Wednesday, July 21, 2010

My Birth Story

It's hard to believe that Sophia Joy is already 18 days old! She was born on July 3 at 1:37 p.m., weighing 3.82 kilograms and measuring 50 centimeters long. Here is the story of her birth:

On Friday, July 2, Keegan and I went to our 40-week prenatal visit. The doctor did an ultrasound and estimated the baby’s weight at nearly four kilograms. She had not “dropped” lower into my pelvis, and I hadn’t been experiencing any Braxton-Hicks contractions. The doctor was eager to induce labor because of the baby’s size, but Keegan and I requested one more week to wait for the baby to come on her own. Everyone was on edge about whether she would make her appearance before induction became necessary! Keegan and I went out to eat after the appointment at our favorite Chinese restaurant, and we saw two of the maternity clinic nurses there. Then we came home and fell asleep exhausted. The last thing we expected was that our baby would be born the next day!

On Saturday morning, I woke up around 2:30 a.m. to go to the bathroom and then had trouble getting back to sleep. Eventually, I got up and went into the guest room to read for a while. While I was up, I went to the bathroom again and noticed that I was bleeding very slightly. I thought that might be a sign that something was happening, but I wasn't sure. At around 5:15 I was still feeling awake but decided to go back to bed. Oddly, Keegan was awake also, and we started chatting. He was spooning me and my huge belly when suddenly we both felt a “pop” somewhere inside me. We both startled and wondered what it was – it didn’t feel like a normal baby kick or punch. Shortly afterward I got up to go to the bathroom and saw what I thought must be my "bloody show." Now I was certain that something was happening, but I wasn’t sure that labor was beginning. Still, Keegan and I got up and decided to have some breakfast. He made ratatouille omelets, while I frantically consulted my pregnancy books about what the bloody show should look like.

As we ate, I began to feel some pain in my back, like lower back achiness. It was mild, but it was coming on and then fading again at regular intervals. I was sure it was labor and that I was feeling it in my back because the baby was turned sideways in the uterus instead of face-down. Keegan started a log sheet for when the contractions started. They were coming about three minutes apart but were very mild. I didn’t have to stop what I was doing at all when I felt one, just putting my hands on my back and rubbing a little bit felt good. We puttered around the house for a while, getting together some last minute items for the hospital, doing dishes, and making sure the cats were fed. During this time, I had to go to the bathroom often, and each time a lot of fluid was coming out. I wondered if my water had broken and it was amniotic fluid. Hard to say, since it was a totally new experience. Finally, I decided it was time to call Dr. Lee, which I did around 7:30 a.m. He told me to come in to the clinic. We arrived there around 8 a.m.

The third floor of the clinic is the labor, delivery, and recovery floor. We made our way to the front desk where I sat on a couch while Keegan gamely tried to communicate with the nurses to get the necessary paperwork filled out. The nurses were very upset because they told us that we needed 40 “baby pads” (i.e. diapers) for the baby. Well, I had brought a few diapers, but not very many because I assumed they would be provided by the hospital. Why didn’t they tell us beforehand what we needed to bring? Minorly annoyed, I was led back into a labor room where I was asked to change into a hospital gown and lie down for fetal monitoring. As soon as I lay down, I noticed that my regular back contractions felt less regular and less painful. I was a little nervous about that and about the fact that Keegan wasn’t with me. While I lay on the bed with the monitoring machine, another woman came in to lie on the bed next to mine. I found out later that her baby was breech, and she was preparing for a c-section. With nothing else to do, I watched as she was shaved and given an enema. I was glad to avoid both of those procedures. At last, Dr. Lee came in to give me an internal exam. He told me that my water had broken and that I was about two centimeters dilated. He expressed concern that the contractions recorded on the fetal monitor were mild and irregular and told me that he wanted to augment my labor with oxytocin because my water had broken and the longer you wait after your water breaks, the greater the chance of infection. I told him that we really, really wanted to avoid oxytocin, and he asked me what time my water broke. I told him. He said that he felt he could give me four hours after my water broke for my labor to kick in strongly and that he would check me again one hour later, after performing a cesarean at 9:30.

After that, I was moved to a recovery room to wait and get my labor moving. Keegan came in to join me, and we got down to business with all of our natural birth techniques. I put my iPod on a portable stereo and turned on my birth playlist (lots of Simon and Garfunkel, with some Belle and Sebastian and other quiet favorites). I read up on good positions for back labor and spent all of my time walking to encourage the baby to drop lower. My contractions began to get stronger, so I asked Keegan to rub my back during them, while I got down on my knees and leaned on the bed. Keegan’s firm touch helped a lot with the pain. Besides being more intense, the contractions were coming every two to three minutes, so I was sure we were making progress.

We were moved to the VIP room (the largest, private recovery room) at a little before 9:30. Soon after, a nurse came in to start an IV with antibiotics, to ward off any infection because my water had already broken. The IV wasn’t that bad, but it did make it harder to walk around, especially since the pole kept running into the chandeliers in the overly-decorated VIP room. Next, I was asked to lie on my back again for the fetal monitoring. Without the constant motion of walking and the aid of gravity, my contractions once again slowed up, although they were now quite uncomfortable since I didn’t have the ability to move or have Keegan rub my back during them. Dr. Lee looked at the results of the monitoring and told me that my contractions were not any stronger. I told him that they had been getting more intense and that they were closer together, but he didn’t seem to give much credence to anything but the results of the monitoring. The pelvic exam revealed that I was still two centimeters dilated, although I was 80% effaced. Dr. Lee insisted that we start an oxytocin drip in my IV. I was both terrified, because I had heard that contractions are much stronger on oxytocin and disappointed, because I had really hoped to avoid any drugs during delivery. But I was in Dr. Lee’s care, and I had stated my case, so we agreed to the next step.

We moved yet again to another labor room where a nurse started the oxytocin at a very low level in my IV bag. Keegan gave me a hug, and I cried a little bit, and then we got on with the business of labor. I continued to pace around the room and tow my IV pole around. The contractions were getting really painful. I tried hugging Keegan, hanging onto his hands, and leaning over a table, but eventually we figured out that the best position was to get on my knees on the bed and hang onto the elevated headboard while moving my hips around. I started groaning and yelling about the pain, while Keegan faithfully rubbed my back and offered words of encouragement. During this stage, I felt very alone because we didn’t see any doctors or nurses, and I was anxious to know where I was in the process. I felt a desperate need to know how much longer I would be in this much pain. A nurse came in to up my dose of oxytocin, and I felt scared that they were raising the dose without checking how the first amount was affecting me. At one point, I felt like I might throw up, and I asked Keegan to grab a small plastic basin that I had seen in the bathroom in case I needed it. When a few nurses finally came in, they were very concerned about why the basin was on the bed instead of in the bathroom, and they were upset because the way I was hanging onto the bed during contractions was pulling on my IV tube. I couldn’t understand why anyone would be concerned with such mundane things when such huge pains were washing over me at such regular intervals!

At last, a nurse came in with a fetal monitor. By now, lying on my back was pure agony – it’s probably the worst thing you can do when you’re having back labor. I was gripping Keegan’s hands for all I was worth and yelling to beat the band. The nurse did another internal exam and told me that I was six centimeters dilated. I felt so disappointed: so much pain and still four centimeters to go! I started asking whether it was still possible to get an epidural. The nurses said they would consult the anesthesiologist. Meanwhile, I was able to get back into my more comfortable position on my hands and knees. I immediately felt better, although the contractions were coming closer together than ever. I really wanted a drink of water, but by the time I could get myself together after a contraction to ask Keegan for it, the next contraction was on me. All I could think about was that I would get some drugs and then I would have a break and could drink something. I just needed that mental encouragement that the pain was going to stop.

The next part of the experience is a bit blurry for me because I think I was in “transition,” which is the most difficult stage of labor for most women. I know Dr. Lee came in and told me that an epidural was not recommended for back labor. He offered a narcotic injection (Demerol) to take the edge off the pain. I agreed. Very shortly after receiving the injection in my butt, I started feeling the urge to push. For a long time, I thought what I felt was the urge to go to the bathroom, but finally I realized that I needed to push the baby out! Pushing was such a relief! I could almost immediately feel a burning sensation, and I knew that meant the baby was moving into the birth canal. I was so happy and excited. Nurses started coming into the room to encourage me to breathe deeply and push. They wanted me to lie in a semi-sitting position and pull my legs back along my hips, like a frog. One nurse even sat on the bed with me, put the soles of her feet against mine, and helped me to push against her. I liked that a lot and wished she had stayed longer. One poor nurse had to catheterize me briefly to remove the urine I had in my bladder – she definitely got yelled at, because I was afraid of how much it would hurt. The catheter did sting a little, but it wasn’t as bad as I thought.

When some of the hubbub died down, Keegan and I tried pushing while squatting. It did feel good, but it was hard for me to move back into the reclining position to rest between contractions. I was scared of moving because I could feel the baby was in a new position, and it just felt funny, like if I laid the wrong way, I could squish her somehow.

Finally, the nurses told me that after two more pushes they would take me to the delivery room. They brought in a wheelchair for me. I was petrified of getting off the bed and sitting on the chair, but I managed. They wheeled me across the hall, and I climbed gingerly onto the delivery table. I put my legs into the stirrups, and they strapped my legs down around the knees, which made me nervous because I had gotten used to pushing with my legs bent a lot more. I asked Dr. Lee if I could change positions, but he asked me to try it like this first, and it really wasn’t so bad. The nurses put these huge surgical drape booties over my feet – they went all the way up to my thighs. There were four or five nurses in the delivery room, with Dr. Lee in the place of honor. The nurse who usually assists Dr. Lee and who helped me at all of my prenatal visits was at my head encouraging me. I was so happy to be so close to delivering the baby. I noticed that the ceiling of the delivery room was painted blue with clouds, which I thought was a nice, calming touch. Every time I had a contraction, the nurses and Dr. Lee told me to push for a good long time. I felt like they were my cheering squad at the end of a race.

After a few minutes, Keegan came into the room wearing scrubs. Much hilarity ensued as one of the nurses tried to help Keegan get a sticky latex glove on over his sweaty palms. It took several tries, and lightened the mood a bit until my next contraction started. Dr. Lee told me that the baby’s head was large, and he wanted to perform an episiotomy. I told him to do whatever he thought was necessary to get the baby out – at that point, all I wanted was to reach the finish line and see my baby girl! After the cuts were made, everyone told me to give one last, strong push, and I gave it my all. I could hear Sophie crying, I felt a painful sting as her shoulders came out, and suddenly I could see a little human, upside-down, blue-gray, and covered in poop. The pushing part of the labor and the emergence of my baby girl was the most amazing, exhilarating thing I have ever seen. I couldn’t believe that I had done it or that this tiny bluish, bloody creature was the girl who had been poking and prodding me from inside for all these months.

After the birth, the placenta came out without any trouble, and then Dr. Lee spent what seemed like an eternity stitching me up. I was cranky because I just wanted to see and hold my baby. Keegan got some pictures of the nurses weighing her and stamping her footprints into my pregnancy diary. They did bring her over to lie next to me on the delivery table for a moment, but I didn’t get to hold her until a bit later. It’s traditional for babies born in the Korean hospital to sit in an incubator for four hours after birth, so it was quite a push for us to do something different. We succeeded in negotiating a fifteen-minute session with her before she was taken away. I was able to introduce Sophie to the breast, and she did latch on and start suckling for a little bit, so we were very happy about that. After only a couple hours and several requests, Sophie was out of the incubator, washed up, and back in our arms. We spent both days in the hospital rooming in with our girl, and I think it was the best decision we made – we had a head start in caring for our baby before we left the relative safety of the hospital. Of course, we had no idea that the challenges of parenting were just beginning….but that’s a whole new story.