Tuesday, August 25, 2009

Wednesday's child? (Fig's birth, Part 2)

Warning: This does eventually have a very happy ending, but because it involves a fair amount of unpleasantness, I might suggest that my pregnant friends not read this before giving birth. Also, if it is going to upset or offend you that I go against medical advice, don’t read any of what follows.

See Part 1 for the set up.

Now, back to the birth story.

The nurses at the hospital were really nice, and that actually helped calm me down a little bit. At least, I eventually stopped crying. But everything took so long. I had “pre-registered” at the hospital, but was still met with a barrage of seemingly useless cover-your-ass questions that I certainly could not have answered had I been in real, significant pain. And there was the fetal monitoring, which required me to lie down, or at least recline, in bed. It was only supposed to take 20 minutes, but I swear I was tied down in that bed for an hour and a half. I was glad to be reassured that Fig was doing fine, but I was not happy about being stuck in bed. I was so afraid that lying down would make the contractions go away again, and I kept begging them to let me get up and move around.

My doula arrived at some point. She was a god-send, I swear. If she wouldn’t have been there, it would just have been Rob and me alone in that room forever. With her there, she helped calm me down and saw to it that I got what I needed. She kept telling them that I wanted to be unhooked from the monitors; maybe it helped speed them up, I don’t know.

Eventually it was time that they were going to “check” me… ie., to see how far I had dilated if at all. I was terrified of this, knowing that I would completely lose it if they determined that I was zero centimeters and zero percent effaced. I was afraid it would hurt to get checked, but it didn’t hurt at all. And the nurse pronounced that I was 4cm and 90% effaced. My doula cheered, and I gave a halting sigh of relief. It was better than nothing. In fact, for someone who’s water had “just” broken, it would have been pretty good. But considering that this had been going on for over 12 hours now, it was a little bit disappointing. I tried to feed off everyone else’s enthusiasm, even though they were unaware of how long my water had been broken.

They eventually started the IV (pricking me several times with no success and causing more pain than the contractions at this point) to give me the antibiotics for GBS. Thankfully my doula got them to unhook me from all the other stuff they had me hooked up to so that I could at least stand and sway again. I think that sometime around this point, we talked Rob into grabbing a bite to eat in the cafeteria while things were still calm with me. Unfortunately, the only thing vegetarian that they had to eat was some kind of garden burger I had once thrown up, and I smelled its repugnant stench on him for the rest of the time I was in the hospital.

Rob asked me if I wanted to let our parents know that we were at the hospital, but I still felt too insecure and out of control at this point to tell anyone. I felt like I at least wanted a better handle on what was happening before we told anyone. I guess I was still in a bit of denial, having been so sure that Fig would be born during a thunderstorm, when the moon was new. I was too terrified of what might happen to let anyone know.

Things began picking up at some point after this. Rob said that when he returned from dinner, my doula had me rocking on the birth ball, but I have no such recollection of this. The pain intensity definitely picked up, and I began feeling very sick to my stomach. During contractions, I started to dry heave, and my doula anticipated actual vomit just in the nick of time by producing one of those little kidney shaped bowls for me to puke in. After 9 months of hyperemesis gravidarum, throwing up during labor didn’t phase me. In fact, it gave me some hope for 2 reasons. First, the contractions didn’t hurt as bad when I puked through them. And second, puking is often a sign that you’re entering the transition phase and the baby’s arrival is imminent.

When the checked me again I was at 5 cm and still 90% effaced. My doula was again enthusiastic, but I felt crestfallen. God, how many hours had it been and how many times had I puked? I had thought I was close to the end, but I was still only halfway there and in definite, real pain.

I said I wanted to go into the Jacuzzi. At this hospital and with my OB, having a water birth was not possible, but I would be allowed to labor in the tub until I got to 9 cm. Unfortunately, even though water is a non-medicinal form of pain management, the OB still had to approve it in order for me to get in. By this point, there had been a shift change and I had a new nurse. She was nice but strictly professional and she looked so young I could hardly believe she was old enough to have graduated from nursing school already. I was vomiting and in substantial pain, and I kept asking for the tub because I thought somehow, water would make it all better. The young nurse told me she had called Dr. T 3 times and left messages requesting to let me get in the tub, but Dr. T had not called back yet. I tersely told her to go call Dr. T again.

My doula suggested that I get in the shower until Dr. T approved the order to allow me to get in the Jacuzzi. I agreed. My contractions were all very low, and I couldn’t really tell if they were in the back or the front. I eventually decided that I wanted the water running on my lower back, and my doula unhooked the showerhead and held it where I asked. The showerhead was kind of like one of those kitchen sprayers—small and ineffective. Everywhere but the small area where the water was actually hitting me was very, very cold. My teeth were chattering and I was shaking uncontrollably all over, partially because I was freezing and partially because that sort of thing just happens during labor. Oh, and also I kept throwing up, sometimes 2 or 3 times during each contraction. My doula was wearing scrubs and must have gotten drenched to the bone as she patiently held the water on me, unfailingly telling me how good I was doing, how good my breathing was, etc. I don’t know how long I was in the shower, it seemed like hours or days. Rob and my doula took turns holding the water on me.

At some point while I was in the shower, I asked when my midwife would be coming in. Even in my haze of pain and nausea, I could see a shadow pass over my doula’s face. “Honey, she’s not on call tonight. Dr. T will be the one to catch your baby.” No, no, no, no! I wanted my midwife!! She would be sure to say something like, “Girl, you’re doing great,” and it would make me feel better. After everything I had done to assure that a midwife would catch my baby, it turned out that it would be a doctor afterall. I think I cried for a while and kept asking for my midwife, but eventually everything hurt too bad to care anymore. It was just something else I would have to endure.

Finally, mercifully, the young nurse came in and said that Dr. T had approved the order for the Jacuzzi and she was filling it up with warm water for me. Hallelujah. I thought for sure that this would ease the overwhelming pain I felt. Somehow, Rob and my doula packed up all our things and we moved to the room with the Jacuzzi in it. I got in, just as my entire body was wracked with the strongest contraction I’d had up to this point. I couldn’t help but make some kind of inhuman wail and fall to my knees in the tub. There was no relief to the pain once I was in the water. In fact, it seemed to be even stronger.

Dr. T came in at some point and said in her lilting sing-song voice, “How are we doing in here?” Rob said I did not respond (in fact, I could not respond), I just stared at her with a look that would have killed a lesser woman. I guess I was still bitter about her long delay to approve the Jacuzzi, even though being in the water hadn’t helped anything.

Rob knelt or sat at the edge of the tub, and I clung to him, alternately breathing in the veggie-burger stench and vomiting. The room was dark and the water was warm, so that part was nice, but the pain was so intense it felt like my pelvis was breaking in two and that all of my organs were about to fall through my pelvic floor. It felt like I was in the tub for hours or days; I didn’t even notice when the water got cold. Finally, the young nurse said she would check me again and that she would try to do it in the water so that I wouldn’t have to get out. This time it hurt really bad when she checked me. I thought for sure I must be at 9, that there would be an end to all of this soon. She tried to sound professional, but I could hear remorse in her voice when she said, “It’s the same, you’re still at 5.”

It was inconceivable to me that I had not progressed at all. I had no sense of time at that point, but my doula later told me that I had been stalled at 5 for 4 hours. It was quickly approaching Wednesday. And I knew it was over, it was all over. I would lose all autonomy, I would lose every last shred of my hope to bring Fig into this world in as gentle a way as possible, all waterlogged and tender. It would be a cruel entry into the world now. There would be drugs and their consequences. Terror and contractions do not mix well. I was in unimaginable pain. Continuing like this for a few moments longer felt like something I could handle, but the knowledge that I was still only halfway there was insurmountable. I had tried and failed. My body could not do this on its own. Everybody had been right.

My doula’s eyes were sad and concerned when she asked me what I was feeling, if I was angry. I could barely respond, but I said that no, I was not angry. I just didn’t know what to feel. My doula and the young nurse went over to another corner of the room to whisper; I didn’t even have to hear the word pitocin to know that was what was being discussed. And I reconciled myself to it, just like that. I thought fine, let them give me pit. If I get pit, I’ll get an epidural, and then I won’t feel this anymore. I could see my yoga teacher telling us not to feel bad if we ended up getting an epidural… sometimes your body just gets so stressed that you’re actually holding yourself back and if you go ahead and get the epidural, it allows you to relax and have the baby in no time. That’s what I wanted. This wasn’t about my pride, this was about giving Fig the best possible birth. And Rob had said all along that Fig was a fighter. Fig would prevail whether the birth was gentle or not.

Sunday, August 23, 2009

Tuesday's child? (Fig's birth, Part 1)

Warning: This does eventually have a very happy ending, but because it involves a fair amount of unpleasantness, I might suggest that my pregnant friends not read this before giving birth. Also, if it is going to upset or offend you that I go against medical advice, don’t read any of what follows.

So. I wrote several entries that I never actually posted because they were too anti-everything, but that means there is some pertinent background information that is missing. I’ll try to summarize it now.

At my 37-week prenatal appointment, I found out that I was GBS positive, meaning that I am carrier of a bacterium called Group B Strep. It’s no big deal; something like 30% of the population carries this in the microbiome. I don’t think GBS really does anything (it is not the bacterium that causes strep throat, for instance), because if you have it, (like me), you don’t even know. And just because you have it at one time, that doesn’t mean that you always have it. You could test positive at 37 weeks and end up not having it at all when you go into labor. Or vice versa—your test results could show up negative, but a few weeks later when you’re in labor you could have it and nobody would know. The problem is that if you are GBS positive, during birth, the baby might pick it up. I’m not sure what the transmission rates are—only that sometimes it happens. And sometimes, sometimes if the baby does acquire it, the baby could become really sick and possibly even die. Statistics for morbidity and mortality of infants who get GBS from their moms during birth vary depending on what source you are looking at. I’ve seen 1/4400, 1/2000, and 1/5000.

So what they do for this is give the mother antibiotics intravenously during labor in order to prevent the baby from getting GBS. I don’t know why it has to be intravenously (i.e., through an IV and not in the form of a pill or something); for some reason, I guess it just does. It’s not like this is something that has been done since the dawn of time though—they only started screening for GBS and giving antibiotics sometime during the 80’s. So… you’d think that this should have a positive impact on reducing neonatal mortality, right? Well, not exactly. There’s not been any good evidence to show that this protocol is really doing anything to lower the already extremely low rates of infants who acquire a GBS infection during birth. In fact, there was just a Cochran review (considered a gold standard in the medical community, from what I gather) published that indicates the use of antibiotics is probably not worth it. Here’s a direct quote from the summary of the article: “Very few of the women in labor who are GBS positive give birth to babies who are infected with GBS and antibiotics can have harmful effects such as severe maternal allergic reactions, increase in drug-resistant organisms and exposure of newborn infants to resistant bacteria, and postnatal maternal and neonatal yeast infections.” In fact, the article is pretty much summed up by this statement: “This review finds that giving antibiotics is not supported by conclusive evidence.” But still. Doctors give the antibiotics. Because.

Typically, they give you penicillin for this, but I am allergic, so they have to give you something else. You must be given 2 doses of this antibiotic, 8 hours apart. Which means, I would have to be in the hospital for at least 8 hours before giving birth. Plus, instead of releasing you 24 hours after birth, they keep you and the baby for 48 hours for observation. Being GBS+ also puts you on a different timeline for delivery. Because transmission of infection is more likely in longer labors, when the water has been broken for more than 18-24 hours prior to delivery, OBs are wont to speed things up. I specifically asked about this, and my particular OB/midwife team only gives you about 12 hours after the water breaks before they start pushing the pitocin and talking c-section. This news seemed like a death sentence to my dream of a natural, unmedicated childbirth. After getting the GBS results back, I lived in constant terror that my water would break and I’d be put on the countdown-to-“unnecesarean” timeline. It was not a happy way to spend the remainder of my pregnancy.

So that brings us to Monday, the 10th of August. I was 38 weeks pregnant, just at the cusp of what is considered “full term.” I went about my day as normal. I had a prenatal appointment in the morning and everything looked good. In the evening, I walked over to a La Leche League meeting, about 1 mile away. I had a really good time talking to the other mothers. Then I walked home. I felt good but was tired and strangely hungry and non-hungry at the same time. I got home about 8:30 or 9pm and checked my email. I had a message from SL, saying that he had made it most of the way through my dissertation and that he thought it was in good shape and I could anticipate defending it soon. A sigh of relief. I realized I had never really eaten dinner and was hungry, so I made a banana-soymilk-chocolate-peanut butter smoothie. After I ate it, Fig moved around like crazy. I’d never felt Fig move like this. I didn’t know whether to laugh or be a little bit worried.

Eventually I went to bed. Everything seemed fine. I woke up around 2:30 in the morning feeling intense pressure. I jumped out of bed a split second before water started trickling out of me and I ran in the bathroom. Has anyone ever hoped more fervently that she had just peed herself? No such luck. It was my water, breaking. I said something that I cannot repeat here on the blog. I was filled with a white-hot, ice-cold terror, more panicked than I ever had been before in my life. My water had broken and I was having no contractions. It was the worst case scenario I had feared my whole pregnancy, and even moreso since finding out I was GBS positive.

I didn’t know what to do. A huge part of me wanted to pretend that it hadn’t happened and just go back to bed. No part of me considered going into the hospital immediately, as I had been carefully instructed to do on account of the GBS.

The house was a mess. I did a load of laundry, scrubbed the floor. There, was that a contraction?? It was hardly noticeable, so how could it be? I stayed moving, constantly swaying, hoping that in the very least I could get the baby into a good position. I tried to reconcile myself to the fact that this baby would be born on August 11, a Tuesday, 10 days before it was due. It just didn’t seem real. I was exhausted. Finally I tried to go back to bed, in a state of terror and denial. I couldn’t sleep because it hurt. Contractions that were barely noticeable while I was standing, swaying, were much more evident when I was lying down. I tried to think of this as a good sign. Too panicked to sleep, I got back up and made Fig’s birthday cake. Throughout the whole pregnancy, one thing I wanted to be sure to do was make a cake for Fig’s birthday while I was in early labor. I thought maybe if I went ahead and made the cake, it would speed things along. I still didn’t have a plan of what to tell my doctor, the hospital, my doula.

The cake was done, then what? The same light contractions sometimes came every 5 minutes, sometimes spacing out to 8 or 10 minutes. The sun came up. It had been several hours already. I had to figure out what to do.

Rob didn’t go to work. We tried to watch TV but every time I sat down the contractions stopped. I knew I needed to rest, but I was scared of the contractions stopping. We walked around the neighborhood several times. I rocked on the birth ball. Every hour I took my temperature to make sure I hadn’t spiked a fever (which would be a sign of infection). I checked the baby’s heartbeat with a Doppler as an indicator of whether or not he/she was in distress. Everything kept checking out fine, but I knew that was no guarantee.

It’s just that at this point, I was going to have to lie to everyone about when my water broke, and that was incredibly stressful to me. As the day wore on I became positively frantic. I realized that my level of stress was probably holding me back from progressing. I tried to do some yoga breathing/relaxation to calm myself down, but that was easier said than done. Finally, about 12 hours after my water broke, I just couldn’t handle it anymore. I was a little scared about infection and GBS transmission, but I was really scared about even rarer complications, such as cord prolapse. I felt like this might go on forever with no progress if I continued doing what I was doing. I had been trying everything possible to get this going, and nothing had worked. I was getting really tired—having basically been on my feet and in constant motion for the past 12 hours. It was time to face the music.

Filled to the brim with dread and terror, I called my OB’s office, expecting to speak to my midwife and to have her tell me to come in and we’d decide if I needed to go to the hospital or not. But they patched me through to the OB instead. I did my best to convincingly state that I thought my water may have “just” broken, and she told me to go straight to the hospital. I called my doula and she said she would meet us there.

There was nothing left to do but go. I had visualized and meditated on the birth for my entire pregnancy and it had been nothing like this. I knew how important it was to go into this with no fear, no panic, but now, fear and panic was all I had. I sobbed all the way to the hospital. It felt like I was marching straight towards the operating room—never in my whole life had I felt such a strong sense of something going terribly, terribly wrong.

We rode the elevator with a woman in a wheelchair. “Oh, when are you having your baby?” the woman asked, her voice raspy like it was hard for her to breathe. “Today,” I said, but was crying so hard I could only manage a whisper. The woman smiled and congratulated me. “You know, they play a lullaby through the whole hospital every time a baby is born. I will be listening for the next lullaby they play… it will be for your baby!” I tried to smile and think of the lullaby they would play for Fig, and to push away my fears of pitocin, scalpels, operating rooms.

We stepped off the elevator onto the Labor and Delivery floor, and it felt like I was walking straight into doom. By telling them that my water had just broken, I had bought myself 12 hours. I only hoped it was enough.

(To be continued)

Tuesday, August 18, 2009

Nothing like a marathon

Most people who follow this blog probably already know by now that Fig has arrived. Fig was born on August 12th at 1:19 in the morning, weighing 6 pounds, 12 ounces and measuring 19.5 inches long. We named him William Miles Raguet-Schofield. He came 9 days early and 2 days before my 30th birthday. He is wonderfully healthy and happy; he loves to eat and sometimes likes to sleep, but usually not at nighttime.

Someday I will write the whole story of his birth, which ended up involving a lot more drama than I’d hoped. Giving birth was absolutely nothing like running a marathon. It wasn’t even like running a hundred marathons back to back. Writing the story may take me a while; I don’t really have the time to get anything done these days. I’m not even finished with the thank-you notes from our last baby shower.

Rob has posted a lot of pictures on his blog and flickr account; here are a few of my favorite ones.

Thanks for reading.

Waterlogged and tender
Minutes after birth

Meli & Will

Joyful daddy

Will sleeps

Will relaxes

Tuesday, August 4, 2009

Fig's month

As soon as I flipped the calendar over to August, I thought, well, this is Fig’s month. I suppose there’s a slight chance that it could happen during the very early days of September, but more than likely, it will be August. Really, from any day now to the end.

My yoga teacher is out of town for the next two weeks and when I found out she would be gone, I had a brief moment of panic. Over these past several months I’ve realized how much she knows about getting your mind and body ready for birth and labor and how much I've benefited from the class. We’ll have a substitute teacher while she is gone, but it won’t be the same. After class last Thursday, she hugged me and wished me the best just in case I had the baby before she got back. But she doesn’t think it’s going to happen while she’s gone. She predicts that Fig will be born on August 25 and that he will be a boy. We’ll see.

On Saturday, we had another baby shower. This was mainly a family shower that my mother in law put together, and it was great! I had felt really sick the morning of the shower, to the point of freaking out about whether or not I was even going to be able to go, but I eventually got my second wind. My mother in law had gone to so much work organizing everything and making it really nice. And there were so many presents. But afterwards, really, we have just about everything Fig could possibly need. It took me forever to organize, sort, wash and fold little clothes and blankets, but I am finally starting to feel like we might be somewhat ready.

With the grandmothers

37 weeks

A very cute book from Auntie

The guys congregated at Rob's parents' house and showered Rob with gifts as well.

Our Nausea was starting to act up again towards the end, and even "Proud Dad" was getting a bit tired.

It will be a race to the finish to see which will happen first—will I finish my dissertation or will Fig be born? As of today, I’ve got a 260-page, 60,186 word draft of the entire thing (excluding references and random front-matter). All the other drafts I’ve completed have been lacking a conclusion chapter, but I’ve finally gotten that put together, so I went ahead and threw it in and then sent it off to SL in the vain hope that he’ll read it. I have no idea how close it is to being finished. My NSF proposal took 10 full drafts before it was defensible. I’ve lost count of what draft this is for my dissertation, but technically, I’m still calling it draft 2. SL has looked at most of the chapters at least one time, and this version consists of my revisions based on his comments. If it takes 10 drafts before this thing is ready to go, that could end up taking another 10 years. Though I suppose they would kick me out of the department before then, and SL might be close to retiring by that time. So hopefully it won’t come to that. Keeping my fingers crossed that I can get all major revisions taken care of before Fig is born and still defend it this semester.

Thanks for reading.