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18 December 2013

Owie! Owie! Owie! Gwendolyn's Birth Story


Born: October 24, 2013 @ 10:10 am

Weighing: 8 pounds 10 ounces

Measuring: 21 inches long Here is the story of how Gwendolyn made her entrance...and then some, because I don't know how to put things in nutshells. :)

I had three wonderful medicated births.  And when I say wonderful, what I really mean is that the actual act of pushing the baby out was pretty much painless, I had no negative or lasting side effects from the anesthesia, and the moment each of my first three children came into the world was completely joyful.

However, looking back, none of the experiences leading up to that joyful moment (which I know is the MOST important part, but not the only important part) were actually that pleasant.  I have always considered my labors to be good experiences because I never faced any severe or scary complications.  But, with each one I was either faced with hospital staff that didn’t really care about how I wanted to do things and used scare tactics to convince me do it their way or had interesting but temporary results from the epidural (going completely numb from the waist UP and feeling pins and needles in my legs for hours).  This never bothered me much at the time because I wasn’t as educated about birth as I should have been. I never really cared because I was pretty laid back about it as long as I got a baby out of it in the end.  Que sera, sera. But, having educated myself more and more with each consecutive pregnancy, I realized that being blissfully ignorant to certain risks presented by “their way” is not what I wanted to be this time.

I never desired a natural birth before, so I was never upset with the interventions...and I am still not upset over the experiences I've had.  But this time, the idea that this could be my last birthing experience ever made me really want to see how different things would be if I tried this thing the natural way.  I was also older this time and felt that going this route would decrease the likelihood of interventions leading to a surgical birth.  In addition to these reasons fueling my interest in natural birth, I thought having a natural birth experience would make me a more desirable surrogate option in the future for a family who might prefer their baby to be born this way.

Brad is a huge fan of epidurals.  Every time I have ever brought up even the slightest hint that I might want to birth naturally, he has been against it.  He doesn't like seeing me in pain and not being able to do anything about it. He likes the giggling while pushing baby out much better than the roaring banshee noises.  Haha.  However, this time I was serious.  He didn’t believe me.  Much like that time I told him I was going to run a half marathon and he didn’t believe me until mile 10, when he wanted to quit and admitted to me that he thought I would never even show up for the race.  He tested my desire for a natural birth by making me choose between a Catalina Island weekend to celebrate my 30th birthday and my completion of my bachelor’s degree OR hiring a doula.   When I passed on the weekend trip in favor of the doula, he was shocked.  He thought for sure I was going to choose the trip.  Wrong again, Brad.  Even then, though, he still didn’t think I would end up with a natural birth.  And, I am almost positive that I wouldn’t have if we hadn't had our doula, Sarah.

As I prepared, I read a couple books, did some more online research, and felt much more comfortable with my decision, and much less scared.  Having had three painless births, I was still a little terrified of how much it would hurt!  My biggest fear, though, was ending up with a surgical birth.  When my water broke with Carolyn, we went straight to the hospital and I wasn’t even in labor.  I wasn’t dilated, and the staff immediately started talking about interventions they wanted to use so they wouldn’t have to perform a c-section at the 24 hour mark after my water broke.  I didn’t understand then that the risk of infection goes up 24 hours after your water breaks…that doesn’t mean they need to immediately cut baby out at the 24 hour mark.  And, if you don’t have any cervical/vaginal checks or other interventions like a Foley ball entering your baby making parts, the risk for infection is quite low.  So, we were scared into a bed and Pitocin when we should have just kept walking.  Oh well.  That is the past, and I got Carolyn out of it without surgery.  But this time, I knew I would not be going to the hospital immediately if my water broke, at least until I felt like something was already happening on its own.  I wanted time to progress by myself without being pressured into unnecessary interventions.

Well, it happened again.  Tuesday night around 7:30, three days after my due date, I was lifting Carolyn out of the bath tub and I felt like I peed my pants.  I HOPED that I had peed my pants.  I really didn’t want my water to break before I was actually experiencing other labor symptoms, AGAIN.  It wasn’t pee.  I was pissed.  I then had to face the pressure of making the decision about when to go to the hospital and when the risk of infection actually became enough of a threat to me and Gwendolyn to seek intervention.  It was very stressful.  It had been a long day and I knew that if I was going to push a baby out without pain killers that I was going to need some rest, so I knew we were not going to the hospital that night.  We got the kids in bed and Brad went to sleep, unsure of whether he would be going to work in the morning or not.  I stayed up to pack my hospital bag, install the car seat, and get some other stuff done around the house so that Gabe and Melynda would be prepared to get Jocelyn to school and what not if Brad and I were to go to the hospital sometime during the night or early morning.

I got a decent amount of sleep, despite having to change my giant pad often throughout the night.  I felt maybe 4 or 5 contractions throughout the night, but nothing exciting.  When I woke up, I felt great.  That angered me.  I wanted something to happen!  Brad was ready to go to the hospital and I wanted to wait longer.  The midwife I had seen at my appointment the day before called to let me know about the non-stress test appointment she had scheduled for me.  I told her that I wouldn’t need it because my water broke the previous night, and she berated me for not being in the hospital yet.  She actually said, “You need to go to the hospital and get some Pitocin right now!”  I would have expected that from an OB, but I was really put off hearing that from a midwife.  I called my doula and she comforted me, and I comforted myself with the stuff I have learned about evidence based care.

At that point, I just wanted to distract myself for a little bit.  I went to a hair place to have my hair braided.  That might not seem like a logical priority to anyone else 12+ hours after their water breaks, but I am glad I did it.  It was a little reprieve from thinking about all the things the rest of the day would bring. It was a little break from the “Let’s go to the hospital looks” I was getting from Brad.  It was just nice to have that little bit of time for me before everything really started.  While I was at the salon, I had three missed calls from Labor and Delivery because the midwife who told me to go to the hospital had called them to let them know my water had broken the night before.  Swell.

After lunch time, the doula came to hang out with us.  We went for a decent walk, in which I couldn’t get a single substantial contraction to appear.  She encouraged me to pump (meaning to use my breast pump as nipple stimulation to produce oxytocin that would encourage contractions), and that didn’t really work either.  Sitting down and relaxing, doing nothing seemed to be the only time I could feel anything going on.  She made me some red raspberry leaf tea, and really just nothing was happening.  I was starting to realize I would have to go to the hospital with no labor symptoms AGAIN, but this time I was sure they would be more adamant about intervention/surgery because we had waited so long after my water breaking.  Brad, the doula and I agreed that we would go in at the 24 hour mark.  We ate dinner and left for the hospital right around 8pm.

I was freaking out on the way there.  I had two good contractions in the car during the 20-30 minute drive.  That wasn’t enough to convince me that I was progressing much at all.  I assumed the staff would be similar to the staff at Tripler (where Carolyn and Sam were born) and that they would want to wheel me off to the operating room as soon as we walked in the door.

WELL, I was SO wrong!  Thank God!  My desperate pleas in the car were answered, and God totally provided a blanket of grace for me upon my arrival.  My fears were eased by a midwife (or as Cori called him: a manwife) named Al.  Al was a fast talking, straightforward, understanding, compassionate angel.  I liked everything about him.

When we signed in at Labor & Delivery, we had to fill out a short form that asked about contractions and how far apart they were, if my water had broken and when, etc.  The form just asked for the time that my water broke, not the date.  I wrote 1930…and it was about 2030.  I didn’t mention right away that it had happened at 1930 the previous day.  So, the triage girl didn’t think much of it.  In fact, when she was taking my vitals, she said something about, “If we decide to keep you.”  Haha!  That was strange because I would never have expected them to send me home even if my water had only broken an hour prior.  It seemed so different from Tripler already!

I was exchanging looks with Brad and Sarah (the doula, who I am tired of referring to as “the doula”), like “when should we tell them that my water broke yesterday?”

Then Al came in and introduced himself as the midwife on shift and we told him that it had been over 24 hours since my water broke.  He kind of looked at me and gave a little head shake, like “tsk tsk.”  I shared my fears about surgical birth and my desire to have a natural birth.  He basically said, “Okay, we can do that.”  And just like that, a HUGE burden of stress and fear was lifted from my shoulders.  I am pretty sure I cried tears of joy/relief.  We were there for another 14 hours before Gwendolyn was born, and not a single person mentioned a c-section even once the whole time.  I couldn’t believe it.  There is no way that would have happened at Yokosuka or Tripler.

He waited a couple hours before even checking me for dilation, which told me that he was aware that kind of thing added to the risk of infection and he was being careful with me in order to increase my chances of having my desired birth experience.  I was only 2 centimeters dilated when he finally checked and I cried.  He discussed my intervention options with me in detail and mentioned that he wanted to avoid Pitocin at this point, I think because he knew that I would end up with an epidural if I had to endure Pitocin contractions from 2 to 10 centimeters.  He told me about Cervadil and Cytotec.  He explained that the Cytotec (misoprostal) doesn’t contain artificial oxytocin like Pitocin does, but that it helps the uterus become more receptive to the natural oxytocin already being released by my body.  The detailed explanation made sense to me even though he mentioned that it was something that has only recently started being used in labor.  I wasn’t in a position to research this pill online at the time, but Al had totally earned my trust at this point.  I decided to trust him and go with the pill.  They gave me half of one at midnight, explaining that it might not do much until they gave me the second half, four hours later.  I was checked again at 4 am and was still a 2!  Grrrr.  I freaked out a little, but they gave me the other half of the pill and everyone around me remained positive that I would be fine and nobody mentioned surgery.

Shift change happened around 7am, and I was so sad to see Al go.  I wanted him to deliver my baby!  On his way out he offered me some comforting words and even said something about the possibility of him delivering me when he came back that night at 7.  The thought of still being pregnant 12 hours later was both terrifying and comforting because that meant that nobody had any intention of cutting me open if Gwendolyn was still in my belly at 48 hours after my water breaking.

I had been having some pretty decent (read: excruciating) contractions since that second dose of Cytotec at 4am, and when the new midwife on shift checked me about an hour or so after shift change I was ready to push a baby out…but my cervix wasn’t.  I was dilated to “seven or eight”.  I was starting to doubt my pain tolerance.  This was when I started talking about pain relief and asking where the anesthesiologist was.  Brad and Sarah both did a really good job of reminding me that I didn’t really want that and that I could handle it.  Sarah and the staff were both constantly reminding me that going from 8 to 10 is the fastest part and that I was almost done.  It was starting to get hard for Brad.  He took a short video of me begging him to call the anesthesiologist, and he responded with, “You push the button”.  He later told me that he really wanted to go get the guy, and that it was really hard for him not to.  Also, the nurses told me that when I was really asking for it, it would have been too late anyway.

As much as I hated each of those contractions, I really loved the freedom of intermittent fetal monitoring and not being constantly hooked to an IV.  I went for a short walk and sat in the hot shower for a while, which both seemed to help a lot.  I labored on all fours in the bed for a little bit and it was great to be able to move and change positions to find the most comfortable way to get through each contraction.  For about the last hour I really wanted to push, and bearing down and basically grunting was the only way I could cope with the contractions.  I went from the shower to using a squat bar over the bed.  After squatting for a bit, my hamstrings were killing me and I just needed to stand up and stretch out.  When I stood up on the bed, I was instructed to stand on the floor instead.  As soon as I got to standing on the floor, I felt the urge to push again with the next contraction and dropped right down into squatting again, holding on to the side of the squat bar.  I felt weak all over, it was really intense.

This is when I thought, “Okay, I think I am almost done.  Oh God, please let me be almost done!”  My arms were not strong enough to hold me up in the squatting position for more than a few seconds and in between my painful screeching I shouted something like, “My arms aren’t working anymore!”  Then I was surrounded by nurses who let me fall back into their arms.  They supported all my weight in the squatting position while I pushed twice and the head emerged.  Then two more intense burning pushes and Gwendolyn was in my arms!  I sat down on the floor (which they had covered in chux pads before I moved from the bed to the floor) and kind of collapsed on top of the nurses who were there.  They put a pillow behind my head and continued to support me as they toweled her off and sucked fluid from her mouth.  Several minutes later, I delivered my placenta right there on the floor, then moved back up into the bed to snuggle with my Gwendolyn.

I could not believe the immediate relief!  It was amazing.  I was in shock that I actually did it.

I held her to my chest for a few minutes before Brad cut the cord, and then for over an hour before they took her to the warmer for a minute to weigh and measure her.  They gave her right back to me, and it was hours before they actually cleaned her.  She had a big spot of blood on her cheek for that whole time that I joked about being a birthmark.  We had never been offered, or known enough to request, delayed cord clamping before.  It is standard procedure at Balboa!  Also, immediate and prolonged (at least an hour) of skin to skin is also standard procedure!  In the past, with my other babies, they have always immediately taken the baby to weigh, measure, bathe, apply eye goop and what not, then returned baby to me.  This time it was so nice that they were all so laid back and I just got to enjoy my baby the whole time without anyone wanting to grab her from me!

She latched on and began nursing very shortly after she was born and has been eating well since then.  However, because she was over 3850 grams (or something like that—8.5ish pounds) they were required to prick her foot to test her blood sugar.  I guess larger babies can have a harder time keeping their blood sugar up to acceptable levels.  I loved everything about everyone in Labor and Delivery, but when I moved to the Mother Infant Unit…I was a little less impressed.   The lowest allowable number for blood sugar is 45.  Gwendolyn’s initial test was 41.  They immediately told me they wanted to take her to the nursery and feed her formula.  UH…no.  They were quite pushy, and made me feel like crap for refusing, but I didn’t want to put our nursing success at risk so early by introducing her to a bottle/syringe in her first 24 hours.  Plus, breast milk can raise her blood sugar just as well as formula can.  Then they gave me some crap about not being able to measure breast milk consumption and that they couldn’t know she was actually getting anything.   Aye yay yay.

The best part of my time in the MIU was when AL came down to check on me during his next shift.  He told me that even though he had to shake his head at me for waiting so long to come in the night before that he thought I made all the right choices and applauded me for sticking to them.  It made me feel SO good.  Hospital policies mean that he cannot support or endorse certain decisions while the mother is laboring, but the fact that he took the time to come down and tell me that he thought I did everything right (after the fact) meant a lot to me.  He also thought it was good that I was refusing the formula, so that made me feel good to have a little back up from a medical professional (with a little more evidence based care background than my nurses had) in that area as well.

Anyway, I kept nursing Gwendolyn and she was peeing and pooping a lot, so I was not worried about her not getting enough to eat.  The next test was a 44.  Grr.  They had to do three in a row, a couple hours apart, but they wanted me to not feed her for 1.5 hours before each test.  This made me mad, because I feed my babies on demand.  If she is acting hungry, I am not going to deprive her for 90 minutes...OF COURSE her blood sugar will drop.  Such a silly test!  The first one was another 44, then we got a 47 and a 51.  But, they have to have a >45 score three times, once every eight hours before we could be released from the hospital.  So, we were at 19 hours after birth (Friday morning at 5), and they told us we would be there for a minimum of another 24 hours, and that was only if she passed the next three tests.  I started to get worried that we would be there for a while, but the next three tests were passing, and the Saturday morning, 0500 test was 67, so we were good to go (though Gwednolyn’s little feet were full of several tiny holes from all the pricks).  I knew my boob juice wouldn’t fail me!

We were discharged right at 0900, which was the exact time of kick off for the Nebraska game.  We rushed home so Brad could watch it, and I got some things unpacked and settled. Gabe’s brother, a submariner, happened to be in port in San Diego for the weekend, so he and Melynda (and baby Henry) went out to Ikea and some other places to hang out with him for the afternoon.  After a bit, I got a little frustrated with Brad watching football (though I couldn't think of anything better for him to do).  I needed some things for Sam/Carolyn’s birthday party the next day, so I loaded all four of them up in the van and went out for some errands.  I left Brad a honey-do list, and went to Kohl’s, Babies’R’Us, Panda Express, Wal-Mart, and the Commissary.  Someone at Panda express asked me, “How old is she, about two months?”  I told her that she was two days and thought to myself, “My stomach better not look like this when she is two months old!”  Haha. (update: it totally does--I need to stop eating cookies by the dozen)

Anyway, it felt good to get right back into the swing of things after having to spend that extra day in the hospital.  I feel like the longer I would have relaxed and taken things easy, the harder it would have been to get back into our normal schedule.  But, now I am already comfortable going places and doing things with all of them because I just hit the ground running.

The Paines were so much help the whole time they were here.  They put the kids to bed several times, and took Jocelyn to school and picked her up.  They fed the kids, read to them, lovingly and consistently disciplined them, helped them with homework, etc…experiencing the full “parenting four children” life as they managed our three along with their ten month old, Henry.  They brought them all to the hospital to visit a couple hours after Gwendolyn was born, and just generally proved their awesomeness by taking up a challenge that would terrify most of our other friends.  And, they flew all the way from Hawaii to do this for us!  In case you don’t know, Melynda was one of the first people to visit me in the hospital immediately after Jocelyn’s birth, then she came over to watch Jocelyn when I went to the hospital in the middle of the night to have Sam, THEN she came over to watch Jocelyn and Sam when I went to the hospital in the middle of the night AGAIN to have Carolyn.  So, she made the trip from Hawaii to San Diego to keep up the tradition.  She is amazing, and I am so thankful to have been blessed with her friendship in this life.  And Gabe is not so bad, either.  Brad has surely been equally blessed by his friendship through the years, from Nebraska to Japan to Hawaii.

Anyway, when all is said and done, we are home with a healthy and happy baby girl who I was able to bring into the world in a way that was very close to what I desired (I am not sure I can actually call it a natural birth because of the Cytotec pill, but eh, who cares what it’s called).   It was only possible with the Paine’s help, with the help of Sarah (our doula), with the help of a husband who is really great at giving me what I want and need, and a God who knows and loves me on a such a personal level that He provided me these things and so much more exactly when and where I needed them.
My other birth stories have all ended with something sounding like, “and we will start trying for the next one in X months.”  Not this time.  We are pretty sure that Gwendolyn will be our last biological child.  However, I don’t think I am done being pregnant, and we are not sure our family is complete.  We shall see what God has planned for our future.  For now, Team Hayes is going to hang out at six members. (The video says our family is complete...but that just means for the time being we don't have any plans to add to it).

Here it is, if you are brave enough to watch it.  It's short. You might have to open it in youtube to see the whole thing, my blog format cuts off the right side. To open it in YouTube, just click on 'Amy's Delivery' in the top left corner of the video):

Now, before you judge my song choices, hear me out.  Not only does the loud and fast 'yelling' of the first song totally fit how I was feeling while Gwendolyn was crowning...but the lyrics are so relevant to childbirth.  Think about it, "Can't take much more"...yeah, pretty much exactly what I was thinking. And, the counting, along with the phrase, "Nothing wrong with me" makes me think of how I don't need anyone to count how long I push for because my body totally knew what it was doing...because there is "nothing wrong with me".  See where I am going?  "Something's got to give!" Yup.  I am almost convinced that Drowning Pool wrote that song about unmedicated chidbirth!   And, I know the transition from that song to the IZ song might seem kind of weird, but that was exactly what it was like when she came out.  In an instant I went from screaming in pain, begging for someone to just pull her out and get it over with to an overwhelming sense of peace just washing over me.  It's nuts how quickly I changed from one extreme to the other!  So, though my music choices might seem "different", or like they lack a traditional segue, they actually make perfect sense...to me.

Did you make it to the end?  Wow!  I should make you some cookies...and actually give them to you instead of eating them myself!
Posted by Team Hayes at 8:03 AM Cori Gentry said...

I knew you could do it.. I'm so glad that you finally gave natural birth a chance. My rantings were not for nothing!

December 18, 2013 at 11:57 AM Blogs that I love to read