Monday, February 7, 2011

Callum's birth story

Depending on how you count it, my labor was either very long or very short. If you include pre-labor (the less intense contractions that got me to 4 cm), I was in labor for a total of 33.5 hours. But if you only count active labor (from 4 cm to delivery), it was only 5.5 hours.

It's weird because the time kind of blurs, and so does the memory of it all. My memory of what happened during his birth isn't chronological. Like, I know at one point I cried, but I can't remember when. And I know that I was at 4 cm, and then I was at 6.5 cm, and logically I know how much time passed between those two things, but in my memory it doesn't feel that way.

Anyway, let's start at the beginning. At around 8 a.m. on Sunday, January 23, I woke up and felt a pop low-down in my abdomen. It was in the vicinity of the baby, but I could tell it wasn't a baby kick. I thought to myself, "I wonder if my water just broke." Then I stood up and fluid gushed down my legs all over the floor. So that pretty much confirmed it.

I wasn't really in labor at that point--I had been vaguely crampy all night, and had woken up a few times wondering if something was on its way to getting started--but soon after, the contractions started. At first they just felt like period cramps, and were very irregular and mild. Over the course of the day they got progressively stronger and closer together. I spoke to my midwife, who said that she wanted me to check into the hospital 12 hours after my water had broken, but that we wouldn't even discuss induction until the next morning--she just wanted to keep an eye on things.

So, I labored at home for most of Sunday. I took a shower, Torsten and I went for a walk, I ate some lunch, and I spent most of the day on my yoga mat and birthing ball. We watched the Packers-Bears playoff game and timed my contractions. By around 4 p.m. they met the criteria for going to the hospital--less than four minutes apart, lasting at least a minute, and had been that way for an hour. I still wasn't sure that I was in active labor, per se, but since we had to go to the hospital in a few hours anyway, the midwife said we might as well just come in now.

When we got to the hospital, since my water was broken they did not do an internal exam to check how dilated I was. I was also able to skip triage and check directly into labor and delivery. My contractions had slowed down somewhat in both frequency and intensity ever since I'd gotten off the birthing ball and into the car, so we waited for them to pick back up. Torsten and I walked and walked around the hospital halls, and I spent a lot of time on the birthing ball. Both of those things caused the contractions to pick back up, but whenever I would stop doing that and just lie in bed, the contractions would slow down again. The midwife said this was not a good sign as far as labor progressing on its own--in true active labor, nothing would be able to stop the contractions. But the contractions that I was having were definitely quite painful--every time I had one, everything else would just kind of stop, and I would lean into Torsten and groan through it and try to breathe, and he would hold me and rub my lower back until it ended.

We continued like this for most of the evening and then the midwife suggested that I take a sleeping pill so that I could get some rest. She was concerned that I was going to use up all my energy in early labor and then the next day would come, I wouldn't have progressed much, and I would already be so exhausted that I wouldn't have the energy to get through active labor and delivery. So, we agreed, I took a sleeping pill, and I managed to get about five hours of sleep.

In the morning a different midwife was on duty and she came in to discuss the options with me. My contractions were still only about 6-8 minutes apart at that point and while they were painful, they weren't incredibly intense (especially in retrospect now that I can compare them to the much more intense contractions I felt later on). They still had not done a cervical check at this point and did not want to because of the infection risk with the broken water.

The midwife said that since it had been 24 hours since my water had broken, and I still wasn't in active labor, we needed to discuss options for augmenting the labor, such as Cytotec or Pitocin. I asked if I could have another hour to walk, spend more time on the birthing ball, and so on, and hope that those things would naturally kick my body into active labor. She said that was fine, and one way or another I would soon be on my way and then we could set up the birthing tub. However, before I started walking and all that again, she wanted to check on the baby with the external monitor.

When we put on the monitor, we discovered that the baby's heart rate was dropping during every contraction, and not coming up fast enough after they ended. The midwife wasn't overly concerned about this because between contractions his heart rate was nice and strong, with lots of accelerations and variation, which is what they look for. But they weren't happy about how low it was dipping during the contractions or how long it was taking to speed back up afterward.

They decided to keep him on the monitor for a bit longer to see if anything changed. But we had a lot of trouble with the external monitor--I needed to change positions during each contraction, and whenever I moved we would lose his heartbeat, and they would struggle to find it again. It was also hard to time his heart rate against my contractions to figure out exactly how long it was staying low after the contractions ended.

After awhile of the extended external monitoring and ensuing confusion, the midwife said that we needed a new plan of action. Since his heart rate was not improving, she really wanted to get the labor started--and Cytotec was not an option since once it's taken, it can't be controlled, and she didn't want to risk having it cause strong contractions that put the baby into distress and couldn't be stopped. So, she recommended Pitocin, since that can be turned on and off instantaneously. And with the Pitocin, she wanted to use an internal monitor (the kind that screws into the baby's scalp) so that we could have a better, more consistent understanding of what the baby's heart rate was doing during and after each contraction.

I think this is where I cried--I was terrified. (But I'm not sure... because I have a vague memory that the crying was at nighttime, and this was in the morning.) I'd heard all sorts of terrible things about Pitocin and the really strong contractions that it causes. The internal monitor meant that not only would I not be able to do the water birth that I had planned (and that was my main plan for pain management), but that my range of motion in general would be severely limited for the rest of the birth. I was also scared that the baby would respond poorly to the Pitocin, which would have left a c-section as the only option.

Luckily, everyone who was there supporting me was so great. I love love love my midwives--and I loved that I was able to know without a doubt that her recommendation for next steps was the right choice. I loved that I could absolutely trust her opinion and that I knew she was doing what she felt was best for the baby and for me. And Torsten was wonderful--not just in supporting me and making me feel better about the change in plans, but in general throughout the entire birth. Our nurse was also awesome... incredibly supportive and encouraging, and stayed with us during the entire birth.

They hooked up the internal monitor late in the morning, at maybe around 11? And since they had to go internal to do it, they were able to finally do a cervical check, and they found that I was dilated to 4 cm and 90% effaced. The internal monitor was a great idea in theory--not only did it provide continuous monitoring of the baby's heart rate, but it also monitored my contractions, so it was able to tell us exactly how the contractions were affecting his heart rate.

However, in practice they had major issues with the internal monitor. Something about the connection to the machine wasn't working right, so it kept losing his heart rate for many-second periods of time. They tried everything to fix it, including reconnecting it to his scalp (so he came out with two little cuts on his scalp instead of one), but they weren't able to solve the issue. It worked well enough, however, for us to see that while his heart rate was still dropping during contractions, it wasn't yet far enough to be an issue--just something to keep an eye on. And it monitored the contractions perfectly, so that helped us see the timing of his heart rate against the contractions.

At noon on Monday, when I was at 4 cm, they hooked up the IV and started the Pitocin. They put it on the very lowest dose--1 milliunit per hour (apparently it can go as high as 20)--and kept a careful eye on the baby's heart rate. At first he didn't seem to be responding very well to the Pitocin contractions, so they briefly turned it off, but since Pitocin was the only option left other than a c-section, they decided to turn it back on for a little while longer to see how he would handle it.

And, miraculously, his heart rate actually started to get better, and not drop so much during the contractions. So, they cautiously turned the Pitocin dose up to 2, the baby's heart was still handling it fine, and it turned out that I didn't need any more than that--the small dose I was receiving was enough to kick my body into active labor. The contractions started coming closer together and they were much more intense.

At this point it wasn't possible to get comfortable, even between contractions--I would try to sit on the bed and then a contraction would start and I would HAVE to get off the bed, the contraction was compelling me to stand up, and I would yell, "Ball! Ball!" and Torsten would get the birthing ball and put it on the bed and I would lean on the birthing ball and sort of sway with the contraction and the nurse would remind me to breathe slowly, try to breathe the pain away, and Torsten would massage my lower back and tell me I was doing great and remind me that the contraction was almost over and I would feel better in a second. Sometimes the midwife or the nurse would try to rub my back but I shooed them off--the only person whose touch felt good was Torsten's.

Then the contraction would end and I would need to sit down, so Torsten would take the birthing ball back off the bed so I could sit, but it felt like as soon as I managed to sit down the next contraction was already coming and I would have to get up and do it all over again. Sometimes I would have a double contraction, like a double wave in the ocean where just when you think you've crested it and you're on your way out, there it comes rising up again, and those were especially excruciating because there was no recovery time between them.

After a couple hours the pressure low down was so intense that I started to feel like I might need to push, so the nurse called the midwife to check me and I was at 6.5 cm. This was apparently actually a good thing--they only expect you to dilate 1 cm every two hours--but to me it felt so daunting, like I'd only gotten 2.5 cm in all that time and it was going to be hours and hours before I got to 10, and it was already so intense and painful, and the pushing pressure was so much and how could it not be time to push? Because it really FELT like it was time to push.

At that point I moved into transition, which I guess took a couple more hours? But it actually felt like time moved very fast during that part. The contractions felt like they were coming nonstop, like even when they broke and I was between them, there was still so much pressure that I couldn't get a break. There was definitely some announcing that I couldn't do this anymore and that I was going to die. I reminded myself at this point that our Bradley instructor had taught us that when you get to the point where you think you can't do it anymore, you're actually very close to the end--but I was convinced that for me it would really be several more hours before I was ready to push, because I had only been at 6.5 cm during the previous check, and I was really not sure I was going to be able to make it.

I was also a little worried that the baby might be in the wrong position, because I was feeling the contractions not just in my belly but also in my lower back, and that can be a sign that the baby is facing the wrong way. The contractions were so strong in both the front and the back that it felt like my entire pelvis was being crushed between boulders during every contraction. I couldn't escape from the pain no matter which way I went. I couldn't imagine taking contractions at that level for another several hours, and then still having to push for possibly several hours after that.

But then I started REALLY feeling the urge to push. Like, I couldn't NOT push. With every contraction I was pushing and moaning and I couldn't stop it. The nurse called the midwife and she checked me and said that I was at 10, that there was just one tiny bit of cervix left that she was moving out of the way, and then I could push. Since I was on the bed for her to check me, she asked if I wanted to try pushing on the bed, and I said NO, absolutely NOT, that sounded like the worst possible idea I could imagine. So she said OK, get out of bed and just do whatever feels right, and she asked the nurse to get a squat bar but there was no time for that.

I squatted down on the floor and held onto the bed and just pushed and pushed. I could tell people were doing things behind me, putting a mat on the floor and moving monitors and my IV pole around, and Torsten was there rubbing my back and the nurse was coaching me on breathing, and then the midwife was behind me and the baby was crowning and I was pushing and pushing and the midwife told me to reach down and feel the baby's head and I did and it was soft and downy and she told me to just keep pushing, that I was doing great.

I could feel him in the birth canal and it was incredibly painful and all I wanted was to have him out, have the pressure end and the baby born, and the midwife was telling me I needed to keep pushing, I needed to get him out, she told me his head was out and all I needed to do was push his shoulders out and I would be done, and I held onto the bed and pushed as hard as I could and I felt the strangest sensation, almost like a tiny wet tornado, a huge flopping fish kind of feeling, and I couldn't tell if the baby was coming out or moving back up and the feeling went on and on and I pushed and pushed and then suddenly he was out and Torsten and the midwife sort of caught him together and handed him through between my legs to me and they had trouble getting him to my arms and I could hear the midwife say, "Short cord, short cord," and suddenly I was holding Callum in my arms. I had pushed for 10 minutes total.

He was tiny and dark and bloody and his head was soft and elongated from being pushed through the birth canal so fast and his nose was all mashed and he was grunting but he wasn't crying and the midwife and the nurse were trying to get him to cry and then another nurse was there also trying to get him to cry. And then he did cry, only for a second, and then the cord stopped pulsing and the midwife had Torsten cut it, and then they took Callum away from me because he was still struggling to breathe.

I got back in the bed and birthed the placenta, and then it turned out that I had two second-degree tears so they stitched me up while Torsten was with Callum across the room while they checked his oxygen saturation and tried to help him breathe. The pediatric nurse who was dealing with him really overreacted a bit--she gave him a 5 on his Apgar at one minute and a 7 at five minutes, and the midwife and the delivery nurse both told me later that those scores were way too low for his condition--and she said his oxygen saturation was 90 even though it was actually 94--and the midwife told me she wasn't concerned because even though he didn't pink up right away, his lips were pink from the start and that's a sign that he is just fine.

I could hear Torsten from across the room, constantly pestering the pediatric nurse to bring me the baby. It was like a broken record: "Can my wife hold the baby now? Can we please bring the baby to her?" and I'm sure he was pissing the nurse off but I felt such an overwhelming wave of love and gratitude to him for being so insistent and demanding, and eventually it worked and after a few minutes they brought him to me and I held him on my chest and nursed him and cuddled him, and it was perfect, and the few minutes that he'd been across the room from me didn't even matter.


He looked like the tiniest baby in the world to me, but everyone kept saying that he was huge, and guessing that he was over 9 pounds. I knew that he wasn't over 9 pounds--I knew that he would be 8 pounds something, and when they did take him away to weigh him he came in at 8 pounds 12 ounces. Everyone kept going on about how I did such a good job in labor, and they couldn't believe that I'd pushed such a big baby out in only 10 minutes.


After it was over I felt such a huge sense of relief that it was done. And I feel so, so happy with how it went. It wasn't exactly according to plan--I had hoped to avoid Pitocin and internal monitors, and I had wanted to do a water birth--but part of the plan was knowing that you can't plan for everything, and I feel really comfortable with the decisions that we made and the way everything turned out. And I'm really happy that I was able to have the natural birth that I wanted despite some of the unexpected snags along the way. And I still can't get over what an incredible coach Torsten was--how great and loving and supportive he was. During the labor he was all that I wanted, and he was everything that I needed. I know he was worried beforehand that he wouldn't know what to do, but he was perfect.


And Callum is perfect too. I know some people say that you forget about the pain after the labor is over--and for me that's definitely not true--but what is true is that it doesn't matter anymore. It was by far the most painful experience of my life, but now Callum is here and that is more important than any amount of pain. All that waiting and all that work--and now he's here, and we are a whole different type of family. And it is wonderful.

36 comments:

  1. I am crying reading this, because it is so beautiful. And also because your story makes me want to use a midwife for my next delivery.
    What a beautiful family. And you looked so great, even in the hospital!

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  2. What a wonderful way to start my day!!! Thank you for sharing this beautiful story.

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  3. Oh I love that last shot of you all. Beautiful!

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  4. Loved reading your story! Congratulations again :)

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  5. Thanks for sharing. Great picture. Your hair has gotten so long!

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  6. OH YAY!!! I've been waiting for your birth story and I loved reading all of it! The "flopping fish" sensation is oh-so-true! It is just like that.

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  7. What a fantastic story. I am so impressed that you managed all of that without an epidural or other pain management. So glad he's here safe and sound.

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  8. *Sniff.*

    I always get a little weepy at birth stories.

    Beautiful story, and congratulations, again.

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  9. I'm so happy for you and your family! What an amazing experience -- glad Callum is healthy (and here finally! YAY!)

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  10. Oh, what a fantastic story! I'm so glad you were able to find time to write it while it's all still fresh... what an adventure! Congrats again on such a beautiful boy and beautiful new family!

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  11. I'm glad it went so well. My 2nd labor went so fast that I remember almost nothing.

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  12. The whole thing about losing your sense of time is so true!

    I'm glad everything worked out so well, even though it wasn't exactly what you'd planned.

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  13. What an incredible story! I know you said time was fuzzy for you, but I'm envious of what you do recall. I'm so happy that everything turned out the way it did for you and that you had a phenomenal support system in Torsten.

    You've inspired me to read Eric's notes and finally work on Hannah's now!

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  14. Wow what a great story! Thanks for sharing!

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  15. Jess, this is beautiful. I'm so happy for your family!! Callum is just perfect.

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  16. Thank you for sharing! I'm so happy you feel good about your experience.

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  17. What a beautiful birth story, Jess. I can pretty much promise that had someone told me they needed to screw something into my baby's head, I would've cried, too. Screw whatever you want into me, but not my baby! That said, I think most women come to terms that their birth journey / experience isn't exactly what they expected or planned ... but, at the end, when you have a beautiful baby, none of it matters at all. And what a beautiful family you do have!

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  18. What a beautiful story. Absolutely amazing!

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  19. I'm so glad you shared this, and I am so glad that Callum is here!

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  20. Great birth story! I'm incredibly amazed at moms who manage pit contractions with no epidural, you rock! And why is it that all birth stories make me cry? Maybe it's because having gone through it myself I know how amazing it is when they come out...

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  21. You look so GORGEOUS in the family picture! Truly radiating! :)

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  22. He is so cute. LOVE LOVE LOVE that everything went great, it just a tiny bit off the plan. The end result was the same!

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  23. Thank you for sharing, Jess. What a wonderful story! I'm so happy for your new family!

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  24. Wow, you are amazing! I've never given birth (I have two sons who are adopted) but can only HOPE to be as strong as you were when (if?) I do. What a beautiful story and you guys look so cute together :)

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  25. Great story! I love, love, love birth stories! I almost started crying. Congrats again!!

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  26. I love how even in the final photo, Torsten is checking on the baby. So sweet! And you look intensely beautiful in that photo after the birth, wow.

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  27. A beautiful story about the birth of a most beautiful baby. I love the fact that Torsten was so insistent that Callum be brought to you. What a wonderful birth partner.

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  28. Oh, I've been anxiously awaiting this post! Congratulations again, and what a beautiful story! Sounds like you did a great job with a fairly long and complicated labor. BTW, I felt the same way you did- my labor was either very long or very short, depending on when you start counting. Early labor for me literally took DAYS, but active labor took about four hours. Although, my water wasn't broken the whole time! Contractions hurt much less with your water still intact, I think. So you had it worse! I'm glad you took that sleeping pill at least!
    Also, I TOTALLY felt that "being crushed between boulders" sensation when I was in labor with Addy. I just read my journal with her birth story the other day and I kept saying how no matter how I tried to lay on the bed during transition, it just felt like my hips and my pelvis were being crushed. Like the pain actually had WEIGHT to it. I've never heard anyone else describe it that way, but I know what you mean!
    Also, like you, I had to wait to really cuddle with my baby at both Addy and Jamie's births- Addy because she was so tiny, and Jamie because, like Callum, he was blueish and not breathing well at first. It's SO frustrating and agonizing to wait! I really felt your pain at that part of the story!

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  29. Jess- as a newly pregnant lady, thank you so much for this realistic portrayal of your birth. I laughed when you talked about forgetting the pain of birth. My sister told me the exact same thing and that if anyone told you that you forgot, they were lying. HA! That being said, I think I need to move to your area and use the hospital you did because I don't hear anything that great about the hospital I will likely be birthing our baby in. Ack!

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  30. AHHHHHH!


    I don't know how I missed that you posted this, but I am so, so, SO happy to see it.

    I teared up reading about Torsten advocating for you. So, so sweet.

    It's crazy how much the Bradley Method helped us plan and prepare for birth; Mike especially. I knew he wanted to be involved, and it really, really gave him a great .

    Rereading this reminded me of my own birth. By now, lots of the details are getting fuzzy for me, but I so many of your feelings I remember. (Except 100% trusting your midwife. I 75% trusted mine, but 110% trusted the nurse. Crazy, right?)

    I'm quite envious of your short time pushing!! I pushed for 2.5. :( My baby was 6 lbs 13 oz. And I've read that babies that weigh more than 8 lbs actually are easier to get out than smaller babies. Something about weight and gravity? I'm not sure if it's true, of course.

    Anyway, YAY! For you and a great birth experience. :)

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  31. great birth story! congrats again. Oh, and you do kind of eventually forget the pain... well not forget, but it gets kind of fuzzy. :)

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  32. Beautiful story -- Jess, I've been a long time avid reader and adore your writing style and getting to watch/read your life story unfold. Best wishes for you and your family.

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  33. Nice work, Jess! Get all the rest you can and enjoy that handsome baby. Can't wait to hear about his further adventures!

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