I won't lie: it's a long one I wrote here, and it's probably full of grammatical errors of which I would normally be ashamed -- but since I just had a baby, I'm giving myself a pass. Just letting you know ahead of time!
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I wrote recently about how my blood pressure had been climbing fairly consistently at my doctor’s office visits. And I wrote about how I knew it was related to anxiety attending what was waiting for us, but that our care provider decided to run some tests anyway – just so there were no surprises. I was sent home with a prescription for blood pressure medication and we were scheduled to follow up with a non-stress test at 3 pm on Friday, September 17 so they could see how Ewan was handling me being on the blood pressure medication. I got a call from the doctor’s office in the middle of my work day on Thursday, September 16 that I was to go home and be on modified bed rest (lying down or sitting).
At first I was upset, and then I decided I’d make the most of it. I slept nine and a half hours that night. I woke up without an ounce of tension in my whole body. I joked with James that they should try and take my blood pressure now – if I would even have one. I rested all the next day: reading my book, snoozing in and out of a few movies, letting James take care of me. I thought of all the things I could finish: packing my hospital bag, waiting for the arrival of those last few packages that would mean our material readiness, reading and finishing some books, relaxing before our little boy came.
As I rested on Friday, Ewan was incredibly active as usual. And as was my custom, I recognized and praised each movement, laughing as I watched and felt feet, knees, and elbows poking out of me. I could feel my anxiety mount slightly as we got closer to the time to leave for the doctor. It was so deeply ingrained in my subconscious, still; I told myself that Ewan was handling things well, having been so active all day.
After we got to the doctor’s office, I was hooked up to a couple of monitors to measure contractions, movement, and the baby’s heart rate. I was sent for an ultrasound. It was pretty obvious they didn’t like what they were seeing. The little guy that had been so active all day (and all the days before) hadn’t moved at all in nearly an hour – no flexing, stretching, or anything. The ultrasound tech didn’t need to say anything. It was clear we weren’t going to hear anything good.
When we talked to our doctor right after this appointment, and the look on her face was sober. She explained what they saw on the tests and how it wasn’t good news – how babies in utero typically sleep for 20-40 minute stretches at a time at most. She said with any other doctor, this would be a cue for an automatic c-section. She advised us to head to the hospital where she would meet us in about thirty minutes. They would monitor me there and quite likely, induce labor.
We took in a collective sharp intake of breath. Once more, we were faced with a reality we hadn’t quite expected.
This took us entirely by surprise – our little squirmer not moving at all –alarm bells going off. I took a deep breath, wanting to take it in, but not entirely able to. Why hadn’t he moved?
I trust my doctor completely and knew she wouldn’t be alarmed unless there were good cause. So we called our doula, called my family, and drove the two miles from the doctor’s office to the hospital, stopping on the way to get some food. I hadn’t packed a hospital bag – we hadn’t come prepared with anything. I had my purse and my cell phone and the clothes I was wearing. We weren’t ready for this.
I thought of all the things at home that I wanted with me: my birthing ball, all the things on my list of what to pack in my hospital bag, and at least some vague notion of who was going to come to the hospital and when and what we were going to do. Several text messages were exchanged. We had fortunately given my sister a key to our apartment when she was down for my last baby shower the week before. There was a list sitting by the computer of what needed to be packed. We sent more text messages, asking for more of what we knew we would need.
When James and I arrived at the birth center, they were expecting us, our doctor having called ahead. We were taken to our room and checked in. I put on a gown and mentally tried to prepare myself for our time there. It still felt so surreal, like this wasn’t really happening. I had been mentally preparing myself to go past the due date, and here I was getting ready to be induced two and a half weeks prior.
Some very sweet and funny nurses came in and captured some of my information: food allergies, age, and the like. Everyone there was prepped on our story and knew what was going on. Their own ease helped me relax.
They hooked me up to the monitors again to measure contractions, fetal movement, and the heart rate. By this time, Ewan was squirming and rolling consistently again. His heart rate was making the variations that they look for and expect. When Dr. J came by to check on us, she said she would have had an entirely different assessment if she had seen this strip just the hour before when we were in her office. Pointing to the printout we were seeing at the hospital she said, This is what we want to see.
|Top graph (in blue) are baby's heart rate. Bottom lines are my contractions|
That Ewan. What a little stinker!
She explained to us what our options were. She could send us home, seeing as the baby was obviously doing fine at this point. Her concern was that there might be a drop in activity that we wouldn’t know to be alarmed about and that they wouldn’t be able to get him out in time. That’s what my heart can’t handle, she said, choking up and her eyes misting over. The other option was to stay and induce. She would try some natural means first, stripping the membranes and seeing how that worked before we tried anything like pitocin. She left us so we could discuss, and would come back to check and see what kind of progress I might have made already.
She left the room so James and I could discuss what we wanted to do. We looked back at the monitor and the nurses pointed out I was having contractions about every three minutes, each lasting about a minute. They couldn’t believe I wasn’t really feeling anything yet. They weren’t the least bit painful, but were decently strong. It just felt like the kind of tightness you might have in your stomach when you’re sitting up in bed.
Dr. J came back to checked me several minutes later and asked what we wanted to do. We hadn’t entirely come to a consensus, but I had a deep level of trust in what she saw, in what she was telling us. I knew she cared about us and this baby. I knew she wanted a healthy mom and a healthy baby. And so we decided to stay. This was at about 5 pm.
That’s when I learned I was already 3 cm dilated and 80% effaced: decent progress for not really feeling anything at all. And look at that: I was still contracting well on my own. She stripped the membranes and we braced ourselves to meet our baby, heads still swimming in thick clouds of surreal. We called our doula again and let her know what was happening and she gave us instructions on when we should call her back: at the point at which I felt like I was going to need help.
The evening wore on little by little and eventually my family arrived with my hospital bag, my birthing ball, and the other things we had asked for. I joked through my contractions, feeling them obviously at this point, but was still comfortable enough to joke through them. They were coming every two-and-a-half to three minutes and were increasing in intensity. I updated Facebook, we watched videos on YouTube, and we waited.
I knew moving around in different positions was going to be my best bet, so we were hooked up to the monitors that would allow me to walk around, get in the bathrub, or sit on the birthing ball. I did it all, walking the halls, sitting on the ball, relaxing in the tub. I knew this movement will help bring Ewan down. The last thing I wanted to do was to be stuck in the bed.
My progress was monitored at 11 pm and 2 am. I was progressing: 4 cm, then 5. By the time I got to five, I was 100% effaced. This was good progress. This was good news. Dr. J was going to go home, but assured me she was just six minutes away and would be here to deliver this baby. By about 3:30 am, I was at 6.5 cm. Things were uncomfortable at this point and I was having a lot of back labor. James, my mom, and my sister took turn rubbing my back through contractions and we tried different positions to provide relief. We called Annie since I knew I was getting to the point where I was losing focus and the ability to get myself to relax in between.
When Annie (our doula) arrived and I was so relieved. She has such a gentle and compassionate way of taking charge. We walked, we sat on the birthing ball, we moved to the tub, I sat on the toilet for awhile. She helped both James and I. She commanded my focus and taught me helpful ways to breathe.
I had gone without any pain relief or other augmentation for my entire labor; this was my plan. I didn’t want an epidural, I didn’t want analgesics – I wanted to experience this naturally not only for my own sake, but because I believed this would be best for Ewan too. As I entered the transition phase, the contractions became stronger and closer together. I started waiting throughout and in between. I was in so much pain. Annie commanded open eyes, breathing through loose flappy lips like a horse, low tones from the back of an open throat, a relaxed body that welcomed the contractions. I was only getting a minute or so in between contractions. It took more will than I had at times to “blow that one away” and relax as deeply as I could in between.
|Annie the doula!!|
I could see how it pained James to see me like this. He held my hands, maintained eye contact with me, and cried with me.
Having done a fair amount of laboring on my side in the tub, we decided to get up, knowing that changing the position would help move the baby down. No sooner did I stand up in the tub than another contraction came. I held on to James’ arms as I bent my knees and bent my upper body over, breathing as Annie had instructed me. Suddenly things felt very different – my water bag (which had not broken yet) was coming out.
They told me it wouldn’t be long now. I was fully dilated and ready to push.
Dr. J was paged at about 8:00 am or so (from what I can remember), but it could be any minute. They got me back into the bed. A team of doctors and NICU nurses surrounded me, waiting. I was ecstatic with relief – it wouldn’t be long now.
The water bag had broken and we tried a few pushes in bed. I was still having incredible back labor with each contraction and bearing down to push was excruciating. My body was shaking and exhausted, adrenaline pumping through me. I got a several good pushes in that helped the baby down, but it still wasn’t happening as quickly as we thought.
Dr J finally arrived, surprised at how quickly I had progressed to be ready to push. She checked me and found that there was a small lip of the cervix holding the baby back; she explained this was common in first-time mothers and how it was probably my water bag holding it back the whole time. She emptied my bladder to remove any pillow he might be resting on in hopes of making things progress.
I was starting to feel discouraged; the pain was incredible, the contractions still stopping for only about a minute and lasting for at least as long. They had me lean over the top of the birthing ball on the bed. And then we tried squatting – I knew this would be effective, but my body was so shaky and I was feeling so weak. I kept saying I couldn’t do this. I held on to Annie in the front, and James supported me from behind. I squatted deep and pushed hard with every contraction. We went through several this way until I knew I needed to move to the bed.
We pushed more from the bed, Annie and James and the nurses helping me hold back my legs. It took more strength than I felt like I had available. I just wanted Ewan to come out.
And then we heard his heart rate was dropping. They had put an internal monitor in to measure his heart rate more accurately, and it was clear he needed to get out. I pushed hard and felt the burning that meant he was crowning. Dr J explained she was going to use the vacuum to help him out since his heart rate was telling us he needed help. I pushed and pushed and with one extended pull from the vacuum, I could feel his head come out. And then his body.
And then suddenly there he was, on my belly. Ewan. This so-loved, prayed over, extraordinary baby. Saturday, September 18 at 9:49 am.
I was all kinds of emotions: relieved, ecstatic, blissful. Still in disbelief. Nurses took him and cleaned him up, wrapping him in blankets and putting a knit hat on his head. They put him on my chest and suddenly, all of the previous seventeen hours had been worth it. He was not as pink as a normal baby, but had good color. I touched his little turned-up nose, stroked his face and just held on to him. He wasn’t wailing, but just gentle cries like I had – maybe he was as relieved as I was.
Annie snapped a few family photos for us. The NICU nurses took him from me after a minute or so, putting him in the isolette that was waiting to be rolled off to the NICU. James went with him, meeting my family on the way. They couldn’t believe it was him – he was alert and awake, looking cute and pink as babies do.
Annie stayed with me and held my hand as James was away. And Dr J started to stitch me up. She suspected the tearing wouldn’t have been an issue had we not used to vacuum in order to help him out quickly. But I was torn up pretty good – third degree tears in multiple places. I really didn’t care.
I was suddenly so shaky and cold as I came off the adrenaline. Annie held my hand and told me what a good job I did (even though I had been wailing like a banshee for the previous two or three hours), how strong I was, and how perfect he looked. Dr J took her time stitching me up. The nurse hugged and congratulated me and it was just the four of us. For that hour or so, it felt like a perfect little tribe of women who had stayed with me through that, reminding me that I could do it, that I was meant to do it, and that I would.
And I did.
James eventually came back with pictures and stats: 6 lbs, 7 oz and 18.5” long. Beautiful and perfect. Dark hair with a little curl in it. Eyes wide open. Breathing well on his own. Stats looking absolutely perfect.
|Visiting him in the NICU|
We later found out that after doing a thorough examination, everything but his poor little heart is absolutely perfect: lungs are strong and healthy, liver and stomach and kidneys are working and in the right places, good bowel sounds (and movements). Tracking right in the middle for all his measurements except his head, which was greater than the 90the percentile (the better to hold all those brains in).
A few other facts not included in the story:
- My BP was measured periodically throughout labor. It was consistently in normal ranges, one time measuring even 117/68. I think that at its highest during labor, it was 133/80. On Friday afternoon at the doctor’s office (after we obviously knew we were getting bad news), it was 158/100.
- From the time we were admitted (and I had no idea I was in labor yet) to the time Ewan was born was about 17 hours. I’m told this is “quick” for a first-time mom, though the last several hours (from transition on) felt like 17 days. ;o)
- No pitocin taken or required! We found it simply miraculous that because my BP had been high in the doctor’s office, they took care to put me on medication and see how the baby reacted to it. The lack of his movement would not have been detected when it was, and we would not have known to go to the hospital. Baby Ewan was telling us he was ready to go.
- Labor started totally on its own. I was already having contractions that were moving things along. Stripping the membranes sped things up, I’m sure. But it really was baby Ewan’s time to come. I feared being induced, but just as I had hoped, I went into labor on my own anyway.
- I had no pain medication of any kind for labor and delivery. Believe me, I can hardly brag about this, because in my mind I was begging for it – screaming out to God and whoever else would listen about the pain, about how tired I was, about how I couldn’t do it anymore, about how I wanted that baby out. I never actually said anything explicitly about being given drugs or an epidural, but I was thinking about it (back labor is hell). As much as it hurt, I’m glad now that I didn’t. I learned that yes, I could do it.
- I think you already know this, but I really love and trust our doctor. She guided us through an incredibly difficult time and showed us a lot of love and personalized care. Lord willing if we should have another baby, I would seriously consider seeing her again and opting for a hospital birth (though she did say there is no reason I couldn’t have an out-of-hospital delivery for my next baby), just so she could take care of us again. She is nothing short of amazing.
- Annie the doula was worth every penny and more. Dr J said it too, and I will add as emphatically as I can: (in my humble opinion) every pregnant woman should have a doula. I know for a fact I would not have made it through labor and delivery naturally were it not for her. She was tremendous, and obviously meant to do exactly what she does.