Birth Day

The past week has been a whirlwind of doctors' appointments, adjusting to life with a newborn, getting to know Nate, and very occasionally getting some sleep. I am way behind on blogging with so much going on so I am posting a few consecutive posts to catch up. First let's talk about Nate's birth day. Warning: This is very long and detailed!

John and I arrived at the hospital around 7:00 AM to check in for our induction. We were sent up to labor and delivery and a nurse showed us to our room and asked background questions and prepped me. She put in the IV which was just as bad as I imagined, put me on a fetal monitor, and took all my vitals. They drew blood twice because the secretary missed some labs the first time around. Dr. Martin arrived and checked me. She said I was 3.5 cm and the baby was still posterior. She offered me the choice of using Cytotec which could basically jump start a natural labor but also might take a long time and might not work or Pitocin which would mean staying in bed, continuously being monitored, but would work fairly quickly. We opted to try the Cytotec to give me a chance to try for a more natural labor. After two doses, 6 hours, and many trips walking around the maternity floor and nothing to show for it except some sporadic mild contractions; we agreed it just wasn't working and that we would have to try the Pitocin.

They started an IV drip of the Pitocin which was gradually increased to create stronger and more closely spaced contractions. The Pitocin is a synthetic version of oxytocin (what your body normally produces during labor) it creates stronger and less natural contractions which sometimes the baby doesn't tolerate well so you are required to have continuous fetal monitoring. They also continuously monitor your contraction pattern. Nate was a champ and his heart rate stayed in a good range the entire time. My body, however, was not doing such a good job so if I moved any which way the monitor would lose the heart rate and it would look like a deceleration in his heart rate. It also was not accurately picking up my contractions so I would have a really intense contraction and the monitor would barely register it or maybe not register it at all. Because the nurse is supposed to keep increasing the pitocin until the contraction pattern is regular and strong they increased my levels assuming the monitor was accurate. They also broke my water to help my body respond. What ended up happening is that I had non-stop, intense contractions. There was no break in between them and they were strong enough that I was vomiting and my blood pressure sky-rocketed. All this while being told you have to lie still in one position. The nurse called Dr. Martin who came in and immediately scaled back my dosage.

At that point we had been at the hospital for more than 15 hours and I had had no real rest. I had barely slept the night before because I was nervous about the induction and anxious about the baby. I was a mess and Dr. Martin was worried about my heart rate and blood pressure as well as my ability to keep this up for several more hours and still push. I heard the word "stroke" be used by the nurse to Dr. Martin. I was 7 cm but decided with how my body was reacting it was safer at that point to get the epidural than to try to keep on going without it. I couldn't imagine pushing with how awful I was feeling and knew I would at least be able to nap with the epidural. The anesthesiologist came up after about 15 minutes and proceeded to try to place the epidural. I say "try" because she basically kept inserting and re-inserting the needle until she thought she got it in the right place. It took about half an hour and I was told to keep my back rounded like a c and try to stay still the entire time but was still having contractions through the procedure. At least they had eased up a little bit since the pitocin had been adjusted. Finally she was done and said I should start feeling relief immediately but it would take 15-20 minutes for it to fully work. I waited the entire 20 minutes and nothing happened. The nurse called the doctor back and she said they could try to take it out and put in another. She actually admitted though that they had better call a different anesthesiologist. I was not pleased but luckily this doctor came quickly and inserted the epidural right away and I was feeling relief within 5 minutes. Very soon after that I started having tremendous pressure and felt like I needed to push so we called the nurse back. She checked me again and said I was 9.5 and the baby's head was very low (+1 I think) and that was why I was feeling so much pressure. I was breathing through the contractions so that I wouldn't push because it was really hard not to with that much pressure. My blood pressure went off the charts and the nurse said she thought they needed to up my does of the epidural medicine. She called Dr. Martin and the nurse anesthetist who both agreed. They gave me more medicine and then John and I took a nap.

They came to check on me in about 2 hours and told me I was ready to push. Dr. Martin told me the baby was still posterior and that she wanted to warn me that the angle and size of the head were not looking too good for the size and shape of the opening of my uterus. She didn't seem too optimistic but said to try my best and that maybe the baby's head would be "squishy" enough. We pushed for 3 hours with the nurse. She had to keep her hand on my abdomen to feel for a contraction since the monitor wasn't picking them up and I couldn't feel them too much because of the epidural. She checked a few times and the baby's head was still posterior. I kept requesting to be able to try pushing on all fours or squatting or hanging over the top of the bed kneeling because I knew those were all ways that could help a baby turn, but the nurse said no because it wasn't safe since I had the epidural. I felt like I could support myself but she was insistent it was not allowed. I felt like I wasn't making much progress even though I was trying really hard. I started to think about the real possibility of a c-section and was scared.

When Dr. Martin came back she said the baby's head was wedged into my pelvis and that it was swelling and my body was swelling and that she just didn't think that it was going to happen. She told me she recommended a c-section at this point while the baby was still doing fine and it wouldn't be an emergency. She said it was my choice though. I was very, very upset and basically lost it in the delivery room. It had been such a long day with nothing going smoothly or naturally and here I was after all the effort and work ending up with a c-section which was something I had really, really wanted to avoid. I asked Dr. Martin if I could try a few pushes in another position before deciding and she agreed. She suggested over the top of the bed so I tried with the next contraction. I immediately felt more pressure like the baby had moved some. I asked her and she said the baby's head was getting more wedged and she actually sounded a little worried. I thought about it briefly and didn't know what to do. I trust her judgment though and kept thinking of a friend of mine whose baby was wedged so far in that by the time they did the c-section both her and the baby were not doing well and they both ended up pretty sick. So, I okayed the c-section. I was pretty mad at the nurse and myself though for not trying that position earlier. I kept thinking if I had tried it before we were both so swollen, maybe it would have worked. I was really emotional and upset and also scared something was going to go wrong.

They took me in and prepped me. John suited up and came in. A few minutes later Dr. Martin pulled the baby out. She commented on how hard I must have been pushing because of the cone head he had going on. She also had to push him back up before she could get him out. I could hardly see him and they took him over to the pediatrician. I told John to go over with him and I waited on the table for somebody to say something. I could hear him crying but still was worried. I kept asking if he was okay but no one could hear me because of the oxygen mask I had on. Finally the nurse anesthetist heard me and said he was fine. They brought him over for me to see but it was less than a minute and they had to take him away because the OR was too cold for him. I told John to go with him and stayed by myself. It was the longest wait of my life.

I was really sad all these strangers were handling our child before we were and that he was just born and already separated from me for so long. I just wanted to hold him so badly. They finally wheeled me out and brought me to him where I could hold him and see him and just take him in. John and I talked for a few minutes about what name suited him and we decided on Nathan. It means "God's Gift" and I do believe he is gift to us. He is perfect and despite so many complications and such a difficult labor, he was born just fine. We also like the biblical reference and that Nathan was a prophet who wasn't afraid to stand up to King David to tell him what he was doing was wrong. He had a strong sense of right and wrong and wasn't swayed by others. Paul was John's uncle's name. He was a police officer who was killed in the line of duty. He was a brave man who gave his life helping others.

So, that is our birth story. It is not pretty or pleasant, but after almost 24 hours we were given a beautiful gift that makes it worth it. Nathan has brought such joy to us already and we are so grateful he is here safe and sound.