- 4 years ago
- Wedding: August 2012
This is incredibly long!!! I could try to cut it down more, but I know as an expectant mom I appreciated detailed birth stories, so I didn’t hold back.
This was our first baby. Our plan was to labor at home until as late in the process as possible, then head into the hospital for, ideally, a medication-free birth. Things didn’t quite turn out that way, but bringing Matthew into this world was an amazing experience and I wouldn’t change a thing! Here’s our story. 🙂
I was due with our little boy Matthew on March 4th. On Saturday morning, 2/22/14 (38w4d), at 2am when I went to pee I noticed things down there were more wet than usual, but I didn’t really think anything of it. At 8:30am, I was getting ready to jump in the shower when there was a sudden gush of clear, odorless, watery fluid that ran down my legs – probably 2-3 tablespoons worth. So exciting! I called our midwife and our doula, then DH and I went about our day and waited for labor to start. Well, it didn’t. At 5pm we met our midwife at the clinic to check on Matt – his NST looked great so our midwife gave us our options: induce in the hospital with a prostaglandin drug like Cytotec or Cervadil, try a home induction with castor oil (which is thought to work by irritating the GI tract, thus causing the release of prostaglandins naturally), or give things till morning to start on their own. We discussed the studies done to date on PROM: if labor is going to start on it’s own, it will do so within 24 hours (typically within 8); if baby doesn’t arrive by 72 hours, risk of infection and NICU time increases. When exactly my water broke was up for debate – 8:30am if you went by first gush, but perhaps as early as midnight if you go by increase in wetness. With this in mind, we did not want to wait it out any longer. We chose to try the castor oil, give it until midnight to kickstart labor, and if no labor by midnight, we’d do a hospital induction.
*Recipe for labor:
Castor oil – 2 Tbsp
Peanut butter – 2 Tbsp
Bread – 2 slices
Mix castor oil and peanut butter in a small bowl. Pour/smear onto bread. Eat slimey peanut butter bread concoction. Wait 30 minutes to make sure slime is going to stay within the GI tract. Walk, walk, and walk some more.
I consumed the PB&C sandwich at 6pm. We waited the instructed half-hour and I never felt even a little queesy, so we set out on our walk. I began to get crampy and uncomfortable about 20 minutes into our stroll, but when the got back to the house and relaxed a bit the cramps stopped. I figured that was less than ideal, so we set out on another walk at around 8pm, during which it felt like a cantelope somehow became lodged in my butt (or perhaps that was Matthew dropping into my pelvis), and the cramps returned, stronger than ever. By the time we made it back to the house around 8:45pm, I was having difficulty walking; for 20 minutes all I could do was lay in bed and breathe through the discomfort – it was like horrible period cramps. Then, suddenly, they were gone. It occurred to me that I likely just had one massive contraction. Alas, nothing else exciting happened – just some mild crampiness and BHs. At 11:30 we updated our midwife and headed in to the hospital to force my uterus to get into gear.
We arrived at the hospital at 12:30am on Sunday, 2/23/14. We were ushered into an L&D suite where the monitors showed something very unexpected – I was not only having contractions, I was having contractions every 1-2 minutes lasting 60-90 seconds each with no complete uterine relaxation. In other words, there was no break at all between my contractions – my uterus sometimes paused for a few seconds, but it never went back to its relaxed state, and more commonly just rolled from contraction into contraction. More importantly, though, Matthew had a resting heart rate of nearly 160 and was deceling to 50-60bpm with each contraction. I (amazingly) kept my cool, but the nurse didn’t have to say a word – I knew we were in trouble just by the sound of the fetal heart rate monitor. Things happened pretty quick after that – lots of flipping from side to side, an IV cath was placed and fluids bolused, someone put an oxygen mask on my face, and my nurse anxiously asked muliple times how far out my midwife was. Being that we thought we were heading in for a leisurely induction, we just left it that we’d both shower and head into the hospital “soon”, so our midwife wasn’t there yet when all hell started breaking loose.
Things were getting very tense at that point; the nurse wanted to do a cervical check as she suspected I was a lot further along than anyone anticipated (as in, the back-to-back contractions were because I was at 10cm and ready to push baby out), but I knew our midwife wanted to keep checks to a minimum due to the risk of introducing bacteria and I was about to tell my nurse to back up and give my midwife a chance to get there when our midwife stepped through the doors at about 1:15am to save the day. She was as surprised as I was with what was going on – I believe her words were “They said my patient was in room 2, but I looked at the monitor at the nurses station and told them there must be some mistake, because the patient in room 2 was contracting every 2 minutes!”.
Our midwife checked me and I was 2-3cm, 80% effaced, 0 station (definitely not in pushing stage!). Matthew had stopped doing the scary decels after the IV fluids, oxygen, and position changes, but there were still concerns that my labor might be too much, too fast for him to handle safely. Our midwife pulled a chair up to the side of my bed and took my hand; she was such a calming and reassuring presence during the many, many hours that followed! After watching Matthew work through 10 more minutes of contractions, our midwife decided it was all too much for the little guy and ordered an injection of terbutaline (a smooth muscle (ie. uterine mucle) relaxant). The terbutaline did the trick (and gave me a massive case of the shakes!) – my contractions were still every 2 minutes, but less intense and with definite periods of relaxation in between – precious time that allowed Matthew to get a “breather” between squeezes. Our midwife thought that the umbilical cord was likely trapped between Matthew’s shoulder and the uterine wall or it was wrapped around his neck; with each contraction, the pressure was cutting off blood flow through the cord and depriving Matthew of oxygen. Without any time for full uterine relaxation, Matthew had no time to recover between contractions and was quickly running low on reserves. Scary stuff. Poor little Matthew. 🙁
DH and I spent the next several hours staring at the monitors. We finally decided we should try to get some rest at 7am and napped till 9am. When we awoke, the contractions were completely gone. Around 10am we sat down for a heart to heart with our midwife. There were two things that could be going on:
1. My water broke but my body didn’t know it and we were going to need more drugs to get it going or
2. The gushes I experienced were something else (cervical fluid for example) and labor stalled out because my body was seriously not ready for this baby to come out.
If #2 was correct, the best thing would be to let me go home, put all this nonsense behind us, and wait for labor to start on its own. While I would have done anything our midwife thought was right, the idea of leaving the hospital after everything that just happened was hard to take. Our midwife suggested we perform an Amnisure test to help determine if my water had indeed broken – a positive would be very reliable and we wouldn’t be leaving the hospital without a baby; a negative, however, would not mean very much and we would have to make some tough decisions weighing the risks of induction, given how stressed Matthew had shown he was by labor, vs. the risk of an infection due to potentially missing a PROM. DH and I were rooting for the test to be positive so that we wouldn’t have to make that choice. The sample was sent down to the lab at 11am and just 30 minutes later we had our answer – positive! We were both so relieved. We were going to have a baby!
We touched base with our midwife again to decide how to proceed. In an ideal scenario, it would be best to induce with a prostaglandin drug such as Cytotec (misoprostol) or Cervadil (prostaglandin E2), then add in pitocin if needed to augment labor. But, both my body and Matthew had very vehemently shown that prostaglandins were not our friend, and that was just from the effects of castor oil, not the real-deal prostaglandin drugs. Prostaglandins were definitely off the table. That left us with starting pitocin (oxytocin) to induce labor from a standstill. Very much less than ideal, as such labors tend to be very intense. But, at this point, it was our best option.
The pitocin was started at 1:30pm on 2/23/14 at a rate of 2 milliunits/minute. No contractions, no nothing. At 2:30pm we upped it to 4mu/min. But, at 2:45 my nurse scurried back in and was moving quickly – more fluids to be bolused, oxygen mask back on my face – things were obviously not going well. Matt was unhappy again and the pitocin was put back down to 2mu/min.
We chilled at 2mu/min for a couple hours, giving Matthew a break. Then, it was time for another heart-to-heart with our midwife. We needed a new game plan. While the external pressure monitor was showing that at 4mu/min I was having only uterine irritability, she suspected I was having contractions which the machine was unable to pick up. The problem was that in order to be productive (ie. cause cervical change), contractions must measure a certain amount of so-called Montevideo units (a factor of both the strength and frequency of the contractions). My midwife was concerned that Matthew may not be able to handle contractions strong enough / frequent enough to support active labor, meaning there might be no safe way to deliver him vaginally. The only way to know would be to put in an internal uterine pressure monitor so that they could get an accurate measurement of my contractions. Then, they could ramp up the pitocin and see if they were able to get productive contractions without causing Matthew to be in danger. If this wasn’t possible, we’d have to do a C-section. The plan made a lot of sense; we told them to go for it.
5:30pm, 2/23/14. First step in the new plan: place internal pressure monitor and do a check while down there. 2-3cm, 80% effaced, 0 station…as our midwife had suspected, I was virtually unchanged since I presented to the hospital 17 hours earlier… There was no rupture in my membranes at the cervical os (the leak that prompted me to go into the hospital must have been high – I suspect one of Matt’s mighty kicks was the culprit), so, to place the probe, my midwife had to rupture my membranes down low. The monitor itself was a long probe that was pushed through the cervix along the side of the uterus between baby and uterine wall – a bit awkward but not uncomfortable.
Now, it was time for the real party to get started.
6:00pm, 2/23/14. With the internal monitor in place, the pitocin was upped to 6 and, for the first time since all of this started nearly 36 hours earlier, I actually felt contractions! Unfortunately, it was 100% back labor. I felt absolutely nothing in my abdomen, no menstrual-like cramps. Just a horrible lower back ache that came every 4 minutes and lasted 60-90 seconds. Painful, but I could talk through them. I handled these contractions quite well for half an hour by moving from the bed to the birthing ball with DH using tennis balls to massage my lower back. Our midwife, doula, and nurse all left to give us some time alone to work through labor. They were kind enough to up my pit to an 8 on their way out at around 6:30pm.
The next contraction felt like someone was ripping my lower back apart with pliers. That is honestly the best way that I can describe it – like someone was literally trying to pull my spine apart. It took everything I could to get through it without bursting into tears. The next one was just as bad, followed by two contractions back to back for a lovely 3 minute long, yet seemingly unending, torture session. I was done. I had read birth stories that described how much back labor sucks, but factor in that this was pitocin back labor and it was far beyond sucking. There was no way I could continue through the contractions without completely losing it. DH and I both went into this wanting to avoid pain medications, but seeing me go through these contractions he was relieved when I asked for the epidural – there was no way for our birth story to be a positive one with how much pain I felt, and with how helpless DH felt with being unable to provide any relief.
The epidural is a wonderful thing. The anesthesiologist was in my room within 2 contractions of me requesting it. The break between my contractions at that point was about 2 minutes. Somehow, this guy managed to get me off the labor ball and into bed and prepped, placed the catheter, bolused me some fentanyl, and taped everything in, all in the 2 minutes he had to work with between contractions. That guy rocked! As the epidural set in, my back pain disappeared and was replaced instead by severe pain in my left hip. Damn painful, but I could get through the contractions without teetering on the brink of breaking down. I had a urinary catheter placed then rolled over to my left side – after about 20 minutes, the epidural numbed that last bit of nerve and my hip pain finally resolved. I was in no pain whatsoever. It was amazing and pretty unreal, especially because I could still lift my legs and move them relatively normally. That anesthesiologist guy gets a gold star and virtual fist bump from me.
It was 7:30pm at that point. It finally felt like we were making progress, so we figured we should get some food and sleep before it was babytime. We were midway through scarfing down some grade A hospital cuisine when the monitor grabbed our attention again – Matthew’s heartrate was dropping to 80 with each contraction and was slow to come back up. Sure enough, our midwife was at our side within moments. She told me to stop eating, and if anybody asked I last ate at 1pm. She never came out and said that we were potentially moments from an emergency C-section, but she didn’t have to. Another IV fluid bolus was started, I was put back on the oxygen mask, we changed positions trying to find one that gave Matt some relief, and turned the pitocin back down from 8 to 4. Thankfully, Matt was okay, and surgery was avoided once again. After giving him a break, we started gradually ramping up the pitocin again over the next couple hours, eventually topping out at 9mU/min. Matt wasn’t loving the increased pitocin, but he was tolerating things okay as long as I stayed rolled halfway over onto my right side.
PS. The number of tubes and wires coming from my body at this time was amazing and honestly a bit comical: two IV caths, epidural cath, urinary cath, BP monitor, pulse ox monitor, external fetal heart rate monitor, internal uterine pressure monitor, and oxygen mask. 9 different tubes or wires. Quite a far cry from the “no IV or continuous fetal monitoring, please!” requests on my original birth plan. 🙂
At 9:45pm I was checked – I prepared to be disappointed, so I was amazed to hear I was 8-9cm, 100% effaced, 0 station! No wonder those contractions hurt so badly! I went from 2cm to nearly complete in 3 hours! At 10:45pm I was checked again and was 10cm and +2! Time to have a baby! I started pushing a bit after 11pm. Of course things wouldn’t go perfectly smoothly – Matt was deceling to 50 with each push – likely due to his head being compressed in the birth canal. After each push, I would lay on my left side and put on an oxygen mask. We also took a few contractions off to allow Matthew more time to recover between pushes. After about 5 sets of pushes, they had me reach down and scratch his little head! So much hair! They also had a mirror set up so I could watch him come out – that was amazing and I am so thankful to have had that experience! With another couple sets of pushes Matt’s head was out, and the midwife guided DH in delivering his body. As his torso emerged, our midwife told me to reach down and lift my baby to my chest. Matt was crying as he emerged, but when I started talking to him he whipped his head around, became very quiet, and stared at me with the most amazing look of recognition. It was one of the most amazing moments of my life.
I had a feeling Matthew was going to be a big baby (I was betting on 10 pounds at 40 weeks), so I was perhaps the only one in the room who wasn’t shocked to hear he was over 9 pounds despite being a week and a half before his due date. Also shocking was that as a first time mom with a 9+ pound baby, I had no significant tearing. My midwife put inch one stitch to close a small labial tear and a few stitches internally to close a vaginal barrel laceration, but my perineum remained intact! No vaganus here!
Final stats: born at 11:49pm on 2/23/14 (38w5d gestation), 9lbs 1oz, 19.5in, Apgar 10
Side note: I was always a castor oil skeptic and only agreed to take it due to the dearth of other attractive options, but I have to say – it definitely works! Perhaps too well! I’m a believer! Oh, and I never got diarrhea from it – my midwife claims it’s all in the dosing and eating it with a fatty, protein rich food like peanut butter!
As for recovery and the first few days, we’ve had it pretty easy. I was and still am pretty remarkably swollen down in the “bits” – Dermaplast and ibuprofen cover the discomfort very well most of the time, but if I am too active I definitely feel it. The hardest part for DH and I, though, has been that Matthew refuses to sleep in his crib – the second you lay him down he starts to cry. We’re slowly making progress (Matthew slept in his crib for an hour this morning!), but for now DH and I have been sleeping in 3-4 hour shifts with the other person downstairs keeping an eye on Matthew. Hopefully in a few more days we’ll get to sleep in the same room again! 🙂
Final thoughts: Obviously, our birth did not go according to plan. Going into this, I was so very excited to experience labor with my husband – specifically, I wanted to experience a natural, drug-free, intimate labor. What we got was far, far from that. But, given the choice, I wouldn’t change a thing. Thinking back, there were so many times when DH and I should have been terrified, but we weren’t. Our medical team allowed us to be active participants in the decisions made at every step of the way. We felt empowered rather than feeling out of control and overwhelmed. I can’t express enough how amazing my midwife was. Having read many birth stories, I think most practicioners would have pushed me into a C-section at some point during my labor. My midwife, however, kept us informed and did what she needed to do to keep Matthew safe and to keep me out of the OR. There were no time limits. Whenever we reached a roadblock, we just rocked back, regrouped, and forged ahead with a new plan. Eventually, we found one that worked, and DH and I will forever remember the moment when he delivered our baby and handed him to me. For that, I am eternally grateful to everyone involved.
Matthew and I when he was just 12 hours old:
A close-up of that adorable face:
Just 2.5 days post-partum – surprised by how little belly I have left!