The story of Erik’s birth and the events of our first week together:
Saturday, March 2 promised to be a lovely day. Jake had planned to go golfing with a buddy from work and I had planned to have lunch with some friends, followed by pedicures. We figured we should get in some time with friends before Erik made his appearance. I got up at 5 a.m. for a routine bathroom trip, accompanied by the routine Braxton Hicks. After climbing back into bed, however, the contractions (or surges) didn’t stop as they normally do. I decided to start timing them. They were irregular but persistent, coming every 7-10 minutes, but not painful. I let Jake know I was timing them and he snoozed and I rested and wrote for the next two hours. I finally fell asleep around 7 a.m. and slept til 8 a.m. The contractions came back quickly after I woke up, but perhaps they had never left? Jake decided to cancel his golf game but I said I was still going to lunch with the girls. We got up, had breakfast and I gave Jake a haircut while having surges about 5-7 minutes apart. They were starting to “pinch” at this time and I was making “OW” faces. I left for lunch about 12 and by the time lunch was over I was squirming in my chair with each surge and feeling slightly nauseated. We had already agreed to skip the nail salon J I arrived home at 1:45 and my contractions were 2-4 minutes apart but only last 30 seconds. I called the nurse triage line around 2:45 and asked what they thought I should do given the short nature of the contractions. They advised I go to the hospital. I hung around at home for another couple of surges because I didn’t want to get to the hospital and only be 3 or 4 cm. We finally headed out the door at 3:15. Between the car ride and the time we spent registering in the ER I had a few surges that brought tears to my eyes so the ER nurses took me up to OB triage quickly. We did the required 20 minutes of fetal heart monitoring but I chose to lean over the bed instead of lying down. I was 5 cm when she checked me. We were soon in our labor room and I asked for the water tub to be filled.
The next many hours were filled with increasing painful surges, many changes in position and a couple of episodes of vomiting. We had taken the clock off the wall so I wouldn’t get discouraged by the slow passage of time so I don’t really know the timing of the rest of the labor. I had surges on the toilet, in the birth tub, on the birth ball, leaning over the bed, on hands & knees on the bed, hanging around Jake’s neck, leaning on his back as he sat on the edge of the bed, lying down (very painful!), and hanging on the birth bar. After several hours my midwife agreed to check me but I had told her not to tell me how many cms I was if I wasn’t at least 8. She said, “Good job, you made your goal! You’re 8 cm.” In my estimation it took another two hours to get to 9 cm and another hour and a half to get to 9.5 cm. My midwife said I had a large bag of “bulgy forewaters” and offered at 9 cm to break my water. I declined but accepted when she offered again at 9.5 cm. Erik immediately moved further down the birth canal and we got to the pushing stage pretty quickly. But pushing lasted two hours and was the saddest part for me.
Because I had vomited several times and was unable to keep anything down for long I lost my energy and my will to keep going by the time I got to 8 cm. I started saying, “No more. I don’t want to do this anymore.” But I knew I didn’t have any choice. By the time we got to pushing I had completely lost any desire to keep going and any energy I had left. I kept saying, “I’m so tired. I just want to sleep.” I asked for pain medicine but everyone kept telling me, “You’re so close! You said you wanted to do this without medication.” They were sincerely trying to support my birth plan and I knew that and I didn’t push the issue because I didn’t want to go through the hassle of an epidural if I really was “so close”. But I believe that had I insisted they would have listened to me.
Between my lack of energy and having sort of “given up” emotionally & mentally, my midwife suggested that I push in a semi-reclined position. She said, “I know you don’t like the idea of this position but you’ve said you’re really tired and I think you should lie down.” I did try pushing while up on the birth bar but I really was too tired to stay upright. I realized later that I should have had an IV put in and been given some sugar water long before I got to this point. But somehow none of us, at that time, seemed to realize that would have been a big help to me. So I pushed, quite ineffectively, for a while. Then Erik started having variable decelerations with the pushing. I had been trying not to hold my breath while pushing but when his decels started the midwife had the on-call OB notified and the midwife said, “Erik’s ok, but it would be better to get him out sooner rather than later.” So they had me change to closed-mouth pushing, which Jake and I are both sad about because we wanted to avoid that. I don’t know if the closed-mouth pushing caused Erik to continue with decels, or if it led directly to my post-birth complications but I didn’t know what else to do. I wasn’t moving him down well at all and felt like my energy was being diffused rather than directed when pushing. They got the mirror out for me to help me see what I was doing and that did help some, but I know that over and over in my head I was saying, “I don’t want to. I don’t want to.” And I know that that had a huge impact on how slowly things went. Finally the midwife had the OB come in because we were beginning to discuss and episiotomy versus use of the suction. Inside, I was actually relieved to think that I might get some help, although I did not want the episiotomy. Well, the OB came in and assessed the situation and her reaction was, “Oh! She doesn’t need help! She’s got this!” Those words were encouraging in a way because I assume that all OBs just want to intervene but she was confident in my ability to birth unaided. In the end, with a lot of stretching from the OB and the midwife and with a lot of concentrated pushing and with lots of verbal encouragement from Jake and Kori (our hypnobirthing instructor who attended the birth) Erik finally came out at 2:03 a.m. on Sunday, 3/3/2013 and Jake cut the cord. I had a 2nd degree tear and was so, so, so relieved that it was all over and I would never have to re-enact that birth ever again. Erik had his left hand up beside his head and the midwife doesn’t think that I would have torn if his hand hadn’t been there. Erik cried immediately but settled down quickly. He was very tired and didn’t attempt a crawl to the breast and didn’t want to nurse for a good while. We did manage to nurse just before a full hour had passed. In the meantime I gave him to Jake so I could concentrate on staying still for the midwife while she sewed me up. By the time she was finishing I was saying, “Oh, man, I need to get off my butt! It hurts a lot!” (Jake was busy with helping Erik get weighed and cleaned up.)
The pain in my buttocks continued to increase after my midwife had left and within an hour or two I couldn’t move with crying, despite having taken some Vicodin. Also, every time I tried to get up my blood pressure would drop and I would get dizzy. The nurse started IV fluids and checked my bottom but couldn’t see anything amiss. She knew, however, from my behavior that something was wrong. She called my midwife who immediately suspected a hematoma (A collection of blood in the tissues created by a ruptured blood vessel. The growing mass of blood puts increasing pressure on the tissues and creates pain.) The midwife came back to the hospital and as soon as she began an internal exam the hematoma, which was just on the other side of my vaginal wall, partially released. It made my pain level go down dramatically but it made the midwife say, “I need a doctor in here. NOW!” So the OB who had been there during the delivery came back and I got loaded up with some IV pain medicine before being taken off to the OR for packing of the rupture in the vaginal wall and to provide pressure to stop the bleed. I was told later that they took down the original stitches the midwife put in so they could get a better view of things, put the packing in and re-did the stitching of the tear. Then I was sent for a CT scan to see if there was any active bleeding continuing. There was not, but the CT showed why there wasn’t any external evidence of the hematoma. The blood, instead of pooling with gravity in my butt, was pooling in my abdomen.
By the way, Jake did a great job of being my labor partner and then staying calm throughout the following bit of chaos and taking care of Erik. This next bit isn’t really funny because it shows how we medical personnel forget that others don’t always know what we’re talking about, but it is the most amusing thing of the entire story and that’s why I share it. Jake thought when they said “packing” that they were going to use Styrofoam peanuts, like packing a box!
So, after the OR and CT I was taken back to my room, given lots of fluids and three units of blood. I finally got to just hold my little baby and loved snuggling with him. Erik was discharged on Tuesday but he and Jake stayed in the hospital with me til I was discharged on Wednesday. We had to wait for my blood counts to stabilize.
By Friday morning, after only being home for one and a half days, my pain level was increasing and I made an early morning trip with Jake and Erik back to the midwives’ office. The midwife who saw me was reluctant to examine me for fear that the hematoma might re-open. She conferred with the backup OB in the office and they had me go to the ER and told me I would likely be re-admitted. We spent most of the day in the ER trying to get my pain under control, doing another CT scan, realizing that I wasn’t fully emptying my bladder and having a catheter put in. The full bladder, added to the hematoma, added to not having had a bowel movement in a week meant that I had too much matter in a very small space! That was part of the reason for the increased pain. I was admitted to a room later that evening and even though my OB saw me in the ER he didn’t examine me. He said he wanted to keep me overnight for bladder rest and pain control. Right before I left the ER for my overnight room the tech took my vitals and I was starting a fever. The temperature reading was higher when my vital signs were checked later that evening and the on-call OB was notified. She came and not only talked to me but did a gentle pelvic exam and said, “Oh, honey. You have an odor. You’re infected!” She put me on three strong IV antibiotics because she was worried the hematoma might be becoming an abcess and we spent the next three days discussing whether or not they would and could drain the hematoma. Finally I was sent home on oral antibiotics with a decompressed bladder and bowel, feeling much better. (Thankfully, Jake’s mom was here over that time and kept Erik for three nights while Jake and I caught up on sleep.)
So what would I do differently and how have my opinions about birthing changed?
1. I should have had the IV.
2. I don’t know what I could have done differently with the pushing but I hope that next time it’s different.
3. I completely understand why people get epidurals and I’m not sure I’ll tough it out “naturally” next time.
Now you know the rest of the story.