Sunday, August 23, 2009

Isaac's birth story

I can't believe it's been almost 7 weeks since I gave birth to Isaac. It has taken me some time to sit down and write my birth story, mostly because I just didn't really want to think about it too much. But it's always on my mind, it's something that I will never forget. But I think it's important to have the events of those hours somewhere other than only stored in my mind...

In the wee hours of the morning of July 7 I was restless, I just couldn't seem to get settled and sleep. I had of course been having restless sleep for weeks now, but this was different. Also the contractions I had been having for weeks were continuing and maybe getting a bit worse. I finally woke up around 7am and pretty much as soon as I got up, contractions started getting regular, at about 7 min apart. I called my mom and told her I thought this was it. Ken went to work on my promise that I'd call if things got more intense (but he was going to be home at lunch anyway). I got Maddie dressed and we had breakfast. I called my mom and had her on standby. My midwife, Karen, was due to come that morning anyway, but I called her and she said she'd be over around 11am. Well, the contractions continued and kept getting closer apart and more intense. By the time Karen arrived I was having to stop and breathe during a contraction. Ken and my mom made lunch and I could barely eat, but I did. Karen estimated that the baby would arrive before midnight. We were so excited! Well, the pain kept getting stronger. I had the TENS machine on, but it really wasn't working. Karen suspected that Isaac was still posterior so they set up the bean bag on my bed and I laid frontward on it. But it was hard to get through the contractions in that position so I got into the tub. It was heavenly, as heavenly as it can be to get in a tub during full blown labour! By this time the pain was so bad. I had Ken pouring water over my belly during the contractions, and it seemed to help. I also liked it when Ken massaged my lower back. Slowly but surely, the pain was getting worse in my back. I just knew it was going to be one of those awful back labours. Shannon (my doula) arrived around 4pm and she took over helping me in the tub. I was really vocal during contractions. The pressure in my pelvis was so strong, and I was having double contractions, with no break in between. All signs that Isaac was indeed posterior. Well at one point I was moaning so deeply that I scared Karen and she said it was time to go to the hospital. The drive to the hospital was not as bad as I thought it would be. I was still able to breathe through them, but it was so hard. When we got to the hospital we got to our room and Karen checked me and I was 4cm dilated. The next few hours are all blurred together because the pain was so bad. I was in the tub for a long time, it seemed to be the only way to somewhat get through the pain. All I could tell myself was that soon it would be over and I'd have my baby in my arms. Just one contraction at a time...Karen, Ken, Shannon and my L&D nurse Susan were great at keeping me focused. A few times I said to them that I needed something for the pain, but then they were able to re-focus me. Hours went by like this, but I was still only 5-6cm. A couple more hours went by and the pain got worse. I was slipping and I could barely stay focused. I have never felt pain like that. When I was in labour with Maddie, the pain was awful, but it was different. With this labour, the pain was overwhelming. It wouldn't have been so bad if it was only the pain of the contractions, but it was the back pain that made it unbearable. I laid on the bed for a while and Karen checked me again....7cm. At this point I lost it, I yelled, "What the FUCK!!!" I just couldn't believe that all those hours and all that pain only dilated me 1cm!!! I think at this point Karen started to get concerned. My water hadn't broken yet, so she suggested that if she could break it it might help things move faster. But I didn't want her to. I am not sure why. So, the time went on and I really could not take the pain anymore. I made the decision that I needed something for the pain, I just could not do it anymore. I was OK with that decision, it was a deviation from my birth plan, but things so far hadn't really turned out as I thought they would. Little did I know what was to come...

Well, Karen put the order in for the epidural. She came back and said it would be a while. But without my noticing she had told the others that it would be 3 hours because they were in the OR. Thank goodness I didn't notice! Well to help out they started the gas. It made me feel so "drunk". The pain was still there, but it took the edge off, sort of distracted me and I didn't really care. I think another hour passed with the gas. During this time Karen attempted to break my water in the birthing chair. But nothing really happened, no gush of water came. Looking back I think I had very little amniotic fluid I had had some leaking already when we first arrived at the hospital. Well, thankfully, the anesthetist came in between OR cases and was able to put in the epidural. It took him about 20 min to put the epidural in. It was extremely hard to stay still as the pain was horrendous and the contractions were so close together. But the gas really helped and surprisingly I was able to stay still. He was excellent and did it so smoothly and efficiently (unlike my experience with Maddie). I felt such relief. I could still feel the strong pressure but the back pain was gone. I was hooked up to the monitors and shortly after getting the epidural Isaac's heartrate started to decelerate. I remember watching the monitor and seeing the numbers dropping...100, 80, 60...and thinking, "Oh, that is not good." Laying on my right side seemed to be the best position to keep his heartrate somewhat stable. But the pressure was so bad, and the pain of the contractions was starting to creep in again, and I was still only 8 cm dilated. At this point the OB resident came in to talk with us. She suggested we wait and see what 2 more hours would do with his heartrate, and if it was stable we could start some pitocin to get things going. Slowly, I could see my birth becoming more and more exactly what I had hoped to avoid. The chain effect of medical intervention. And there was of course mention of the possibility of a c-section. I was starting to get a bit scared. After a the couple hours went by, there was little progress and his heartrate was not improving, in fact it was getting worse...still dropping and after going back up at times it was going up higher than it should. The staff OB came in and said she would be OK with me trying to push as I had reached 10cm. But I just didn't have the feeling to push. The pressure was extremely intense, but I just didn't have the urge to push like I remembered with Maddie. I knew something wasn't right. But I pushed. And man, did I push. It was kind of awful actually because I was pushing with all my might and it did nothing. Looking back I think the hour and a half that I pushed is one of the two parts of my labour that I dread remembering. The other part I will get to in a bit.

Well, during all the time I pushed, poor little Isaac was suffering more and more. His heartrate was getting dangerously low and then going up way too high (tachycardia). When all this heartrate stuff began I had told everyone that I wanted Isaac's safety to come first, that I wanted to try to deliver him vaginally, but that if things got scary that I would do anything to keep him safe. So, obviously after pushing for so long accomplished nothing, we rushed to the OR. I remember going down the hall, feeling absolutely terrified. I still had the awfully intense pressure and I could do nothing but keep pushing even as we went down the corridors. Once we got to the OR things happened so fast. I was put on the table, draped up, hooked up to monitors, IV's, and in less than 10 min they were cutting me open. Once the incision was made, Isaac was out in less than 5 mins. He was born at 4:22am. Interestingly, just as the doctor was reaching in to grab him, he flipped and turned breech! So after 40 weeks being head down he came into the world feet first...I wonder if that means anything!? Unfortunately for me, I did not tolerate the surgery well. I vomited throughout the whole thing and I felt like I couldn't breathe the whole time. It was awful and very scary. I didn't know this, but c-sections take forever. The "taking the baby out" part is fast, but the "putting everything back together" part took about an hour or longer, and it was the most horrendous, longest hour of my life. I kept asking, "Are they almost done?" I'm sure everyone got sick of hearing me ask that. The ceiling was somewhat metallic and a bit reflective, so I could see blurry images of what they were doing. It was kind of surreal and scary. At one point I said, "Oh my god I'm going to die, I can't breathe!" Shannon comforted me and whispered in my ear, "You feel that way for a reason sweetie, your uterus is on top of your belly, it's no wonder you feel awful!" I later found out the OB's don't necessarily have to take the uterus out, so I wonder why they did with me? That image is still burned into my memory. But as always, time goes on and eventually I heard the words I'd been waiting to hear, "We are done." Phew...

I was wheeled to the recovery room and Ken, Karen, Shannon and Susan were with me. And for the second time, I did not have my baby with me. There are very few things in the world as awful as not being able to hold your baby after it is born. I was so emotionally drained and devastated, but I just could not allow myself to focus on that. I needed to be strong for myself and my baby. I was numb from the chest down and I was so tired, but I just could not sleep. Ken slept on the bed next to me and Shannon and Karen left at around 5:30am. Susan of course stayed, and kept bringing me ice chips, water and warm blankets cause I could not stop shaking. I was also in awful pain, despite all the pain meds floating around in my blood. So she gave me some Demerol, which didn't help. She was off at 7am and when the morning nurses started shift I developed a fever. So, my new nurse (can't remember her name) called the OB resident and I was given some nasty antibiotics which made me feel so yucky. But better that than get an infection. I was able to call one of the other midwives and get some advice on how to ensure I did everything possible to establish breastfeeding. Plus, she was very comforting and helped to calm me down. At about 7:30am, the nurse got me ready to go see Isaac and take me to my room. The readying process included a not so glamorous wipedown. I'm sure my belly was covered in post-surgery gunk, leftover tape stickies all over my back, plus there's the whole post-partum wonderfulness beginning. I was feeling a mixture of emotions. I was so happy, but I was so mad too. I just could still not believe that my sweet little boy was in the NICU. Once again, we just could not stay away from that place...

But when I first saw him I knew it was all worth it and that he would be OK. Holding him for the first time was amazing. He was perfect and I was in love. Unfortunately, they only let me hold him for a few minutes and I was taken up to my room. For the next few hours I shared a room with a lady who also had her baby in the NICU. I started pumping and all the memories of Maddie's birth came rushing back. Maddie came to visit with my mom and she and Ken went to the NICU to see Isaac. She also was amazed and enthralled by her baby brother! Luckily, they were able to find a private room for us, so once again I was moved. But it was nice to have peace and quite (well, as much as you can get on a busy ward). I asked Ken to go home with Maddie and my mom spent the night with me. I don't think I slept at all. I was in so much pain and just in shock about everything, so I was happy when morning came. I spent day 2 mostly in the NICU. I wanted to nurse Isaac so badly, but the doctors would not let me. They were concerned that because of the oxygen deprivation his bowel could have been affected and cause a rupture if he had to digest food. Of course I understood that, but I also knew that was so unlikely to happen...and that bonding with him was so important. I already felt strange about everything, I needed something positive to begin between me and him. The reality of not having the birth I had expected was slowly starting to sink in and I was angry, not that I wanted to be, but I was. I knew that breastfeeding him would help me and him to feel closer. Needless to say, Ken and I were a bit frustrated with it all. The NICU staff were somewhat patronizing (I remember that with Maddie too). But after a long chat with the doctor she agreed that if I pumped first I could put him to the breast so at least he could start getting used to latching and we could bond more. I knew this was a ludicrous suggestion as I was not really producing much milk yet and pumping would probably only initiate the letdown reflex more, but I went along with it. Anything to get to breastfeed him! I did that at about 10pm, but he was so tired that he didn't really latch on. I was a bit sad, but I knew it would all fall in to place soon enough.

That evening I was in the NICU so long that I let my IV dry out! My nurse was a bit upset with me, but oh well. She had to put in a new IV line and also give me those yucky antibiotics. Night 2 was also pretty awful. I had to have bloodwork done 2 times during the night, apparently they had to check that the level of the antibiotics was normal, so yeah, I got pricked twice. The first time I was a bit chatty with the tech, but the second time, I just barely could keep my eyes open. Sleeping was so hard because I could barely move and I felt so bloated and sore. So yet again, I was so happy when the sun came up...another night gone day closer to going home. Day three was a bit better. I was able to walk myself to the NICU, I had a shower and I started to eat something other than jello. And much to my delight, when I went to the NICU the nurse told me that Isaac was now able to nurse and depending on how he did he could come up to my room! The first time I nursed him was of course amazing. There is nothing like that feeling of having such a sweet, new little person so close to you. He needed a bit of coaxing to open up wide, but other than that he was a perfect latcher. I was so very relieved that he had no issues. His nurse was going to call me whenever he woke up and was hungry and I went back to my room to rest. The day dragged on. Around the time I expected his nurse to call, my nurse, also named Shannon, came in to tell me that they were actually bringing him up to my room! Yay! So he was finally with me. He was under the UV lights so we couldn't take him out for too long. Also, for some reason, the IWK has this rule that parents can't take out their own baby from the incubator. OK, I can see that maybe some parents would have problems, but I think they should let parents who have been to through the NICU take their own babies out. Anyways, despite the annoyance of having to buzz the nurse every time Isaac wanted to feed, we had a pretty good night and he did pretty well. It was nice to finally get to know our little boy. We found out that he was a squiggly, restless sleeper, always moving around. He actually managed to wiggle his way to the top of his little mattress in the incubator and his head fell off of the pad! Again, I didn't get much sleep.

Morning came and when the OB resident did her rounds I asked if we could go home. She said that she didn't see why not. I was doing well, IV and catheter were gone. Isaac was also doing well, he was out of the incubator and not under the lights anymore. I think that because the ward was so busy, they were happy to let me go and free up the room. Getting everything ready for our discharge took pretty much all day. There was paperwork to fill out, Isaac's newborn screening, his hearing test, and finally we were ready to go. He looked so tiny in his car seat. Walking out of the IWK was pretty surreal. I was still absorbing the whole birth experience, that I couldn't believe we were going home with our baby. He was actually out, he was now a person in this world, no longer in his watery home within me. Coming home was just what the doctor ordered. Ken thought it was a good idea to rent a hospital bed, which turned out he was right. It was the only way I could sleep comfortably. Just as in the hospital, Isaac continued to sleep restlessly, so I just kept him in bed with me and we were able to sleep peacefully, finally. The next days were spent getting to know Isaac and how to best keep him happy and comfortable. I was in constant pain, so I was happy to have my Tylenol 3 and Ibuprofen. But sleep and being home helped and every day I felt a bit better.

Well, the days turned into weeks and now 7 weeks have gone by. I feel about 90% better. I think the last 10% will take a long time. My incision site is still numb and sore and my muscles protest when I try to sneeze or walk fast or some other things that require my lower abs moving. But it's all OK. I think also I have finally absorbed the reality of everything that happened. In the beginning I couldn't help but feel bitter about the loss of the birth experienced I wanted. Even though I didn't want to feel bitter or mad, I couldn't help it. But we can't change what happens and there are definitely no "what-ifs" so I can't do anything about it. All I care about is that Isaac is here, safe and sound...and I love him oh so very much!

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