Tuesday, October 2, 2012

Race Report: Rowan Marie's Birth Story

I always assumed that I would share our birth story on the blog.  I share so many other personal details of our lives, certainly this would be no exception.  But after going through the experience, part of me wanted to keep this private.  Something just our little family would know and share together.  But then I remembered all of the inspiring birth stories I read while we were trying to conceive and while I was pregnant.  I learned so much from those women.  And regardless of how the labor and birth turned out, I found each story beautiful and empowering.  And so, I decided to share our story as well.
It's been over 2 weeks since the arrival of our baby girl and already some of the details are starting to become blurred and fade into fuzzy memories.  Not that the details were ever very crystal clear for me.  After 27 hours of hard labor, most of which was endured with eyes clenched tightly closed, my recollection of her birth is made up of mostly sounds, smells, and emotions.  I have very few visual memories of the event, but thankfully our dear friend and photographer was able to be there for the last few hours and capture Rowan's arrival.  Thank you, Ravyn, for capturing these beautiful memories for us!  So bear with me as I try to coherently piece together our story and my apologies for anything I get wrong or out of order.
As many of you know, we had been planning a home birth since before even trying to get pregnant.  It's something that we have both become very passionate about and were so looking forward to beginning our family in the comfort of our home.  However, after 9 months of fabulous care through Vivante Midwifery, life threw us a curve ball.  On a Saturday morning, 6 days past my due date, we went in for our 41 week appointment.  Unfortunately, after a healthy and uncomplicated pregnancy, my blood pressure had suddenly become elevated high enough to risk me out of the home birth.  And even worse, it was recommended that we proceed with an induction that evening.  So after many tears and a short grieving process, we packed our bags and headed to OHSU in Portland.  Once there, we were met by two of our midwives, who ended up staying with us through the entire labor and delivery.  In case I forget later in this story, let me pause to recognize how amazing and wonderful these women are.  The support, care, and love we received goes so far beyond what is required of them and I don't know if I can ever thank them enough for helping us through the process and preserving as much of our birth plan as was possible given the circumstances.
Once checked in, I had an internal check done (the first of the entire pregnancy) to determine which method of induction would be the most favorable.  I was only a fingertip dilated, still very posterior, but slightly soft, so we decided on cervadil and then perhaps the foley bulb.  I wanted to delay pitocin as long as possible.  While we were waiting for the meds to arrive in the room, my water suddenly broke.  About 10 minutes later the contractions started up.  And within a half hour they were quite strong and I was having to concentrate and breathe through them.  Labor was well underway - induction avoided!  Ken and I spent the next several hours roaming the hospital grounds, timing contractions, popping back in for periodic fetal monitoring, and bouncing a lot on the birth ball.
I vaguely remember a shift in the intensity during one of the walks.  I couldn't make it more than a handful of steps before another contraction would hit.  I moaned and groaned my way back to the room, hanging on to whatever was nearby - the cafeteria register, the admitting desk, Ken's neck, the elevator railing.  Once back at the room we laid down to try and get some rest, but my contractions were already too intense and frequent to do anything other than sit on the edge of the bed and moan through them.  It was during these early morning hours where things get hazy.
Some random memories from the next dozen or so hours:
- Listening to my hypnobirthing on the iPhone and then ripping the earbuds out because I was so annoyed.
- Yelling at Ken to stop snoring so that I could concentrate on my contractions.  I think there was even a "f*%$ off" thrown out there at one point.  Sorry, sweetie!
- Opening my eyes and realizing that it was daylight again.
- Wanting so desperately to get into a hot bath, but remembering that I was supposed to wait as long as possible before doing so.  We didn't want to slow labor down at all.
- Getting into the shower.  I sat on a bench in there while Ken and one of the midwives took turns holding the hot water over my back.  I think I was there for a few hours.
- Pleading to get into the tub, finally being allowed to, and then once in, realizing that it wasn't at all what I wanted.  Getting back out was torture.
- Sitting on the edge of the bed again for hours.
- Having a forebag of waters broken.  And meconium coming out.
We were now 16+ hours into the labor.  My contractions were becoming over 2 minutes long and 3-5 minutes apart.  Some of them were doubling up on each other, resulting in no break.  I was even getting "pushy".  I thought for sure that I was entering transition and would be meeting our daughter soon.  I asked for an internal check again, but didn't want to know how dilated I was.  I didn't want to be disappointed if I hadn't progressed very far.  But they didn't need to tell me the number.  I could tell by the faces of the nurses that I was far far from holding my little girl.  It was crushing.  I later learned that I was only at 4cm at this point.  Pitocin was mentioned.  I held the debate of the century inside my head.  I begged and pleaded with myself.  I tried to reach deep and tap into that Ironman strength.  No dice.  I did what I was convinced I would be able to avoid - I asked for an epidural.  Everyone solemnly nodded in agreement.  It seemed like the best decision to allow me to get some rest and allow me to have the energy for the later stages of labor yet to come.  For a short while I was devastated.  While we waited [quite awhile] for the anesthesiologist to arrive, I cried quietly to myself.  Our home birth was gone.  Our med-free birth was gone.  And I prayed that I wasn't making a huge mistake and setting myself up for a failed vaginal birth.  I wanted to scream "No, no, never mind, I don't need the epidural!"  But the truth was that I probably would have even surrendered to a c-section in that moment.  I just wanted the pain to go away.
Once the epidural was in place, I was able to lay down for the first time in over a day.  I allowed myself to relax and rest a bit.  It was dark outside again.  The room became peaceful and calm.   I did ask to have the epidural turned down to a very low dose.  I wanted to still feel the contractions, to still be connected to the labor and to the baby.  I didn't want to be completely numb to the process.  I was able to move my legs around, reposition myself, and probably even stand if I wanted to.  But I was no longer in agony.  I was even smiling. I pushed all of the negative thoughts out of my mind and resolved to enjoy the last hours with Ken as just the two of us.  I don't think I ever slept, but I was able to enter a sort of twilight phase.  The nurses came in periodically to check on us, to turn up the pitocin, to check the monitors, read my blood pressure.
A handful of hours later (5?  7?) I had another internal check done.  I was getting close.  It was time to turn the epidural off.  And the pitocin up.  Now that I had grown accustomed to pain relief I was terrified of going back to what I had felt earlier.  I had a moment of panic, but was encouraged by everyone that it was going to be okay.  Pretty soon I had regained all sensation.  But the contractions were different now.  I wanted to bear down and push.  I was able to walk to the bathroom on my own and labor there for some time.  Sitting on the toilet felt amazing, but I also didn't want to have a "toilet baby".  That really wouldn't make for good pictures!  So eventually I worked my way back to the bed.  Laying down sounded like torture, so I stood at the edge of the bed in a semi-squatting position.  I think I pushed like that for over an hour.  I had counter pressure and coconut oil applied to my perineum.  But other than that I didn't want to be touched.  We had The Lumineers playing in the room for awhile, but I remember asking to have the music turned off.  I wanted it quiet.  I think the lights were dimmed too, but my eyes were closed so I honestly couldn't tell you.  I was in my little cocoon and completely unaware of what was going on around me.  Unless someone touched me.  I really didn't want to be touched.
Things weren't progressing as well as they should have been.  So I was asked to change positions.  I climbed onto the bed on my hands and knees, hugging the back of the bed.  I think I pushed this way for another hour or so.  Pushing actually felt fabulous.  It didn't hurt at all.  It was just tiring.  But then my contractions started fizzling out.  I didn't have anything to push against.  Baby wasn't coming.  There was more meconium.  The tone of people's voices started changing.  I was asked to flip onto my back with my knees by my ears.  This was the last resort position.  But baby still wasn't coming.
I later learned that there was a tight vaginal band, sort of like a tendon that wouldn't stretch.  They started numbing me up for an episiotomy.  No, no, no, no.  I couldn't believe that I was going to be cut.  But within a few pushes her head finally came out.  Another push and the rest of her body slid through.
Ken was able to catch her and put her on my body.  Her eyes were open and bright.  But she had meconium coming out of her nose and mouth and had to be suctioned right away.  Ken cut the cord and went over to the pediatric table with her.  I kept asking what was taking so long.  I wanted my baby back on my chest.

The midwives advocated for me - don't wash her, turn down the lights, don't wrap her up in a blanket because we want immediate skin-to-skin.  Within a few minutes she was back on my chest, no longer crying, and rooting around to nurse.
They never again took her away from me.  She nursed while they stitched me up (front-to-back third degree tear plus a little tear up front too), did the second Apgar while she was on me (scores were 8 and 9), and then left us alone while we stared at her in amazement.
Eventually everyone said their goodbyes and we moved to the recovery room.  She slept in my arms for the rest of the morning.  About 12 hours after her birth we started working on the discharge paperwork (upon our strong insistence...they wanted us to stay another day, but we just wanted to be home) and soon thereafter we were all snuggled up in our own bed like we had planned all along.