Tuesday, December 18, 2012

The Birth of Jude Allen - Part Two

Read part one.

I had mentally prepared myself that, if induced, it would be a long labor to a vaginal birth. I based this on my family's history of not progressing and the fact that I started with an unfavorable cervix. For some, an induction means having a baby the same day. Well, not for me.

Early the next morning, I felt the exhaustion set in. I had not really slept the night before the induction since I had contractions about every 15 minutes from my acupuncture that afternoon. So, I was going on about 48 hours with no sleep, except for very short naps. To say I had a meltdown would be a big understatement.  All I wanted was sleep. I began to think about getting an epidural.

My wish had originally been to have a natural birth but, when I agreed to labor augmentation, I knew the chances were that I would eventually want an epidural. For a brief moment, I felt like a failure. We weighed the pros and cons of this intervention. We asked questions. Talked to our doula. I got it.  The anesthesiologist administered it at 5 am on Thursday morning. With the epidural, I also had to be put on IV fluids, which I had declined up until this point.

While we were waiting on the anesthesiologist, I took advantage of my last opportunity to be on my feet.  I stood, facing Stephen, with my hands on his shoulders and head on his chest and we just rocked. I have no idea how long we did that - it seemed like forever. It was one of my favorite moments of labor. I wish I had a picture, but during the wee hours of the morning there was no one there to take it.

The epidural took the edge off the contractions and I slept of and on for a few hours. I was checked around 6 am and was still only a fingertip dialated, but 90% efeaced. While being checked, my water broke, which I was upset about. I knew that would put me on the clock as it increased my risk of infection. They also gave me another dose of miso, as my contractions had spaced out to about every 7 minutes. The medicine increased my contractions back to every 2-4 minutes.

I napped off and on until around 10 am.  Sometime between naps my doula called and we talked about the probability that "c-section" may be mentioned soon since my water was broke and I wasn't making much progress.

At 11 am, the doctor came in to check me and talk to me about our options.  I immediately began to tear up, fearing they would want to do a c-section. But, she knew my feelings about that so she started with, "I think it is too soon to talk about a c-section."  She said she wanted to check me and get a little more agressive by starting pitocin.  She also said she did not want me to be pregnant on the 19th, considering how long I had been off of blood thinners and that my water was broken. I did not like that I was being put on a time frame, but was thankful for her honesty.

So, she checked and I was 1 cm and basically fully effaced. Meaning I still had a long way to go, but now my cervix was favorable enough for pitocin.

The pitocin began and they slowly increased it all throughout the day trying to get me to 3 contractions within 10 minutes.

On oxygen when Judes heart-rate began to slow.
So far, Jude, (who I did not know was Jude at the time) had been doing great. His heart rate looked wonderful and he seemed to be happy. However, after starting the pitocin, we noticed he was not happy when I laid on my right. So, I stayed on my left and was put on oxygen. This caused the medicine to pool on my left side, which meant the epidural was not working on my right side.

The doctor retuned to check me between 4-5 pm. I was dilated to 4 cm!  This may not sound like a big deal to you but, in my family, the women have a history of not dialating. In fact, just a few weeks before I had Jude, I was at a family function where I was told to be prepared that I would not dilate, since this is probably a genetic thing. So when the doctor told me I was 4 cm I almost cried. I said, "I broke a family record!" I am sure she's never seen someone so happy to be 4 cm.

The plan was to check again at 9 pm, at which time I should be 7-8 if my progress continued.

In the meantime the pain on my right got worse. Much worse.  I was having a hard time working though contractions and was wishing I could get up and move though them.

We could not decide if this was from the medicine pooling on my left, or if it was just a hot spot (a hot spot is a place where the epidural just doesn't work at all). Upping the epidural (which was at the lowest dose I could have) was not an option for ether of these. So, we decided to try my right side once again.

I turned to lay on my right, and Jude's heart rate began to decelerate   So,  Patricia and her assistant, Gloria, began pressing pressure points on my legs and feet. As they did, his heart rate immediately picked back up. They continued to apply pressure and massage my legs to help improve my circulation (I had begun to swell) as I worked though contractions.
Me, Patricia, and Gloria
Patricia took such good care of me!
On my right side, the pain did not improve. In fact, the "hot spot" began to grow and soon I could feel my entire right side and some on my left. At this point we called for the anesthesiologist. Of couse, he was in an emergency c-section at the moment.

About 7:00 I began to feel like my catheter was slipping down with each contraction. When we began the pitocin, I had a catheter inserted past my cervix that recorded the strength of my contractions. I told those in the room that I felt like my catheter was slipping out. But, the nurse checked and said it was still in place.

I continued to feel like that catheter was moving down with each contraction. Just a few minutes before 8, I told my doula I was feeling funny. I think I said something like, "I know this sounds crazy, but I am kinda feeling the urge to push."

She said, "You should probably call your nurse."

I did. They summoned a doctor to check me. I was FULLY dilated.

About that time the anesthesiologist showed up. But, of course, there was no adjusting or upping the epidural at this point.

Stephen, Dayle, Patricia, and Gloria (my doula's assistant), gathered around me and Stephen lifted up a prayer of thanksgiving and continued protection to God. It was such a precious moment.

Stephen holding my hand while he prays
Also notice the popsicle in my other hand -
I deserve a reward for how many popsicles I ate!
The nurses and doctors left for a while and my doula had me doing some exercises to help the baby come down more. With each contraction, she had me play tug of war using a towel. During each break of tugging I ate on a popsicle  I think I ate 26 popsicles during all this.  I would eat on my popsicle during my breaks, then pass it to Stephen (or someone else) to hold while I did the tug-of-war thing.

Around 11 pm (I think) the nurse returned and I began doing more directed pushing. I remember looking at the clock and thinking, if this baby wants its own birthday it only has an hour (my sister's birthday is the 19th) and I also remembered what the doctor had told me that morning about being pregnant on the 19th. I thought it would be close.

I think the doctor was called in around 12:45am. I honestly don't remember for sure. But, I do remember that as soon as she came in I saw all 26 of those popsicles again. Someone told me that was a good and normal thing. Yuck.

So, this was it. I knew about the whole breathe your baby out and let your body do the pushing thing, but it did not matter. I wanted it done. I pushed. A lot. And HARD.

He arrived at 1:04 am. Stephen was to announce his sex, so as he was lifted up and over to my chest he said, "We have a baby Jude!" We had a son.
The pic is blurry, but notice the clock.
Jude had just been born and placed on my chest.
We have a son.

Stephen seeing his son for the first time.

Our first family pic

I love this picture.
Look at Patricia's face. Can you tell she loves what she does?

I was surprised he was a boy.  I honestly had begun to expect a girl. My mom and sister had me basically convinced. I had dreamed of our firstborn being a boy, but did not think it was so! Poor guy, I am pretty sure I told him all that while I held him on my chest - "I thought you were a girl, but I am so glad you aren't!"  There was much rejoicing in that room. Then Stephen got to announce the birth to those in the waiting room and there was much more rejoicing.

Watch Stephen announce the gender in the waiting room by clicking here.

Jude was born October 19th at 1:04 am. He weighted 7 pounds 7 ounces and was 19.68 inches long.

I ended up with almost as many medical interventions as I could have had without surgery. But, by the grace of God, I  have no guilt and regret. The staff at Shands were so accommodating and followed every other aspect of my birth plan without hesitation. Things like delayed cord clamping, no shots, no eye ointment, no bath, no bottle/pacifier, and they let me forgo IV fluids (until I go the epidural). They were even prepared to let me labor in water, even with the pitocin, if I had not gotten a epidural.

All in all, I am just so thankful to have a  beautiful baby boy. God's grace to us is undeserved, but so amazing.

The Birth of Jude Allen - Part One

This story really began over two years ago, when Stephen and I first decided to add children to our family.  If you are unfamiliar with our struggle with pregnancy loss you can read more here.

My last prego pic - the evening before I was induced
At Satchel's Pizza in Gainesville
My pregnancy with Jude was textbook (other than the fact that I took heparin injections twice daily to keep him alive). I had minimal amounts of nausea, tiredness, and other symptoms. I felt well overall.  I even continued running until somewhere around 28-30 weeks.

Due to my "high risk" condition, my doctor wanted to induce at 39 weeks. I am "high risk" due to a condition I have - Antiphospholipid Syndrome. I, however, was not on board with induction.  I had hoped for a natural childbirth. When we lived in Loisuana we were even planning for a waterbirth. Sadly, I could not have a waterbirth here in Florida as I would have to be in a  birth center and I am too high risk to be taken by one.

So, I knew there would have to be some compromises. After our long journey, I wanted more than anything to finally hold a living, breathing child. But, I also wanted to aviod a  c-section. I knew that every medical intervention increased the chances of surgery.

My doctor agreed to wait until 40 weeks for an induction assuming the weekly stress tests I was having showed everything to be well.  Jude scored a 10/10 on every stress test, so we waited.

I did all the natural labor inducing methods you can think of, well, except castor oil...I drew the line there. But I tried EVERYTHING else. I even went to the chiropractor and did three rounds of acupuncture.

I was scheduled for an induction on Wednesday, October 17th. I had a doctor appointment the day before. I went into that appointment thinking I would fight to move the induction back to the following Monday. We talked in detail of the plans for induction - what we would do if I failed to dilate, if the baby distressed, etc. Honestly, my doctor was willing to try everything to aviod a c-section (well, except for taking the risk of waiting any longer).

She did not want me to wait until Monday, but she told me that I did not have to show up for the induction. She also told me that they had reserved the room for me that would accomodate an inflatable tub so that I could labor in water.  Yes, they were going to let me labor in water even WITH and induction! In addition, they had arranged for several nurses who were natural birth minded to manage my labor. Stephen and I left the doctors office with a lot to think about. I had my last accupuncture session that afternooon, so I was still hoping to go into labor on my own maybe that night.

The accupuncture did give me contractions ALL NIGHT long. They averaged 10-15 minutes apart, and kept me pretty much awake all night.  After much thought, we decided to proceed with the induction.  My doctor and the hospital staff had went to alot of trouble to set up a birth as close to what I dreamed of as possible even with the induction - I was not promised they would go to that trouble a second time.

We showed up to Shands at UF at 6:00 am. I was 70% effaced but not dialated at all. We began with medicine to ripen my cervix before starting pitocin. They started me with a dose of misoprostal. When they hooked me up to the monitor they commented on the fact that I was still having small contractions (from the accupunture). The first dose of miso amped up my contractions and had them coming every 2-4 minutes lasting 30 seconds to a minute... and the fun began.

My doula, Patricia, visited that evening. She brought me a birthing dress, snacks, and other goodies. She posted positive messages all over the walls of my room and a sign on the door. My favorite message was the one that read "I accept this labor as my labor and believe it is the right labor for me and my baby." It would have been so easy to be envious of friends who had intervention-free births, water births and home births. It would have been easy to get frustrated with my slow progress. Thankfully, by the grace of God, I was reminded that my labor and delivery was not like anyone else's. In fact, it was sheer grace to even be in labor with a full-term baby.

The door to my room. Extra note added by Stephen.
I continued having contractions every 2-4 minutes for the rest of the day and through the night. As long as the contractions were coming that fequently there would be no more miso, for risk of hyperstimulation. To work through the contractions I used the birth ball and leaned over the bed. That evening one of the midwives came in and set up a tub.  I labored for several hours in the tub through the night.  I tried to nap between contractions. Needless to say, there was not much napping to be had. Also, despite the regular contractions I wasn't progressing much - I was only dilated a fingertip.

On the birth ball texting updates

My sweet husband decided to document the whole labor/delivery by writing a letter to our baby telling them about their birth. As he updated, he would read them to me.

To be continued.....