Tuesday, March 10, 2009

My First Birth

As my baby boy's birth draws closer, I find myself reminiscing about my first two birth experiences. I thought my readers might enjoy reading the accounts of those births. So... here's my first daughter's birth, written five and a half years ago. I'll also add present commentary about things I would have done differently knowing what I know now in italics. Enjoy!Ax (my husband) and I were lying in bed on Monday night, September 22, 2003. We had been talking about the baby and wondering when she would be born. A few weeks before, Ax had guessed that she would be born on September 23. He was getting impatient and kept telling the baby, “Come out and play!” Even though I was nervous, I was also starting to get impatient. I just wanted to get on with things.

It was a few hours later (about 12:40 a.m. on September 23) when I felt and heard a “pop-pop.” My first reaction was, “What was that?” And then I was suddenly afraid because I figured that maybe my water had broken. I didn’t want to move because I was sure that fluid would start to come out. Eventually I did move and, sure enough, I felt a warm trickle of fluid. I made my way to the bathroom, and by that point it was certain. I was sort of in denial. A part of me was excited and happy, but another part of me was terrified because I knew there was no turning back. I knew that I would have a baby in the next 24 hours and I knew that a great deal of pain was coming. It didn’t seem real.

I had been having frequent Braxton-Hicks contractions for a couple of weeks, and they had intensified, but I hadn’t had any contractions that were really painful. As soon as my water broke, though, the contractions started to feel like cramps. Since I hadn’t had any real labor contractions until that point, I was worried that it was going to be a long labor. And the contractions didn’t seem to come at any regular interval--nothing like I had expected. I figured they would have started out 20 minutes apart or so and then gradually they would have come closer together. Instead they started coming suddenly and they were between three and eleven minutes apart. Anyway, we gathered our stuff, got into regular clothes, and took one last pregnancy picture before we got in the car.

When we arrived at the hospital, the security guard by the elevators saw us and automatically said we could head up to the fifth floor--I guess he could tell why we were there. We checked in at Labor and Delivery and they put me in a room. It was strange to be there. There was a warming table with a blanket all set up on one side of the room. I remember thinking... that’s going to be for my baby... holy cow, I’m having a baby. After I had changed into my hospital gown, we met the nurse who would end up helping me through my entire labor and delivery--Eve. She hooked me up to the fetal heart monitor, the contraction monitor, and the blood pressure cuff. She checked my cervix and I was 3 centimeters dilated and 90% effaced.

The contractions were still pretty mild at this point. I breathed through them--the “slow-paced breathing” we had learned in our Lamaze class. Next she gave me my I.V. She said I had “good veins,” but, even so, she had difficulty getting a good spot for the needle. She had to try twice before it worked, and my hand was bleeding and swelling up. I still have bruises and sore spots from it all.

[If I could go back now, I think I would have taken a different prenatal class--Hypnobirthing or Bradley. Though they probably would have been too expensive for us to afford. The Lamaze "focal points" and funky "hee-hee" breathing techniques were totally useless, though I've heard the classes don't teach those breathing techniques anymore. In retrospect, I would also have hired a doula. And I would have requested a heplock instead of IV fluids.]

Eve asked me a bunch of questions and had me sign several forms. One of them was a release form for epidurals. It talked about the risks involved and explained that 80% of the patients at that hospital received epidurals. They had me sign it just in case I decided I wanted one. I had already thought a lot about the decision and done a lot of research, and I wanted to try to go natural. But I was also open to pain relief if it became necessary. Eve was really friendly and let us know that she was more than willing to help us if we needed anything and that if I wanted to go natural she could give us ideas of different positions to try and other coping strategies--that was wonderful to hear and such a relief. I knew I would need a supportive nurse, and I definitely got one! She said she would be back in an hour or so to check on me and left.

The contractions were slowly becoming more intense, but I was still cheerful and excited. I just breathed through them and sometimes utilized a focal point--something on the wall, the clock, or Ax’s face. I noticed that if he was talking to me, it distracted me from the pain, so I had him talk me through several contractions. He massaged my feet also. So far, things weren’t too tough, and I was feeling good.

[If I could go back, I wouldn't have spent this time reclined in a hospital bed. Sheesh. I would have asked for a birth ball right away to sit and rock on and would have remained upright and mobile during these easy early labor contractions.]

When Eve came back and checked me, I was dilated to “4 plus” centimeters. My first thought was... that’s all?? But she and Ax both seemed to think that was an accomplishment. I thought... boy this is going to be a long night. Six centimeters to go. The contractions were becoming even more intense. I started closing my eyes and pulling more inward. I was feeling a lot of the pain in my back, and I had heard horror stories about “back labor,” so it worried me. Eve showed us a position that was supposed to help with back labor. She raised the back of the bed to almost a 90 degree angle and had me sit with my back against it and my legs over the end of the bed. She showed Ax how to push on my knees during the contractions so that the bed put counter pressure on my back. I’m not sure whether it really helped, but just the sheer fact that we were doing something was better than just sitting there through the pain.

I had lost track of time by this point. Time had dissolved into short intervals--contracting, not contracting, contracting, not contracting. All I could think about was getting through each contraction and trying to utilize the breaks between them. I tried to focus on keeping my body relaxed. I knew that if I created tension elsewhere in my body, the pain would only intensify. And I also knew that the more relaxed I was, the more of my body’s energy could be focused on my uterus, and the more effective the contractions would be--which would mean the labor would be shorter.

After a while, the position Eve showed us was no longer as effective. But she surprised and thrilled me when she asked if I wanted to get in the shower. I had read and heard a lot about how water and heat can help to ease the pain. Getting from the bed to the shower was difficult though. I had expected that standing would ease the pain because I had seen so many pictures of laboring women standing--supposedly as a means of handling the pain. For me, though, it seemed like standing up made the contractions even worse. A couple of them hit as I headed to the bathroom. All I could do was lean on Ax and rock backward and forward. Then, once I got to the bathroom, I sat on the toilet for a while and leaned forward onto Ax some more. I think it was then that I started moaning.

Finally, I made it into the shower and Ax took the hand sprayer and sprayed hot water on my back. First, I kneeled in the tub and leaned over a stool, rocking back and forth. Then I stood up for a while and rocked some more. And again I kneeled and again I stood up. I was completely oblivious to everything but what I was feeling. I’m not sure how long I was in the shower, but I knew by the intensity of the pain that my labor was certainly moving forward--which was both good and bad. Eventually, I decided to get out, and promptly sat back on the toilet for several more contractions--still moaning. We managed to get my robe back on between contractions and we headed back into the room.

As soon as I got out of the bathroom, Eve offered the birth ball for me to sit on. I sat and rocked through a few contractions, but it wasn’t really working for me. At this point it seemed that nothing eased the pain. Really, all I wanted to do was lie in the bed and curl up in a ball. So I did. Eve checked my cervix and I was at six centimeters. I was relieved to know that I only had four more to go and that all that pain had brought results. She asked if I wanted anything for the pain, and I toyed with the idea but decided I could wait a little longer. So I just lay there on my side, moaning and breathing through each contraction.

I had been told that, if I could get to seven centimeters, I could make it all the way without medication/epidural. I could tell by the pain and by my own responses to my situation that I was likely nearing “transition”--the seven to ten centimeter span. With each contraction, it seemed I could feel the baby descending and opening my cervix--pushing and stretching, lots of pressure. As I lay there, I focused on only a few things--Eve’s and Ax’s reassuring voices and touches and my own breathing. I was essentially oblivious to everything else.

It didn’t seem like much time had passed before Eve asked me again if I wanted some pain relief. I wasn’t in much of a state for making a decision. I remember moaning, “I don’t know.” I also remember asking if it was too late. Eve said it wasn’t, but said, “Let me check you first.” She checked my cervix and said I was nine centimeters dilated. I was shocked and relieved that I was so close. She said I could still get an epidural but other drugs wouldn’t be possible. I decided that I could make it the rest of the way--only one more centimeter. She said that she had delivered naturally before and that it felt good once you could push. I was grateful for her experience and her encouragement. At some point, she asked me if I would mind if a resident came into the room to observe/help. I really could not have cared less if the entire hospital staff was in the room. I said, between moans, that I did not care. So, Dr. Ron Hansen came in.

All of the sudden, during a contraction, I felt an involuntary convulsive pushing motion in my lower abdomen. It was happening on its own. I told them, “I need to push.” Dr. Hansen checked my cervix again and said that I was fully dilated--finally ten centimeters! All I remember after that was being given the go-ahead to push. And I couldn’t have been more ready. I started pushing with the contractions, and Eve was right. It did feel better to push--at least the contractions didn’t seem as painful. It felt good to be doing something proactive. It took me a few pushes to get the hang of how to really be productive. Unfortunately, to my embarrassment, I pushed out more than I had bargained for even before the baby was born. Dr. Hansen and Eve had to clean up a few messes, but they said it was normal and expected since the same muscles control the vaginal opening as well as the rest of that region.

[Umm... yeah... make sure you use the bathroom a few times before you get to pushing.] :-)

I remember looking at the clock when I started pushing. I think it was five or ten minutes after 6:00, but I can’t remember exactly. I had heard and read that some women push for hours. That prospect sounded horrible. I wanted to be as effective as I could be so I could get the pushing over with as soon as possible. I didn’t even care about the pain anymore--in fact, I don’t even remember feeling painful contractions. What I remember is the burning sensation when I would bear down.

At this point it was time for the nurses’ shift change. But Eve said she didn’t want to leave, so she ended up staying until the birth. So, I had two nurses. The other nurse (I wish I could remember her name) was also wonderful. She gave me a perfect piece of advice as I was pushing. She said not to stop pushing when it started to burn--to push into the burn. That bit of advice made a huge difference. A couple of pushes like that and the head was crowning. That’s when I knew what they meant by “ring of fire.” I remember Dr. Hansen saying she had lots of hair, and I remember looking down and seeing part of her head as it was coming out. They told me to stop pushing just as her head was coming out so they could ease it out. I had to kind of pant/blow to keep from pushing. Dr. Hansen said I was “stretching well.” I was glad to hear it because I really didn’t want an episiotomy.

It was a strange feeling having her head there between my legs. Not very comfortable, actually, but it was exhilarating at the same time because I knew how close the birth actually was. It seemed unreal that this could be happening to me. And I couldn’t believe how quickly the past few hours had flown by and how crazy it was that I was about to have a baby. The shoulders were the widest part, so it burned as they eased out, but then the rest of her body just slid right out, slippery and wiggly. It was 6:24 a.m. I remember breathing in and out quickly and heavily, full of unbelief and wonder at what had just happened. They held her up for a brief moment--she looked so small and red. It was unbelievable. I couldn’t believe I had done it! And I couldn’t believe I had a baby.

[I really wish I could go back and re-do this delivery. Oy. First of all, I would have pushed with my urges rather than doing the stupid hold-your-breath-and-count-to-ten maneuver. Second of all, I would have requested an upright delivery position, or at the very least a side-lying position. Third, I would have taken my sweet time. Pushing "into the pain" was a horrible piece of advice, actually. Sure, the baby came out fast, but she also tore me up inside. If I had taken it easy and listened to my body, I really don't think I would have torn as badly as I did. Lastly, I would have requested to hold her immediately. Instead, it was a considerable amount of time before I was able to hold her, and it certainly wasn't skin-to-skin like it should have been. I really think our initial separation messed with our bonding.]

I was in a state of bewilderment and shock and wonder. I tried to take in everything that was happening as everyone bustled around, but it was hard to focus. I was still so overwhelmed by the intense experience my body had just gone through. I watched Ax cut the umbilical cord. They took her over to the warming table and I remember hearing her start to cry. I remember turning as Dr. Lohner walked in the door with a shocked look on his face. He was supposed to be the delivering doctor, but he arrived too late. He went straight to work on me though--delivering the placenta. I remember turning to Dr. Hansen and Eve and thanking them over and over. And I asked them if the baby was okay--they said she was fine. Dr. Hansen seemed impressed with me. He said some people push for several hours, and “You don’t see many natural births around here.” Dr. Lohner said, “You’re a brave girl.” I was so grateful I was able to obtain my goal. I know everyone’s experience is different, and I was grateful mine had gone so smoothly.

I also asked Eve if I had been given an episiotomy. She said I hadn’t, but that I had torn. It turned out that I had torn quite severely in several places. Dr. Hansen looked so apologetic--he seemed to feel really bad. Dr. Lohner looked agitated and told Dr. Hansen he ought to have cut me. Personally, I’m glad he didn’t. Dr. Lohner gave me a local anesthetic and stitched up my tears, not very gently I might add. It was quite unpleasant, and he kept telling me to put my bottom down (I was tensing and lifting up). They never told me exactly how severe the tearing was, but before the local anesthetic had even worn off, the nurses were giving me a cocktail of pain killers--Tylenol with Codeine, Perkacet, and Motrin. I was in a bit of a drugged daze after that to say the least.

Back to the stitches... Dr. Hansen continued to look sympathetic and compassionate throughout the ordeal. I was grateful for his gentle kindness. I was so relieved when Dr. Lohner finished. Then Dr. Hansen took over to “clean me up.” He was so much more gentle, as though he felt really bad about the tearing and the way Dr. Lohner had stitched me so roughly. When he came back later to say good-bye, I thanked him again and again and was so grateful he had been the one to deliver my baby.

After they got my baby cleaned up, they brought her to me to hold--all bundled up. I couldn’t believe I was holding my baby. She was so beautiful. The nurse said we had a “good recipe.” I spoke to her softly and she seemed calmed by my voice--she seemed to know me. That was a wonderful feeling, knowing that my voice could calm her cries. I could see the tears in Ax’s eyes. He was so full of love and joy. We just looked at each other in amazement. I had never felt so much closeness and intimacy--the three of us together.


Liz Johnson said...

I still love reading your story!!!! Ahhhh!!

Fig said...

I'm scared. And excited.

I love your story. I cried a little.

The Fifes said...

That is so sweet. I love it. Thank you.

emily said...

that was terrific.

ironic: i had my first baby on sept. 22, 2003 in the evening--right when you were telling your gal to come.

we also did a brief lamaze course that i'm glad to have augmented with hypnobirthing since. thanks for sharing this!

HollySteffen said...

Yours wasn't that awful! =] Lucky.

I thought I would want to be upright to push but then when I was in the moment, I wanted to be laying down.

I totally HATED the hold-your-breath-count-to-ten pushing too!! That's what I did with my first and with my second I pushed when I wanted to and it was SO much better!!

Buscando la Luz said...

Not at all awful, Holly. :-) I definitely wasn't trying to imply that it was awful. I feel really lucky that everything went so well. It was a great experience.

Diana J. said...

Hadn't read your first birth story before - thanks for sharing! And I'm so glad you mentioned the "pushing out more than baby" part - that happened to me too, and I was so embarrassed!!! It's nice to know one isn't the only one. :)