May 26, 2011

Our Birth Story Part II: Labor and Delivery

Jenn: My water broke early with no contractions at 6am on Thursday March 3rd. I woke up and found the bed under me was wet, and felt like I was peeing, but couldn't control it. It wasn't a big gush or anything dramatic, just a slow trickle. The first thing we did was to call our doula, who was getting ready to attend an all-day seminar on breastfeeding. She had told us earlier that this was the only week that she would not be available during the day time. She wanted to stop by with her amniotic fluid test kit to confirm if it's in fact my water that had broken, but as she got on her way, she quickly realized that there's no way she would be able to make it to our house, and then to Albany with rush hour traffic and get to her class on time. She did mention that amniotic fluid should be basic, so we applied our chemistry skills. I had these big pads under me in bed by now, and once in a while, there would be a bit of fluid leaking out making a little puddle. We used our fish tank test kit and put a few drops of the pH test solution on the big pad. We then put some tap water on a different spot on the pad and dropped the solution there too to act as a control. In fact, the amniotic fluid spots turned blue, meaning basic, and tap water was brown, near neutral. As scientists, we knew then that without a doubt our baby is on the way.

Jenn: We remembered from our Bradley classes that this early labor period should be a time of rest to prepare for the difficult hours ahead. So we took some naps, ate good food, and took a walk outside. By about 5pm, our doula's classes were over, and she stopped by with her test kit, in fact, positive for amniotic fluid. She laughed when we showed her our fish tank test version. We had called the hospital by now, and the midwife on-call told us that I was strep-B negative, therefore didn't need to go into the hospital right away. But she did want us to go in at about 6pm, 12 hours from the start of the amniotic sac rupture, to be admitted and put on IV antibiotics. If the labor had not started by then, she would recommend Cervadil, a drug inserted through the vagina to soften the cervix and left there over night. If by morning still no contractions, they would start Pitocin, an IV drug to induce contractions. When our doula arrived, it was almost 5pm, and no contractions yet. We didn't want to go to the hospital yet. So we called the midwives again, and this time our doula talked to them and explained that my water was only a trickle, and that we wanted to wait for labor to start naturally. She let them know that she would be available to us throughout the evening, and we would go into the hospital by 6am on Friday even if nothing progressed by then. We were relieved to hear that the midwife was on board with that plan. So our doula went home, and told us to call when needed. We ate dinner and I took a shower. At about 10pm, I felt my first contraction, I think the warm shower and the little bit of nipple stimulation helped. The pain was not so intense, just tightness around my abdomen that lasted for about 30 seconds at a time.

Paul: I called my co-workers that day to say I needed to help Jenn and won't be able to come to work.  We took the day to start packing things that we will need at the hospital.  It took us the whole day to get most things ready and packed.

Jenn: I thought I would move around to different parts of the house, but I really just wanted to stay in our bedroom. I guess I felt the most safe there. Paul helped me time the contractions, they were about 10 minutes apart at the beginning, then got closer together to once every 3-4 minutes, lasting about 30 seconds to 1 minute. By about midnight, I started to feel like we needed more support. I felt bad to wake up our doula, but we called her anyway, and she was quickly on her way. It was nice when our doula arrived because Paul could take a break and get some sleep. She helped by giving me back massages with some lavender oil, it smelled fantastic and felt really nice. I made sure I drank a lot of water, and went to pee often. I would have a contraction or two on the toilet and some more fluid would come out. It felt good to not have to worry about leaking on the floor or bed. I guess I could have worn a pad which would have allowed me to move around more, but I didn't think of it at the time.

Paul: Jenn even downloaded an iPhone app to time the contractions.  It was interesting, but we didn't keep it up all the time.  Through the night, Jenn had contractions and couldn't really rest.  I made some microwave potatoes for her to eat, but then she threw it up afterward.  I was diligent in making sure Jenn drank water whenever she gets a chance between contractions.

Jenn: We went to the St. Mary's hospital at 5:30am. It was early March in Albany so it was still cold. I was all bundled up. I dreaded being in the car and hoped I wouldn't have too many contractions there. The ride was 25 minutes, and my contractions were about 10 minutes apart, so I had I think only 4 contractions in the car. I had the birth ball in the back seat but didn't really use it. I leaned against the back of the seat and looked out through the rear window at the cars behind us. It was nice that our doula could drive separately and get there first to meet us at the door and help carry stuff. I remember walking into the lobby and having a contraction near the elevator. The receptionist asked if I needed a wheel chair, and I happily refused. Walking around felt good after the car ride!

Paul: Before going to the hospital, Jenn was in her pajamas, so I helped her dress up for the cold weather, plus moving a lot of stuff onto the car.  The ride was smooth because it was early morning and the traffic was on the opposite direction.  It was weird that the day had just dawned and I hadn't slept much that night, but I was quite awake and perhaps even excited that we were going to the hospital.

Jenn: I got checked in and got a room with a shower (instead of a jetted tub) since we wanted to try for water birth in the birthing pool. They measured my blood pressure and body temperature, and also put me on the fetal monitor for a while. I really disliked the fetal monitor. There are two round disks, one measures baby's heart beats, and the other measures the strength of my contractions. The disks are hooked up to a machine that prints out a strip of paper. The information is also transmitted to a central location outside our room so the nurses can keep track of how things are going. I was told that I only needed to be on the monitor for 20 minutes, it felt like forever. The little knobs from the contraction measuring disk was digging into my very pregnant belly, making it very uncomfortable. Also because I was hooked up to the machine, I couldn't get up and move around. I had to keep still because if the monitor shifted positions, they may have to start all over again. Sigh!

Jenn: Around 7am, our doula needed to go to her last day of class or else she would have wasted the whole week worth of classes. Luckily, Emily, our Bradley teacher was available for a while in the morning, so she came to us at about 8:30am. By the time she got there, I really needed her and broke down in tears because I was so happy to see her. Before Emily left, I was sitting in the bathroom when she told me that I should stop worrying about who's going to be here to help or not, and that I can do this myself and I needed to own the labor, to make it my own.

Jenn: The funny thing was that our doula was not available due to her breastfeeding class. Her backup person was also not available, it was the only day that she was not available, since she was teaching a class. Emily, our Bradley teacher came to stay with us a while at the hospital, but was also not available for the rest of the day. Later we found out that the midwife we frequently saw was actually out of state that weekend too. So Micah came three weeks early on a day that wasn't particularly convenient for everyone, but it was the perfect day for him. I think it was God's way of teaching me that I am capable of doing it myself without depending on others too much.

Jenn: I was given IV antibiotics since my water had broken for so long, and my contractions started to space out, and was not getting any closer together. We tried nipple stimulation in the shower in the afternoon, but it didn't help much. So they gave me a tiny amount of pitocin to try to get things going. At the time I was really afraid of pitocin though so I held off as long as I could. Also I was on the fetal monitor and I really didn't like that. I was 5cm dilated at about 2pm on Friday March 4th before any pitocin, and was really happy about that.

Paul: Because we didn't want to use pitocin to speed up labor, and the midwife saw that Jenn was tired and dehydrated from the 20 hours of labor by 4pm, they suggested putting some water into Jenn's IV.  The extra fluid seemed to help, but the labor was not progressing as fast as they wanted.  We also tried showering with nipple stimulation, but in the end we agreed to using a small dose of pitocin.  The pitocin was effective in strengthening and lengthening the contractions. They started it with the smallest dose possible, and then after 30 minutes increased it by another notch.  I think toward the end, they increased it another half notch, and that was as high as they went with the drug.  We couldn't do the water birth because when they use pitocin, Jenn had to be on the monitor at all times, and having the IV attached also makes it hard to use the birthing pool.

Jenn: I got pitocin at 8pm, and was 8cm dilated by 10pm. I asked to be put on the wireless fetal monitor and went to relax in the jetted tub. It felt really good for like 10min, then I kept asking for the water to be hotter. I really felt like I couldn't do it anymore. I was in "Transition". I got half a dose of nubain, which made me sleepy, and I was dosing off in the tub. They were afraid I would fall into the water. 30min after the nubain I was fully dilated and ready to push. I went back to the bed and started pushing, but I didn't really know how, and was dosing off between contractions because of the nubain I think. I tried all kinds of positions, finally I was on my back, and finally was pushing correctly, and making grunting noises really helped. Then after pushing correctly for 30min and Micah was born, 6lbs 6oz, and 18.5inches long at 2:44am Sat. March 5th! I was so amazed at what had just happened, I couldn't believe I had a baby in my arms. My reaction was "Where did this baby come from?"

Paul: Everybody laughed when she asked where the baby came from.  It sounds obvious, but I think Jenn was so amazed and the sudden loss of pain and the build-up and release of endorphin gave her an especially peculiar state of mind. When Jenn was in the jetting tub and going through the toughest stage, she told me to go away and wanted the doula to be with her.  I wasn't offended, and I was glad that we had the doula to help her.  I talked to the midwife about the nubain and she told me that the dose is small and the effect would wear off soon enough for her to push.  But I think Jenn had progressed a little faster than they anticipated, and the effect of the drug had not completely gone until after the baby was born.  By the time Jenn was in the pushing stage, it had been almost 30 hours of labor.  I was very tired, but also excited at the same time.  As Jenn pushed Micah out, I could see his head and hair emerging and rotating with each push.  The midwife put mineral oil around and into the vaginal opening for lubrication, but Jenn did not like that.  When Micah's head came out completely, I was surprised at how big his head is compared to Jenn's opening.  Once the head came out, the midwife was able to help his body come out with only a little more effort on Jenn's part.  When Micah first came out, his skin was very dark, just like someone who has been living on a tropical island, and I thought that was the color of his skin.  But his skin turned lighter within an hour or two.

Jenn: The midwife placed Micah on my belly right away, and we started breastfeeding. I should say, we started learning breastfeeding. We really didn't go pro until about after 4 weeks. Although baby was kind of tired and sleepy. We did skin to skin for about 2 hours, I loved Micah's smell and loved to hold and cuddle his tiny slippery body! We chose to keep the placenta intact for a while, so Micah was still connected to the umbilical cord for those 2 hours, and the placenta was wrapped up and sitting next to me. It felt a bit odd, but I didn't really care at that point. We also chose to not give him a bath right away. We had learned in our class that the newborn baby fluid is a good barrier to bacteria and a good moisturizer for his skin. We didn't give him a real bath until after his cord stump fell off about a week or so later.

Paul: We've asked the hospital staff to keep the placenta attached for the first two hours, so they wrap the placenta in some absorption pads and placed it next to Jenn.  The cord stays attached while Micah and Jenn were trying breastfeeding for the first time.  Later when they were finished, the nurse came to do the routine checks and measurements.  At that time I was asked to cut the cord, so I did, after the nurse put the plastic clamp on the cord.  Before the birth, I was wondering what determines whether one's belly button is concave or convex.  Some claim that there are procedures to ensure you get an innie, but others say it is purely based on genetics.  So far Micah seem to be an innie, just like me!

Jenn: And me! Micah is almost 3 months old now, and definitely has an innie. He also had beautiful fingers and long nails when he was born. I wonder if it was because he made some scratches in the aminotic sac to cause the water to break. Paul took some video of our skin to skin time and went outside to show my parents and tell them that the baby's out and everyone is doing fine. It was the first day of our parenthood, a beautiful beginning. Micah slept a lot the first day, so we also were able to rest after so many intense hours. Although the birth was accomplished, there were still many challenges waiting for us in the first few weeks. Stay tuned for Our Birth Story Part III: Baby's First Month.

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