**** If you are following a natural childbirth method that emphasizes focusing on only positive stories about childbirth, then close this window and slowly back away from the computer. Things did not go as planned with Lily's birth, but we are working through it. ****
So, around 10:15pm on Sunday, February 20, 2011 (2 days before our due date), after taking a shower in preparation for work on Monday and while relaxing, waiting for my hair to dry I felt a gush and knew immediately that my water had broken. When I went to the bathroom, I realized that the amniotic fluid was tinged with brown. I knew immediately that if this was what I thought it was, meconium in the fluid, then the whole ball game had just changed.
I went down stairs and told Jay, "um... I think my water just broke!" We called the on call service and got a call back form the nurse. She said that it did in fact sound like my water had broken and she would have the midwife on call at the hospital give me a call. Within a few minutes Jan called. I told her what was going on and she said that meconium was actually more green than brown and that we had a couple of options. Because I wasn't feeling any contractions, I could either come into the hospital and we could try a small dose of pitocin and see what happened or I could wait a few hours and see if things got started on their own, but if we did that then we would have to start on a higher dose of pitocin if contractions didn't start.
Since I still wasn't sure if there was meconium in the water, I felt more comfortable going on into the hospital and given that my water was broken I knew that we were legitimately on the clock and only had a matter of hours before it would be imperative that Lily be out. One way or another we were going to have a baby very, very soon.
I tried to eat a little bit, finished up packing our hospital bad, and strung my labor beads so I could wear them as a necklace. We packed up and made our way to the hospital while I texted a few people to let them know what was going on.
Although it wasn't what I was hoping for, it was nice to be calm and relaxed when we checked into the hospital. They showed us to our room and I got changed into the hospital gown. I left my nursing bra and tank top on under the gown thinking it would make me feel better and less exposed given the slits in the nursing gown. Little did I know that all modesty would be completely gone in the hours that followed.
The nurse came in and we filled out all the paperwork and she got me hooked up to the fetal monitor to see what was going on. Lily's heartbeat was great and I was having some mild contractions but nothing I could feel. The nurse ran the swab test to see if the fluid I was leaking was in fact amniotic fluid. She didn't even have to wait for the test to register because she could tell from the volume that it was my water. She also confirmed that there was meconium in the fluid. Basically, meconium is the baby's first poop and shouldn't come out until after birth. If the baby has its first poop in the womb it could be because it's over due, because she was in distress at some point (maybe she grabbed the cord and cut off the blood flow temporarily), or maybe because she just felt like it. But the important part is that between the water breaking and the meconium in the water, it was going to be important that we get Lily out sooner rather than later. It wasn't an emergency situation where a c-section was going to be necessary, but I knew that we wouldn't have the luxury of waiting for nature to take over.
The midwife came in and checked my cervix and said that I was only 1 cm, high and posterior, and about 70% effaced. Basically, that means that my body was making very little progress towards birthing this baby. So after discussing our options with the midwife we made the decision to start on Pitocin to jump start labor. This was a difficult decision because I knew it would make my goal of going without an epidural more difficult. When one is on Pitocin it is necessary to have continuous fetal monitoring in order to guarantee that the baby is handling the contractions ok. This continuous monitoring means that I couldn't walk around. I would either have to labor in the bed or very close to it. Additionally, because Pitocin is a synthetic form of the Oxytocin your body naturally makes, Pitocin contractions tend to be stronger and more consistent then "natural" contractions. And finally, when one is on Pitocin, they also have to be hooked up to IV fluids which restricts movement even further.
So, with the deck stacked against us, we soldiered on towards our goal. They got me all hooked up and I laid down to hopefully get some sleep, but after only a few minutes I was getting hit with bad back pains. Now back pain isn't anything new to me. I've been getting splitting me in two type back aches every month since I was a teenager, but these rivaled even my worst and we were only getting started. Very soon, I was unable to lay on my side which is what I was hoping would work. I found that sitting up in the bed helped some. Jay would sit beside me and hold my hand. When a contraction would come, I'd squeeze his hand and lay back concentrating on relaxing my body fully and completely. The hypnosis didn't work quite like I expected it to, but it worked in that it allowed me to fully relax my body which is what it was meant to do. Jay would lightly stroke my hand and arm giving me something else to focus on and I'd remind myself to ride each contraction like a wave. The more I focused on "staying out in front" of the contraction the better I did.
We labored like this for about 4 hours and it was time for a shift change. The new midwife came in and checked me. After 4 hours of difficult contractions, I was a whole TWO centimeters! That's right! ONE WHOLE CENTIMETER IN FOUR WHOLE HOURS! But we kept soldiering on. They upped my Pitocin drip to a 4 (out of 20) and things got more difficult. The new nurse (Kathy) was amazing! She hovered in our room more than I thought I would be comfortable with, but she never bothered me other than to adjust the monitors. Looking back through, I realize that she was actively watching and listening to me. When I told Jay that I wasn't sure how much longer I could do this, she suggested that we try the rocking chair or the birthing ball. Both of these caused the monitors to move and therefore required her to be very close by to keep them adjusted. She could have just as easily encouraged me to stay in the bed so that she could hang out at the nurses station and monitor everything from there, but she was willing to really work hard those hours with me to try and help me attain my goal. I will be forever grateful to her for that.
By about 11:30 am (Monday, February 21), I was quickly approaching my limit. I knew if things didn't change pretty soon, I was going to need to ask for help. But true to my plan I asked the midwife to check my progress before asking for anything. I knew that often times when women hit transition (around 7 cm) things get really tough and they think they can't make it. But once you've hit that point, you are almost to the finish line. But when she checked me, I was only 3 cm. Yep... another 1 cm in 4 hours. I broke down into tears, and told the midwife that we needed to discuss our options. I explained my thinking to them... 1) It had now been 12 hours since my water had broken. 2) I knew they were trying their hardest to keep the Pitocin at a low level in order to give me the chance to go pain med free, however, I knew they wouldn't be able to do that much longer. 3) If I got an epidural, they would be able to crank up the Pitocin and get the show on the road.
The midwife said that was her assessment of the situation as well. So... with many tears and a heavy heart I asked for the epidural. Thankfully, I made the decision while I was still in control of the contractions because it took close to an hour before everything was ready for the anesthesiologist. The midwife and nurse were also great in helping me make the transition in my expectations for the experience. They were both so encouraging and understanding. When the anesthesiologist got there they told me that I could have one person in the room when they put it in, but I decided that I just wanted to do it by myself. I was truthfully TERRIFIED of the epi and didn't want the added stress of watching the reaction of Jay or my mom. My nurse stayed in with me and rubbed my shoulders but truthfully it was such a breeze, especially after dealing with the contractions for so many hours.
The epi was in before I knew it and within just a few minutes the pain was gone. I laid down and was able to get some sleep and Jay got some sleep too. Basically, the next few hours were pretty uneventful. I woke up feeling some pressure and they checked me but I was only at 6 cm, although that was a big improvement! So, I went back to sleep. The next time I woke up the pressure had gotten very, very intense which is something I wasn't really prepared for. I called my nurse who got the midwife. They didn't expect me to be as far along as I was, but when she checked I was 9 1/2- 9 3/4 cm and it was time to get stuff ready. They broke down the bed and alerted the baby nurse and NICU (neonatal intensive care unit) nurse that we were getting really close.
Because of the meconium it was important that they suction as much fluid out of her month and nose as possible because if she breathed it into her lungs after delivery she could get an infection and it could be very, very bad. So, that is why the NICU nurse was in the room. They let me know that if she didn't cry right away that they would take her to the warmer and do a deep suction, but if she cried right away they would put her on my chest and evaluate her from there.
Pushing was literally the most challenging thing I've ever done in my entire life. I hoped it wouldn't take too long since I knew I couldn't do hours and hours of it. It was like being at the gym, lifting weights, knowing you are completely out of steam, but having to keep going anyway! I was so exhausted. Other than a couple of naps, I'd been up for close to 36 hours. I hadn't had anything to eat in almost 24 hours and what I did have in my stomach had been vomited up hours before. So, I pushed and pushed and begged the Universe to make it quick. Unfortunately, I was flat on my back with my legs in stirrups which is exactly where I did NOT picture myself, but at that point I didn't even care. I was just ready to get some relief!
After only about 20-30 minutes the midwife told me to stop pushing with the contractions and start easing Lily's head out. I tried my hardest, but apparently she wasn't having it because I still ended up with a 3rd degree tear. Her body quickly followed after her head came out without any problems. And at 9:51pm (25 minutes shy of the 24 hours mark), Lillian Louise was born! They quickly suctioned her month and nose to remove as much meconium as possible and then laid her on my chest since she wasn't having any problems breathing. The midwife clamped off the cord and asked if Jay wanted to cut it, but he declined and she cut it. I don't remember much about those first few moments because I was still in a lot of discomfort but I remember looking down at her and saying, "Hello Sweetheart!" over and over again. Oh and she lifted her head up and looked me right in the eyes. I remember thinking, "I'm not sure you're supposed to do that yet!"
The placenta delivered fairly quickly there after and that's when I finally got some relief from the pressure! But then it was time to stitch me up. Seeing that I'd never had stitches before I was pretty scared of that part too, but it wasn't that bad in comparison to everything else I'd been through that day. Although the midwife kept asking for a tool that she couldn't remember the name of because she didn't have to use it that often. She kept saying, "It holds everything together so that I can stitch it up." That's not really something you want to hear! Hehe. Jay went outside to let everyone know that Lily was here and come to find out Mom, Luke, Dan and Shannon were all standing outside in the hallway since they knew they'd be able to hear the baby cry when she came out. I caught a glemps of Dan when he opened the door and I started yelling, "DON'T LET HIM IN HERE!!" since I was still lying there in the stirrups getting stitched up.
Our hospital has a no visitors for the first hour after delivery rule and that was awesome! The nurse (unfortunately Kathy had gone off shift just 3 hours shy of Lily's arrival, but we had gotten another wonderful nurse, Holly) gave me some snacks and got me some soda. The first thing I opened from her snack pack was some Oreos and let me tell you that was the single best thing I've ever eaten in my entire life! In fact I've eaten about 3 packages of Oreos since and I wasn't even a huge fan before. Thankfully by the time the hour was up they had gotten me some pain meds and I had some sugar in my system so when everyone came in to meet Lily I was feeling like a human being again. My mom says I was the hostess with the mostess but I'm not sure if I'd go that far.
So, it was far from what I had hoped for or expected, and I'm still processing everything. Do I feel like a failure? Sometimes. Do I feel like my body failed me by allowing my water to break before I was ready to go into labor? Sometimes. Do I grieve the loss of a spiritual experience I have been looking forward to for years? Yes. Do I love my daughter more than life itself and am thankful to those who helped her get here safely? ABSOLUTELY!
Even though things didn't go as I had hoped, there are a few things I was very thankful for and proud of:
1) I'd heard that your nurse can really make or break you since they are the one that is really with you during the bulk of the labor process. I was really worried about getting nurses that would think I was being silly wanting to wait as long as possible without pain meds. I was afraid they would keep asking me if I wanted pain meds and giving me a hard time. But we ended up with three wonderful nurses during the labor process and another wonderful one after Lily got here. They were all very encouraging, understanding, and nurturing. I really couldn't have asked for better labor assistants.
2) I was worried that regardless of what everyone said, when we got to the hospital the midwives would try to pressure me into doing things I didn't want to do and consenting to interventions that I didn't want to have. But just like my favorite midwife, Tina Hayes, said at my first appointment, all decisions were made as a team. Me, Jay, and the midwife discussed the decisions that needed to be made and we came to a conclusion. I felt completely in control of the labor process and what happened to me, even though things didn't go as I would have planned.
3) I was very thankful to have done as much research as I did. Even though things didn't go as I had hoped, I knew enough to know that what we were dealing with was a different ball game. I knew that due to the water breaking and the meconium that this was a time that medical interventions were appropriate. I had thought a lot about under what circumstances I was comfortable accepting interventions, so when my water broke and there was meconium I already knew what was going to be necessary.
4) Even though we weren't able to go completely med-free and the hypnosis didn't work quite the way I expected it to, I am still very thankful that I took the Hypnobabies class and studied the program. I feel that it taught me how to relax which is something I never knew how to do. It allowed me to stay in control during the 9 hours that we were laboring without pain meds. I never yelled or screamed or told Jay he was never going to touch me again or that he had done this to me. I was able to keep my sense of humor and even laugh in between contractions. All the nurses and midwives commented on how well I handled the contractions. My mom said the same thing. The midwife even said the next day that given "normal" circumstances (i.e. contractions coming on before the water breaks, no Pitocin, etc) that she had no doubt that I'd have been able to make it without any interventions.
So, even though I didn't reach my goal of a pain-med-free birth, I was able to have a calm and peaceful birthing environment and I think that was actually more important to me in the long run. So, if you made it this far congratulations to you! And as your rewards I'd like to introduce for the first time, Ms. Lillian Louise.