Tuesday, July 1, 2008

Little Butterfly's birth story

It is eleven days past the longest day of the year - both literally and figuratively. I have made peace with how it all played out. At least as much peace as I ever make when things don't go the way I had planned. For me, that is a pretty big step in just eleven days, especially for a dream I have held for more than 6 years. I suppose I could just be too busy with LB to have the energy to care that much. Fine with me either way.

It all started on Friday June 20th, the summer solstice in my neck of the woods. I had another treatment of acupuncture to help bring on labor the night before. I had also seen Dr. Wonderful the previous day and his confidence helped make me feel like I had some breathing room to let labor come in it's own time. Perhaps it was the combination or just coincidence, but I woke up in labor on Friday morning.

It was early stages and I wasn't 100% convinced it was true labor so I sent Brad off to work and took Ender for a walk in the nearby field. I got back around 8:30 or so and was more convinced this was the real deal. I called Brad at work to update him and then I called Stacey to let her know. She suggested that I ask Brad to come home for support. I decided that was a pretty good idea and asked Brad to come home. At this point I was more excited than anything and felt confident I would make it through whatever was to come. I called Dr. Wonderful's office and left a message letting him know I was in labor. Brad and I realized we would have a solstice baby. How appropriate was that?

In order to not focus on the labor, I put on some music and danced. It felt wonderful. There were some contractions I couldn't dance through, but in between I felt fine. I called Stacey again and she timed the contractions with me while Brad was on his way home. They were coming fast, but not lasting very long. Maybe every 2-3 minutes and lasting about 30 seconds. Cathy, my midwife, later said that this was probably my body's attempt to turn LB from a posterior position.

Fairly quickly, the back labor started to get pretty painful. I called Cathy to let her know how things were going and asked Stacey to come over. When Stacey arrived we decided to go for a walk. I don't think we went more than a block before I had to stop for each contraction and have Stacey or Brad apply pressure to my lower back. After another block we headed home. I had always heard that back labor was painful and that is no lie.

When we got back home, Stacey called Cathy and let her know the contractions were getting more painful. Cathy suggested getting on all fours with my rump in the air for 45 minutes to help turn the baby. I was tolerating the contractions, but needing to breathe through each one. After less than 45 minutes, I wanted to change positions so we tried the side lying position Cathy also said might help. I tolerated this position better. With each contraction I would shout for "Back Pressure!" This went on until 10:00 or so when I started to beg for Cathy to get there. I knew I couldn't get into the birth pool until she said I could. If I got in too soon, it could slow down contractions. I remember asking, "Where is Cathy? Call her again! When will she be here?" Stacey and Brad kept saying things like "Soon." or "In 20 minutes." I haven't asked, but I think they were lying. Cathy knew it was still too early.

This time was such a blur. I remember finding great comfort as Stacey brushed my hair away from my face and needing to hold Brad's hand as much as possible. They were both wonderful and so much needed throughout the day.

I think Cathy arrived around noon or so. The birth pool had been set up, but not filled. Cathy checked me and I was about 6 cm dilated. I needed to be a 7. She told Brad to start filling the pool. I don't remember for sure, but I suspect I was begging to get in. I know there were times when I cried between contractions and said, "I can't do this." Stacey and Brad would reassure me and say things like, "Yes, you can." and "You are doing it." Stacey was perfect. Brad was wonderful although sometimes he would say something lighthearted or jokingly. That just irritated me and I told him so. It was too hard to get my mind around anything but very simple statements.

By this point, I was moaning through each contraction and thankful when I would get one that wasn't as painful as most. Occasionally, I would get the urge to push. I don't know if this is normal or not, but "urge" does not really describe it. To me it felt like throwing up, but in the opposite direction. It was a reflex, not an urge. They were short, staccato kind of pushes. I wasn't fully dilated and Cathy believes it was another attempt by my body trying to get Little Butterfly to turn.

After about 45 minutes, Cathy let me get in the pool. It felt so good. I had taken a bath almost every night for the previous six months to calm my mind and my jumpy legs and had unknowingly developed my own little routine. I swayed my hips back and forth and felt the water move around me. It was very soothing. When I felt a contraction coming on, I would get in a position where someone could push on my back. Sometimes I wouldn't move fast enough because it felt so good to be more submerged in the pool and those contractions were extra painful. I was occasionally pushing during a contraction. It was about this time I started to feel a lot of fear. At first I thought I was afraid of the pain, but later I said I was afraid of losing control. Maybe it was both. Cathy told me to stop analyzing everything.

It was also about this point, unknown to me, that Cathy started to be concerned about dropping heart tones. I knew something wasn't perfect because she started checking more often, but for whatever reason, I was never concerned about LB. I knew she was fine throughout the entire labor. Perhaps I was just too focused on coping with the labor, but I think it was intuition.

At some point Cathy had me get back out of the water. She said it was slowing down my labor too much. Now I wonder if she wanted to get me into different positions to see if the heart tones would stop dropping so much during each contraction or at least recover more quickly. I got out, labor intensified and I more often felt the urge to push for brief moments.

Around 5:00 pm, Cathy suggested we go to the hospital. She said that since I felt safe enough to go into labor only after I saw Dr. Wonderful, perhaps I needed to be in his care in order to feel safe enough to continue with labor and birth. At this point I was well into transition and feeling more afraid. I hadn't really eaten since breakfast and was losing energy - although I was doing my best to drink and eat during labor. Yes, I caved pretty fast. I could get some relief from the pain and I liked the idea of seeing Dr. W. I suppose Cathy knew I would. She probably knew offering a woman in transition with back labor a break from the pain would be as easy as enticing a drowning person to take a few breaths of air.

Later I learned that both Stacey and Brad were surprised that Cathy would suggest transporting. It was that suggestion that led to me feeling at fault for how things went. I had been saying things like "I can't do it." or even crying between contractions. Perhaps if I hadn't been so afraid - of losing control or just because of the association of when I gave birth to Ernest. Eventually, I came to believe Stacey when she said that I was never that freaked out in her opinion. She has seen several births and had two of her own and she said everyone gets scared at some point - especially during transition. She gave me several examples of women much more scared, much less focused than I was and still had a vaginal birth. I no longer feel that it was my fault. Even if the fear had a contributing factor, I still did the best I could in that moment.

What I also didn't realize at the time was that Cathy was very concerned about the heart tones. Perhaps she thought if I relaxed emotionally it would be enough. Perhaps she just didn't want to scare us by letting us know. Cathy called the hospital and let them know we were on our way. Brad called Dr. Wonderful's cell phone and left a message.

The 15 minute drive was all kinds of fun as I sat with my fists in my back and breathed through contractions. Not surprisingly, when I thought relief was on the way, it became harder to cope with the pain. Fortunately, I had a friend who also transported to a hospital after attempting a home birth and knew relief could easily be an hour away. I think that knowledge helped me stay focused.

At the hospital, they had a room ready. They told me Dr. W knew that I was there and would see me as soon as he was finished with his office patients. It was about 5:30 pm. Did I mention what a great doctor and kind person he is? He was with us from about 6:00 until after midnight. He wasn't the doctor on call at the hospital that night. He was there just for us. He spent a good amount of that time just hanging out in the room with us. At some point he returned to the room; after, I assume, letting his wife know that he was going to be getting home later than he thought, to say that his wife was praying for me and our baby. He added, "Mostly your baby though because she knows I am praying for you."

I don't remember how long it took, but right away they were hooking me up to everything. I got a blood draw so they could get a platelet count so the anesthesiologist, Pete, would know how much drugs to give me. I got hooked up to an IV and the fetal and contraction monitors. The only problem was that they couldn't be sure they had the baby's heartbeat because it was so close to mine - around 90 bpm. The next thing I knew Dr. W was there with a tiny u/s machine looking for the heart to confirm we had LB's heartbeat. Brad told me later that he had never seen our OB look so worried. I suppose they were worried that there was no fetal heartbeat. Again, I was oblivious to their concerns. I knew she was fine.

Through all of this, I was having contractions with lots of back pain. With each contraction I would ask for someone to apply back pressure. Pete had everything set up and was ready to go as soon as he got the platelet count. I told him I wanted just enough to take the edge off and I just needed a break. I was hoping it would wear off by the time I started to push. He was very good and a nice guy. When I got a contraction just as he was getting ready to administer the epidural I shouted "back pressure!" and since he was the only one there, he started pushing. Then he gave me just the right amount of drugs. I still had to breathe through each contraction and sometimes needed to vocalize, but it was enough of a relief that I was able to calm my mind. I figured I would be pushing soon and home in a few hours. I told the doctor we were expecting a solstice baby.

The baby's heart tones also recovered about this time. In my mind, it was because I was producing less adrenaline which, while it makes an adult's heart race, it will cause a fetus to slow down (the better able to conserve energy and oxygen when supplies may be more limited through the cord). This made me think that I was causing all the problems because I was afraid. I remember my doctor saying something about most OB's would have probably just done an emergency c-section, but he thought we had time to try to get the baby doing better. I remember thinking it was such an odd thing to say.

Dr. Wonderful checked my cervix and I was 9.5 cm dilated and although I had been leaking fluid, my water hadn't broken. It was agreed that he would break the bag of waters. When he did, my cervix went down to an 8. Stacey told me later that she thought once they broke my water, the baby would come pretty quickly. I thought so too. I guess this was the second indication things weren't going as I had hoped. At some point, LB had turned and was now anterior.

It was now sometime after 6:00 pm. The next couple of hours, like the hours before getting to the hospital, were indistinct moments of pain and relief. Time passes strangely during labor. I was doing pretty well emotionally, it was nice to have the edge off the pain and I figured my body was continuing to progress nicely. Sometime after 8:00 Dr. Wonderful checked me again and I was still 8 cm dilated. This I understood to be a bad sign and it was the first time I thought things might end up with the ultimate bad ending in terms of my birth experience. I was still sure LB was fine.

Although I had started the day excited about meeting our Someday Baby, as the day wore on and the pain intensified I retreated to my usual mindset. I could believe in a baby moving and healthy inside of me, but I couldn't get around the idea that it could translate to a real, live baby outside of me. At some point the nurse said she was going to get the crib prepared. I told her I wasn't ready to see it yet. The idea of having a baby was too much to hope for. Even though if asked, I would have said LB was fine and would continue to be fine. A part of my mind was still not ready to believe in what could still be taken away.

Cathy (perhaps thinking that believing might help get me through) started to tell me that I really was going to be a mom soon. "Do you think so?", I asked her. "Yes," she replied. "Dr. Wonderful, do you think I am going to be a mom?" He agreed. Wow. I was going to be a mom after all this time. I started to get excited again. I told the nurse that I was ready to see the crib. I was expecting the little bassinets I had seen waiting outside the rooms on previous visits to maternity wards. It was, instead, the kind with the heat lamps that they put the baby in right after birth to check them and wrap them up. From my emotional and physical view points it looked exactly like the one Ernest had died in. I started sobbing and for the first time realized how much that previous experience was coloring this one. My midwife talked me down by saying, "This is a different day, a different hospital. Priscilla (Ernest's neonatologist) is not here. This is different experience than Ernest's birth." A bit later I heard Dr. Wonderful tell my nurse, than when the baby arrived, they would take care of him/her without anyone else coming into the room like they usually do. How many doctors would do that?

The epidural started to wear off and I started to get more panic feeling again. I asked for a bit more knowing that we were no where near pushing yet. Pete told me that he would need to use a different drug combination than last time (not sure why . . . I think he may have given me some narcotics), but he would try to match the same level of pain relief. It was actually much stronger and my contractions started to slow down. It was about 10:00 pm.

Unknown to me, but later related to me by both my midwife and Dr. Wonderful, Cathy followed my OB out into the hallway. She asked him, "Isn't it about time we started talking about a c-section?" He replied, "You knew that when you brought her in, didn't you?" She said she did. Later I also learned that my midwife was pushing on my upper leg (I was laying on my side) not because it offered comfort, but because she knew it would help open up the birth canal allowing the baby to move down. LB would move down and her heart tones would drop and be slow to recover. Cathy had already become convinced that LB would not be best served being born vaginally.

I got the first official "maybe we should do a c-section" talk. Although I wasn't exactly surprised, I was convinced we could avoid it. I told Dr. Wonderful that it wasn't an option. "I'll do anything. Tell me what I should do. I can get into a different position. We could let the epidural wear off." He said he didn't think a different position would help. We agreed to let the epidural wear off. Cathy suggested trying some Pitocin. We did both. Later research suggests that when the uterus is contracting like mine was - long contractions with a certain pattern on the trace - it indicates the muscle is tired and probably not releasing enough lactic acid. It was like trying to run with a muscle cramp in your leg - not very effective. Pitocin also tends not to help. It didn't. Dr. Wonderful even tried pushing my cervix out of the way while I pushed during a contraction. That didn't help either.

By the time Dr. Wonderful made the announcement, I was expecting it, but it didn't make it any easier. He said, "I think we need to do a cesarean." I started crying again and feeling like a complete failure. I remember saying it several times - "I am a failure." "I can't even manage to make a baby without help." "I am such a failure." Stacey, Brad, Cathy and Dr. W. all tried to console me. I didn't believe them when they said I wasn't a failure. Cathy sat next to me and said, "Natural births don't go this way." At the time, I couldn't fathom what she meant. Now I understood that she was saying, "Something beyond your control is going on and we have indications of that something. If it was going to be 'natural' we wouldn't be having these issues.

I was still crying and unconvinced. Dr. W. sat down close to my face and told me how the cesarean would go - that I would feel pressure as they did the procedure and that I would still be giving birth. The baby would just come out a different way. I asked if I could see the surgery. He said he would see what he could do. He didn't know if we would have her on the solstice, but agreed to try. He got up to go. I held his hand and begged him to stay. In that moment I thought if I could keep him from prepping for surgery, I could avoid the inevitable. I wasn't that out of it and realized in the next second that it was too late to change course. I let Dr. Wonderful go as Pete made his way to give me enough drugs for the surgery. Just as this was happening, another contraction was starting. I grabbed the bed rail and in anger, frustration and disappointment shouted, "Fuck! Fuck! Fuck!"

I continued to cry as Pete administered the drugs. Cathy, who's opinionated nature sometimes frustrated me during our prenatal visits, has the perfect personality to assist in a birth. She got in front of me, grabbed my face so that I was looking at her and said sternly, "Look at me. You are going to be a mom in about 10 minutes. This is not about you any more. You need to be there for your baby. You need to pull yourself together." This got through. I wanted to be present for our child's birth. Stacey followed up by saying, "You are doing the next best thing." A phrase I recognized from when we taught Birthing from Within style childbirth classes together. The idea is to be present during the moment, even when you have to choose something you would like to have avoided. I calmed myself down as best I could. It had already been such a traumatic up and down experience that I had the adrenaline shakes. Cathy later told me that she had never seen anyone get the shakes before the baby was born.

Brad walked by with scrubs in his hand telling me that he would change and be right back. Dr. Wonderful, breaking protocol, invited Cathy in as well. He apologized to Stacey for not being able to get her in also.

A few minutes later I was being wheeled into the OR. It was the most surreal part of the whole day. The bright lights and sterile environment was such a stark contrast to where we started and where I had thought it would end - in my home with the sounds of birds and the sight of our trees.

Dr. W set up a mirror along the side of the bed so I could watch. Unfortunately, by the time the sheet was put up and the second doctor was in place, I could no longer see, but I appreciated the effort. I was still shaking so bad that I had to hug myself to still my body enough so they could lift me from my bed to the OR table. I think they were concerned about me because Pete kept trying to calm me down. I remember the nurse saying that if I wanted the baby to stay with me, I had to keep extra adrenaline out of her system. I kept thinking calming thoughts and willed my body to shop shaking.

The surgery started and I could see smoke drifting over the curtain. Whatever they used to cut me open was causing it. I felt a strange downward pressure and my Dr. W told me that he was pushing the bladder out of they way. There was a pause and the next thing I knew the curtain in front of me was down most of the way. Cathy lifted my head up and asked if I could see the baby's head. I couldn't. Brad could see it though and as the head came out, they suctioned her. Dr. W then noticed that the cord was wrapped around the baby's neck twice and said that the baby had been trying to tell us something. Then they lifted her out the rest of they way. I could feel the pulling sensation and then I could see LB. My first image is of her being held aloft, with her head away from me and her little hands opening and closing. They held her forward and I saw just as Brad said, "It's a girl!" The doctor noted the time - 11:36 and announced that we had made it on the solstice. I was unbelievably excited. I started shaking again. I was so happy. I watched her as they took her about five feet away under the heat lamps. Brad went with her and put his hand on her chest. She grabbed his pinky finger and thumb with her hands. She started crying right away. It was magic!

I guess the joy and euphoria of her birth was a bit much for my already taxed body. Pete grabbed my hand and asked if I was ok. Cathy told me to calm down. Dr. W. told me to let Brad have his time with his daughter and to stay focused on them. Dr. Wonderful massaged my uterus and started putting me back together. Soon, LB was wrapped up and Brad held her next to my face. Because of the bright lights, she kept her eyes closed until she was away from them. Brad said I was the first thing that she saw. I was laughing and so happy. The first thing I said was, "I can't believe I was worried about bonding!" She wanted to nurse so Cathy suggested I put my finger in her mouth. Our daughter was sucking on my finger! I was shaking so bad that Cathy had to hold my hand steady. They continued to close me up and when they were done, they let me hold LB on the way back to our room. I sung her a lullaby on the way. It was a lullaby I have sung to our Someday Baby for years.

We got back to my room and I nursed her right away. I didn't sleep more than an hour that night. I was wired on adrenaline, mentally trying to make sense of how things unfolded as they did and staring at our sleeping daughter. Our Someday Baby was really here.


Jen said...

A perfect story - plenty of surprises, some not so welcome, but with a "happily ever after" ending. Congratulations.

Tracy said...

I have tears in my eyes.

What a beautiful story. I know you didn't get the birth you wanted, and for that I am sorry, but your baby is here and healthy.

I'm so happy for all of you.

Anonymous said...

Sitting here with tears running down my face...you know my story and it brought back those memories as well.. and I understand all you were saying.. you are truly an amazing woman!!

Lori Lavender Luz said...

For me, even though I didn't get the story I expected, I ended up with the one that was mine.

I wonder if you feel that way, too?

Or maybe not.

Welcome to the world, LB. You have quite a mama, who has quite a big heart.

Anonymous said...

You bring tears to my eyes.

All those worries, and now she is here...best wishes!

DCat said...

WHat an amazing story!! You did just wonderful!!!! I am so very happy for you and your family!!

Kristine said...

I'm all teared up! What a great story, because you had the happiest of all endings!

It sounds to me like you did everything you possibly could and should have absolutely no regrets that it wasn't your "dream" birth.

I had horrible back labor too, and was never able to push my little boy out on my own (in the end finding out he had a nuchal cord (wrapped twice like you) that was preventing him from moving down). We were lucky in a way that they were able to get him out with forceps. Unfortunately it tore me up something fierce and took me months to recover. I actually wished after that we had done a c-section.

Birth is such an amazing thing, but also so difficult to predict. Mine was nothing like what I had envisioned, but the end result was my little boy, my healthy, happy little boy. And that was the most important outcome of all.

Congratulations! And enjoy being a mom! I think those of us who go through hell to get there appreciate every minute that much more.

DE Mommy said...

Oh my goodness. What a great story. I laughed, I cried, I read parts aloud to my husband.

Hooray for you and your family!

Anonymous said...

What a wonderful birth story. Thank you for sharing it.

battynurse said...

Wow. Such and eventful day. And a beautiful story. I'm sorry that you didn't get the birth you wanted or had planned for but am so happy for you, Brad and your little butterfuly.

Ryan's Mommy said...

Beautiful. Thanks for sharing your birth story.

MrsSpock said...

Our stories have a lot of similarities, including the double nuchal cord that necessitated a c/s. I think since Peanut had already announced his distress before my first contraction, I was already prepared for a c/s as soon as he failed the biophysical profile. I often wonder what I missed out on by not experiencing a spontaneous labor or the urge to push. I am so curious as to what that urge feels like. Of course, there isn't an iota of me that is unhappy with the end result.

Geohde said...

Smiling here, Kami.

Perhaps not the birth you envisioned, but wonderful none the less.



Lanie said...

Thank you for sharing such an emotional and beautiful story. LB is very lucky to have you for a mom.

Off to dry my eyes now . . .

Anonymous said...

Wow! I know it did not go exactly as you had planned, but what an amazing story! May your family continue to be blessed.

Anonymous said...

One again you have me in tears!

Welcome to the world, Little Butterfly!

Summer said...

I've got tears in my eyes, too.

It's probably not the story you hoped to have, but it's wonderful the way it ended.

Irish Girl said...

Oh Kami! I am crying happy tears for you. Congratulations to you and Brad. Welcome LB!!!

Kate said...

A story LB will love to hear someday! I couldn't be happier for you!

Skerry said...

It may not have gone exactly as you had hoped but the outcome was spectacular...a beautiful baby girl! Thank you for sharing.

Bee Cee said...

Although not the journey you wanted, I am glad the outcome was. Thanks for sharing, I'm off to blow my nose and wipe my eyes!

One View said...

Wow.....!! Thank you Kami for sharing your story. You've captured so much here and it truly is an amazing story. I'm so so happy that you finally have your someday baby in your arms. Congrats again.

Anonymous said...

There are so many similarities between our birth stories I got shivers.

Yes, the main thing is that our daughters are here safely and are healthy and marvelous. But, if the time ever comes that you need to grieve the birth you desired and did not have, do it. Perhaps it will never sneak up on you (let's hope!) but it did sneak up on me. Be gentle with your self if that that time every comes.

With that said. Sending you an exuberant congratulations! You're a mama at last. :D

Anonymous said...

Oh my. Look at my typing errors. How humiliating. :P

annacyclopedia said...

A beautiful birth story, well told with so much love and gentleness for your own experience. Thank you for sharing it - I have tears in my eyes and hope in my heart. May your peace with this birth only grow in the days and years ahead.

From the Lost and Found

Me said...

This story made me cry. Biggest Hugest Congrats Kami!

B said...

Wow Kami

That was amazing. Such harsh and yet such true words from your nurse "it's not about you anymore" ......... It's about someone new.

Congratulations mamma. So much love that has finally found a resting place.

Sending love to you


Phoebe said...

Thanks for sharing such a wonderful story. It sounds like everything turned out for the best, even though it wasn't what you expected. I'm so happy for you!!

Anonymous said...

You did so well.



luna said...

what a beautiful story, kami. I'm glad your midwife realized that LB needed some help. it's true it doesn't matter how she got here, but that she's here now. lovely.