Thursday, July 22, 2010

Jackson William's Birth Story

I have been waiting so long to write this post! I have even imagined what my own personal outcome would have been and “written” it in my head a hundred times. Now, I am so happy to say, I get to write my real story.

Jackson’s birth story actually begins with his older brother’s. During my first pregnancy, I was more interested in what was happening inside of me, with my growing baby, than with how he would come out. I didn’t know it was something I needed to learn about. I thought babies were just born and that was that. I now know it’s a lot more complicated than that, and after agreeing to be induced with Kaden, (ultimately a failed induction) each intervention from artificial rupture of membranes to internal monitors, to Pitocin, and eventually to a c-section for fetal distress, all could possibly have been avoided with a little more knowledge going in.

So when I got pregnant with Jackson I knew I wanted to VBAC. My mom had VBACed 3 babies after she’d had me my c-section, I didn’t think it would be a big deal. Then I started researching and talking to people, and I realized the concept of VBAC was a lot more foreign than I expected. After reading countless books (probably 15) and making my poor husband watch DVDs and read birth stories, not only had I become convinced that I wanted to VBAC, but I’d become an advocate for it in general. So many people I talked to were completely ignorant about the risks of VBAC. I heard more than once things like, “My doctor wants me to have a repeat c-section because I could die in a VBAC attempt” (not true, sometimes babies die in VBAC attempt, there are no statistics about maternal death rate associated with VBAC… moms die on the operating table) and “I’ve had 2 c-sections so I can’t have a VBAC now”.

Then I hit the 40 week mark in my pregnancy. I never really thought I would go to 40 weeks, honestly. I had polyhydramnios, which basically just means too much amniotic fluid, and I guess I just assumed I would (quite literally) pop before then. But 40 weeks I hit and my doctor, while still supportive of VBAC, said at 41 weeks we would need to start induction options. Surely I wouldn’t get to 41 weeks.

Thursday, July 15th

I got checked and had a membrane sweep done. I was 2 cm and 75% effaced, -2 station. After having tried EVERY means of getting him out on my own, including every hare-brained idea anyone threw at me (Castor oil three times, eggplant Parmesan twice, walking for miles, sex as often as possible, nipple stimulation, red raspberry leaf tea since 30 weeks, evening primrose oil since 34 weeks, etc), I was really hoping the membrane sweep would work wonders and I’d have my baby soon.

Saturday, July 17th

Kaden’s birthday was July 21st and since it looked like this baby might actually gestate forever, I decided to go ahead and plan his birthday party, and then if it needed to be moved, we’d move it. (Really, I was hoping Murphy’s law would force me to cancel it and we could have a baby instead.) So we had friends over and celebrated my little man become a big boy 3-year-old. I had been having contractions for at least a week, including several hours’ worth after the Castor oil attempts, but they would all eventually peter out in the wee hours of the morning and I would pass out from exhaustion and start the day again.

I talked with my doctor again and we agreed to an early morning induction with Pitocin at a 1 to see if anything could be jump started. I was adamant that I wanted to keep my waters intact and try no other forms of induction if this one didn’t work. My doc agreed that if after several hours nothing was happening, we’d just go home and try again another day.

Sunday, July 18th

Stu woke me up at 6:30 after I’d managed to set my alarm wrong and overslept my a half-hour, so I didn’t have time to worry or fret before going to the hospital because we were rushing around trying to get out of the door and make it on time. We got there at 7:06 am, which was pretty good for being so late getting up, and we got right in and got my IV placed and hooked up the external monitors.

My nurse, Kelly, was amazing and a Natural Childbirth advocate, as requested in my birth plan. She told me about her 3 kids’ labors (one drug-free, one an epidural delivery, and the last a c-section) and she completely understood why I wanted a VBAC. In all of my research, I’d quickly realized that the best chance of achieving a VBAC was to do so as drug-and-intervention-free as possible, so my birth plan was pretty simple, “stay away from me.” Kelly checked me before starting the Pit and I was about the same as the last check in the doctor’s office.

We had agreed to go up by 1 increment every half hour until I had a good contraction pattern going and then try turning it off to see if my body would take over on it’s own. When I was at 2 units the contractions really started to pick up and I could tell they were finally consistent and by 3 units I needed Stu’s help to feel comfortable through them. He was pushing on my hips through them and that felt amazing.

At around 10 am, I felt a contraction starting and I told Stu to “come push” on my hips and as soon as he started pressing, I felt and heard this huge POP and suddenly water was rushing down my legs. I started laughing and said, “You just broke my water!” We called the nurse to let her know and we all had a good laugh every time she would tell another new person that “her husband broke her water at about 10 am.”

My Mom arrived sometime around 11 and contractions had really started to get more intense. Jackson’s heartrate was not looking as good as they like to see, he was having some late decels after contractions, and no accelerations at all. Kelly said this was because my placenta was just done and the baby needed to come out, hopefully sooner than later. We turned off the Pitocin at this point and it never went back on.

I labored for the next few hours making slow progress from 4-6 cm. I utilized the jacuzzi tub, which was wonderful except that I couldn’t sit on my butt during contractions so my knees and legs got sore pretty quickly. Then getting out of the tub sucked because suddenly my heavy belly was my burden once again without he benefit of the water helping it float.

I got back to my room and alternated between hands and knees over the back of the bed, side-lying with modified squats, and standing up leaning on the bed (this and over the back of the bed were my favorites). But Jackson kept having heartrate decels and by the time I hit 7 cm, I was just DONE with dealing with the pain combined with nurses and the hospitalist (OB) telling me I needed to get an internal fetal scalp electrode monitor on my baby because they couldn’t tell how healthy he was. All I heard, while trying to deal with the pain is, “This is the first step in the interventions that are going to ultimately lead to you getting cut open again.” I felt like my body was a failure, my dreams of holding my goopy baby on my chest were dashed, and also that something really may be wrong with my baby and that if I refused the monitor, I might be saying, “ a vaginal delivery is more important to me than a healthy baby.” My doctor is a family practitioner, and more calm and collected than your typical OB and he was arguing with her about whether we could wait. She was a raging bitch and said that if we were refusing now, we needed to signed an informed refusal, and Stu told them to go get it. After 10 people were in my room, stressing me out, and also that nagging worry about my baby, I finally relented and got the internal monitor.

When I got checked again, I was still at about a 7 and I just couldn’t deal with the pain anymore, so I asked for (demanded) the epidural. Poor Stu, who had been listening to me preach for months about how I wanted a drug-free birth was not as easy to convince that I REALLY wanted the drugs, lol. Poor guy. He didn’t want me to be mad at him later for letting me give in. But I knew then, like I know now, that going drug-free was never about being a crunchy hear-me-roar she-woman, it was about increasing the chances of having a safe, healthy VBAC. With as much pain as I was in, I doubted that it was healthy for either me or my baby at that point and I figured being able to relax some would help my body open up those last few centimeters and have my baby.

Actually getting the epidural was Hell. I had to hold still during some seriously horrible contractions, and wondered why in God’s name I hadn’t asked for it when they were still just this side of manageable. But it got placed and I finally got some relief. It was a perfect epi too, because I could still feel my whole body and I could get up and move around on the bed (hands and knees again was my favorite and what the baby’s heartrate preferred too, so I was there a LOT), but I could finally get some relief of the pain.

I got checked and was at a “stretchy 8” with one side of my cervix completely gone and the other side “a little puffy”. Jackson’s heartrate never really liked my contractions at all, and at this point, about 16 hours into labor, we just really needed to get things moving. So I agreed to an internal contraction monitor (at that point my birth plan was so far gone, and I already had so many things up there, I figured, what’s one more wire?). The contractions proved to be good and strong and eventually I got to 10 cm and was ready to push.

Now, everyone had been telling me that pushing was better than just contractions because, “you actually get to do something” and that it didn’t hurt as bad because you were working with your body to make progress. They were liars. Pushing was the most painful part of the whole ordeal for me. Every single urge to push was evil, evil holy-shit pain. I started pushing at about 1 am and wasn’t making as good of progress as my doctor had hoped. (That’s because it hurt like a bitch and the epi couldn’t even touch it, so I think I was fighting my body and holding back some when I was pushing). But about an hour into it, doctor Shappard called the hospitalist in for a consultation (who was mercifully a NEW doctor by that time, one who got along great with my doc, and wasn’t prone to rash decisions) and I heard them say, “possible vacuum extraction” and that got my attention. I could hear, as well as anyone else could see, that the fetal heartrate was getting worse with each push and as he descended, his heartrate was worse and wasn’t recovering. Once again I panicked and had visions of having made it this far, about 20 hours of labor, only to end up in another emergency c-section. So with every contraction, I pushed my very hardest. Stu was yelling at me, my Mom was saying she could see his head, and Kristin was holding my hand (poor girl probably had bruises) and eventually with as much effort as I could possibly give, his head came out. A tiny push later and I felt his whole body slither out. What a strange and cool feeling! He was immediately placed on my belly, but he had a tight nuchal cord around his neck and body, without enough slack, so I held him under his arms and back toward my doctor so he could get the cord off his neck. Stu cut the cord pretty quickly, but because he had passed meconium and with the nuchal cord, the NICU team was there to assess him. They had to work a little bit to get him to breathe, but eventually I got my baby back while my doc stitched me up (also Hell).

It turned out that in addition to the tight nuchal cord, his head was also presenting transverse, and in a different direction than his body, so that’s what made getting him out so hard. I ended up with a third degree perineal tear and a couple of skid marks, so the repair took quite a bit of time. I got to hold my baby though and it was so awesome because when they brought him to me he was crying and I said, “Don’t cry, baby, Mommy’s here.” And he immediately stopped crying and looked around until he found me and then just stared at me while I talked to him. It was like he really knew who I was and was comforted by just my voice.

Jackson and Dr. Shappard

He was born at 3:13 am and weighed in at 6 pounds, 7 ounces, 20 inches long. After the excitement of getting to meet him died down I realized, “Oh my God, I just got my VBAC!” I was up to go to the bathroom within an hour of having him (I wasn’t up for the first 2 days after my c-section) and we were released from the hospital on Tuesday morning. While recovering has still certainly been a challenge, I am doing things I couldn’t do after WEEKS after my c-section. My downstairs DOES hurt and I have been using ice packs like they’re going out of style, but there is really no comparison to the recovery from major abdominal surgery.

My wonderful husband was the best support I could have asked for. He was there with me every single minute I needed him to be and was encouraging and sweet throughout the whole process. (He was even polite to the nurses and doctors, which I never expected, lol). He got me a ring that has two hearts and my boys’ birthstones, and a necklace that has two hearts to signify my boys. :)