomen cramping. I had to change back to the non-mobile monitor, and stay closer to the bedside because of it. I didn’t mind so much as long as I didn’t have to get in the bed—and I didn’t. By 12:30 the pitocin was 16, but I wasn’t feeling contractions.

About that time my doctor came in and talked about whether or not I wanted my water broken. Because I wanted an unmedicated labor, it’s often a benefit to leave the waters as it can act as a cushion and be easier—though longer—to labor. I wanted them broken to speed up the labor. The doctor checked me and I was still dilated to a 3, but up to 90% effaced. He broke the water at 12:40 PM, which wasn’t painful at all. I expected pain, but just felt the sensation of the water gushing out. The doctor commented he’d expect to be back around 5:30PM. Sam laughed and said “it will be sooner than that.” The doctor kind of chuckled and shrugged and headed out.

By 1:00 PM, I was feeling steady contractions. Even better was I could feel the release of tightness and pressure in between the contractions—that was a wonderful relaxing time. I worked through these contractions fairly easily, with the help of Sam using counter-pressure on my lower back (where I felt the majority of the contraction and pressure). I was leaning on a birthing ball that was placed on top of the bed. With each contraction, I rocked back and forth from side to side or rotated my hips in a circular motion. This worked wonderfully as I focused on my breathing, the rotation of my hips, and the soft music we had in the background. When each contraction ended there was a great release of pain that felt so good and gave me energy for the next one. For about 30 minutes I repeated these rocking-breathing-relaxing patterns through contractions that came about every minute to minute in a half.

Around 1:40 PM, I really needed to use the restroom. Emptying my bladder relieved a lot of pressure from my lower pelvic region that made the contractions a little more bearable, but the contractions on the toilet were miserable. It was nice to get back to the exercise ball for the next contraction.

As I returned to the ball and monitors, the nurse came in to adjust the monitor because it wasn’t picking up the baby’s heart rate very well. I had one really, really hard contraction where I lost all focus and the rocking didn’t work any more. She suggested turning off the pitocin, as the contractions were definitely on their own now. She also said anytime I was ready, she could check me again and see how much progress I had made.

At this point I had many thoughts. I knew that I had only been dilated to a 3 just one hour before, that I needed to have the nurse check me. If I was only a 5, I debated in my mind getting an epidural, because that last contraction was WAY difficult and I couldn’t do that all the way up to a 10. But then I wondered if it was just the pitocin making the contractions falsely strong. I decided to wait and see if they calmed down when she turned off the pitocin. I also noticed that I was getting hot very quickly. It reminded me of how hot and sweaty I got toward the end of my labor with Winston. All during these thoughts I had a couple more of those stronger contractions and despite all counter-pressure and rocking and focusing, I couldn’t get back in control. I had one contraction where I voiced how hard it was and that nothing was working anymore. Then on the next contraction, Sam said I screamed out during a contraction, and the nurse knew it meant things were close.

The nurse asked if I felt like I needed to bear down and push. I realized that was exactly how I felt—all that pressure right at the bottom. The nurse just reached up right then and checked me. I wasn’t in the most convenient position, and it was painful as she reached up. She said something about the head being right there, and she immediately went to the phone. She said something like, “I need help in here now. She is completely ready. Call Doctor Liddle NOW.”

I can’t remember if it was my idea or suggested by the nurse, but I got up on the bed on all fours and had my hospital gown taken off (the amount of heat that suddenly came with my body was too intense). I remember vocalizing that this pressure was worse than I remember. The nurse said if I felt the need to bear down and push just to do it, even if the doctor wasn’t there yet. The next contraction I obliged and pushed. The pressure was intensely, painfully there, but pushing did help me through the contraction. Once again I felt a sweet calm and brief moment of relaxation just before the next contraction. At one point I noticed a bunch of blood all over the bed by my arm; the cap on the IV came undone and blood was coming out through the tube. It made a mess, but the nurse quickly put the cap on again.

I pushed through one or two more contractions on my hands and knees before I heard the doctor come in. I apparently was too high up towards the head of the bed, and he asked if I could come down. I asked if I could squat. The nurses quickly shifted the bottom part of the bed down so I could stand on it, and with a nurse on one shoulder and Sam on the other, I had my hands on my knees and I squatted through the next contraction. I was about to push, but realized squatting just kind of did that for me, and I watched in amazement as I noticed some of the baby’s head was already out—and that she had hair! It was amazing to feel the pressure release as I squatted and to feel and see her head slowly and then suddenly her whole body immerged. I reached down and the doctor gave her to me and I sat back on the bed and sobbed for the intensity and release of pain, for the after shock of it being over so quickly, and the emotions that came from watching my own child enter the world by exiting my body. It was amazing.

Everything else went smoothly. The doctor said I didn’t tear at all. I held our little slippery baby for quite a while as Sam took photos and started calling to announce her birth. She even nursed a little. I showered and they moved us to a different room. I really feel great—and have felt great since she came out. The cramping of my uterus, especially when she nurses, is more painful than those first contractions during labor (and way more noticeable than I ever noticed with Winston), but thankfully they come and go quickly. The day after the birth, I joked with my mom that I just had a baby yesterday, and what hurts the most is the needle prick where they took a sample of my blood that morning.

The doctors and nurses were all very respectful of our desire to leave the hospital as soon as we could, especially given all of their policies and procedures they have to follow. We were able to leave the following morning—out and completely on our way home by noon.

We’re so grateful that little Sapphire entered the world quickly and safely and healthy. Our little family is smitten by her already.

I’m grateful for our careful, prayerful consideration of the induction and for our doctor’s guidance. He encouraged us to make our own decision. In the end, despite the doctor’s and nurse’s belief and experiences that this induction would take a little longer to progress (especially given I was only dilated to a 3 at the start), this baby came even faster than Winston (his labor was 3 ½ hours after my water broke; this one was 1 ½ hours). The entire pregnancy Sam and I talked about what we would do when I went into labor, since we had to drive about 35-45 minutes to get to the hospital where we delivered. The fear was IF we make it to the hospital. Sam and I are grateful she wasn’t born in the car.