December 06, 2014

Hello, Cai Alexander! {A Birth Story}

On November 18, 2014, our lives changed forever. The gift we'd been hoping and praying for six years finally arrived. Very little about Cai coming into this world went as I planned or expected. He wasn't conceived when I wanted him to be, or the way I expected him to be, and his birth didn't go anything like I had planned. But, God had a plan and his timing is perfect. That is one of the biggest lessons I've learned over the past six years. That, and the fact that giving up control and trusting him is much easier and always goes better, than trying to control things myself (I'm learning that even more now, every time I put Cai to bed and have to trust the Lord to keep him safe when I am sleeping and can't see him).

The morning of our induction, 39 weeks 2 days
In the past nine months I have read and planned and researched about what I thought a safe and healthy birth should look like (who am I kidding, I've been doing that for years). Steve and I both wanted a natural birth without pain meds or medical interventions and with all of the good stuff; immediate skin to skin contact, delayed cord clamping, etc. In fact, I was quite a bit elitist about it, silently congratulating myself for doing research whenever somebody talked about their medicated birth or looking forward to joining the club of  natural birthing mamas. Serves me right.

The first hitch in the plans came when at my 37 week appointment, my doctor suspected that I had cholestasis of pregnancy, a condition where your liver produces too much bile. The main, and sometimes only, symptom is all over itchiness that tends to get worse at night. I had suspected it myself because my itchiness was OUT OF CONTROL. I could barely fall asleep at night. I had made the mistake of looking it up online and read that it could cause still birth, but when the doctor gave me the script for blood work to test for it, she was reassuring. Because I seemed to be developing it at that point in my pregnancy, the risk was minimal. The bigger concern is preterm birth for women who develop it at an earlier stage of pregnancy. Phew! However, if the results were positive, they would likely induce right away. So I went for the blood work and waited. For a long time. Apparently the results take a long time because they need to be sent away for. A week later they still hadn't come back.

The second hitch came at my 38 week appointment (Friday, November 14). We had already been keeping an eye on my blood pressure because it had been a little high, so when I came in with my legs and feet EXTREMELY swollen (seriously, that's an understatement) and pitting edema and some protein in my urine, they were concerned about preeclampsia, so they sent me to the hospital for blood work and to be monitored. My blood pressure stayed pretty decent and the protein level in my urine went down while I was there, but between that and the fact that my blood work for the cholestasis came back while I was there (it indicated that I was developing cholestasis though I didn't have it fully yet), they told me to come back Monday morning to be induced.

I had heard horror stories about induction and the evil it makes the pain so much more severe and makes you blow up like a balloon, yada, yada, yada, so I was not looking forward to the induction. I prayed that I would go into labor before then. I was already 3 cm dilated and 80% effaced and having pretty frequent, though not painful, Braxton Hicks contractions, so I was pretty hopeful as were my doctors. I ate spicy food, got a massage, went for walks, bounced on the birthing ball, etc., all in hopes of bringing on labor, with no luck.

So Monday morning rolled around and Steve and I loaded the car seat, diaper bag, and my suitcase into the car. Steve prayed for all three of us before we left the driveway, and we headed to the hospital.

They started me on pitocin shortly after I arrived. According to the nurses, my doctors are more conservative in their use of pitocin and increased it at half the speed that most doctors do in hopes of a more natural result. This meant the pain wasn't bad, but that things progressed quite slowly. I was already having some VERY mild, but somewhat regular contractions when we got there, and they slowly became more intense. I was also almost four centimeters upon arrival. Things moved very slowly. Steve was bored. My back was killing me from sitting in the stupid hospital bed.

This is where the third hitch really came in. Because I was being induced, they wanted to monitor the baby's heartbeat constantly rather and intermittently. And because my son is a stinker who moves constantly, this was difficult. Even if a stayed in the same position, sometimes we would lose his heartbeat because he was so active. This made movement really difficult. At one point my nurse (Sidenote: total God-thing that my nurse was a family friend and was able to be with me until around 7 PM, I think. She was WONDERFUL, and I am so blessed to have had her with me) tried to let me use the birthing ball, but as soon as I would sit on it, we'd lose his heartbeat. At this point my pain wasn't bad, so it wasn't a big deal that I couldn't move except that my back hurt a bit, but later, when my pain became bad, it became a major problem. Almost all of the ways I planned to manage pain had to do with movement (birth ball, using the Jacuzzi, walking, etc.), so when I couldn't move, that left me with essential oils and breathing, which didn't help all that much.

At some point,after 7 PM I think, so at least twelve hours in, one of the residents came in to check my progress. He checked me an looked at the nurse and said, "You said she was 4 cm.? She is not 4 cm." The nurse (a new one who was also wonderful, and pregnant), looked at me and then at the doctor and said, "What do you mean?" We were both confused. I was thinking he was suggesting that I went backwards or something, and I'm pretty sure she did too. "She's like 7 cm." was the response. I think the nurse was more excited than I was. She was quite proud of me.

Shortly after that my doctor came in and said it was time to break my water. Let me tell you, that was nothing like I expected it to be. First of all, it looks like it would hurt; they use a tool that looks like a crochet hook; but it didn't hurt at all. It did feel strange though. It feels just like you're peeing. Uncontrollably. And for me it was for a very long time. Every time I moved more water would come out.

This is where the details start to get blurry because my pain increased dramatically at this point, but it's also where hitch number four comes in.. On a scale of 1 to 10, I went from a 4 to a 10 in what seemed like no time at all. When the doctor checked me a little while later, she said she was concerned about how tight my pubic bone was. She recommended getting an epidural so that if she had to, she could "get in there and move around easily." At first I was totally against it, but my pain escalated so quickly, and the doctor seemed so concerned, that I told Steve that if he was okay with me getting one, I thought it would be a good idea. Somewhere around this time, I kicked my family our of the room. My mom, sister, dad, and Oma had been behind the curtain in the room with us. My mom was a little obsessed about being there, even though she knew, and was okay with the fact that, I planned to kick her out at some point. In the beginning it was nice having them there because things were boring, but once my pain became more severe, I asked Steve to ask them to leave. I didn't want them to hear me moaning which I definitely was doing at this point.

This is the only picture I have of myself with Cai
at the hospital. I kind of hate it. I was retaining SO
much water it was RIDICULOUS! 
I was shocked at how quickly he pain became so strong, and it seemed like forever until the anesthesiologist came to give me the epidural. All the while I was debating with myself about whether or not I would regret getting one. I came to the conclusion that given all of the circumstances, I was making the right decision.

And here was the the fifth hitch. The anesthesiologist gave me the epidural, which freaked me out so much. And I waited for the relief. And waited. And waited. And it didn't come. My legs went all pins and needles, but I could feel every contraction FULLY and the pain was getting worse. So the nurse had me press the button to give myself a bolus of the epidural medication.I could feel the medicine going in. And I waited again. And nothing happened. So fifteen minutes later I pressed it again. And waited again. And nothing happened. So fifteen minutes later I pressed it again. And nothing happened.

Ready to go home!
At this point the nurse called the anesthesiologist back in so he could redo the epidural (which was almost as scary to me as continuing without the epidural). The anesthesiologist was really nice, but he had a really strong accent, so he was super difficult to understand. He was quite frustrated that it hadn't worked because he wasn't sure why it hadn't worked. The only thing he could think of was that he had put it up too high  because it was difficult to tell where my hips were (I told him it was because I was too fat, but he said that wasn't it, haha). The time while he put the second epidural in was the most difficult part of the whole experience. I was sitting on the edge of the bed with my feet on the stool, and Steve stood in front of me so that I could lean my forehead on his shoulder. My pain was so sever at this point that I had been moaning and writhing, but I knew I couldn't do that while he put in the epidural. Between the contractions and the needle in my back itself, it took every once of strength I had to stay still. Plus I was sweating and felt like I was slipping off of Steve's shoulder. Apparently he was watching the doctor give the epidural. He said it was fascinating and that the doctor was afraid Steve would pass out from watching. He didn't though, and I survived.

He's got his daddy's hands (and hairline and ears
and nose and...)
Once the epidural kicked in, I was able to take a nap. The medicine made me quite a bit dopey, which was the whole reason I didn't want to get an epidural in the first place. When I woke up from the nap, at least I think that was the timing, I was a full 10 centimeters dilated and the baby had dropped a little lower. The doctor said that she was still a little concerned about my pubic bone, but I had proved her wrong already (she hadn't expected Cai to drop any lower), so maybe I would again.

So I pushed. It didn't hurt because of the epidural, but I was surprised at how challenging it still was. First of all, I couldn't really feel the timing of the contraction, but mostly it was hard because it took so much breath to give a a good push, and I would run out of air before the doctors wanted me to stop pushing.  According to the doctors though, I did it right though.

Oh, somewhere in all of this, I threw up three times. I don't remember when. I was only allowed to have clear liquids once I arrived at the hospital, but somehow I still managed to throw up a ton. It was awful.

Hitch #6. My doctor came back in and checked me again (the residents were with me for the rest of the pushing), and said that she could tell that I was doing a good job pushing, but after an hour of pushing, Cai hadn't moved any lower. In fact, he was getting a cone head because I was pushing well enough, but only his skin was moving past my pubic bone; his head was not. She said I could continue pushing for another hour and see if I got anywhere, but she recommended a c-section because he wasn't moving.

Cai and Finnegan!
We decided to take her advice, and they quickly prepared me for a c-section. They didn't let Steve in with me, but they told him that as long as they didn't have to sedate me, he would be able to come in after they got me set up.

Funny side note, as I entered the OR, I corrected the grammar of the only male resident. He knew I was an English teacher and had told me how much he hated English. He had used a superlative and used both the word "most" and an "-est" ending. Everyone got a kick out of it.

And then there was hitch #7. At this point, I made sure they knew that I was starting to feel things again. The anesthesiologist told me that they would be switching medicines, so I shouldn't worry. He put the new medicine in, and my doctor tested to see if I could feel anything. And I could. So he upped the anesthesia, and tested again. And I could feel it again. So he upped it again, and tested again, and I could feel it again. So they upped it again, and tested again, and I could feel most of it again. Somewhere in the midst of this I threw up again, a really awkward thing to do when your arms are strapped to the table and you can only turn your head. They couldn't go any higher with that medicine though, so they had to try something else. The something else basically sedated me without actually knocking me out (so Steve wasn't allowed to come in). They didn't tell me what would happen though, so I didn't know what was happening at this point. It was awful. I basically hallucinated the whole time. I thought I was on an episode of Dr. Who, a scary one. I kept flashing from scene scene. At one point I thought I heard Cai cry, but I didn't know that was what I was hearing. I also thought I could feel the pulling in my belly, but I didn't know what that was either. Then I started to come back and suddenly realize the blue stuff I was staring at was the sheet they put up in front of me. I could hear them talking about putting staples in, but I still wasn't fully aware that my baby had been born. I couldn't even think straight enough to ask for details about him. This part seemed to take forever. I also started shaking uncontrollably, which I had been warned about ahead of time, but it was awful.

They wheeled me into recovery and I remember seeing my sister and my mom smiling at me as I passed them in the hallway. Steve came into the recovery room pretty quickly. He showed me pictures of Cai. He was so beautiful! He told me he cried when he saw him, and he got to cut the cord. I was so upset that I hadn't seen him yet. I didn't feel like I had actually had a baby.

Finally they, brought him in, but I couldn't hold him right away because I was still shaking so badly. They had to take him right back to the nursery though because his temp and his blood sugar were both low, but they brought him back  quickly so I could breast feed him. That was when it finally felt real. Steve and me and our boy.

I'm spent with writing for today, but I'll write more soon about our first few weeks (almost three already!)

Daddy in love

Momma in love

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