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|02-24-2012, 04:37 PM||#1|
The VBAC of Naomi
This was not my ideal VBAC by any means. I think the trauma from my first birth may have contributed to the issues I had during labor. I am very happy to say that these issues did not occur with my second VBAC (where I stayed faaar away from the hospital, lol!)
Waiting. Pregnancy includes a lot of waiting, especially if it's planned. Waiting for ovulation, waiting for a positive home test, waiting for doctor confirmation; and when you're pregnant after having lost a baby, waiting to find out if the pregnancy is viable and waiting for your loss week or weeks to pass so you can breathe easier. Then, waiting for each trimester to change, symptoms to come and go, to find out the gender if you plan to and of course, for the baby.
So it's perhaps fitting that the beginning of the end of the waiting game for me began in a waiting room. On Tuesday, I had my 39 week appointment and I was really hoping for it to be my last. The doctor was in surgery, so we were waiting quite a while, chatting with other waiting patients and sitting in the chairs, I started contracting a lot.
I didn't time them, but I knew they were frequent. They were also uncomfortable and I kept wanting to turn around in the chair and kneel on the floor so I could rest my upper body in it, but I knew that would alarm the other patients, so I just dealt with it as they got more intense. I closed my eyes and breathed.
When the doctor came into the exam room, I was taking advantage of the exam table to do just what I wanted with the chair and he wanted to check me. I declined, saying "If you check me, I won't be in labor and that would just be very frustrating." We also explained that we'd left the labor stuff at home anyway, so we'd be back if this was it and if it wasn't, then hopefully it would be soon. He reminded us to call, since he had babies coming at both hospitals he delivered at.
Those contractions would continue to build for seven and a half hours before petering out, much to my disappointment. My husband still took that day off work and we got things ready to go, because if it wasn't soon, I was at least due on Friday, so things should just be ready by then, at least. I also did laundry and some shopping, staying active and trying to keep the contractions going and get labor on the move. So I was pretty tired when they stopped and went to bed early.
I woke up on New Year's Eve the next morning at 9:30-ish and realized it was contractions that woke me up. When I decided they weren't going to go away, I went out to the living room to watch a movie and ignore them to see if they went away. They were too hard to ignore, so eventually, I started writing down times since I could see a clock. A pattern was obvious--every two minutes a new one started. Sometimes it was three and a few times it was five minutes. I got bored with writing down times after about two hours, especially when the cable stopped working so I couldn't watch my movie anymore.
I wandered around the house and told my husband that he should still go to work, to make up for some of the time he'd lost, even if this was it (which I was fairly certain it was). I got to finish my movie and then went in to take a nap since I was tired from all the contracting and waking up early. I forced down some soup first, but food and water were not something I was processing well, so I didn't push it.
Lilly let me nap until the contractions woke me up in pain. I started doing my visualizations and distraction techniques for a while and even tried to read. But the intensity was getting harder to do anything through, so I gave up on the book and got up to do stuff around the house until I realized that nothing was going to get done but a bunch of labor dancing and that was getting too painful to do, even, so I drew a bath.
The water was the relief I'd hoped for, but not as long as I'd hoped. It was all I could do not to call my husband until his lunch break. I debated on the phone on whether he should come home or not--I was having a hard time concentrating at all. Finally, I said I was tired of doing this alone and wanted him home at least for his lunch break to give me a break from Lilly and some support.
By the time he got home, I couldn't visualize anything anymore, I couldn't just breathe through the contractions and it was all I could do to remember to keep my sounds deep and low to be productive. I was sure that it was time, I could feel the baby low in my pelvis and the contractions were so strong they were intolerable. My mind was desperately seeing relief options, so we were pretty sure I was in transition--it certainly sounded like it and I felt like I did when I was ready to push out Lilly.
So my husband called in to work and we set out to go to the hospital. We took our time getting ready, making sure everything was dealt with around the house, but I was getting desperate for relief and the thought of being in the car like I was, when I couldn't take a contraction quietly anymore, was very unpleasant. Somehow, I managed to stay quiet on the ride through most of the contractions, but I felt like I was going to pass out from the pain.
Once at the hospital, it was time for my first check. I no longer planned to avoid all checks because I needed to know that all of this had amounted to something. It seemed to take them forever to get to checking me and I was in a lot of pain. The check, however, was not what I wanted to hear.
"You're at a three and about sixty percent." I started crying and felt on the edge of hysteria. My mind was so jumbled and thick that I couldn't focus on anything and each contraction felt like it was taking me by surprise, I had no relief between them and I was mentally begging them to stop. They were saying they needed to watch to see if I was really in labor and then my water broke.
"My water broke, my water broke," I said, feeling very happy about that. "You can't take it back, I'm in labor, it's not stopping now!" Of course, with my water breaking, the contractions became even more intense. My husband laughed that I'd managed not to get the house or the van with my water, again. We checked the water and I asked if it was clear--it wasn't. Sludge, again.
It wasn't as bad as Lilly's at first, but it got worse and worse with each gush. I was surprising the nurses with how much was in there. I'd tell them that the water was coming and they'd smile and look and never expected how much had come out. I told them a few times that it was the same with my last labor, too--more water than I could possibly have ever held.
I was doing okay here and there, but things were so bad I asked for an epidural because I couldn't keep going. They said I had to have a bag of fluid in me first, especially since I hadn't been eating or drinking all day and it took two nurses to start an IV because I was so dehydrated they couldn't get access to any veins. The first stick was terrible and totally fruitless. The next was painful, but successful. They also had to take blood (which they did with the second try) to make sure that I was healthy enough for the epidural that I both wanted and unknowingly at the time, needed.
The nurses kept trying to get me to get up and move around, but when I tried, I felt so sick I just wanted to lie down and so I did, knowing that it was the worst thing I could do. When I was up, I did dance around and do what I knew worked best, but I couldn't stand it for more than a few minutes at a time, then I wanted back in bed. I had been in painful labor for nine or ten hours after the five hours of easier labor in the morning, and I just wanted to be done.
The pain of the contractions were hurting both me and the baby, as she was going into distress and after a couple hours they brought me Nubain to take the edge off until I was approved for the epidural and the anesthesiologist could come. I asked if it would help and the nurse said that, at the least, I'd be calmer and back in control of the pain, so I readily agreed. Anything that would make me stop feeling insane.
The nice thing about IV meds is that you know how you're affected instantly. I was dizzy and the stuff smelled funny (I always smell IV stuff--I'd known the second they started the antibiotics that I decided to go with since I was accepting so many other interventions anyway--and they weren't giving me the same thing I'd had in my last labor--by the smell) and then this calm came over me that was priceless.
The next contractions, I was able to visualize, chant and sing at the baby. They hurt, a lot, but the pain was controllable again. I felt so much better that I even went to sleep. Unfortunately, I woke up when the Nubain wore off and was back where I'd been before.
The second check had shown me at a two to three (I'd lost progress?), the third at a four. Each check found me making progress at least, but it was slow. Finally, I was approved for the epidural I'd never thought I'd want and the anesthesiologist came in after the nurses prepped me for being still through all of the process. While the contractions continued to be hard and painful, I was still in better control than I had been earlier and I concentrated on singing through them. I found that "Oh I wish I was a fishie in the sea" was just the right length, with two verses, to get me through them. Everyone thought it was funny and the laughter was a relief with the tension all the pain had put me through.
The nurses kept telling me how great I was doing and encouraging me and were surprised to find out that I'd wanted no pain meds previously. I explained that my last labor had been nothing like this. Of course, Lilly had only been posterior--this baby's head was transverse and moving around, hurting me far more than Lilly ever could, since she never descended into my pelvis this far. Everything felt far away, though, and slightly foggy--more like I was watching than participating, much as it had been through my labor for hours now. I felt like someone else was in control of my body before and after the Nubain and I didn't recognize myself at all, which upset me even more.
Finally, there was burning in my spine and I knew that I only had to feel fifteen to twenty-five minutes more of these awful contractions and it made getting through them a lot easier.
The doctor came in a little later, after I'd had some rest and felt better and told me to labor on my side (which I did--I was even able to roll myself there as the epidural had left me still in enough control of my legs to move myself around and I could now feel baby moving instead of the pain of contractions, which was much improved) and then was gone.
My next check I was told that I was progressing and the head was transverse. The nurse said my position was good and helped me get my legs in the most productive position to move baby down. As baby moved lower, I rolled more and kept adjusting myself to keep her from backing into my ribs again (which drove me nuts with both my labors) and the nurse told me that I was looking great each time she saw me. It really helped keep my spirits up, since I felt bad about wanting the epidural in the first place and really didn't want to mess things up worse.
It was the middle of the night, so I was trying to help Lilly get to sleep and get some of my own when the nurse asked me why I wasn't just nursing her. I said I was worried about the drugs I'd had and she said it was fine, just get that baby in bed and let her nurse and snuggle to sleep. So I did and she came back later after Lilly had fallen asleep and said that the nursing had really improved my contractions and we talked about cosleeping--she apparently coslept with her kids, too, and just how great it was.
With Lilly next to me, I fell asleep easily and woke up for the nurse to come in and say that my contractions were spacing out more and more and the doctor wanted pitocin started. I asked if he was concerned about the increased risk with it and if he did it often and then just told her to go with it when she tried to explain--I'd decided before that I'd do what it took to have a vaginal birth, even with added risk like pitocin, if necessary. Besides, I had the epidural and I knew how pitocin affected my contractions from my last birth. My husband was asleep through all of this, as was Lilly.
I fell asleep thinking about the intervention domino effect and hoping I wasn't going to pay for it. My eye was only on the prize--my VBAC. I slept until they checked me and I was a seven to eight. I lied awake, bored and wanting someone to talk to until the contractions got really close together again and I started moaning a little because I was getting overwhelmed with the urge to go to the bathroom. I knew what the urge meant and I let my body do what it wanted with it and pushed a bit.
My husband woke up and said my name questioningly and I told him that the baby would be there soon and asked him to get me some ice water and take my popsicle stick from the orange popsicle that I'd been given when I complained about being hungry at my last check (first time I'd been hungry in over 24 hours). I caught him up on what he'd missed and had him move Lilly to the guest couch-bed so I could roll over even more.
I felt bad about him only getting five hours of sleep, but since I'd only had three, I didn't feel too bad. I wasn't tired at all, though and kept joking about how bad I needed to go to the bathroom. The nurse came in to check me because my contractions were happening every one to two minutes and she said my cervix was gone.
She started breaking down the bed and told me to roll over and I told her I didn't want to be in the stirrups and that I couldn't, because of the symphysis pubis dysfunction. She ignored me and pestered me into them anyway. Annoyed, I at least got the bed into a chair position so I didn't have to do sit-ups to push.
I felt the baby's head turn and it was slightly painful, but a fascinating sensation to me, since she was in my pelvis--somewhere Lilly had never made it to. She was wriggling down my bones between contractions, when I would be pushing with all my strength, to my relief. I had previously not wanted to 'purple push', but it felt so good to do it, unlike with Lilly, that I didn't mind. I didn't even mind the position as it felt easier to push than it had when I was on my side.
I asked if my pushing was doing anything and the nurse brightly encouraged me and started giving me progress reports about how close the head was getting, how baby had moved down past a zero, etc. I asked if it was close enough for me to feel the head and she said that it wasn't yet.
I kept pushing, still worried that it would end just like with Lilly, even though it was already much further than I'd ever got with her and everyone was encouraging me, telling me that I was doing great--the opposite of what I was told with Lilly. Then the nurse told me to reach down and I felt my baby's head for the first time--the first person to touch her without any barrier. It was amazing, soft and hot and alive and I made a bunch of comments that were too sappy and ecstatic.
Baby was almost here and the doctor, true to himself, was late. I don't think he realized how fast I was going to go with that last little boost and the nurse told me to just relax and stop pushing, let my body do the work. It was interesting feeling my body pushing on its own and the baby coming down even more and wiggling painfully. I told them my birth plan--what could be salvaged still, that is, and they told me hospital policy. I said that all I wanted was to do as much as I could without interfering with baby's health (the meconium sludge meant that baby's hair was green) and explained that I'd missed the first hour of Lilly's life and how important it was to me to participate in this birth and be the first one to hold my baby, etc.
They relayed all this information to the doctor when he came in (finally--the head was almost out) and he started to repeat them and I quickly just explained that I understood all that and reiterated my reasons and that I just wanted to do whatever could be done on me and asked him to help me to catch her, so that I was the one pulling her onto me.
My husband, who had been so wary of the thought of all the blood and that associated with childbirth (he doesn't do well with blood) with Lilly, watched and even reached out and touched his baby's head, with fascination and enjoyment. He was clearly amazed, especially when he realized that baby was moving herself down as well.
The doctor told me that he would ask me to stop pushing once the head was out so he could start getting the meconium out and that's how it happened. I heard him say it was a nuchal cord, so I rested while she was suctioned to get the meconium out of her mouth and the cord was removed and listened to my husband going on about how much hair she had.
Then the body was just sliding out of me, no pushing at all and the doctor told me to do my part and kept her out so that I was grabbing her torso and pulling her, bottom first, to me. So I was the first one to see that we'd had a little girl and I announced it to the room.
Pulling her onto my tummy
I touched her cord and blubbered on in joy and babbled about how I'd done it, I'd had a baby, I'd pushed her out, etc. I was so amazed. They clamped her cord and I reminded my husband that he wanted to cut and he said that it was okay if he couldn't (worried he was in the way) and the doctor handed him the scissors and told him where. He cut her loose and went with her over to the warmer where they worked to clean off all the meconium so we could see what color she actually was, weigh her, et cetera. During this, the cell phone rang, playing "Big Bang Theory" by Barenaked Ladies to the room--so Naomi came in with a big bang.
I watched them and reminded my husband to take more pictures while the placenta slipped out and the doctor showed it to me, told me which side was which and then he checked my scar, which was thin but fine and then started doing damage control. When baby was turning around so much in me, she tore my cervix and, as I expected with my body and all the pushing, I'd torn my perineum as well, third degree. The doctor debated calling it between second and third the whole time he was stitching it up (unfortunately, my epidural chose then to start wearing it off and I got to feel eight of the stitches entirely).
While I was being stitched up, my husband brought our little girl back to me. I didn't mind handing her back after a couple minutes because I wanted to rest and relax. He looked up from holding her and asked me, "How about Naomi for a first name?" I looked at her and agreed, she looked like a Naomi. It was one of the middle names we'd been tossing around, having been debating on a girl name for months.
Lilly slept through the whole thing, eliciting comments about how she could sleep through anything (which is quite true) and was surprised and fascinated when she woke up and found that the baby I'd kept telling her was coming was actually there. She seems to like being a big sister (although not sharing her stuff--she's been quite irked with that).
So, at thirty-nine weeks and six days, my waiting was over. I had my VBAC successfully and I met my little girl, Naomi Sara, at 8:19 a.m. on New Year's Day, 2009. She weighed in at eight pounds and seven-point-seven ounces and was twenty-one inches tall. She was basically the same weight as her sister, but over an inch taller and with a visibly smaller head (but she wears preemie clothes). It was the single most amazing experience of my life. It had a rough start, it wasn't my ideal labor, but the birth--nothing can ever compare to feeling a life passing into this world from my body and knowing that I brought her here.
It was worth the wait to meet her. Welcome to the world, Naomi.