Monday, June 22, 2009

Miriam's Birth Story

I think everyone has expectations of what an upcoming birth will be like, even though they know that every birth is different. I think we all have hopes of what it will be anyway. My expectation for my third labor and delivery was that is was going to be very similar to Sadie’s birth. With Sadie I was induced a week early because of muscular skeletal problems. This time I was going to be induced because I was late. With Sadie, a cervix-ripening drug was placed next to my cervix to help thin it a bit and then several hours later (after much walking), my water was broken. Sadie was born four hours later. This is what I was expecting since this third baby was in utero two weeks longer than what Sadie had been.

What happened instead was that when we got to the hospital, I was already 3 cm dilated, so we skipped the cervix ripener and went right to breaking my water. We were ahead of schedule and I was envisioning having this baby by lunch time. My water didn’t gush. Miriam’s head was down low, so only a trickle came out. After walking the halls for an hour with only a few moderate contractions, I discovered that Miriam had pooped in the womb. It wasn’t dark in color and since she was past due, no one was concerned. The only thing the nurse mentioned was that once the baby’s head was out, the midwife would want to immediately suction their nose and mouth so their first breath wouldn’t mean an inhalation of poop. Good thinking.

Since walking didn’t produce a good rhythm of contractions, they suggested I get into the Jacuzzi for awhile. This was extremely relaxing unfortunately. It was supposed to bring on stronger contractions. Instead of that, I had about 6 moderate ones in that 40 minute period. Next, I tried the birthing ball, bouncing and rotating my hips and pelvis. Nothing.

Our midwife at this point suggested starting Pitocin. It made sense as the next logical step, but it made me sad. I was hoping I wasn’t going to need it. Not just because of the intensity that Pitocin brings to contractions (I needed Pit during Sam’s labor as well), but because it meant a less natural process. I started to doubt our decision to be induced, wondering if we should have waited longer. Pitocin was started and so did contractions. By the time they leveled off my dosage (when I was really having to work through each one), I was very discouraged. I was tired. I was disappointed. I was having strong contractions with no idea how much longer this labor was going to last. Also in the not-so back of my mind was the fact that after hours of possible labor loomed transition. I hate transition. It’s the only time I feel out of control and even though it doesn’t last very long, I dislike it immensely.

I started thinking about drugs. With Sadie, I didn’t use any. I ASKED for some, but it turned out I was about ready to push, so there was no time and once I knew how close I was I didn’t want them anymore. This time I wanted them much earlier and this, too, was discouraging to me. I told Jamey I was sad and that I didn’t think I had it in me this time and that I wanted relief. He argued with me a bit and told me I should wait until the midwife checked me to see how dilated I was, just like I had told him to (prior to labor, of course). I was checked and was 5 cm. I asked our midwife what kind of time table I could be looking at and she said that a rule of thumb is about 1 cm per hour. Five hours?! She suspected I would deliver sooner, but couldn’t promise anything. I wanted the drugs. (She was born two hours later, not five.)

I was given pain medication through my IV and within minutes felt the edge come off the contractions (although I still had to breathe through and concentrate on each one) and my mood greatly improved. I felt hope. I was able to relax in between. Before long, the contractions picked up in frequency and intensity and I was having to work really hard to keep myself together. I assumed that even with the drugs, since I was getting closer to delivery, the contractions were just getting harder. During several contractions our midwife lifted my stomach to aid the baby’s movement downward (since I carry so low and out front). After a while I asked about the intensity of the contractions and was told that the drugs had worn off awhile before. The midwife told the nurse that she had timed it well- the way she gave it avoided the baby experiencing much affect at birth. I asked for more. Again, they convinced me to be checked first (just like I had asked them to). This time I was 9 cm. Praise God! I skipped the drugs.

I hunkered down on my side like I do when I need to concentrate and worked through each one maintaining fairly good control. I could feel her moving down, but with each one I expected the familiar urge to push, but it wouldn’t come. During as especially hard one, I could feel the nurse messing with the baby’s heart rate monitor that was strapped to my belly (a requirement when Pitocin is used). It hurt like crazy when she messed with it and I was close to asking her to stop when things changed.

I was made to lie on my back. An oxygen mask was placed over my mouth and nose. I saw my midwife inserting an internal heart rate monitor into me and into the top of the baby’s head still well inside. I thought they were just having trouble finding the heart beat (hence the internal monitor). I was so consumed by the contractions and the uncomfortable position I was in that I found it hard to listen to the instructions I was being given VERY firmly by the nurses (now there were several) and my midwife. I was 10 cm and was being told to push. NOW. The problem was, I had no urge to push, so I was having trouble finding my ‘pushing place’. I tried and couldn’t. I tried to follow their instructions. I knew what they were saying, I just couldn’t make it happen. Soon one of the nurses was physically pushing the baby down by pushing/pulling on my stomach from below. That hurt. What hurt turned out to do the trick. That manual push put Miriam’s head against my cervix and I felt the urge to push.

Look out. I pushed as if I was trying to push everything out of my body- baby and all. Everyone encouraged me to push even between contractions. So for a solid five minutes, I pushed and Miriam came out. I saw the midwife working on her once her head was out and I assumed she was suctioning. She was, but she was also getting the umbilical cord off from around her neck. She breathed. She cried. They placed her on my chest, poop and all and she was (and still is) beautiful. She scored well on her APGAR tests and was (and is) doing great.

I delivered the placenta soon after and was pleased to hear I wouldn’t need stitches. Then, out of nowhere I gushed blood and the midwife ordered the Pitocin back on to help stop the bleeding. I stayed on that until 11pm that night and had no further complications with my bleeding.

It was only over the course of that evening and the next when we had a chance to talk to our labor and delivery nurse did we come to find out the urgency of those last 10 minutes. Miriam’s heart beat was great- averaging in the 140s all during labor. During that tough contraction, the nurse was messing with the monitor on my belly because her heart rate had dropped to 60 and then couldn’t be found. Once the internal monitor was in, that read 60 as well. The OB from the group we go to had been called into the hospital in case I needed a c-section. The oxygen on me was an attempt to get more to Miriam. That was why they wanted me to get her out quickly. What they suspect happened is that she had the cord around her neck and a loose knot in her cord prior to labor. When she descended during those last, tough contractions, both pulled tight causing a drop in her heart rate.

Jamey was able to see more of the urgency in how everyone was working toward the end. He became weepy when Sam and Sadie were born, but when Miriam immerged, he was really crying. I was oblivious to a lot of that and was just so thankful that she was out and healthy and that those blasted contractions were over.

Miriam is a week old as I write this and a wonderful baby. It took her awhile to catch on to nursing. She expected milk after only a few sucks and didn’t have patience to wait for the milk to come. She has since learned patience and is eating well. After a couple semi-sleepless nights for Jamey and I, Miriam has fell into a wonderful sleeping pattern of only waking once or twice at night to nurse. She is starting to be awake more during the day and has even flashed us a few smiles that we are convinced were meant for us. I am trying to relish each day with this sweet newborn as she is our last. We are all in love. Pin It

2 comments:

  1. a little teary reading this, i cannot wait to meet her!!

    ReplyDelete
  2. Wow, Gen. What an honest, moving post. I was thrilled for you, but after reading this, appreciate Miriam and the miracle of birth and life even more! So glad you all are smitten!

    ReplyDelete

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