Wednesday, January 5, 2011

Child Birth

ok, two weeks late... I am so sorry... But here you go...

Let's face the facts. Labor is called labor for a reason. It is not easy, fun or fast. I am just a lucky one where it started and was done and over with in a day. 12 hours and 51 minutes was the amount of time that it took to go from 2 centimeters to 10, for Nikolai's head to move from a -4 station through the cervix, and to thin out at least half way. It only took 30 minutes of pushing, and that I am extremely thankful for. But really it was a lot to take in on one day.

We were supposed to arrive at the hospital at 5 am on December 22, and oops! We woke up to Brandon's work alarm going off at 5 am. So we did not make it to TMC until a little after 6. Really though, that is not bad seen as how it is quite a drive from our place. But in getting there, we had paperwork to take care of (of course) even though we preregistered with the hospital. Then the people told us to wait 30 minutes for a nurse to become available. Well, the 30 minutes turned into an hour, and I cannot blame them. The shifts were changing at 7 am anyway. Well, we spent that hour walking the waiting area and hoping that contractions would speed up a little more to avoid the use of pitocin. That didn't really work though. At least by that time contractions were about 10 minutes apart rather consistently. Yes, we wanted to just say, "if mom and the baby are fine then we will return when labor starts spontaneously". Of course that is not how it turned out after getting into the room around 7:15.

So we got our room around 7:15 ish, got all ready for the monitoring of baby's heart beat, the doctor to check the cervix and to basically get started. I was so nervous and scared. Was I making the right decision? it all moved so quickly. Brandon had explained what we wanted to the nurse (all natural),  to maybe try cervidil (but I guess it depends on a scale of dilation and effacement). But because the appointment was for induction and we were there, we were there for induction. If we hadn't of shown up, we may not have had to have pitocin.  That is what we were there for, inducing. I still kinda feel like I failed. But at least I was able to move around, use a birthing ball, and go without epidural and pain meds. Brandon is impressed by that, and Nikolai is healthy. That is all that matters. I guess I am impressed by no epidural or pain meds too...

By the time they were getting the pitocin started (I was 2-3 cm and no change really of the cervix), I felt that I had failed. I didn't want the pitocin. But they started that around 8 am. No spontaneous labor for me at that point. The nurse kept asking me what the pain was on a scale of 1-10, 10 being the worst. I had nothing for her. The contractions were the same tense feeling, but not painful. By the time they were coming on more frequently I felt maybe they could have been a 3, 4 or 5 depending upon my position, but if it hurt I moved.  She was a little concerned that they weren't doing anything.

Well, they started the pitocin at 8 am with 2 milleunits every minute. What that means I am not sure, but the IV was totally not very comfortable. So much for no IV, but it wasn't that bad I guess. I was able to walk around and I think that I am lucky for that. The nurse said that as long as she can hear baby's heart beat, she didn't mind what I did. Eventually, things got uncomfortable so I asked for a birthing ball and oh was that wonderful! We were also looking for positions to move the baby's head into a closer station, and the ball seemed to do just what we needed. I was looking through word searches to stay busy. I know, weird, but the pain was non-existent, just the tight feelings of the contractions. Every now and then I would get a pain in my hip bones, but nothing major.

They decided to check and see where I was at for dilation and effacement. At 4 cm, 90% effaced and Nikolai at a -2 station, the nurse decided to tell the doctor it may be time to break my water.  The doctor, not my normal doctor, a man from the Russia area (at least that is what his accent sounded like), came in to check and use the crochet hook looking thing to break my water. My contractions at this point were around 2 minutes apart and the doctor said he needed a contraction to break the water. Well, one did not come. The doctor decided that if he pushed on Nikolai's head, he was not engaged enough to break the water bag (his head moved and his fingers fit between his head and the pelvis). So all the pain of them pushing to determine information and waiting with the crochet hook thingy, I was so thankful for that not happening then. I wasn't comfortable with it, and neither was Brandon. 

It wasn't until around 5 that they decided to break my water. Nikolai's head was further engaged, it didn't move when the doctor pushed on it. There was no space between the wall and his head so the umbilical cord could not slip through. That was one of the problems the last time. Well, contraction still coming in pretty quickly and they were getting stronger. I was about the same in dilation, 4 cm maybe about 5. So they decided to use the crochet hook thing again. I have to say that it is not comfortable. It is like a pap exam but instead of the long q-tip only being there for a moment or two, it lingers for a few minutes or more (like 5-10 it feels). Waiting again on the contractions that seem to elude the doctor. I was having them, even the tape showed that, they just disappeared when the doctor wanted them to happen. 

The water breaking is gross. It is like peeing in your pants, literally. The water is warm and it just gushed out like a flowing river. The doctor had to make sure the baby's head would do what it needed and the umbilical cord would not slip between the wall and the head. So there was no comfort even after the water having been broken.  The contraction we were waiting for, so the doctor could break the bag of waters, was a small one and he had the nurse push down on the top of my stomach. More uncomfortableness! The whole thing was scary. Once they broke my water I felt so much lighter! But I do have to say that once the water breaks the contractions are stronger and more painful. They broke my water around 5 something pm. The nurse hoped that Nikolai would be born before her shift ended, but that was not likely.  Our new nurse had come in around 7:30pm.. Up to that point our old nurse was great, rubbing my legs, telling me I was doing great, and helping Brandon. Too bad she couldn't stay the whole time.

It wasn't much longer after the water breaking that the contractions were coming fast and strong. It hurt, I will not lie. It was not fun. The sudden basketball that my stomach became made my ribs hurt and breathing exceptionally difficult. I have to say that low moaning sounds helped so much. Not just to make the pain subside a little, but to regulate breathing so not to hyperventilate. Brandon was right there with me. :) It helped to not being alone, and helped me keep my focus. 

This was the moment where it all started to happen so fast! I could not get comfortable. Brandon had started using a cold washcloth (which later became 3) and was squeezing my head as if I had a migraine. Pressure on the temples, I guess it displaced the pain and made me think about my head more and the contractions less.

Well, the doctor had been pushing an epidural. Each time he came into the room he asked if I wanted pain management. Each time I told him the same answer, "no". Well, by the point that I was getting close to entering the transition stage, he had asked several times. He walks into the room and Brandon had a cold wet washcloth on my forehead. The doctor asks him "whats this?" in his Russian accent. Brandon, a little confused holds up the washcloth and says "a wet washcloth." The look on the doctor's face was priceless. It was confusion as to why we were using washcloths. His response, "washcloth? instead of epidural?". Wonderful! Now, you have to read that with a Russian accent. It was just so funny. Not that we laughed right then, but it gives us something to laugh about now.  

My sister came in and I felt bad because I wasn't very sociable. I was just sitting there, low moans to make the pain a little more bearable. Brandon with the washcloths. When they say the contractions become stronger after your water breaks, they are telling the truth. It was difficult for me because the contractions were not that bad before, just tightness.

I was entering the transition phase. I know that because as I was trying to change positions and Brandon getting a washcloth, I burped. It was the only burp I had, but after that the contractions were coming with no break (literally) and I felt as if I was going to void my empty stomach of it's contents.

The nurse was a little concerned, they kept offering me pain medication through the IV, I had already passed the part of receiving an epidural. It was too late for that. Narcotics was what I would have received. Not to take the pain away, they tell me, but to make me not care so much about it. Well, I have had morphine before and those were the same effects, and that did not help me out much then. I doubted it would help me out so much for labor. Thanks to Brandon for reminding me about that. If it wasn't for him, I may have gone with the narcotics. He reminded me that they only dull the senses, not help relieve the pain. I was having Siamese contractions, one right after the other, no time in between. Even the nurse said there had to be a way to slow them down. The kept saying it's ok to ask for pain relief and I was so ready to give in when I had a thought! I remembered overhearing the nurses say that the pitocin could be turned down if needed, so I asked if they could turn down the pit. "Of Course!" they tell me! They turned it down from 28 milleunits/minute to 14 milleunits/minute. By that point all I had to do was wait for my body to filter through the rest.  Even Brandon was so happy that I thought about that, he couldn't think of anything to do but remind me that narcotics would not get rid of the pain, just make you not care.

Now this is where it all seems to mix together to me. A little after they turned down the pitocin, I told the nurse that I felt I needed to poop. Apparently, pushing out a baby is very similar to passing the biggest poop in your life. Only this one is coming out of the wrong piping. Gross, but true. The new nurse, mean as she was, told me to wait. They needed to check and see if I was 10 cm. Poor Brandon was telling me to breath, and each time I tried I felt the need to push. The nurse kept telling me not to. Now being told not to push and having the need to push makes a very difficult time. Trying to obey the nurse, but trying to do what your body wants to do does not work when they are to different things. You cannot not push when the urge is there. 

Once they did check me I was fully dilated and Nikolai was on his way, whether the doctor was ready or not.  The doctor got suited up, they removed the leg part off the bed (I guess it came in two pieces), and set up the fluid catch bag. I just remember the pushing, but this was what Brandon saw. Brandon took one leg, the nurse took the other and I had to bear down and push. Each contraction came and I was taking in a deep breath, holding it, and pushing with instruction from Brandon.  He did the counting up to 10 and reminding me to breath, when to breath. The contractions came, and once I started pushing I did not feel the pain. It was all about getting the baby out, being able to hold him.

30 minutes of pushing and Nikolai was out.  Of course, that last push caused a spray of fluids that covered the doctor and splashed Brandon's shirt and pants (who was still holding on to my leg).  Before we could say anything, the doctor clamped the umbilical cord. We wanted to let it pulse, but we think he was caught up in the moment. Brandon cut the cord. He says it was liking cutting raw chicken with sharp scissors. Nikolai went into my arms after they wiped some of the blood off, and they continued rubbing him a little after he was in my arms. He tried to latch the moment I did skin to skin contact, but they took him to weigh, measure, and do the apgar scoring. I was getting stitches at this time for my second degree tear. I had no idea until after they took Nikolai that I was getting stitches. The doctor had to inject the local anesthetic 3 different times as he was stitching. I could feel it and ouch! More painful, I think, than pushing!  

Once Brandon gave Nikolai back (after the stitching was done), Nikolai latched on right away. The nurses and support staff was surprised! A baby that latched on right away. They later bragged to other nurses and the nursery nurse that he latched on "as soon as he was born" and to "not believe him if he says he is hungry". LOL, little man came out a good eater.

Our nurse told Brandon he did a good job as a coach because she didn't have to tell me when to breath and when to push. He made her job a little easier. She was surprised, that we must have taken classes or something to prepare us for the labor. I guess most people are not as prepared as we were.  And they were surprised, and proud, that I did not take any pain meds or the epidural. :) I could not have done that if it wasn't for the practice of what we learned from the Bradley method classes and from my husband being by my side through it all.

And that is how Nikolai entered the world.  

Aside from the pitocin, our birth went how we had planned and wanted it to go! What more could we have asked for.