incubating: week forty-one (a.k.a. a very long birth story)

Paige’s birth was nothing like we had imagined, though I will be the first to say that it truly doesn’t matter as in the end she and I are both healthy. For whatever reason, I’ve had this need to get down the chronology of everything that happened. I suppose it’s just my way of processing. I don’t really have any negative emotions about the birth to work through, I’m incredibly thankful I avoided surgery and that I had the support team I had. But, the data nerd in me needs to see it all laid out, so here we go… 

week41to42

Monday, 2/23

Forty-one weeks today! Never really thought I would be pregnant at this point, but I’m thankful to not have been induced yet. Greg and I went to an appointment with the midwives for an NST and an ultrasound. The NST showed a great heartbeat on the baby and some regular but mild contractions for me (I could only feel about 25% of the contractions the machine was  picking up). The ultrasound showed plenty of amniotic fluid left for baby to continue on cooking. I was only 1cm dilated though, which was a bummer. I was hoping for something a little more given how far along I was.

Because things looked good, we were given the option of inducing on Thursday or Sunday evening, if the baby hadn’t come on it’s own. We picked Sunday, wanting to give the baby as much time to choose it’s own birthday as possible.

Tuesday, 2/24

Woke up pregnant again. It’s getting more and more frustrating each day. I took the dog for a walk to return a library book that involved a mile downhill and a mile uphill. Was hoping the incline back up might help, but it didn’t seem to make much of a difference. I’m was getting funny looks as I walked around. I guess I was really big, just hard for me to notice as it’s been such a slow progression over 42 weeks.

At 5pm I went to my first acupuncture appointment. The midwife I saw during week 40 suggested I set up a few appointments to help get things moving. It was very relaxing and only  a tiny bit painful. I had heard so many stories of “so-and-so tried acupuncture and her water broke when she got off the table”. That didn’t happen for me, but I was looking forward to my next appointment on Thursday.

Wednesday, 2/25

Today was probably the hardest day of my pregnancy. I just felt defeated. The clock to induction was ticking very loudly, but still days away. I had no plans or appointments and the day felt like it would be never ending at 7am. I told Greg I was going to make reservations downtown for dinner just so I had something to look forward to.

I spent the day reading then walked to Whole Foods and picked up $9 worth of cut pineapple. I sat in the dining area and at it all (1.2 lbs). I was getting desperate and while I’ve never known anyone that went into labor via pineapple, it’s all over the internet. I also picked up bacon and dates because I read that six dates a day will bring on labor. I walked home (imagine, for your enjoyment, a nine plus months pregnant lady walking a mile home in the rain with a reusable bag full of eggs, dates, an bacon) and made myself some bacon wrapped dates.IMG_7073_edited-1

That night I met Greg at Bell + Whete for yet another “last dinner”. The upside to this delayed birth was trying a ton of new-to-us restaurants in the last few weeks. The food was fine but we were both just a little tired and not so much into it. We went to bed early and I tried to convince myself there was no way I could go another night without going into labor.

Thursday, 2/26

This is where things get interesting. A very brief background: I planned to have a natural birth (completely intervention free, preferably) for several reasons, but mostly because when I thought about labor, what stressed me out most was not being able to move around, being connected to a ton of wires, and not being able to feel my legs. I would panic when I thought about these side effects of pain medication, rather than when I thought about contractions, so for me it was preferable to avoid them. To help with this, we hired Jenne, a labor doula. Greg was totally supportive of my desires but since he is new to this too I didn’t expect him to know how to support me through it; Jenne was there to help us both and given how things went down it was a very smart decision.

I knew as my induction neared the chances of being able to stick to this plan were slimmer and slimmer, but I wanted to keep to it as much as possible. Spoiler alert: our first lesson in parenting was learned the hard way. Something about the best laid plans…

(To keep this from being insanely long and to not share more information than some might want to read, I’ve simply referred to each intervention by name and linked to a description of it rather than detailing them out.)

9:15am Left the house and stopped by Cloud City to drop off canned goods for the food bank and pick up a smoothie for my appointment. At the last NST I had to drink a carton of kids apple juice. I brought my own sugar with me this time to wake up baby, who is a day time sleeper and night time partier.

Note: I had planned to be gone for a few hours to attend an appointment with my midwives, another accupuncture session, and coffee with my friend Becca. I was going to come home and cook a big dinner, hoping that standing in the kitchen for a good long while might start labor.  

9:40am Hooked up to the NST machine at the midwives’ office. It’s showing some steadier contractions and I feel most of them though they are not painful. I was reading a book and didn’t notice how long I’d been in there. In the end, it turned out to be lucky that they were running really behind (for the first time ever).

10:30am My appointment that day was with Deborah, who came in once I’d been hooked up for 50 minutes (I had been scheduled for 20 minutes). We talked about next steps and she called the hospital to schedule us for our induction starting at 8pm on Sunday evening. As she reviewed the strips that print out from the machine, she noticed a big drop in baby’s heart rate. She told me to get dressed and she’d be back in to finish up.

10:45am Deborah returned and told me that she had just talked with Cindy (the midwife on call at the childbirth center (CBC) that day) and together they decided I should head over there for a longer evaluation.

The CBC is not a free-standing birth center. It is part of Northwest Hospital and where my midwives deliver. It is very mom and baby friendly but also has the benefits of a NICU and OBs on call 24/7 should the need for a serious intervention arise. These are pretty popular around the PNW and I’m thankful to have an option between a regular hospital and a home birth.  

11:00am On my way to the hospital, I call and cancel my acupuncture appointment and then call Greg to let him know what’s going on. He asks if he should meet me, but I see no sense in both of us being stuck in a room for a two hour evaluation so I tell him to stay at work and I’ll keep him posted.

11:30am I am put in a room in the CBC and hooked back up to the monitor. Within ten minutes of being there, the baby’s heart rate has dropped twice. My nurse, Amy, takes a few minutes to explain to me why it’s worrisome. The baby’s heart rate was dropping at the peak of contractions, which is a sign of an aging placenta. However, it wasn’t happening with every contraction which is not something that they usually see. I went the next hour with no drops.

11:45am Cindy comes in and asks me if Greg is on his way. I ask if he should be. She says yes, based on what they are seeing the next time I’m leaving the hospital will be with a baby.

Screen Shot 2015-03-07 at 1.15.24 PMThis is so not how I imagined leaving for the hospital. I thought we’d finish packing our bags, take one last picture with us and the dog, etc. 

12:00pm I order lunch from the hospital menu, a spinach and chicken salad with a side of mashed potatoes. You can order one entree and as many sides as you want every hour.

12:30pm Greg arrives and they move us to our actual room, 203. One of the reasons I picked this hospital was that you labor, deliver, and recover in the same room. Little did I know I’d be spending five days and four nights in room 203.

1:00pm Time for my hep lock. This is the one thing I had agree to pre-labor. If something was going to go wrong (ha!), I wanted to make sure they could administer any needed medications as soon as possible. My nurse attempted to insert the lock twice, on the two good veins on my left hand. This is not a painless procedure, FYI. Because she wasn’t able to salvage either one, she called in another nurse to help.

1:30pm Hep lock attempt number three. Unfortunately the second nurse had to use my right hand as there were no good veins on the left use. Ideally, you want this on your non-dominant hand so that it’s less in the way for however long you have to have it on.

2:00pm Cindy (along with Anna, the midwife in training) comes in to talk about induction options. Because my Bishop’s score is still really low (my body is not really in labor on it’s own at all), we have to do two rounds of induction. They suggest that we use the Cook balloon method, which is the method I wanted to go with for induction number one as it’s non-medicinal. They told me they’d come back at 3:15 to do the procedure.

2:30pm Amy has me change into a hospital gown. Up until this point I was just wearing the jeans and sweater I had on from the morning. It seems more real now that I’m in a hospital gown and slippers.

2:45pm My first unwanted intervention – I’m told that I will have to have an external fetal monitor on at all times until the baby is born. The original plan was that once I was in labor, they’d use an external monitor for 20 minutes to make sure the baby is okay and then I would just have a check by my midwife every 30 minutes with the doppler. When I’m in bed I’m hooked up to the machine next to my bed, but I do have the option of a travel pack so that I can be mobile.

3:00pm Greg and I decide that if we’re going to be in the hospital for awhile, it would be nice to watch some Top Chef. He heads out to get cables at Best Buy so we can hook up our iPad to the TV, get his own lunch, and drop one of our cars off at home.

3:15pm The birth clock has started, it’s time for my first induction! The baby was not happy with me laying on my back in bed, so I had to switch to my side. It took three attempts to complete the procedure given that I wasn’t flat on my back. I would rate the procedure as very unpleasant, but not necessarily painful. For the first hour post-procedure I was pretty uncomfortable and after that (12 hours in total) it was more of an annoyance.

4:00pm Greg returns from errands and we settle in to watch Top Chef for the evening.

6:00pm We ordered dinner, but at this point I have no idea what I ate.

7:00pm We ordered a second entree so Greg could have dinner. Again, no memory of even getting the food, but I know we ordered two dinners that night.

8:00pm I start to feel decent contractions! I’m really hopeful that this is my own body and not just the Cook balloon causing contractions. They are not active labor type contractions, meaning I can still talk and walk through them. But they are something.

8:30pm We start to feel a little stir crazy in 203 so I request my travel pack for the fetal monitor and Greg and I spend some time walking up and down the hall. Unfortunately we only have a hallway about 50 yards long where we can walk. If we go out the L&D doors the monitor won’t pick up the baby’s heart rate.

We happened to be walking while a tour of the center is going on. It was a little awkward to be in my gown and robe and somewhat on display. We also ran into Evash, one of the dad’s in our birth class, coming out of the snack room while we were walking. His wife, Lisa, had delivered a baby boy that morning.

9:00pm I call Jenne, our doula, to let her know what’s going on. My contractions are about 5 minutes apart, but still walkable and talkable. We agree that I’ll give her a call once I can only breath through them.

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9:30pm There are only so many episodes of Top Chef we can watch in one evening. Greg unfolds and makes up his couch bed and we decided to try to get some sleep before the next procedure in a few hours.

Friday, 2/27

3:15am Cindy comes in to remove the Cook balloon. The procedure has worked well and I’ve progressed from 1.5cm to 4cm. I also am much more comfortable and able to fall into a decent sleep finally.

5:45am We learn our first hospital lesson – the louder the noise, the less scary the problem – when we are woken out of deep sleep to a very loud beeping from the machine monitoring my contractions and the baby’s heart rate. Turns out it was out of paper to record the data.

Also, I notice that my contractions are gone. Turns out they were caused by the Cook balloon and not my body actually moving into labor on it’s own.

6:00am The night nurse is in to check my vitals. Routine procedure, until she notices baby’s heart rate has dipped and the usual flipping to my side isn’t bringing it back up. She hands me an oxygen mask and says “I’m going to press a button that’s going to have a lot of people come running”. She was not kidding. Several nurses and Cindy come running and after a bit of moving me around baby is doing well again. I’m pretty shaken up, but also crazy impressed at how quickly the room was full of care providers who fixed the situation.

6:15am My hep lock is put to use much earlier than I was hoping or expecting when they decide the baby could benefit from fluids. Now I’m tethered to both the heart rate / contraction monitor and the IV pole. Cindy had planned to start my second induction (pitocin) at 7am, but lets us know we’ll push it back to closer to 8am to give the baby more time to recover.

7:45am The real fun starts as Cindy gives my nurse the go-ahead to start the second induction. A bag of pitocin is added to my IV pole and a low dose is administered. The plan is to keep an eye on how the baby reacts and slowly increase the dose every thirty minutes until I’m in a sustained active labor.

10:00am I’m officially in active labor! Contractions are regular and I’m having to concentrate and breath through them. The baby is handing the pitocin fine so we’ve steadily been increasing it.

11:00am We have a decal and Mary Lou and Anna want me to stay in bed on my side to help the baby. The contractions are getting worse and I’m not able to move around or use gravity to work with them. Frustrating given that this was my birth plan. I ask Greg to call Jenne at this point. I’m ready for her to arrive for more support.

12:00pm Jenne arrives and I’m still in bed on my side, but now flipped to the other side. This is not a fun way to labor at all but I need to stay on this side for another hour. My early active labor has helped me progress to 6 cm. This gives me a little boost to keep going as I am.

I don’t remember a lot about the next eight and a half hours in terms of timelines. I took my glasses off so that I could focus inward a little more and not be distracted by everything going on around me, but that also meant that I couldn’t see a clock.

I tried laboring in several positions that would work with gravity, but the baby did not like any of those, including walking. It got to the point where it was more stressful for me to try new positions than to just lay on the bed because I didn’t know how the baby would handle them. Being in middle of a contraction and told to flip around or move into a new position while a heart rate monitor is beeping much more slowly than it should be is pretty awful. I was able to get into the tub for a while in a laying position that supported the baby, which was helpful.

These eight hours were not fun, to put it lightly. The pitocin was inducing contractions one after another. At some points I would have five contractions in a row with no break between them. I used everything I learned in prenatal yoga and suggestions from Jenne to get through it. I did very little speaking, if any, during these hours and had a little liquid that Greg was able to get me to get down. I was completely in my own world as that was the only way I could handle each contraction. 

Eventually I make it back to the bed. It had been hours and I was hoping to hear a good progress report from the midwives… 

8:30pm I’m checked again and hear Anna tell Mary Lou “no change”. I’m hoping I heard wrong, but they quickly confirm that I’m still at 6cm after all these hours of hard labor.

I decide that after 12+ hours of natural labor on pitocin, I’m done. All the complications that I had been hoping to avoid by not going with an epidural (not being able to walk around or easily change position, not being tethered to anything) are part of my reality now, so I decide to ask for relief. Everyone agrees I need rest and that this is the right decision. Mary Lou calls for the anesthesiologist.

Also during this time, I’ve had three more interventions. The external fetal monitor is no longer picking up the baby’s heart rate very well so we are switched to an internal fetal monitor. This has me tethered to the heart rate monitor with no ability to get out of bed. While they did that, they also switched the contraction monitor to internal. My water was broken in hopes that it will move labor along. The downside to breaking water is that it starts the twenty four hour clock to a c-section.

8:40pm Of course I have a fever! A bag of antibiotics is added to my very crowded IV pole and I’m told that the baby will have to have at least four doses of antibiotics because they can’t rule out an infection causing the fever.  Also, we will be required to stay an extra 24 hours in the hospital. As much as I want to say no to the antibiotics for both me and the baby, I realize that as a nutritional therapist I understand the risks of getting antibiotics. What I don’t know are the risks of not taking them on both me and the baby and at this point I’m in no shape to ask questions so I decide to trust my providers.

8:50pm Mary Lou and Anna let me know that they found meconium when they broke my water. Of course they did! They let the neonatologist on call know that he will need to be present at the birth in case the baby needs to have his or her lungs suctioned.

9:00pm Dr. Lubeck arrives and is very matter of fact. She’s an ex-military anesthesiologist and I found her to be hilarious. I also found her to be awesome because within about eight minutes of being in our room, for the first time in twelve hours I felt like I could function like a human being again. It was an awesome epidural – I couldn’t feel my contractions but was still able to move my legs, and my body in general, on my own.

The epidural adds another wire over my shoulder and taped down my back plus I now have to have a blood pressure cuff on 24/7 as it automatically takes a reading every 15 minutes. I’m also no longer allowed out of bed (though I couldn’t anyway with the internal monitoring) and can only have water and ice chips. I really should have eaten something (as everyone suggested) before Dr. Lubeck arrived.

Funny note: As soon as I had the epidural I immediately popped back to life and started questioning how I would approach the birth of baby number two. Try for natural again? Go straight for the epi? Jenne was looking at me like I was crazy but my sweet husband knows me and just let me talk. I can’t help being a planner, it’s just how my brain works. If you’re curious, I’m totally undecided. Right now I’m leaning towards adoption. 🙂 

9:15pm It’s been fifteen minutes, so of course we should have another intervention! This is actually one that Greg and I had never come across in our birth class, a sort of reverse breaking the waters if you will. To help avoid a c-section, we start fluid injection back into the uterus. I think this is the point that I laughed – what else was there left to do? A c-section is pretty much the only intervention I haven’t had at this point.

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I asked Greg to take this picture of my IV pole. Earlier in the day the nurses had been laughing that there were so many hooks on it (this pole was from another floor, not typically the one that they have in the CBC). By the time I was done, they were nearly out of hooks to hang new bags on. This is totally what the natural birth I had envisioned looked like…

9:30pm We have another major heart rate deceleration and I flip around back and forth (with the help of nurses now that I’m somewhat numb) until we land in child’s pose with a big bean bag supporting me. This seems to be the only position that makes the baby happy so I stay in it for three or four hours. I didn’t realize how sore my hips were because I was numb, but this made pushing later on quite difficult.IMG_0146_edited-1

Thumbs up to epidurals. There are no pictures of me in labor pre-epidural, which is probably a good thing. I’m not sure I will ever enjoy child’s pose again. 

11:00pm I’m starting to feel some pain from contractions, which I let my nurse know about. She calls in Mary Lou who suggests that we have Dr. Lubeck come back and top me off. I get the top off a few minutes later and while it takes the contraction pressure away, it also makes me legs go completely numb. Of everything that’s happened, this is the first thing that almost makes me break down. I could not stand the feeling of not being able to move my toes voluntarily.

11:30pm The midwives tell me I really need to sleep, so Jenne goes off to find a place to rest and Greg remakes his couch bed and settles in for the evening. Unfortunately my nurse has left the sound up on baby’s heart rate monitor so I spend most of the night awake listening to it and monitoring. It’s a very helpless feeling to not be able to fix something like this. The few times there are decelerations, nurses quickly come in (they are monitoring from their station) and flip me around as I’m unable to do it myself now. I eventually ask them to turn the sound down as I’m making myself crazy and know I need sleep.

Saturday, 2/28

12:30am Anna and Mary Lou come in and we talk about the reality of what’s going on. It’s been almost 36 hours since my induction started. More worrisome, it’s been four hours since my water was broken and there has been no progress. They give us a deadline of 2:30am (two hours away) to show progress or we will have to really think about a c-section. They have been in contact all evening with the on-call OB and everyone is comfortable giving me another two hours.

1:30am My nurse comes in to take vitals and I mention to her that I’m feeling new pressure sensations. She let Mary Lou know, who sends Anna in to check me. Finally some good news – I’m at 7 cm! Progress means tat the 2:30am c-section discussion is off the table.

I attempted to sleep through the rest of the night but only got a few minutes here and there. I would have nurses come in to change my position about once an hour or so when the baby’s heart rate dropped since I couldn’t move my lower body at all at this point. It was a terrible night of sleep in which I pretty much just looked out the window and waited for sunrise.

7:30am Mary Lou and Anna come in to say good morning and check progress. I’m not quite at a ten, so they decide to dial up the pitocin a bit to see if we can get me to a ten and get this baby out.

8:00am Baby is not liking the pitocin, so we’ve turned it off and the midwives decide that my 9.5 cm is going to have to be good enough. Deborah is now the midwife on call and Mary Lou and Anna come in to say good bye. (They also had another ‘problem’ labor going on at the same time that had ended in an emergency c-section around midnight. I can only imagine it was a very long shift for them.) You know you are in labor for a long time when you’ve gone through three midwives – they work 24 hour shifts!

8:30am Deborah is ready to go and we start pushing. I can’t feel any of the pushing but the epidural is wearing off enough that I can feel contractions again. This is really helpful for knowing when to push. Greg and Jenne help me with my legs since I still don’t have much ability to move them, no matter how hard I try. My hips are also incredibly sore from spending hours in child’s pose the night before, which does not make pushing a ton of fun.

While the pushing felt productive, it was exhausting. I hadn’t slept in about 36 hours (and hadn’t had good sleep in days) and I hadn’t eaten anything in 24 hours. There were a few times I seriously thought I could fall asleep right there and just not have a baby. I was alternating every other contraction between pushing and oxygen. By this time I’m really over oxygen. I’d been having it fairly regularly for more than 24 hours and my mouth and lips were so dry. It also feels much better to push during a contraction than to just lay back and breath in the oxygen. But it was helping the baby so it was worth it. 

10:00am Deborah says we are very close and calls the baby’s nurse and the neonatalogist into the room. She tells me we’re going to have the baby in the next three pushes.

10:07am I tell Deborah I’m not interested in three more contractions and I push the baby out on the next one (in retrospect, probably not the smartest idea ever). The baby is born 43 hours after my induction was started.

I’m not able to hold her immediately as the mystery of her heart rate is solved when we see that she has the cord wrapped around her neck. In the end it turned out to be a blessing that she had the meconium and we had the neonatologist in the room at birth. She let out a little squeal but not much else so was taken to the other side of the room where they regulated her breathing.

10:15am We all realize in the hurry to get her stabilized no one looked at gender. Greg walked over to where they were working on her and proudly announced “it’s a Paige!”. We had a girl name picked out but for a boy we had not settled on a name, just had a short list of five names going. We were both a little relieved we didn’t have to figure out which seemed most appropriate for a little guy.

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10:20am Paige is brought over to me and laid on my chest. Greg and I just stared at her until Jenne suggested we talk to her. The next hour is a blur of being totally fixated on this beautiful little girl.

11:30am Paige’s nurse lets us know she has to take her to the NICU to get the antibiotics started. My legs are still numb and I can’t get out of bed so Greg goes with her. Jenne suggests I hand express some colostrum that Greg can feed her with his pinky, since we hadn’t managed to breastfeed before they needed to take her.

We spent the next two days in the hospital as Paige had to have antibiotics until her blood culture showed no infections at 48 hours after birth. We had a few visitors and mostly spent time cuddling our sweet girl and learning how to feed her. Greg quickly became the diaper changing king. On Monday morning both Paige and I were examined and given the okay to go home. I

We struggled for quite some time with adjusting the carseat to her size and were sure they were going to consider us unfit to care for this tiny human. But no, once we got it sorted out they made sure she was secure and sent us on our way. It’s sort of surreal when they tell you to take the baby home. After the slowest two mile drive home (and a stop at Chipotle to pick up lunch), we made it home to start this next phase of our lives as a family of four. Yes, Alfred still counts. 

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8 thoughts on “incubating: week forty-one (a.k.a. a very long birth story)

  1. rann1950

    Dear Beth, albeit an arduous childbirth experience (to say the least) your precious Paige Clara Martin is a beautiful gift to the entire family.

    Reply
  2. danimpark

    Thanks for sharing. I love hearing about other birth experiences. I wish I would have wrote down my story. It’s only been 15 months but the details are blurry. All the best with your new addition to your family.

    Reply
    1. Beth Martin Post author

      Thank you! It was hard to remember details just three weeks later, I’m sure in 15 months I will not remember much. That’s how people end up with more than one kid, right? 😉

      Reply
  3. Shaunacey

    congrats!!! She is beautiful!
    What a story! I’m glad it all worked out and you got your healthy, beautiful baby girl.
    Hope you’re adjusting to new parenthood and hopefully getting a little sleep 🙂

    Reply
    1. Beth Martin Post author

      Thank you! It’s been a fun three weeks but exhausting. Congrats on your upcoming little boy – I am in awe of how you will deal with a newborn and a toddler!

      Reply
  4. Debbie

    I think the picture of the IV’s pretty much tells the story. You guys were so calm every time we talked to you we had no idea all this was going on! So glad it all came out okay.

    Reply
    1. Beth Martin Post author

      I’m glad we managed not to worry everyone! Had she been in true danger we would have told everyone but since it was being managed well figured there was no reason to worry everyone.

      Reply
  5. Dad

    I’m so proud of you two (now three, sorry Alfred, four). Facing challenges together is the key. You have a beautiful family. Enjoy the journey. Dad

    Reply

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