Saturday, September 19, 2009

Birth Story, Part II

Madeline has been doing great. We're starting to get the breast feeding thing down (had I written this post a few days ago I would not have felt so encouraged). We still have some issues, but they seem to slowly be getting better. I think she's hit her first growth spurt; she's hungry constantly and constantly awake. Makes for tiring days, but I'm glad she's doing well. So on to part deux.

I got the epidural. I remember saying to A "this is the best decision I ever made". I felt very good about it. I figured this would let me rest for pushing, and, at least at first, it wasn't complete numbness. It was about 10:30 am and I slept for a couple hours. Now time actually seemed to slow down. Two hours later they checked me again and I had not progressed, however. I was so disappointed. The staff even seemed surprised, because I had been going so fast and I was still having consistent contractions. We discussed and decided on Pitocin.

I realized this was becoming the birth I did NOT want. Everything I had hoped to avoid. I never felt like things were being pushed on me, but there was the meconium issue, which was getting worse. And by this time there were dips in her heart rate, too. It was unclear how much of it was the monitor and how much was her. They discussed a scalp monitor until her heart rate came back up. I was too out of it to really protest. I had agreed to the epidural, knowing it ties me to all these other things. I remember being frustrated but still feeling like everything was progressing well and it would all end well. I didn't really feel like anything was wrong with her.

After a couple hours of pitocin it was time to push. Everything seemed to be going well, at least to me. I had sensation in half my body, so I could feel well enough to push. There was pain but it wasn't intolerable, which I was okay with. She was descending, a little slowly, but I felt okay. I think everyone thought I was more tired than I was because my eyes were closed. But it felt more meditative than anything. The lights were bright, there was too much commotion so I just closed my eyes and focused. Then I started to realize they were concerned. She wasn't descending. Her heart rate kept dipping. They thought I was tired, though I didn't feel that tired, my pushes just weren't doing anything. Mostly I just felt like I was pushing wrong.

The OB team showed up in the room, the midwife must have called them. I remember the midwife saying she was getting stuck on a bone; she asked if I'd ever damaged my tailbone, which I had. I broke it ~8 years ago while snowboarding. It had never occurred to me this could be a problem. Anyway, they discussed. They agreed to let me continue pushing as long as I felt up to it. But they were concerned that her heart rate kept dipping, sometimes down to a sustained 60 or 90 bpm. There was meconium. If I didn't progress, they would try the vacuum.

If that didn't work they said c-section might be my best option. This was the first time c-section was mentioned and I think I cried. I was so determined to get her out, but I just remember being disbelieving. How could she get stuck? Everything had been going so well. It just didn't seem like a real possibility.

So when the OB team left I suggested I push on hands and knees; I had pretty good sensation and felt certain this could work. I pushed this way for a while. Her heart rate was much better, but eventually I got tired and she had essentially not moved at all. We tried again on my back; her heart rate dropped again. No progress. Then I suggested the toilet; they suggest the squat bar instead which I was fine with. Her heart rate was fine again, but I was getting nowhere. The midwife was trying to turn her, but I guess her head was transverse (so that her ear was facing out) and there was not much success. Eventually I agreed to try the vacuum; they told me I had about 3 tries and then it was a c-section. I pushed as hard as I knew how. In total, I pushed for over 2.5 hours, but I think all of her progress was in the first 45 minutes or so.

I couldn't believe it was going to be a c-section. It seemed so unreal. I felt like I had more pushing left in me. But I could tell A was very worried. And I didn't know what else to suggest. I felt like I had to. Like to not get a c-section would have been irresponsible. And so we did. I remember A talking to the doctor about using double layer sutures, about how I wanted to try a VBAC in the future, and she was on board. It made me feel slightly better to know how supportive of vaginal birth she was, it was one small concession. My epidural was completely ineffective at this point, I remember still trying to push even while they were getting things ready for a c-section, hoping I could get somewhere. That they were just giving up on me too soon. But I got nowhere. I was sobbing as they wheeled me in. As they were performing it. I couldn't stop crying. For that matter, I can't not cry as I write this.

They gave me a spinal. All the nurses and techs were trying to console me as I sobbed. When they began the operation A began telling me everything they were doing, and I looked at him horrified and told him to stop. It took a little longer than I expected to get her out, and once she was out there was just quiet. I started bawling, not knowing what was going on. Then she started to cry and I immediately felt like it was all worth it. I had asked A to stay with her, but it felt like an eternity before I knew what was going on. It was probably only a couple minutes, but it seemed much longer. A brought her over to me and she was fine. No problems. Scored 8 and 9 on her apgars. This, in spite of the fact that she had been severely wedged in my pelvis and took them quite a while to get her out. And A said there was more meconium than he'd ever seen (he's probably been at ~20 c-section births).

So after all that, was a C-section necessary? A week out I can think about this a little bit more objectively, but not much. Yes, I'm happy I have a beautiful, healthy girl. She's perfect. So if the C-section was truly necessary, it was totally worth it. No hesitation. But could it have been avoided? Do I have an inadequate pelvis? I recall reading that only ~5% of women do, and I find it hard to believe that I'm one of them. I don't have a small frame, I have no reason to believe that a baby can't fit. How much of a role did my broken tail bone play? I don't know, but I have an appointment to meet with both the midwife and the OB to ask them their opinion of my likelihood of having a VBAC in the future.

There you go. Not the birth I had hoped and planned for. But a healthy girl nonetheless, the consolation I have to focus on. I found stories such as mine discouraging when I was pregnant, but I guess I wrote this all out more for myself than other people (because who really reads all this, anyway!) It's healing I find to think through and write out everything that happened. And now I can focus on MJ, the cutest baby ever.

4 comments:

  1. Birth never really goes the way we plan it, does it? It's our first lesson as parents - as in parenting, we can control some aspects of the situation, but most of it is out of our control. We just have to go with the flow and do the best we can with every surprise that comes at us.

    It sounds like you did a wonderful job. That must have been the hardest work you have ever done.

    Congratulations, and way to go!

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  2. Hey, I found your website from "exploiting my baby". I just wanted to let you know that I had a similar birth situation about 3 weeks ago and have similar feelings of "did they really need to do this, or this, if they hadn't/had done this would it have been better". I have a hard time believing that I and so many of my friends with medical interventions would have died in childbirth without them. I don't have any advice, but just wanted you know your are not the only one :).

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  3. I read your post, and it makes me happy to know, that whatever happens at the birth, things will be good afterwards and it won´t be an issue later - you have two beautiful girls now :)

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  4. Anna, this is too true. I think I was reading too much Ina May Gaskin and felt that the birth experience is some defining event. It is important, but if it doesn't go perfect things will still work out just fine (most of the time). Parenthood is a long process, and there will be many opportunities to mess up, and thankfully many opportunities to redeem yourself.

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