Thursday, September 15, 2016

The Birth of Juliana Grace (A Retrospective)

I can hardly believe that six years ago, I was still impatiently awaiting this day that would change my life in ways I couldn't possibly imagine.  I wrote up my birth story at the time, but as I have since published my other birth stories, I wanted to publish this story as well, with a few additional thoughts.  This is for all my friends who enjoy birth stories as much as I do!

On Saturday morning I woke up to my first regular contractions. “This is it!” I thought, but they stayed mild and went away after a few hours. The baby was moving a ton all morning – in retrospect, I think she was probably twisting around frontwards! I kept expecting the contractions to start up again, but since nothing was happening I went with my mom to a quilt show in a historical southern home. It was so hot that I started feeling sick, so we headed home to rest. That night we watched Star Wars: A New Hope and I finally went to bed around midnight (what can I say, I didn't actually have kids yet).

I woke up to contractions at about 2:30am, after a couple of hours sleep. I had been having a lot of Braxton-Hicks contractions over the past couple of weeks, but these felt different. I timed them for about an hour and they stayed about 5-7 minutes apart so we headed for the hospital, 45 minutes away.

Looking back I realized I could have stayed at home much longer, but it was the first baby and I had no idea how things would go. I was measuring 5cm at my appointment a few days before and my midwife thought labor might progress quickly, so she suggested heading to the hospital as soon as I was having regular contractions. She also said I had a “perfect pelvis,” which is about the best compliment you can get when you are about to give birth!

I had been dreading the long car ride, but the contractions were still mild, so it was actually pretty peaceful – not much traffic at 4am. When we got to the hospital at 4:30, I was still measuring 5 cm. After monitoring my contractions for a while, nurse said to go walk around some and they'd check again in a couple of hours.

My mom had come with us to the hospital and by now my dad and cousin were in the waiting room. My dad hadn't brought anything to do; he said, “I thought the baby might be here by now!” With all four kids, my mom rushed to the hospital and the baby was usually born within the hour, sometimes before the doctor arrived. (See where Adalyn's labor came from?) My cousin walked with Kevin and I all around the hospital, where she had given birth almost exactly a year before.

I was checked again at 7:30am but was still at 5cm. The contractions were coming 3-5 minutes apart but not much stronger than before. We were officially admitted and after settling into our room, we listened Enya and tried to rest for a bit. I spent most of the next three hours walking the halls with my mom and cousin, slowing or pausing during contractions.  Every so often, the nurse or midwife would hook me up to the fetal monitor and predictably my very regular contractions would immediately stop. We would wait for ten or even twenty minutes and then as soon as the nurse left, they resumed their 3-4 minute pattern. I told the nurse my uterus must have performance anxiety (which after reading Ina May makes perfect sense).
One last pregnancy picture at the hospital
When the midwife checked me again at noon, I was 7.5cm. I was glad that there was finally more progress, though it didn't seem like much after all those hours. The midwife asked if I wanted to consider having my water broken to help things progress more quickly. She knew I wanted a natural delivery and was afraid that I would be too exhausted once we got to pushing. We discussed what would happen and any risks involved.

Kevin had gone to grab some lunch, so when he came back we talked together and decided to go ahead with it. I was a little nervous because I knew things would get more intense. The contractions had been hurting, but they had still been very manageable up until now.

My cousin offered to stay if I wanted her there. I found her presence reassuring since she had been through all this recently and really knew what I was experiencing. When my water was broken, there was meconium in the fluid. The midwife explained that probably everything was okay, but they would need to have a fetal monitor on me the rest of the time (fortunately a portable one) and the NICU doctor would be there at delivery to check out the baby.

My contractions did immediately get stronger, and I started throwing up. I was glad when that was over and I could concentrate on breathing. I decided to sit in the shower and run warm water over my belly and back to help with the pain. I found the water so helpful that I stayed there for the next few hours.

Kevin sat/squatted behind me, putting pressure on my back, guiding me in breathing, encouraging me and massaging my tensed muscles to help me relax between contractions. My cousin sat beside me with a cold wash cloth, offering encouragement, reminding me to breathe, and feeding me ice chips. During this period, the contractions were intense and I had a hard time not tensing up, but I was able to manage them pretty well with breathing and was feeling good about things.

At 3:40 pm, the midwife checked me again and told me the bad news – I hadn't progressed any further. She discovered the reason for the lack of progress was that the baby was posterior (facing forward). The midwife tried to manually turn the baby internally – the one time I remember screaming - but was unfortunately unsuccessful. Because of the baby's position, I had started having bad back pain which made the contractions much more difficult. I also felt very discouraged, thinking, “All that work and no progress. The baby is stuck. This is going to go on forever and is only getting worse.”

The midwife wanted me to get on hands and knees for a while to see if the baby would turn. I got back in the shower, kneeling on a yoga mat, but this time the water and breathing weren't doing much. The whole universe compressed into the space of one shower, the world was lost in pain, and time itself stood still in deference to the cosmic force of labor.

Because the baby's head was putting uneven pressure on my cervix, I was completely dilated on one side so my body felt ready to push, but the other side was not complete. I didn't recognize the desire to push – I just knew that during each contraction my body seized up, my concentration broke, and I found myself gasping and unable to breathe. The back pressure was unrelenting and even in the brief breaks between contractions I couldn't function clearly. I started telling the others, “I can't do this.”

The midwife said, “Just stay here for 20 more minutes. You can do it.” When I kept saying I couldn't do it anymore, she would say, “You've just got 5 more minutes,” stretching out each 5 minutes into 10 and 15 minutes more. Somewhere inside my mind I knew the game she was playing, but I was too absorbed to argue. Who was I to judge twenty minutes from two hours, when time had ceased to exist?

In reality, it was about an hour until I went back and laid on the bed. All my muscles were tensed and fatigued, but I was too overwhelmed to relax. The midwife gave me a narcotic shot, which allowed me to rest some between contractions. I was pretty out of it, but I could still feel all the pain, and I didn't think I could handle it anymore.

Though I hadn't planned to have one, I told the midwife I wanted an epidural. She told me to make sure I was 100% certain about it, and after a few more contractions I decided I was. The nurses started me on some preparatory IV fluids and the midwife checked the baby again. The baby had turned somewhat, but now her head was crooked so her ear was facing down, and I was continuing to dilate unevenly. After unsuccessfully trying to turn the baby again, the midwife had me turn on my side hoping gravity would help.

I had to wait for the IV fluids to finished, but at 5:15 I was ready for the epidural. The anesthesiologist had been called, and the midwife checked me one more time. She said, “I don't think you want this epidural – you're ready to push!” I could hardly believe it! I really thought it would be hours more before I got to this point. She asked if I still wanted the epidural and I said no. I was still in pain but I didn't feel so discouraged anymore. The end was in sight! With a bustle of activity, everyone got into delivery mode.

I found pushing much easier. The contractions weren't as bad because now I had something I could do – what my body had been wanting to do all this time. I was working with them instead of just riding them out. I pushed for about 40 minutes. I kept my eyes closed almost the whole time and concentrated. Afterward I discovered I had a big fat lip – I must have been biting down on it. I could hear the nurses and midwife calling encouragement and helping me know when to push. Kevin stood beside me and held my hand. Everyone exclaimed when they could see the baby's head with all her hair.

And then, at 5:55pm, baby was born! I heard her start crying right away, and she was whisked off to the side where it seemed like a whole pack of doctors and nurses were waiting to check her out.

At first I just felt incredible relief. I couldn't quite connect what had just happened to “I have a baby now.” I was aware of all kinds of activity – Kevin cutting the cord, the nurses telling her weight and length and apgar score. In the meantime, the midwife was still with me and I felt consumed with the final stage of labor. I had a moderate tear, and though the stitches didn't hurt as much as everything else had, I just wanted it to be done. I was shaking all over and my arms felt like dead weight, but I had returned to the land of time and space.

During the whole time, I didn't really even look at the baby. I thought this might seem uncaring, but I had the idea that when when I saw the baby I wanted to be able to really concentrate on her, and I felt like I wouldn't be able to do that at the time.
She was pretty thrilled about the examination
The midwife finished with the stitches just about when the doctors and nurses finished checking out the baby. They handed her to me, and I got to look at Juliana for the first time. I still couldn't believe that she was my baby, the baby that had been inside of me all this time. I didn't feel the rush of love – that would develop gradually – instead I felt something more like awe. I thought she was the most beautiful baby I had ever seen. She curled up contentedly on my chest because in this big, new, crazy world, she already knew me.
Yup, still not sold on the outside world
My birth experience was not exactly what I expected it to be. How can you really know what to expect from labor when you haven't experienced it before? It was much more difficult than I had thought, much more cosmic. In the hours afterward, when all the pain was still quite fresh in mind, mostly I just felt grateful for the experience. I was grateful to the midwife for continuing to try different things when another doctor might have just done a c-section. I was grateful for the opportunity to go through that with Kevin, really working together. I was grateful for the unflagging support of my cousin, woman helping woman as it has always been. I was grateful for the strength I didn't know I had, to keep on going past what I thought I could endure.

My other birth experiences were quite different - a whirlwind delivery and a peaceful, even enjoyable labor - but I am glad that this is my story of becoming a mother. It helped prepare me for what was ahead.

And as everyone says, in the end, it is always more than worth it!

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