Saturday, January 19, 2013

Labor of Love (and Bellowing)

This is Ishmael's birth story. To me, it seems like the craziest thing in the world, which makes it that much more amazing that just about half the people on Earth go through this at some point. Having a baby was a scarring, profound, and beautiful experience all at once for both Jonas and I, and probably Ishmael as well. It seems far away already, but going over the details again is still sobering for me. That being said, if you're about to have a baby, you may want to skip this one for now so as not to send yourself into labor with anxiety. [I wrote this in several stages, so references to Ishmael's age don't always correlate with the tense.] 



Jonas and I got married on January 14th, 2012 and got pregnant on our honeymoon - that's how it's done, people. It's incredible how quickly you can't remember what your normal body looks like upon getting pregnant and then again how quickly you forget what a huge stomach was like, 10 days after giving birth. It's also strange not to know what new things in your life are because you just got married and which things are a result of being pregnant. I had my first OB visit at 10 weeks. 

I was given an estimated due-date of October 18th, and knew right away that I wanted to do everything as naturally as possible. In California, most doctors will induce labor if you go 10 days past your due date to prevent the baby from growing too large to birth vaginally. The 18th finally rolled around, after what seemed like eons, but my body was showing next to no signs of gearing up of its own accord. Several people, including Dr. Dillon (my OB) kept saying, "I really feel like today [or this weekend] is when he's going to come!" which only made it that much more difficult that he didn't (hint-hint to any of you who may have a pregnant lady in your life). Furthermore, I had been 3cm dilated a week before the 18th (and oh how excited I was, because it had been totally painless and I thought I had this birthing thing down!), but by my next visit, the baby's head was sitting so low on my cervix that the doctor was unable to even reach the cervix (which is called being "posteriorly oriented") and moved me back to "functionally 1cm" or in other words, "no one can say." If the opening is posterior, it means you're not too close to giving birth, regardless of how dilated you are. I tried nearly every single "natural" inducer I heard of - raspberry tea, the exercise ball, pressure point massages, coconut water... you name it, I tried it. Not even an earthquake and an extreme heat wave got me going.

My last day of work was October 12th, at which point I promptly got a bad cold. It was miserable thinking that maybe my baby was staying inside until my cough cleared up, which I wasn't in control of. Then Jonas started to get it too, a week after I did. By this point, I'd been sitting at home for 2 weeks, feeling almost no signs of labor, and having emotional breakdowns every other day (though to be fair, the in between days were ok!). I wouldn't call myself a particularly patient person, but those last few days were some of the worst in my life, dealing with depression and wondering if I was doing something wrong such that the baby didn't want to come out. I know it was all in my head, but it was still so miserable. I really wanted to avoid being induced by drugs because of some horror stories surrounding Pitocin (I didn't want to be responsible for my baby being squeezed too hard because of the drugs and I really didn't want things to end in a c-section), but by the time I was a week overdue, I was frantic to be unpregnant. 

It was devastating to go see the OB at that point and after still not being able to reach my cervix to check dilation, say he was going to let me go past 10 days. He did offer to try and "strip" my cervix to encourage labor, which sounds terrifying but didn't happen because he couldn't reach it (which is amazing considering doctors and nurses can pretty much stick their whole arm up there!) and I said go for it, at which point he did an ultrasound to check how much amniotic fluid was left. There was hardly any, which can be a problem, but he wasn't yet too worried about my situation. Then I asked him to please calculate the baby's weight and after determining that he was about 8 1//2 lbs (Ishmael ended up being 9 lb 12 oz - not a bad excuse for having gained 50 myself!), he decided it probably was a good idea to induce me sooner rather than later. He put me on call for an open room at the hospital that weekend.

We waited Thursday. Friday. Saturday. 
Sunday, the 28th, was blisteringly hot and we went to church. I was such a wreck, having anticipated being in the hospital rather than church several Sundays in a row prior to that one. I couldn't talk to anyone without crying and I was about to rip heads off as people kept saying, "wow, I thought your baby would be here by now!" So did I, so did I.

While at church, Michelle told me that our friend Laura, who had been induced at the same hospital I was going to (Marian) had had to continuously call the staff and beg for a room. At first I was wary of doing so, wondering if the fact that we hadn't heard from the hospital yet was God's way of saying he didn't want us to induce, but as I struggled to sit even through half an hour of sermon, I was ready by the end of church to call. Jonas and I had been planning to go to our church's annual pumpkin killing event, but I said I needed to go home instead and Jonas was going to go alone. I was so distraught by the time we had reached home that I could barely talk to Jonas and ran into the house and fell on to the bed crying (drama!). Jonas, like the awesomesauce husband that he is, knew I was not doing so well and stayed with me. He called the hospital and I could hardly believe my ears that we were #1 on the waiting list and should be getting a call soon to come in. Jonas ran out to get a Redbox movie (Snow White and the Huntsmen, kind of a dud) and then the phone rang at about 4 in the afternoon. I made Jonas answer it, and we both panicked with bipolar feelings of sheer bliss and crippling terror.

We scrambled to get all our stuff in the car and I was trying to make sure there was no food on the counter and all the dirty dishes were in the sink. Jonas told me we had to go, and to just leave stuff. I texted our moms on the way to the hospital. We spent a bit of time registering and then went to our room. Our hospital is brand new and beautiful. They did the customary weighing and I had to pee in a cup, which you think I'd be a pro at by now, considering how often you visit the OB in the last few weeks, but it cracks me up that they ask you to do that when you can't see your belly button, let alone where your pee is going. Good luck with that "clean catch" (getting pee in the cup without touching the rim should be an Olympic sport). I was given lots of plastic ID bracelets and several needles to the arm for saline locks (so they don't have to bother with finding a vein later, in case of emergency, and good thing they did!) and by 6pm, I was on Cervadil, which is like a druggy tampon to make babies come out.































I can't remember what was for dinner that night, but I was fairly impressed with the hospital food in general. We watched news on TV as Sandy built up its fury, and we were bummed to miss our Sunday night bible study, but texted back and forth with our friends about how things were going on that night's episode of The Walking Dead. Thank goodness it wasn't until next week that Lori had her baby, sheesh. Our families had headed home by 10 pm or so, as nothing much appeared to be happening in my body. Jonas went to sleep on the fold-out couch in our room. Then, around 11, I started to have contractions. At first they were just uncomfortable, and I tossed and turned for a few hours while Jonas got some rest (I figured there was nothing he could do at that point anyway). What started out as kidney-are pain, that I'd felt a little of in the previous weeks, began to escalate into real back labor.

After a few more hours,the night shift nurse let me get in the shower, which immediately made me feel significantly better. I would have stayed in there all night if she had let me. I asked her at one point if I was anywhere close to giving birth, just to get a feel for how much worse things might get. I imagine those are hard moments for nurses, when they have to give you a little grimace and tell you that you're pretty much no where near having a baby yet. My contractions would immediately become more intense and painful when I had to get out of the shower so they could monitor the baby's heartbeat every hour. By now, Jonas had woken up, and I asked him to go get me a sandwich, but a nurse caught him on the way and they wouldn't give it to me (I wasn't allowed to eat after a certain point because I might throw up from various sorts of pain later). Foiled! It's a good thing pregnant women aren't very mobile when their emotions are running high.

My memory of the progression of contractions is a little fuzzy, but somewhere in the wee hours of the morning, they took the Cervadil out, ahead of schedule since I had obviously started contractions without needing Pitocin. I realized later that my water broke sometime during when the Cervadil was in, but I never felt it. Technically, I think Cervadil is really just to help soften the cervix, but it sent me into contractions too, and that was at least a small consolation because I was worried of getting caught in the Pitocin/Epidural cycle and ending up with a panicked baby and a c-section. Anyway, after the Cervadil came out, I got to go into the tub. I remember waiting for the nurse to say the tub was full enough and it feeling like an incredibly long wait. Jonas got in with me  and the jets in the tub made my skin itch, but the warm water helped a little bit. I was so exhausted at this point (contractions every 2 to 3 minutes and I hadn't slept in about 20 hours) that I would fall asleep between contractions and then have to sit up and grip the sides when they would hit. The water was no longer helping the pain of actual contractions which was discouraging.

Eventually I got out of the tub to go back to the shower, which I much preferred. Again, my memory of the timeline of that night isn't very good, but I had been having contractions every 1 to 2 minutes for hours (many of which were peaking off the graph) and was at the point of letting out full blown screams by the time my mom came back to the hospital at 6 in the morning on Monday, the 29th. I asked a nurse again whether things would get any more painful, and she said no, which was mildly comforting, but I had no idea how much longer things would persist. It was really difficult knowing another contraction would be coming inevitably and there was really nothing to be done about it or to ease the intensity. By 7am, my mom had been holding the shower head over me for about 45 minutes and I had a few contractions that were more like 5+ minutes apart, but they were the worst yet and I wished so hard that I could somehow separate my back from the rest of my body.

It was frustrating when people would encourage me to breath through the contractions because they were so exhausting and my throat was so dry from bellowing. Sometimes I would cry from pain, sometimes I would cry from misery or frustration. I felt broken down every now and again, but couldn't even get a good cry in because I would have to gulp too much air which was impossible during a contraction, or any extra shaking of my body would cause more pain. Sometimes people would ask me something or tell me something and I was aware of them speaking, but I would have to wait several minutes to answer. I could almost find the humor in saying to Jonas one time, "Can I have some...[5 minutes later]...juice!!!" At least "juice" was enough to get the point across because he'd probably forgotten the first half of the sentence.

My original nurse from the night before was back for her next shift at 7am and as soon as she saw me, she really started pushing the idea of an Epidural. I had asked nurses not to offer me drugs unless I requested them (she either didn't get the memo or realized more than I did how crazy I was), and I wasn't able to answer her right away anyway. I always had to wait for the 30 second pause in between contractions to move anywhere or say anything, so the nurse helped me hobble/scamper into bed, where she discovered I was still at 3cm, like I had been hours and hours before when they took out the Cervadil. As grueling as the contractions were, I think I could have kept going a little longer if I had a timeline, but there was no telling how much longer it would take (or whether it was physically possible, naturally) to progress further. When I heard I was still at 3cm, I very quickly said I would take the Epidural. BEST. DECISION. EVER!

The anethesieologist came in and I quivered my way to sitting on the edge of the bed. He said I would need to stay still while he put the needle in, which sounded completely impossible, but the nurse had me look her in the eye (also mostly impossible since my eyes had been squeezed shut for about the past 10 hours) and talked me through each breath. Jonas and my mom had to leave the room (so they wouldn't see the needle, which is apparently horrifyingly large) and I felt 3 pokes in my back, but they were not so very bad. One reason I had been nervous about getting an Epidural was simply the idea of someone shoving a huge metal rod in my spine. But no joke, I was feeling SO much better within 10 minutes that I pretty much slept and smiled from 8am until an hour or so before I had to start pushing, around 8pm that night. Heaven! I suddenly understand drug addictions  I got my nails painted, put on make up, smiled, made jokes, took pictures, etc. Yah, yah, yah! Jonas, Jordan (my brother-in-law) and I were laughing at the standard hospital 1 to 10 pain scale with "happy" faces for what each stage is supposed to feel like. They had to re-draw them to be more accurate, since the face that goes with level-10 pain looks like someone just stepped on your in-grown toe nail. Oh, and bonus feature, I was at 6 cm in like half an hour (laboring so hard before actually made me tense up so much that the dilating couldn't progress). Sometimes when I got too reclined, the Epidural would start creeping up into my chest and I would get tingly and numb, but only later when I was pushing, did I lose control of any movement, and then it was just my right leg.

All the while that I was in no pain because of the Epidural, my contractions on the monitor were literally off the chart. I continued to dilate another inch or so every hour until I was at 10 cm by dinner time. They'd turned the Epidural down, so I was a little uncomfortable, but not in too much pain. They also started Pitocin because even though I was fully dilated, nothing was happening.

When you're getting near the end of labor, you supposedly feel "an urge to push," which I did not have. That was frustrating since I was fully dilated - what else was left to do? The nurses were telling me not to push until I had the urge, because I would tire myself out without getting anywhere. But after an hour of still not having the urge, a nurse started having me push during the contractions (which I still wasn't feeling much at all). It felt kind of ridiculous because I was "pushing" but it didn't feel like anything was happening. What was eventually really helpful was a nurse massaging and widening the canal with her fingers every time I pushed. Someone would let me know when the monitor said I was about to have another contraction, then I would take a "cleansing breath" - in and out - then a deep breath, hold it for 10 seconds, tuck my chin down, pull my knees toward my chest (people did that for me later on as things progressed) and focus my energy into my baby-exit-region. Three times per contraction. The nurse kept saying "think toward your butt!". My husband, parents and mother in law would continue to count me through the breaths when the nurse would go to do something else, but I was always a little bummed when she would leave because having her there massaging and reminding me to focus energy and telling me when I was doing well was pretty helpful.

Somewhere in the midst of fake pushing, it got going for real. And it started to hurt. My tailbone started to kill me, which they said was the baby pressing on it. The real pushing probably didn't last more than an hour, if it was even a whole hour, and as difficult as it was (hyperventilating while crying and screeching), it was good to finally be nearing the end and I didn't want to stop pushing because a) it's not comfortable to have a child just hanging out in your birth canal and b) as I said, things were almost over! When I only had 4 or 5 pushes left, they almost started to feel good (like when you're getting over being constipated), and then the last 2 pushes hurt on a whole new level as I tore both my cervix and perineum. It didn't feel like what I thought tearing would feel like (and I guess I'm assuming that the pain of the last two pushes was tearing, but I don't know that for a fact). Later I was told that Ishmael's head came out with one push and then one shoulder on the second push, and after the shoulder was out, he slid out completely.

Ishmael Azure Rajan Tucker was born at 9:08 PM on Monday, October 29th, 2012. He weighed 9 pounds, 12 ounces and measured 22 inches long. I was so happy that he had hair (and boy, does he have hair - everywhere) and apparently he had an extreme cone head, but I never saw it. Ishmael doesn't have any birth marks, but he does have at least 2 cowlicks on the back of his head and a notched earlobe. There was a full moon that night and my doctor delivered four babies. 

The next thing that happened was that Jonas cut the chord. They put Ishmael on my chest for about 30 seconds, and I remember him looking blue-ish grey and having white wet fuzz all over him. I didn't feel an immediate connection with him and I didn't stop laboring right away either. I remember almost panicking as I realized that pushing the baby out wasn't the end of all the pain and struggle. He didn't look like I had imagined him. I was still crying and heaving and totally unaware that I was loosing a ton of blood. I guess it's common not to have immediate fuzzy bonding feelings when your body goes into shock. I remember looking over and watching as the nurses and Jonas rubbed Ishmael in towels for a minute or two [the picture below is from later], and then they took him away (Jonas went with him). I don't remember what it felt like when the placenta came out, except that they pressed on my abdomen to help it along which is very uncomfortable.































At this point, my doctor made everyone leave the room except for 4 or 5 nurses. I was fully awake, but rather apathetic. I just kind of lay there for 2 hours while he sewed and propped things up and yanked and prodded. I do remember asking whether the damage (between tearing and hemorrhaging) would make it difficult to have more kids and he said no, which was a relief (people later told me I was definitely in shock if I was asking about more kids when I was still on the operating table, haha). I ended up getting a balloon in the uterus to prop it up, a blood-clot-draining catheter, and a regular catheter (surprisingly so very nice and convenient!). I remember the doctor being in very-serious-mode, though I was at peace that he had things under control and knew what he was doing. I also remember him really snapping at the nurses for not being prepared with the right tools or taking notes at first. I thought later how bizarre it was that I was fairly near death, but had no notion of that being the case. And how crazy to think that I would have died if I hadn't been in a hospital.

Now for the impressive numbers, I lost 1 1/2 liters of blood, which is 6 times more than if you give blood at a blood bank and 1/4 of the total amount of blood in a normal adult body (though you actually "grow" more blood when you're pregnant). I guess what happened is that my uterus was really exhausted from the intensity and duration of my contractions, and instead of continuing to contract after the baby came out (like it's supposed to), it just collapsed, which results in excessive blood loss. I'm not exactly clear on the logistics of how and why all that happens, but thankfully the placenta didn't leave parts of itself on the uterus wall, which I understand to be the main reason woman will hemorrhage after giving birth (and can make future pregnancies difficult). Somehow, the uterus continuing to contract after birth helps the blood to stop flowing, but it's unable to contract if the muscles give out - go figure. I didn't end up needing a transfusion, so it definitely could have been worse. I did have IV bags going into both arms and kept having to have my blood taken, which was sort of aggravating and painful after having gone through labor.

After I was finished getting fixed up, my parents were allowed back in and after 15 minutes or so, I started to get really frustrated that they hadn't brought Ishmael back yet. I asked my mom to go find out what was going on, right as Jonas walked in with Ishmael. But I remember still being pretty apathetic when I was able to hold him, and Jonas saying later that he was a little worried with my reaction. I felt like I didn't know Ishmael and didn't expect that I would have to get to know him a little, just like another person. I also remember that I could barely move my arms.

My mom stayed with us the first night and help Ishmael most of the time while I was basically delirious. I apparently have little to no memory of some of the times that I fed him, though I do know he did great latching on from the get-go. Over the next few days, he went 12 (and later 8, later 5) hours without eating, after the first 3 times he fed, which kind of freaked me out, but we got the hang of things eventually. It was funny that my boobs were suddenly just public property and it didn't really bother me that people saw them. 

We were in the hospital for 4 days and 3 nights, including Halloween, which I kept forgetting about and was sadly lacking in costumes and candy, though we did get to Skype with my sister Annelise (it was her birthday) and Taylor Gates. There are crucifixes in every room at Marian, which is an image that somehow sticks in my mind from our stay there. 

Ishmael had some trouble with gagging the first few days and the nurses ended up propping up his bassinet to cut down on gagging incidences. Once, in the middle of the night, a nurse didn't prop his bassinet up after taking him out for a hearing test, and I woke up suddenly to nurses rushing in and suctioning out his mouth as he gagged. I don't know if the events were correlated, but the nurses had come rushing because the monitor on his foot had set off an alarm (which is supposed to happen if he were to be taken more than a room away from me), and when they came in to check on the alarm, he happened to be choking. Ugh, scary! He also snorted a lot, apparently due to small and swollen nasal passages. He squeeked a lot when swallowing, which he still does sometimes and people think it's hilarious. You can often hear it from another room. At 1 month, he's started to eat so quickly that he'll usually gorge himself and throw at least part of it up right away. But he's also sleeping for 6 hours during the night!

I'm happy that I had Ishmael vaginally because I've heard that recovery time for c-sections is longer (and recovery from a regular delivery has been much harder than I expected!), but at the time, a c-section didn't seem like a bad alternative to 22 hours of labor and a near-death delivery. My mom agreed with me, which is saying something (not that we agreed, but that a c-section couldn't have been much worse). Furthermore, I didn't get the immediate bonding with Ishmael, which is another reason I wanted to stay away from a c-section. With subsequent children, I'd still rather have natural births, but if my labor is similar, I'll take the Epidural a lot sooner so my uterus doesn't hate me.

And here, I totally have to give a shout out to my doctor, Keith Dillon. Although he offered very little information during all the office visits (though he will certainly answer questions you ask of him), I felt very comfortable with him during the entire pregnancy, and then during the birth, as I mentioned above, felt very confident with his attitude when things were serious, and appreciated his easy-going and friendly manner the rest of the time. Once, when he came in to check on us a day after Ishmael was born, he was excited that we were listening to John Legend and sang along while he did whatever procedure he needed to do. I think I had a thankfulness crush on him for a few days after he delivered Ishmael and saved my life, as dramatic as that sounds. The nurses at Marian were also great, with few and minor exceptions. They each had different (though not usually conflicting) advice, which I appreciated. The new hospital is incredible - clean, comfortable, and spacious. I would totally recommend both Dr. Dillon and Marian to anyone in this area.

Like everyone says, I didn't fit into my regular clothes right away again (in fact, I popped a button off an old jacket, which was embarrassing), and my heartburn lingered. I still can't get my wedding ring off (and actually had an allergic reaction, I think!) and my shoes don't fit me anymore (3 months later!). Your butt, and related activities, hurt for weeks. My advice to new moms: take everything they give you at the hospital for both yourself and the baby - I was going to just squirrel it away, but it turns out they give it to you. I guess I should have realized they wouldn't want to give a half-used item to some other lady. And for the love of all things good, TAKE THE EPIDURAL. And let people help you. 

Ishmael is a very healthy baby and has passed every test with flying colors. He got a few shots and pricks in the hospital and it barely phased him at all - he seemed to cry more from annoyance at being disturbed than pain (like 10 seconds, all told). It's actually pretty awesome that he's so big, now that the birth part is over, because he's been able to lift his head from day one, which really cuts down on his chances of suffocating, and he has so much body fat that he doesn't need to feed as often as smaller newborns. He pretty much never fit into newborn clothes, which was a teensy bit sad. His legs and arms are so strong that I genuinely struggle to pin his arms when I swaddle him, and he does not appreciate us trying to manipulate his limbs when getting dressed. He kicks out of my grip and into his own poop on occasion.

Almost everyone says Ishmael looks like his dad, now that he's a month old, but the one feature he appears to have inherited from me are his lips (and some facial expressions).  His eyebrows and nose are definitely his dad's. 

I tell everyone that a combination of drugs, hormones and Jesus made all the worst parts seem like a memory almost immediately after they happened, even as I was like practically dead. Jonas and I are already excited to have more kids. Having a baby makes you feel like a warrior, and "your heart grows 3 sizes that day." As I think back on it now, the birth process is almost a good analogy for parenthood; constantly walking the line between near-death and pure joy. 

1 comment:

  1. Loved reading this! Thanks for laying it all out there.

    ReplyDelete

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