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Friday, July 21, 2017

Margaret's Birth Story: Part II

So as I explained in my previous post... Margaret is a few months old now... and I feel like it's a good time to get back to blogging. I hope you'll enjoy reading these posts - I want to continue to be writing honest and realistic memories and reflections about my pregnancy, my birth story for her, and my adjustments to life as a Mom! So sometimes I may share more than is typical... but due to my honesty following our struggle for me to become pregnant... get over it! This blog is my space and I want to be a resource for anyone else who may have questions or want to know if others had their experience. Love.

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In my last post, I talked about the long almost 24 hours of labor I had while at home and our checking into the birthing suite at Martha Jefferson Hospital in Charlottesville. After checking in, Mike and I had our bags placed and started doing some settling in. I wanted to get an idea of the layout of the space, not knowing how long I would be in the hospital for this second leg of our journey before Margaret's arrival. The biggest thing for me was I wanted to continue to do as little medical interventions as possible (as was safe) for this labor, since it was my first. To not be redundant, I'm going to post again the photos of the hospital's birthing suite:



Since I wasn't 100% sure what the Obstetrician had planned, I decided to walk around and really familiarize myself with the space between contractions before the nurses arrived to learn my game plan. I figured out what light switches went to what light fixture, opened all of the cabinets, found all of the comfort items - Martha Jefferson's labor and delivery rooms have all kinds of birthing balls, bars, chairs, stools, rocker, etc. etc. In the top photo you can see my hospital bed and the time - 10:50:22 on Tues. March 21. My only complaint was how uncomfortable these hospital beds were. Especially after enjoying laboring at home in my own bed and our living room couches. That said the labor and delivery beds were comfier than the postpartum rooms (the folding metal bar underneath the mattress was uncomfortable as I'm long-waisted so it hit me in the worst spots). Anyway, these rooms are really comfortable and roomy otherwise. The couch to the right of my bed was actually a futon Mike slept on, with drawers underneath for storage. Behind the painting on the wall was medical equipment hidden away. The chair between my bed and the futon/couch was a rocker. The tub was a massive tub Mike and I could fit in - but I opted out of it only because it had stalled my labor the day before - but with a nurse monitoring you I would do it in a second for our next child and highly recommend it! Lots of storage in the bathroom on both the counters and the shelves. We had brought an essential oil diffuser, essential oils, some body oil and muscle lotion, LED candles to keep the lights low in the room, a Bluetooth speaker for music, and the like for the room to feel better. I changed into the delivery gown I had purchased ahead of time to wear during the process.

When our the nurses on duty came in, they asked if we happened to have a birth plan on us. And yes, in fact we did. It was a huge amount of relief for us that they cared enough to make that one of the first things which they discussed with us. There were only 3 or 4 other couples on the wing. I was coming in at the tail end of a nursing shift so I had one nurse for a few hours, but then our second nurse was with us for the duration. The nurse made notes on the birth plan as she asked us for clarification (or ranking of specific items) and they told us it was posted at the nurses station for the staff to review. A lot of my tension went away with that dialogue! Apparently the majority of laboring mothers enter the hospital, ask for the drugs, and delivery is a quick turnaround. I was an unusual case in that way, and so there was a nursing student on duty that we granted permission to observe. She was really helpful - grabbing popsicles, drinks, timing contractions, helping Michael walk me around the wing, etc. etc.

When our OB came in, the first one of VERY few hiccups came up. It turned out when she came in that I was only 2-3 cm dilated. All of my OB appts leading up to labor had been fingertip and 1cm dilation. That was SO FRUSTRATING. I had been leaking all day and to learn that there was little development after a whole DAY blew our minds. That was when we decided to slightly adapt our birth plan. I was receptive to having some slight intervention, so our OB on duty gave me the teensiest slice of a Cytotec pill (oral not vaginal) - I would say fingernail size so maybe 1/6 of a full dose. This pill brought back contraction regularity and I tried to rest. Really, Mike rested and I just lay there bored out of my mind. I was truly exhausted but knew I might only do a natural(ish) labor once so I just had my heightened awareness and creeped around online without people knowing I was in labor. I had done research online, so I knew then and know now that Cytotec is used off-label for this purpose often. I was glad to have been aware of this information. Make sure you do your own research, too! In future pregnancies, I plan to decline it, as it truly did nothing to speed up my labor or dilate me more.

When the next OB shift change came around for my practice, my nurse was motivated to have the baby before she left for the day (not for pressure, just out of enthusiasm for our birth plan). Margaret's heartbeat was consistently strong, I was feeling strong and just really tired, and I was continuing to go to the restroom regularly, so the OB was incredibly supportive of my sticking with my birth plan until I personally felt otherwise. My nurse was a rockstar (her name is Nancy, and is a former Bradley instructor). We did all of the Bradley Method tips and tricks for labor. I was up and down, swiveling my hips, using the medicine ball, squatting, pelvic rocking, half laying on the labor peanut ball, walking around the wing, deep breaths, bearing down and timing of the contractions. Nancy was using her fists (and so was Michael!) to knead into my tailbone and all around that area of my pelvis. Mike was giving me all kinds of massage to help me mask the pain. I got up every 45-60 minutes to go to the restroom. So after about 17 hours (such a long time) after getting the Cytotec dose, I was at 8cm (during a contraction dilated). Yes, other than the sliver of Cytotec, I'd had no other drugs to help the labor along.

At this point I was at my wits end. I had not really slept in almost 2 days. My body was in agony. I was bawling my eyes out as I had neglected to ask my doctor for something for my caffeine headache - don't forget to pinpoint your symptoms everyone!! I remember sobbing into the pillow thinking, "I'm not able to push yet... but I've been basically pushing for 15+ hours... I don't think I can do this anymore." I wasn't giving up in a morbid sense, but I knew my body well enough, and lets just say I was a REALLY active and healthy pregnant person, so I knew I was approaching a place where I didn't have 100% control of my mental, emotional, psychological self. I needed to pat myself on the back for trying for so hard. Michael and nurse Nancy gave me about a half hour to really collect my thoughts and come to the decision. I asked Michael difficult questions (had he ever seen me this way, what did my face and eyes look like to him at this point) and I asked Nancy difficult questions too (if I was your daughter what kind of advice or gentle input would you give) and since I felt myself slipping I finally adapted my birth plan by giving them my code word - which Michael and Nancy asked for TWICE to make sure I was sure. I wasn't giving up was the main thing. And I wanted to be as aware as I could be postpartum. My labor had stalled but not in a dangerous way, it just was stalling (we learned later) due to my hymenal ring being intact. But my BODY and MIND was stalling by hitting a wall. I really had done a marathon with my body and my mind and I finally asked for all the comfort measures. I had the Fentanyl, an epidural, and Pitocin at around 3:30 p.m. to open and ripen my body from the 8cm I had done naturally to the full 10 cm. My only big freak out was the epidural making me afraid that I would possibly be paralyzed. I had a contraction while he was putting in my line which was terrifying but thankfully M was facing me on the other side of the bed to keep me steady. The Fentanyl helped me nap, briefly, for the first time in almost 24 hours. Everything came together in just 2 hours once I had given the green light for the comfort measures. These amendments did mean I had to have a monitor on, IV line, and couldn't really leave the bed, but that was okay by me at that point. I just melted into the bed and tried to relax. It was fun feeling the contractions progress without the pain. I distinctly remember saying to Nancy or Mike, "WOW is that a contraction? I hope that was a contraction because that was SO POWERFUL."

At around 4:45 or so, Nancy had me practice the Bradley method of a push. She then put my legs up in the stirrups and turned on the overhead light. She called a nurse over and said, "hmm, well you are definitely ready." She also said something along the lines of, "Hmmm, now what is that ring like thing?!" which was very funny (more on that later). The nurses agreed I was in the right place to push... only problem was finding an available OB from my practice! The OB from my practice on duty was in an emergency C-section. The next one coming on duty was leisurely making his way to the hospital. I was ready to push and the nurse at the nurses station yelled, "STOP PUSHING" at everyone in my room. It was very funny. I say "leisurely" as my OB's office is a mere 1 mile or less away, so it would only take minutes for him to arrive. Nurse Nancy told Michael "Hey! You have got to see this (pointing between my legs)" and he actually looked! This action made me screech as we had agreed he wouldn't look to keep that mystery alive in our marriage. Looking back he says, "I saw her hair. Plain as day, the top of her head! It wasn't gross. Just amazing." The OB strolled in and Michael and I were SO EXCITED. Everything was ready to go and laid out. The OB started making small talk. The nurses gave him a MAJOR look and he turned, looked between my legs and realized it was GO TIME. It was all very funny, truly, I was laughing as I was comfortable and knew I was meeting Margaret in just moments. My OB was between my knees, I was ready to go, and I pushed once. He said the baby's ears or something was caught on my hymenal ring, so he broke the ring and she naturally moved out. She was crying already and in full color once he broke the ring. He let me put my hands under her shoulders (at her armpits) and I pulled her with the last push putting her directly onto my naked chest. Yes, I pulled Margaret out with my own bare hands.

I was astounded. I was relieved. I was excited. I was crying. There were no words for how incredible I felt and how wonderful it all was. I felt so strong. The tiredness was gone. It was euphoric. Margaret was born on Wednesday, March 22 at 5:49 p.m. 6 pounds, 8 ounces. The past four months have been incredible.