Fiona's Birth

And now for the long version...

Like I said in my last post, I was awakened in the middle of the night, early on August 14th, with contractions that were strong and regular, but not that frequent. They built in intensity and frequency slowly throughout the day. Slowly enough that I called my mom before she left for work in the morning to let her know she could now begin to get excited (every other time something would happen, I would call and tell her, "Don't get excited, but...") and that we would call her when it was time to head up to our house. At little before lunch we went to the grocery store, but nothing was appealing there, and it was a bit uncomfortable to be walking through the meat department and have to lean over the steaks and ground beef and breathe through a contraction. So, we went out to Macaroni Grill and had delicious pasta while we wrote down the times of the contractions on the paper table cloth. It was fun to do that because I was convinced they were going to go away despite how strong they were. I kept saying to Dan that they were too far apart and this wasn't labor and he would just laugh and tell me how often they were coming. At this point they had been about every 5-7 minutes for over 6 hours...not active labor, but no sign of slowing down, either.

When we got home, we took a walk on the beach, and that's when we really started getting down to business. It's a two block walk from our house to the little community beach that opens out onto the bay. It took a while to get down there, and even longer to get back. We took Cocoa, and Dan started timing the contractions consistently. Dan would throw Cocoa's toy in the water, and every four minutes come back and sit with me through a contraction. I sat on a park bench for a while and tried to carry on polite conversations with a couple of dog owners who were very sympathetic. We walked down to the end of our little beach and by that time I was starting to moan through some of them. Dan started to rate the contractions as well as time them, to see if they were getting generally stronger. What can I say? We're both nerdy that way, and it was encouraging to look back over his little scrap of paper and note that the contractions had gone from a 2 to a 4 in the past hour, and had averaged 3.5 minutes apart. Halfway down the beach I said goodbye to the last of my lunch, which I tried to catch in a little doggie bag. It didn't fit :(

We made our way slowly back home and they were getting strong enough that I felt a little panicky during some of them. I had to really start concentrating on relaxing my body through the contractions, and consciously felt the different muscles in my body working and then relaxing. When we got home, I wanted to try something to distract me, so we set the birthing ball up in front of the computer so I could do some emailing. It felt HORRIBLE. I couldn't handle the pain sitting down like that. Dan propped me up on my hands and knees on the couch with tons of pillows under my belly and chest to support me, and that was manageable. At this point, as it was getting dark, Dan had to support me through each contraction, sometimes holding my hands, sometimes rubbing my back and giving counterpressure. When I changed positions, he sat behind me to hold me up or stood in front of me and let me lean on him. I talked about what I was doing mentally that was helping me cope with the contractions, like focusing on feeling the contraction start, build, peak, relax, and then fade away, and Dan totally came through by talking me through them. I would be moaning and feel my voice getting higher with the pain and Dan would moan with a low voice and bring me back down. Every contraction he was there, talking me through it, speaking to my whole body, helping me relax into each contraction. At some point during all of this, Dan's brother Eric arrived, and was moving his things in. I really don't remember much of that, though, and I don't think he stuck around for long.

Sometime late in the evening, I felt like I was finally able to say that this was labor. I continued to eat and drink, but was also vomiting. The contractions had been consistent and also frequent for a few hours, and they were certainly painful enough, so I had Dan check me just to see if we had made any progress. Still 3cm, but I wasn't discouraged because I had thought all along this was going to take a good 24 hours at least. I thought, ok, so it will be tomorrow afternoon before we have a baby, probably. I moved to the shower at Dan's suggestion, to see if that would give me some relief, and IT WAS AMAZING! I was so thankful for our new bathroom. The warm water came out of this semi-rainshower showerhead. It covered my back, and I leaned over the stool we have in the shower and it ran around my belly and the pain all but went away. I was still having the contractions every 3-4 minutes, but I didn't even have to concentrate to deal with them. I LOVED the shower. I even shaved my legs! I was afraid of using all the hot water, though, and not having any for the tub, which I thought I might want later when I got tired. I went ahead and filled the tub with what was left of the hot water, and Dan got our huge crab pots out and started to boil water to help keep the tub filled with warm water through the night. The tub was not so magic as the shower, though, and you can't exactly boil water for the shower. So, when the water started to cool, I got out, and went back to working on the contractions.

My memories start to get fuzzy here. I went back and forth to the big room and sat on the edge of the couch, or got on hands and knees, tried the same thing on the bed, and generally was just uncomfortable in any position. At some point I realized I'd been up for 24 hours, and thought how weird it was that time just kept passing while I was having these contractions. At some point Dan checked me again and said I was 3.5 cm--that was a little discouraging, because I was working hard and they were every 2-3 minutes all night. Later he had me get back in the tub, which seemed to help, enough that I didn't get back out this time. He kept bringing in more warm water as it cooled, and I kept moaning through the contractions. He didn't have to help me as much when I was in the tub, but faithfully brought me juice with ice and sips of honey to keep me going since I couldn't keep any food down. I couldn't seem to find a good position and kept going from my hands and knees to sitting. At some point he checked me and said I was 4cm. Ok, that was something. Not much, but something at least. He was also amazed because the cervix was much easier to reach that time, which was a good sign, and it was easy to feel the forebag of waters and the baby's head. So, I was encouraged that maybe we were going to start seeing some progress. I was just in this haze of contraction and rest, contraction and rest, but I thought I can do this if it's working.

Sometime around 5am, though, I started to feel the urge to push. I was positive that it wasn't time to push, and a little worried about this. Dan was napping on the floor between contractions and waking up to help me when I needed it, and after a several of these really strong urges to push came and I was unable to keep from pushing, I had him page the midwife on call. It hadn't been long since he had said I was 4cm. JoAnne listened to me push through one contraction and said we should come on in to the birth center. Before I got out of the tub, though, in one huge contraction that made me push so hard, I felt a POP! and my water broke explosively. Quick check of the doptones was great, fluid was clear, and we kept going. Dan packed up a few things while I got myself out of the tub and dressed, and we made the ten minute trip with a little more speed than I would have liked. By this time I was really pushing and almost roaring with each contraction. I think this made Dan a little nervous because he was speeding a little on the way and I was yelling at him to slow down because this baby wasn't gonna fall out when I was four centimeters! Poor guy. It was the first time I yelled at him all night, though :)

I called my mom to tell her what we were doing and had to give the phone to Dan because I had a contraction almost as soon as she picked up. They made arrangements to be picked up by our friends Ray and Kathryn from the airport, and they arrived at the birth center an hour or two after us. My sense of time at the birth center is really out of whack. When we got there and got settled in, Tammy checked me and I was 5/100/0, which was really encouraging to me. Five centimeters dilated, so halfway there, and 100% effaced, which meant my cervix wasn't swelling yet from this pushing. So, we worked on positions. Usually this early urge to push is from the baby being positioned backwards in the pelvis, or OP (occiput posterior). Amid my roaring and pushing through the contractions, Dan and the midwives, David and Tammy turned me in order to try to turn the baby. We tried hands and knees for a while, we tried lunges for just a little bit, we turned me on my left side with my leg supported so that I was almost laying on my belly I was so far over. Eventually, but before my parents got there, I was checked again, and I was 7cm, still 100% effaced. No swelling, despite all that pushing. I was so encouraged. It was the first time that I thought, "Wow, this child might actually come out of me here in this room. I'm really going to do this!" Dan and I were both elated and we moved me to the tub to see if I could get a little more control over these contractions and try not to push.

The contractions, though, got stronger still. They changed. They became this force that I could not reckon with. I just held onto Dan, staring straight into his eyes through each one. At some point my parents came in and said hello, even my Dad, poor guy! I tried to breathe through each contraction. I would feel it rising in me, and would relax my legs, my belly, my shoulders, ride it up, and feel it wash over me, but then it would take over and I would let out this ROAR and bear down like she was coming out any second. I would try panting through it, long slow breaths through it, no matter what, it would take over every time. Another while longer and we checked again. Still 7cm, and now a little swelling on the top of the cervix.

There was no way I was going to dilate fully and be able to push the baby out if I couldn't stop pushing too early, so we decided to go with some IV medication to give me some rest and my best shot at doing this at the birth center. I already had an IV in place for my antibiotics and hydration, so I got out of the tub and into bed, laying on my left side, and got Stadol, a shot in the muscle and in my IV, with some phenergan, both of which will make you sleepy. The hope was that I would be so sleepy that I wouldn't feel the urge to push during my contractions. I did get some rest, but not enough. I fell deeply asleep between the contractions, woke up to push uncontrollably with each one, and feel asleep again immediately after. And the whole time Dan was laying there beside me, holding my hands through the contractions, and sleeping between them with me. An hour or so later, my cervix had swollen so much that I was back to 4cm. The only option left was to transfer to the hospital for an epidural and possible c-section. This had been my fear when we first paged JoAnn early in the morning, so I wasn't surprised, only disappointed.

I got dressed with lots of help, and my dad drove us in our van. I remember his huge hands helping me into the van, thinking how odd this picture was. I never expected my daddy to be there in my labor, since it's such a womanly place and he's such a... manly man. At any rate, it was immensely reassuring to have him there. I was pushing all the way to the hospital (another ten minute ride), and when we got to the (very full) parking garage, there was a bit of comic relief as my dad asked the attendant in his slow southern drawl where he should park for labor and delivery. Just about the same time another contraction rolled through my body and I let out another gigantic roar and pushed with all I had. I guess that poor lady thought I might deliver that baby in the van, so she moved some cones from around the very first spot by the entrance, and there we parked.

My daddy pushed me in a wheelchair up to the labor and delivery unit, and straight to a room they had ready for me while Dan did the paperwork at the front desk. By this time, I was feeling much more lucid, and also was feeling the frustration of having decided to get an epidural and still having to push through each contraction. I got myself changed and was getting on the monitor before my nurse could get in the room. I was ready. Let's do this. Knowing it would be a while before the labwork came back and I could get my epidural, I got another dose of stadol, which did let me nap between the contractions again, but again did nothing to stop the pushing. I finally got relief from the pushing when I got my epidural. That was around 2pm on the 15th. I slept. Dan slept. My daddy said, "The exorcism is complete." Evidently I didn't quite sound like me while roaring through my pushes :)

I had the option of just having a c-section right away when we got there, but I really wanted to give myself every opportunity to do this if I could, so we waited a couple of hours after getting the epidural to see if the swelling would go down and my cervix would dilate. I didn't need any pitocin, since I was contracting every 2-3 minutes on my own. After a couple of hours, David checked me and said I was 5cm, but still very swollen, and so that was that. We called the section, and boy was that a new experience for me. Normally there's a lot to do when that decision is made. Care maps to stamp up, a patient to shave, don't forget the TEDs and SCDs, get OR scrubs for the dad, make sure you have all your baby stuff ready... this time I just laid there. It was all done to me. No papers. Someone else to prep me. I just laid there. By then I'd had a nap, and wasn't feeling a bit of pain, so I was feeling a bit cheeky and was bantering with everyone and trying to help out where I could. Right before we left the room, the baby had a decel--the first and only one ever traced, but I was the first one to hear it, and it freaked me out a little. I couldn't see the strip, but I heard her heartrate drop and I tried to turn to my left. Of course, I couldn't feel ANYTHING below my belly button, so nothing happened. "I need to turn over now!" I'm yelling to my mom and Dan, and they've heard it, too, by now. We turn me first one direction (it's still in the 80's), then the other (still in the 80's), I reach back and open up my IV fluids, and am breathing as deeply as I can when my nurse walks in with the surgeon, anesthesia and my midwife, and the heartrate is back up. They all laugh at the baby for doing that right before we're going to cut anyway, and at me for trying to fix it myself.

Being in the OR was so different than I had imagined. I've never wanted to be the one on that table, always imagined it would feel very traumatic if it ever happened. But, I lived in that OR for two and half years. That very OR is where I learned to circulate and that anesthesiologist was the one (out of all I've ever worked with) whom I would have requested if I could have. I've known the surgeons for years, and have spent many nights sitting up with them talking about everything in life. The nurses were my coworkers and friends. I was very grateful to have such a home court advantage when it came to such a disappointing turn of events for me. Even better was the NICU staff--people I didn't really know at all, who went out of their way to make sure that I wasn't separated from the baby for longer than was absolutely necessary due to short staffing.

During the surgery, there was a mirror for me to be able to watch what was happening on the other side of the curtain. Poor Dan didn't want to look, but when it came time for Fiona to make her appearance, he couldn't help himself, so he ended up watching in the mirror with me. (He could have just stood up.) This was another piece for which I was so very grateful. Being anesthetized from the chest down, I really would have had no concept of when she was born, or that the baby being handed to me came from my own body, which is very disconcerting. The difference for me was watching the entire procedure in the mirror, and talking to the colleagues I'm seeing while it's happening. That made it real and connected for me. I saw them get to the uterus, and heard them exclaim how you could see her lips and nose sticking up, and then had one of them stick his head over the curtain to talk to me... And THEN! ~5:52pm on August 15th~ Then she was out! All gi-normous 9lbs and 14oz of her was out of me, and the relief I felt in my body! It was crazy. Even as anesthetized as I was, when they pulled her out, I felt empty and small again. She was huge!!! and so cute!! And she cried right away, while she was still on the table. The pictures on flickr that show her at birth are courtesy of David. He stayed with us through the whole process, making sure that Dan got all the pictures he should and taking pictures when he couldn't. I am so thankful for so many things that happened to make her delivery an overall positive experience, and David is a big reason for that.

So, they brought the baby to me, I got to touch her and kiss her and say hello before she and Dan went off the NICU for her to get her weights and measures. This hospital doesn't have a nursery (all babies room in with mom), but that means that when L&D is short staffed, babies sometimes go to the NICU while mom is in recovery. There wasn't anything wrong with her, and she came back in about 20 minutes due to the diligence and willingness of the NICU nurses to go out of their way to reunite us. She and Dan met me back in the recovery room, and when my hour was up, the three of us headed to our postpartum room upstairs. That was Wednesday, and we stayed there until about noon on Friday, when we finally headed home. She got a bath in our room, we went with her to get her blood drawn and get her weighed at night. She stayed with us the whole time, has never been out of our sight, and we're completely in love.

It's a little funny because each of us has fallen in love with this new third person in our life. On separate occasions, Dan has uttered some endearment, and I've responded, only to realize he was talking to Fiona. And later, I asked for a kiss and headed for the baby's cheek only to have a misplaced kiss from Dan land somewhere near my eyebrow. Oops! But those little adventures are for another post...