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Tuesday, February 2, 2016

Birth #3 - Induced

I have had 2 natural labor/deliveries in the past, and this was 'planned' to be no different, meaning I fully expected to go into spontaneous labor on my own, and have the baby at the hospital this time (because baby #2 was born in the car), with as few interventions/medications as possible.  The weeks leading up to the due date were full of a myriad of differences from my last pregnancies, and a considerable amount of pain. You can read about them in the previous post - Pregnancy #3.

Monday, January 25, 2016, I woke up before 3 am with some contractions that were mostly in the front of my belly. After so much back pain recently, I welcomed gladly pain in the front! They continued, got longer, most lasting around 2 minutes, but stayed around 9-12 minutes apart. However, all my movement in and around our bedroom woke up John, so he started being comforting as we both hoped this was the real deal. At 6am, they were bad enough that I called my mom and asked her to come over to our house instead of going to work, because she had decide to take 2 days off in order to help with the kids.  Right after I called her, I laid down to rest a second, and the contractions stopped. I had one more small one twenty minutes later, then I just felt exhausted again, so I called her back around 6:40 and told her to just go ahead to work, false alarm again. John was also exhausted, but needed to go to work in order to have his 5 days off when the baby came, so he had to get up, get ready and go.

Frustrated, a little sad to have had false labor again, 5 days overdue, and extremely exhausted, I saw him out the door, made breakfast for the kids, and then had a morning of movies while I dozed in our big cuddled recliner between the kids.  I woke up to make the kids lunch, and put them down for a nap. I took a shower, did make up, and made coffee to help myself wake up a little more.  One of our good friends from church came over to stay with the kids while I went for my doctor's appointment.  I had to have an ultrasound and non-stress test because I was overdue.  I was honestly not looking forward to this.

I went in ready for them to tell me the baby was measuring large and to try to convince me to induce.  I was prepared to argue for waiting on the basis that I was not afraid to deliver a large baby, and lots of recent research proves that ultrasound can be off by up to a pound either way, and I would wait to go into labor spontaneously until I hit 42 weeks.  I was surprised and taken completely off guard then when the ultrasound tech did not even mention the size of the baby, other than to say
"Baby looks good, great heartbeat, all the organs look great." However, she did throw some brand new information at me, "Your fluid is very low. The doctor will probably talk to you about inducing." Confusion washed over me like a cold shower, and I started asking questions,
"What does that mean? How much fluid should I have? How much do I have? Can that hurt the baby?" She answered calmly and politely,
"Baby looks good, healthy and fine, so it's not affecting her, yet. We like to see numbers above 10, but we will take as low as 8 when you go overdue like this. You're at a 6, so the doctor will talk to you about inducing."
I took some deep breaths and went to get hooked up to the non-stress test, where they monitor baby's heartbeat for twenty minutes. I prayed about all this, and sent a few text messages out asking for prayer, and then just gave it to the Lord and waited to see what the doctor would say. I had asked God to keep the baby healthy despite my pain, and He had. Baby was ok, and that was very reassuring.

I had some terrific back pain in the days prior to this, and now it made sense. My fluid was so low that the baby's skull was literally resting very close to my spine and just bumping nerves all the time.  It made sense that some of the back pain was sharp and electrical feeling while some was just constantly aching. I had asked God to know why this was painful, and now I knew. I looked smaller and gained less weight because there was so much less liquid.  I remembered with Karis they did an ultrasound at 37 weeks because I was measuring "large," and my fluid was at 17 or 18, and they had said that was a lot. I remembered the huge gush as my water broke in the car with her.  I thought about reading birth stories where a woman's water was broken hours before labor and how sometimes it led to a more painful "dry birth," and I didn't like the thought of that.

Her heart rate bounced around between 120 and 160 and they were happy with all that, so they promptly removed the monitors at the 20 minute mark and the doctor came in shortly afterward. He examined me and said there was definitely not a leak in fluid, I was still dilated to slightly less than 2, and since there was no leak, it meant the placenta had stopped doing its job. He said that when the body goes overdue and fluid gets low it means the placenta has basically quit, and although it doesn't harm the baby much, the fluid will not replenish, it will only continue going down, until a "dry birth" is likely.  He said we needed to induce the next day.  I was still a little in shock, and kept frowning and saying, "I just didn't want to induce." to which he would answer, "I'm really sorry." However, when he said I needed to come in the following day, it was to Huntsville Hospital. That made me even more uncomfortable, because I had only great experiences with Crestwood, and did not want to make this new territory in birth even more new. I expressed my concerns, and he explained the only reason he chose Huntsville was because he had an 8am surgery there, and he didn't want me 15 minutes down the road if he was still in the middle of surgery when I needed to deliver. I understood, but my response was still, "If I MUST be induced, then I ONLY want to do it at Crestwood." I have read enough and been through labor enough to know that my personal comfort level/anxiety level is a huge factor in labor, and I did not feel comfortable switching locations now. He frowned now. "I really don't want you to wait 2 days." So I offered,
"I can come in this afternoon to Crestwood. Would that work?" He thought a moment and said yes. It was almost 2pm. He asked if I could be there by 4pm. I thought I could. It was set. I texted John all the info, and thought about how he had been up since 3am with me, and had not had a nap. Poor guy.

On the drive home I prayed about this some more, and felt total peace.  This was not me going in and requesting an induction because I couldn't stand the back pain. This was the doctor saying it was medically necessary to induce. Being induced had always scared me because of the stories of how bad pitocin contractions are, and how most people cannot continue to go without an epidural. However,  my doctor said he had plenty of patients who were induced and continued to go without an epidural.  I only have one friend who has done this, so hearing him say he had 'plenty' was more reassuring. I don't know you - women of the 'plenty'- but I am thankful for your story, and it gave me hope.

I went home and carb loaded for my marathon ahead, eating gluten free spaghetti leftovers, a banana muffin, and had another cup of coffee. My bags had been packed for weeks, so I just threw in last minute items and put them by the door. My mom came to spend the night with the kids and keep them for the next 2 days. John came home and we left.  Agreeing to be induced, and showing up 2 hours later for it is a fast turn-around time.  My doctor said that since it was my third, he felt that once I hit 4 cm, the process would "fly." That was hopeful as well.

We were checked in to the exact same room we had been in for false labor almost a month earlier. It was calming to be somewhere familiar, and I was very happy that I had stood up for myself and insisted upon Crestwood. We saw a few of the same nurses, and a few new ones.  When we had come in for the false labor, our nurse had given me a hospital gown, but said, "Unless you have your own you'd like to wear?" That day I had forgotten that I had my own, but walking around in the bottom-showing, scratchy hospital gown for several hours, reminded me to go home and pack mine. I put on the little Old Navy maternity dress, that is either truly a night gown or a swim cover-up, but not a 'real' dress, however, the color is one that makes me happy, and it was very soft, and covered my behind most of the time.  No one said a word about it, and I was thankful again to the Lord for giving me the false labor to be reminded of this one thing, because in labor - comfort is power!

Last belly picture, before getting induced in the hospital.

I put a few drops of essential oils on the shoulders of my 'birthing dress' to help me take deep, calming breaths. I put 2 drops of peppermint on one shoulder and 2 drops of lavender on the other shoulder. This is far easier than using a diffuser when away from home. If I needed the scent to be stronger, I just turned to that side.  I reapplied the drops once, several hours in. At one point during labor I did feel the need to pee, but couldn't, and putting a drop or two of peppermint oil in the toilet fixed that problem immediately.

Without even having to request it, the nurse said, "Oh, you'll want the wireless monitors. Let me go get them for you." That was also a huge blessing, because in labor, you need to move around a lot, and being confined to the bed is far from ideal. The wireless monitors seemed to work great all over the room, but I'm not sure if they would have worked in the hallway, I didn't try.

I hate needles. Getting the IV with the catheter in my arm was by far part of the worst of it all. I had to have it for the pitocin and the antibiotics, because I was Beta Strep positive again. There was also a bag of just 'fluid' up there on the pole. Having that in my arm was very uncomfortable the entire time. My first nurse for the evening explained how the pitocin induction process worked - with them starting me out at 2 (I don't know what measurement - 2 somethings per minute), and every fifteen minutes they would turn it up more if I was "comfortable" with it.  She said she felt like 6 was a good number to stay at for a while, although some doctor and nurses seem to think it's OK to turn it all the way up to 30.  I don't remember feeling anything with it on 2, so I was happy to get to 4, which started some itty bitty short contractions, and then at 6 they did increase to lasting almost 20 seconds, but still at least 4 minutes apart. I was happy for them to keep turning it up until we hit 10. I worked with level 10 for about an hour before I said, "Ok, let's try 12." Romans 12 is my favorite chapter in the bible, and talks about being a living sacrifice, and for some reason, I felt like 12 was where it needed to stay for a long time. I thought about how to worship through birth. I tried to sing along to some of my music, but decided that it was worshipful to just focus on the task at hand, pray for strength, and stay kind to everyone around me.

Here's also where I feel like God was all over the timing of this process - my false labor that very morning gave me a true sense of how my own body ran contractions. For three hours I monitored their length, I knew how much my body would put me through on its own, and how much I could stand, and now this knowledge gave me confidence in how much I was going to allow in the pitocin. Isn't God cool like that? Because pain is something you don't always remember details of - so having false labor that morning gave me a specific starting point.  At the end of it all, when the doctor asked me,
"Was that as bad as you thought it would be?" and I said,
"No," he then told me,
"Yes, contractions are contractions - whether they're natural or pit, or whatever, people shouldn't be so scared of it." Says the MAN who has never had one contraction. Also, I don't know what would have happened if I had let them turn it above 12 - I don't want to think about 30! This is one of the few things I do disagree with him on, because here are the differences in my natural contractions and the pitocin synthesized ones (in case you were interested in being induced after going natural a time or two):

Natural contractions for me begin and end more gradually - like they creep up the front of my belly before taking over as a big huge total core squeeze that sometimes wraps around the back, sometimes not, and then they fade away as well.  This is where some people compare them to waves that wash over you and recede. It's like they begin on a pain scale of 5, then cap out at like an 8 or 9, and then fade away again, sometimes down to 1 or 2 in the beginning, but as labor progresses, the pain does not completely go away between contractions, but stays somewhere between a 3 and 5.

The pitocin contractions began and ended rather abruptly - it was sort of like 'all or nothing' with them. Pain scale ranging from 2 in between contractions, to suddenly being a full on 7-9, lasting it's length and then suddenly stopping again. I do not believe this would have changed had I let them turn the pitocin up any higher.

Natural contractions lasted much longer for me - averaging 2 minutes, but going up to 3 minutes several times as well. I remember that with my other two labors, and had that experience that morning, which was one reason I was so shocked it stopped - I mean having a three minute contraction should turn into real labor! Then they would also wait several minutes apart and gradually build up to coming closer together.

Pitocin contractions never lasted much more than a minute, even after several hours.  They also came a lot faster. 30-50 second long contractions, that were about 1 - 2 minutes apart for several hours is what I experienced on level 10 and 12. Had I let them turn it up higher, they may have lasted longer, but their intensity and speed were enough to keep me happy with their duration.

After 3 hours, and getting up to pitocin level 10, when she checked me and I was at 3, we were rather disappointed and that was when I let them turn it up to 12. After an hour of that, she checked me and I was at 5. I do want to say that my nice little nurse was always very respectful and gentle when checking me, and waited for contractions to end.  She was a gem, and spent a lot of time in the room with us, bringing me ice water (they encouraged real drinking! - not just ice chips), and anything we asked for.  She suggested a cool washcloth on the back of my neck when I started getting hot, and that was nice for a little while. She told us that my doctor wanted to know when I was at 6, and he would come up to the hospital and hang out until the baby was born.  After an hour of some longer contractions, that now seemed to come about a minute apart, we asked to be checked again, and she informed us, almost apologetically,
"Almost the same, not yet to six. But I can tell it's getting harder for you, so I am going to call your doctor and let him know." He came in shortly after that, watched for a few minutes and commented nicely,
"You have excellent pain control. You're doing a great job."

It was probably around 11pm, and John and I were both getting really exhausted. I did not want to be checked again and told 5, so I decided mentally to just power through it, and wait for my water to break so I could push.  Now, with Jonah (my first), I got very nauseated right at the end, and throwing up made my water break. After the water broke, they checked me and said I was at 10, to wait for the doctor, but I never felt the urge to push. I think my body wanted to rest. With Karis (my second), I felt like I was trying to hold back in the car as we went to the hospital. This sounds strange, but it was the feeling like needing to pass gas, but hoping it will be silent, and then giving a teeny tiny push, and my water broke - all over the car, and we had to pull over and have her in the Jet Pep parking lot.

Because of those two experiences, I really wanted to make my water break, and I got to the point with these rapid-fire fast intense contractions to where I realized I was pushing a little during the contractions. I wondered if that was OK, but decided not to tell anyone. I did that for an hour or more, moving around like crazy, trying different positions on the ball, on the bed, standing, lunging, rocking, squatting, always having John there to hold his hand or lean against him. I had my music on, I had read my encouragement cards and scripture so much the day before, I only read through them all maybe twice in the hospital. I told John, "Tell me it's almost over." So, he would try to say that every now and then and be as encouraging as he could, being so very tired, and not really having an encouraging spirit. I think around midnight we were both shocked that we still hadn't had a baby yet, and so very tired. I asked the nurse to turn the pitocin back down to 10 because I felt like everything was getting a little too hard to take. I think we were getting close to 'transition.'  I felt like the room was darkening around me, and the pain was getting very intense, like I wanted to bite something and scream. At this point, had a large birthing tub been available, I would have probably spent the remainder of the time there, and I believe it would have been a shorter time. Alabama really needs to get on board!

At the end, I was kneeling on the end of the hospital bed, and John was sitting on the ball in front of the bed (because he admitted he was absolutely too tired to stand up), and I had my head and elbows in his lap, with my behind up in the air, and he was hugging my upper body and holding my belly through each contraction. I had done this sort of position near the end of labor at home with Karis, just pushing back into a downward dog yoga position, so I felt like this meant we were close. I was still pushing just a little during the contractions, and starting to moan very loudly. In labor with Karis, my awesome doula Hannah had taught me to open the mouth wide and make low sounds - because, little high pitch shrills with a tight mouth do not help the body/uterus to relax and open. I remembered and followed that advice the whole time - wide mouth, low noises, volume doesn't matter, as long as it's not high pitch. Suddenly, I realized the pain was not going away between contractions at all - it was staying a hard, high 8 or 9 on the pain scale (I hesitate to say 10 because I always feel like it's bad, but could probably get a little worse) - and I felt a little dizzy with my head down. I realized I was trying to push harder hoping to break my water, and I felt hot all over, and pictures of babies born with their water intact popped in my head and it occurred to me that I might be ready to push even though my water had not broken!

I decided to go with that, and began saying loudly, "I'm ready to push. I'm ready to push. I'm ready to push," and I just started moving back up in the bed, raising the head so I could sit up all the way. The nurse said, "I need to check you then," but I was not really cooperating well, because the contractions did not feel like they were stopping, and so I think I was laying on my side, gripping the bed rails, growling, and she checked me and said, "Yep!" and ran out of the room, and came back with the doctor, saying, "She's at a high 8, maybe 9, very soft though, but she wants to push." This woke up John fully, and he was standing by me, saying very honestly now, "It really is almost over, babe. Almost over. You can do it." The doctor just nodded, pulled up a seat, and I started pushing and yelling like crazy!

I pushed really hard, and my water broke, and then her head started immediately coming down, and I was yelling a lot. John said he thought it looked like the doctor was pushing against me, holding his hand down just under where her head was coming out, and I think that counter-pressure low did help me to tear much less. However, it also slowed me down just a little, because her head was out and I stopped a second to breathe. She was already screaming, and I felt like I was coming out of a big black cloud of pain. The doctor told me to push one more big time and she'd be out. I did, but I don't know if I was too tired or what, I didn't get that huge rumbly, bones and baby leaving my body feeling like I did when Karis was born all at once.

Then it was all better.
I felt like the lights got turned back on in the room, but they had never been turned off.
Josie Faith was born at 1:09am, Tuesday, January 26th.

The miracle of birth is so crazy that the second that kid is out, your mind clears from the pain fog, and all these amazing happy hormones flood your brain, and no matter how tired you were, you are suddenly wide awake like a red bull was just shot up in that IV! They held up her little wiggly, wet self and gave her to me. The doctor let the cord stop pulsing, and I don't know how long that took because I felt like I was holding this little baby outside of time. I remember feeling like that after the other two. It's this wide-awake dream-like I can NOT believe that just happened feeling. I don't know when I delivered the placenta, but it had a lot of white stripes/streaks that I do not remember seeing on the other two, so I wonder if that had to do with it 'quitting.' I did not get to hold her for very long before the nurses wanted to suction her mouth/nose because she was sort of gagging a little. The doctor said I only needed 2 stitches, and he did that quickly. Then the shaking began really bad. I remember the violent leg shaking, total body tremors after the other two births, but I also thought it had to do with feeling cold both times. I made sure to keep my hospital room very warm this time, and it still was, and I even told the doctor, "I'm not cold at all! Why am I shaking so bad?" He just laughed a little and said, "Oh that's the adrenaline." Then he put some very warm blankets on top of me anyway, and softly pushed down on my legs, smoothing the blankets out, and that helped most of the shaking to stop.

She was 8 lbs, 5oz, and 20 inches long. One ounce smaller than her siblings. When they gave her back, John took a few pictures and then we started breastfeeding. Every prayer, answered. I was induced, but no epidural, no other interventions, healthy baby, healthy mama, so very thankful.

I love her little popeye nose!

Her hair is much darker than my other two kids, for now.

Christi Haney Photography - 5 days old

Christi Haney Photography - All THREE kids!

Christi Haney Photography - 5 days old

1 comment:

  1. Hi, I'm copying over all my old blog posts to a new blog and I found your comment on one regarding when I did the 31 Days of Communion post, so I thought I would pop over. This story was very encouraging, I'm 9 weeks out from having my 2nd and the first birth was terrible and ended in a C-Section. I'm not sure what they are going to want to do with this one as I've just been diagnosed with Gestational Diabetes, but this helped to remember God is in control of all the little details. While I was praying today I felt to write out what I wanted in a birth and that helped too. Blessings, I hope you're enjoying some time with your new baby.