Sunday, October 25, 2009

My First Bradley Birth, or my " Really?" birth...

Well, now that I've stated my case somewhat, I'm ready to share my glorious birth experience with my Handsome friend, son #1. By the way, my sons like to pull stunts, and they start early. When I share about baby #3, you'll see that this is a trend. That's why I'm slightly hopeful that since this next baby is a girl (have I mentioned I'm pregnant again?), we might be in better shape. But as we all know, anything is possible.

Anyway, my oldest son was due on January 1, 2005. I didn't mind not coming early, as I new it would make the holidays even more stressful, and my son might not forgive me having him right around Christmas Day. It sounds frustrating for some people.

I also didn't mind him not coming early, because I was in total "natural" mode; and "natural" mode prepares you to go a week or two past your due date. By the way, did you know that a huge percentage of babies come at 41 weeks? I bet this bugs some OBs. With how big mine tend to be, that would bug me. But lots of women go "overdue," and their babies do alright. So let that be encouraging to some mom out there who is 40 1/2 weeks along and feels like she's going to burst. Or she could throw rocks at me.

Anyway, after a fun New Year's Eve of dinner and watching "Napoleon Dynamite" with my husband's parents, I woke to an invitation from my groovy neighbor to take our daughters to see "Sharktale" at the dollar movie. We rode over together, and by the time we got there, I was starting to feel pretty uncomfortable. I had been having plenty of Braxton Hicks all week (well, all during the month of December, to be honest). But these contractions were pretty steady. I will admit, though, that timing contractions is not one of my strong-points. So I can't say how far apart they were. What I can say was that as the movie progressed (with my daughter, then almost 3, popping in and out of the theater for drinks and potty breaks - even she can spot a bad movie a mile away), I felt more and more sensitive to my stomach. My friend commented that her family had gotten over a stomach flu pretty recently, and I wasn't excited to think I might be coming down with something. She kindly offered to take us home, and we returned in time for me to lay down for a second and then get up and empty my stomach completely. I did this a few times, and in stomach flu form, I could not hold anything down for the rest of the day. My kind husband let me rest, and I took a long nap or two. At about 6 or 7ish, my husband woke me from a nap, declared that he was worried about me, and suggested that we get me to the hospital for an IV. I agreed.

Now I must break to share that I had a birth contract, and it was so beautiful. A birth contract, for those unfamiliar, is essentially a wish list. It always starts with something like, "If baby and I are doing well, these are my requests," and they usually include requests for no IV, episiotomy, etc. My birth contract had all of the above - no IV, only intermittent fetal monitoring rather than continuous fetal monitoring, permission to eat and drink lightly in labor, and a "Please don't suggest pain meds - We'll ask if we need some" plea.

My husband and I packed our bag in case the baby was coming. I took a look at my lovely green pallor, and we headed to the hospital (a different, smaller one than the first one in my daughter's birth). We dropped off our daughter with a nearby relative, got to the labor and delivery ward, entered, and I said to the admitting nurses, "I think I need an IV." See what a good girl I am?

They agreed, but suggested that they check my dilation just in case this was a sign of labor. I was shocked to find that I was dilated to 5. Those really were some mild contractions. We decided to do the IV and check me again in hour, and then we'd decide from there if I should stay and have a baby. I got my IV, drank some apple juice, threw up a bit (so much for eating and drinking in labor), and took a brief walk down the hallways.

About halfway through my walk, I knew that I was pretty sick, because my "flu" was causing gastrointestinal discomforts, and we scurried back to the room just in time to avoid a very embarrassing situation. Unfortunately, for the next several hours, my vomiting slowly subsided while my gastrointestinal challenges increased. Yikes and oh so embarrassing! The good news was that between having a nice dim room, some relaxing music, and regular back-rubs during my tougher contractions, my husband and I were having a positive time laboring for our baby. I started out with intermittent fetal monitoring, because the guy's heartbeat was looking fabulous and no one was very worried about him. But when the nurse kept bursting in every 15 minutes, she suggested we just go with continuous fetal monitoring so that I could have some privacy. Happily, she knew that I wasn't planning on an epidural, and she expected that I'd be moving around quite a bit. (It's good when they expect lots of movement, or they could get really panicked if the readings look bad every time you switch sides).

I stepped in and out of the shower here and there, sometimes for relaxation and sometimes because I felt icky with all of the flu symptoms I was having. When the contractions came, I closed my eyes, relaxed my body, breathed as deeply as possible, and my husband firmly massaged a spot on my lower back where I felt a deep, burning pain. It was uncomfortable, but not too tough. Each hour the nurse came in to check my dilation (by the way, I don't enjoy cervical checks), and we were pretty hopeful at first that my dilation seemed pretty steady. At entrance (8:PMish), 5 centimeters. Around 9:00, almost 6 centimeters. Around 10:00PM, 7 centimeters. 11:00 PM, about 8 centimeters. 12:00 AM - 8 centimeters. 1:00 AM - 8 centimeters.

Wait, what's happening?! I thought we were progressing. Oh yeah, well, my water hadn't broken. The thing was, I had a wonderful family practitioner - a doctor - who was at home sleeping. The nurse was so sure that with my steady contractions and my, up until then, steady progress, once my water broke, I'd be pushing the baby and my doctor would still be home sleeping. At least, that's what she explained to me on the 6th cervical check. At this point, I stopped liking the nurse. I burst into tears, curled up in a ball, and asked her why she was checking me so often. She explained her concern, and I insisted that she call my doctor and ask him to come and sleep at the hospital. She returned shortly after and explained that he was headed over to sleep there. Then I have to admit that I felt guilty, though I don't now. I was still grateful, though, because from that point on, the nurse stopped checking my dilation (perhaps in fear for her life).

By 6:00 AM, my flu symptoms had slowed down, and my water still had not broken. My husband and I were pretty tired. We had learned in our class that transition typically occurred around the time a woman got to 8 centimeters, and when transition hits the bag of waters typically breaks. (I say "typically" because I have a friend who's bag actually didn't break once - the baby was born in it. Haha!!) A new nurse came in who I trusted less but appreciated more later on, and she declared that once that bag of waters broke, I'd be pushing soon after. I scowled at her. I was afraid to have my water broken medically for a few reasons: I feared the possibility of infection, that my dilation would regress, or that my contractions would become more painful than I could manage (all possibilities that come with breaking a bag of waters too soon). At about 6:30, my doctor, who I'll call Nice Dr. J (as opposed to Evil Dr. J, who strips your cervix without telling you), came in and cheerfully asked how I was doing. I said that I was feeling kind of grumpy and I didn't understand why I was still in labor. At this time I was hunched over a birthing ball, which helped a little. My contractions had grown pretty strong at this point, and it was hard to ignore that they had become painful. He complimented me on having a good bag of waters and suggested that we consider breaking it. I asked for a few minutes to ponder.

My husband was bushed, and I was pretty exhausted too. I didn't feel like I could go on much longer like this. We decided to have the bag broken. Looking back now, I was headed right into transition. Again, I'm not good at keeping track of my contractions, but they couldn't have been more than 90 seconds apart. It seemed that every time someone asked me a question, I needed a minute to breath through a contraction. I'm still glad that we broke the bag, because it gave the doctor and nurses a heads-up of what was coming. I climbed up onto the table, and before I laid back to have the bag broken (why, oh why do you have to lay back for such things?!), I had to roll over onto my side for a contraction. I breathed through the contraction, laid back, and felt another come on just as the doctor broke the water. Then things changed instantly.

I couldn't relax. I knew I needed to get off of my back, but I couldn't relax. My son had gone from having his head pressing against my cervix and the bag of waters to sliding right down to a bearing down position. It was painful and very scary. I grabbed the railing, raised my voice, swore like a German (there's a word they use a lot when frustrated), and raised my bottom off of the table. I couldn't relax. In the meantime, the doctor said, "Wait, get the lights on. That fluid was brown," and he started giving instructions on how they could get some saline into me to clean out the environment the baby was in.

The baby had clearly passed mechonium and had been floating around in mucky fluid. If he ingested some, it wouldn't be good for him. If he breathed it, it would be very dangerous. Mechonium aspiration leads to major respiratory issues and, if unchecked, could kill a baby.

What a shock this was to everyone, because the baby's heart rate had been great all the way up until that point! He clearly had not been in fetal distress, a common cause for passing mechonium prematurely. It must've just been because he was such a big baby. Either way, Nice Dr. J's hopes of getting saline into the womb to clean up quickly passed, because after what had seemed like a 5 minute contraction (though it was more like 90 seconds), I yelled out that I needed something in my IV and then declared that I needed to push. (This was a little embarrassing 30 minutes later, but I laugh now, because it's pretty normal to hit a panic spot). Nice Dr. J announced that the baby was coming too fast, so "Let's get a good respiration specialist in here." The room suddenly filled up with people.

I realized that I needed to push, which meant that my job of relaxing through contractions was over. I was home free!! (Well, sort of). But I could push! I calmed down, got my second wind, requested a mirror, and got ready to push. I first tried to squat (I'd seen a short film of a squatting birth, and it looked amazing). But the nurse could tell that I'd do better in a C-squat - slightly sitting up, legs pulled back - position. Though their mirror had broken off of it's stand, a nice lady stood behind the doctor and held it up for me to see how the pushing was going. It amazed me.

It probably sounds crazy, but seeing the baby coming down as I pushed was very motivating. The exercises and stretches were all paying off, and now I could see this person emerging. As I pushed at the peak of each contraction, Nice Dr. J folded his arms, stood back and declared, "That's how you have a baby." If I wasn't so focused on pushing, I would've laughed out loud. But it was amazing. I could see and feel the progress. What a difference it was from my first baby!

The baby quickly crowned, and then it started to sting. Unfortunately, the nice lady holding the mirror completely switched positions, and I had to take my eyes off of the mirror. So I couldn't see what was happening. I did feel burning and stinging, and then I complained, "Oh, that hurts!" The nurse reassured me that it would sting, but it's okay.

Then the nurse told me not to push with my next contraction. I moaned, "Oh no," but I listened and just breathed. Then my little guy came sliding out with his arm tied right up to his side in a make-shift sling created by a wrapping umbilical. Little stinker!! It was such a relief to have him out, and I couldn't believe what a wild feeling it was. My husband burst into tears and kissed me as they cut the cord and hurried the baby over to the respiration specialist. It was such a mixed moment. We were happy that it went so well and that this terribly beautiful guy came out, and yet we were terribly confused over what to expect now. As you can guess, the prognosis wasn't very good. He wasn't dying, but he had clearly aspirated mechonium, lots of it, and he was struggling breath well.

The specialist said that he wanted the baby in the ICU, but first he laid the little (well big - 9'4") guy on my chest, where I leaned forward to kiss his filthy back, and then they hurried him off to the NICU.

The next part, since I've been so graphic already, is very important. I looked down and realized that Nice Dr. J was looking at the cord and gently pulling on it. I insisted on pushing so as to improve the chance that it would come out fully intact. Then this greenish/greyish thing came sliding out of my body. Ick and weird! The placenta was almost unrecognizable. What was later speculated by the respiratory specialist who analyzed the mechonium in the baby's lungs was that Mr. Handsome had passed mechonium, ingested it, and then passed it again about 24 before he was born. Yucky! It was also suggested that if the cord hadn't wrapped and pull taut, he might not have aspirated it. But you cannot predict cord issues, especially when you have 6-8 hours of perfect fetal monitor readings.

Another speculation that a lay midwife friend of my mother-in-law (say that ten times fast) made was that, rather than my sickness being a flu that kicked me into labor, it's likely that Mr. Handsome's mechonium fest was making me sick. And from the image of that placenta which will be forever locked in my mind, I'm thinking she was probably right. So I was being slightly poisoned by the little guy.

The rest of the story was dramatic, but miraculous as well. I had that euphoric "Wow, I just had a baby feeling" for a few hours after the baby was born. I was amazed to be able to walk and use the bathroom so soon (I know it sounds silly, but it's just neat to have control over your body). Incidentally, I did tear with the baby, but it was only a 2nd degree tear - so much better than the first tear. When the nurse reached over to massage my abdomen, I flinched but was amazed that it didn't hurt very much. In fact, as I previously mentioned, the only pain medication I needed was Motrin.

All of this good recovery feeling was a great blessing, because it soon became clear that our son wasn't doing so great. He just didn't breath well, and the first x-ray of his lungs after birth was pretty ugly. He had aspirated a great deal of mechonium, was suffering with a kind of baby pheumonia, and it was clear he'd need to be life-flighted to the big hospital nearby for their NICU, which is an excellent NICU. They let me come in and see him, and he looked so beautiful and frustrated laying there with all of those tubes in him. I wanted to hold him, but instead I just touched his little fists and wondered why he had to be so uncomfortable.

About an hour later, the respiration specialist offered to join my husband in giving the baby a priesthood blessing (familiar mostly to Latter-Day Saints). My husband later shared that he felt good about how the baby would do. The Life-Flight people arrived shortly after and explained what we should expect from our baby's trip and stay at the NICU. They wanted to prepare us for all possibilities, but told us that we had to be patient. "Mechonium can make babies pretty sick." It was very sobering, though just seeing our little man so intubated had been sobering enough already.

Not long afterward, the same Life-Flight people came brightly into the room with positive looks on their faces. They took a second x-ray, and the baby's lungs looked so much better. Not clean - he'd still need to be Life-Flighted - but much better, almost like a different baby. Whatever the cause of the improvement, he was clearly fighting a good fight. (Go, Tiger!) My husband and I settled in, I requested a pump to get going ASAP on lactating, and we got some food and rest. I awoke during the night to pump, and when I was done, I couldn't sleep right away. Where was my baby? Why wasn't I with him? I got out of the hospital bed and climbed into the bed and cuddled into my husband's back. We laid there and cried quietly, wondering if it felt worse than it was or if we weren't worrying enough.

The next morning, 24 hours after my delivery, I was released from the hospital. Thank goodness I could go and see my baby. He was so beautiful and strong. Long ending made shorter, in 4 1/2 days he was home. We had been told to expect at least a week and a half. He had a night with a little stress, but some oxygen and a medication which I can't remember set him right. They had expected him to need a respirator, but he only ever needed oxygen. He seemed tiny to me, but at such a size he was huge next to the others. I pumped consistently and nursed him the second day when the doctor said he was ready. I continued to nurse him until he was 4 months old, when my own health issues made it clear that I should probably stop.

As I mentioned before, Mr. Handsome is healthy and...well, handsome. He has grown well (huge - along the trend of his sister), and he's bright and happy. So all's well that ends well indeed, and we feel truly blessed that, when all is said and done, all of our kids are healthy.

You might even wonder why I started this blog. This is therapy for me. (The check is in the mail, and thank you for the hours). But seriously, I'm now expecting our 4th (and final) child, and Mr. Handsome's birthday surprise was the first of two stunning deliveries. I can't approach childbirth without a lot of anxiety - not over the pain, but over what surprise will come with the baby. And there are few people I can talk to who understand my concern for the safety of the baby coupled with a hope that I can deliver unmedicated. They don't see how there could be any relation between the two.

I wish I could say that Bradley birthing eliminated complications in my sons' deliveries (that was part of the point - to make it safer for them too), but I can't. I was still glad that I eluded the epidural, because I feel in my heart that it helped them to be unmedicated at such crucial times. Of course, it might just have blessed me at a time when I needed to be in pretty good condition to focus on their needs. Either way, it was the right decision.

I'm also so grateful that we had learned so much in our class about possible complications and medical interventions and their risks and benefits, because it reduced our confusion and helped us give our consent with a clear head. That alone was worth the class that we took.

I'm also grateful Mr. Handsome is such a good fighter (for now). It's good to have him with us.

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