Monday, March 29, 2010

Welcome to the light, little Bug! (NSFW birth photo included.)

My pregnancy with Bug sucked.  A lot.  First trimester saw a placental abruption and restricted activity.  Second trimester brought SEVERE SPD and blinding headaches, which resulted in off and on bed rest.  Third trimester brought pre-term dilation and effacement (4 CM and 50% at 30 weeks,) and severe pre-eclampsia, with home bed-rest and in-patient bedrest.

I was already being followed by an obstetrician due to prior medical conditions that precluded anything but a hospital birth, so this was all taken in stride and quite well managed.

I was a week exactly into an in-patient session of bedrest and monitoring due to extremely high blood pressures and abnormal kidney functions, and 36w5d.  We were desperately trying to hold off until at least 37w3d, but preferrably 38 weeks.  My OB and I got along great - it wasn't uncommon for him to come in at 6 AM to drink his coffee and keep me company as I ate my breakfast.  We had been chatting off and on all week about the potential for induction - my pressures were rising and the edema in my legs was becoming so severe that the skin was beginning to crack.

That morning, though, I woke up and something just wasn't... right.  It wasn't something that was an emergency, just a gut feeling.

When my Doc came in, I told him that I had this feeling.  He reviewed my BP readings from the night, and checked my cervix, which had dilated another cm and almost fully effaced overnight, bringing me to 6 cm and 80%.  His reaction to this was to "Hmmm" and tell me he'd be right back.

When he came in again, he greeted me with the word "Waffles."  I naturally replied "Belgian" and then arched an eyebrow, which produced the response of "You have a doctor that waffles."  He then checked the BP strip again, checked my legs, and wandered back out.  Bug was making his entrance that day.

The induction went well.  My faithful birth companions were my mother and a dear friend of mine.

When my waters were ruptured, they were decently stained with meconium - that hunch was correct.  SOMETHING was stressing my little man out.  Not enough to show up on the CFM or Doppler, but enough to cause the staining.

After my waters were ruptured, the pit was hung.  I had decided that I was going to push things a bit and see how long I could tolerate pit contractions.  I did well - got a few hours worth in - before I asked for the epidural.  I also had magnesium going at this point.

The atmosphere in my room (after some initial misunderstandings and a few tears from all parties,) was more like a slumber party than an induction.  We laughed and joked around, the nurse and doctor joining in the fun when they came in to check or adjust.  I was relaxed and content and joyous.  Never once was the confidence in me and my body doubted, never once was a c/s even hinted at.  I was informed that if my labor stalled, we'd simply wait it out, give my body time to work it's magic.

I requested my epidural mid-afternoon.  I had been finding a lot of relief through centering myself and vocalizing through contractions, but pit contractions are evil.  They make you want to push (and push hard,) when conditions are not ideal.  Pushing at that stage (7 cm and 90%) would have been exhausting and fruitless, and I knew that.  I knew my body, I knew my limits.  Still, though, I was laughing going into contractions, and laughing coming out of them.  I was still quite happy and content.  No one looked at me askance when I made jokes in the middle of a contraction.  No one was disparaging or disbelieving when I smiled through them, even though the pain was intense and fast.

Epidural in, we turned the mag sulfate down to see how I'd tolerate it.  At this point, I was in that dreamy transition state, due in part to the relief of no longer feeling the pit contractions, and in part to being... well, in transition. ;)

I remember more joking and laughing, but the memories here are in watercolor instead of snapshots.  I dozed off and rested, and when we turned the mag sulf back up, stripped down to minimal clothing and dozed and rested some more.

As evening approached, my faithful and awesome nurse was due to go off shift.  By then I was nearly ten cm with just barely a lip of cervix left.  I desperately wanted her to be there for Bug's entrance, so Doc and I agreed that a few trial pushes might just get me to ten and finish my effacement.

Totally didn't work.  My pushing was self-directed with a little help from my cheerleading squad (we were rowdy and boisterous, I'm not gonna lie.)  Since I was still feeling the epidural pretty well, I did request being informed when there were contractions starting, but I didn't need pushing counts and direction - it was in my hands.

A few pushes in, it was apparent that we weren't ready, and that was it.  I tearfully bade my nurse goodnight, and welcomed her replacement.

I liked her replacement far, far less.  Still, I didn't let her distract me.  The party was still going. :)  I requested that the anesthesiologist come in and top off my epidural, he teased me about not having had Bug yet.  I grinned and told him that by 8 PM, we'd have a baby.  (That was at about 7 PM.)

During this time, I took the opportunity to get myself into a better position.  I moved the bed up, re-adjusted my legs (with help) into more of a squat, and decided it was time for another practice push.  We didn't call Doc in right away - I still had that darn lip that hadn't effaced.  I gave one push, and we went "Okay, time for the doc!"

He came in, complained a bit about things not being ready (did I mention I wasn't fond of the new nurse,) we made some snarky comments to each other about said new nurse, laughed quite a bit, and commenced with the pushing.

Push one, cheerleading squad rooting for me, stop.  Bug's head cleared my cervix.  I rested, re-adjusted again because I wasn't quite as squatty as I wanted to be and I was feeling it in my back, and we moved on to push two.  Cue cheerleading squad, bug's head descended further.  Push three, cheerleaders, brief laughter from me about a goofy comment made, and then I orgasmed as I continued my pushing efforts, which was when he crowned.  Push four, I delivered his shoulder and Bug was born!  At 8:16 PM on Wednesday, 11/11/2009, my beautiful (and BIG) boy was placed on my belly. (Photo below jump, NSFW birth photo.) I pulled him up to my breast and began stimulating him as he was suctioned.

He did need further suctioning and resuscitation, so they took him from me to weigh him and get him moving.  We didn't get to delay cord clamping like I would have preferred, because...

...I ended up hemorrhaging again, which was no real surprise.  My Doc handled it quickly and efficiently - I firmly believe that his pro-active approach to it saved me a whoooole lot of blood.  I was in and out during that time - vagal responses are a bitch, really.

I was conscious and alert enough to catch his measurements as they were called out - 9 lbs. 8 oz (or 9 lbs. 7 oz, depending on who you ask.)

Yes folks, you read that right.  My 36 weeks and change baby was nine and a half pounds.  We were expecting it, though.  We were expecting as high as 13 lbs had he been term.  No, before you ask, I had no sugar concerns.  I just have robust babies, with my first having been ten lbs. at term.  (ALSO a vaginal birth.)  Still, expecting it doesn't always mean you REALLY expect it, and Doc actually did a double take, pausing his efforts to stitch my mild perineal tear to check the scale himself. ;)

Bug spent a few days in the NICU lite, AKA the "Special Care Nursery" for continued respiratory issues and severe jaundice.  During that time we did more mag sulf to bring my pressures back down to a safe level, and I convalesced.

We were released four days later.

I am living testimony that not all obstetricians are bad, and hospital births can be beautiful, laughing, orgasmic things.  Be informed, be assertive, and be picky about your care providers.

P.S. In case you were wondering about the nurse that no one liked, an official complaint was lodged.  The manner in which she treated the family I requested to have around me, as well as her ineptitude were simply inexcusable.  I'm unaware as to what disciplinary actions were taken, but I did receive a formal apology from her. 

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