Wednesday, January 20, 2010

Makena's Birth Story

On Sunday night around 10:30 pm we were just getting into bed and laying down to watch some TV before bedtime. I felt something that sorta felt like a cramp, but totally different at the same time. It started small and felt bigger and then went away slowly. And I said to Pam "Hmm. That was a new feeling." She asked if it was a contraction and I said "I don't know, maybe?" And soon we were asleep.

At 11:23 pm I woke up. I felt it again. I got out of bed and went pee. Lay back in bed and felt another one at 11:32, 11:36 and 11:43. I figured they were only 10 seconds or so long, I wasn't timing them and they weren't painful. But definitely a different feeling than the tightening of a Braxton Hicks. I fell asleep.

Woke up again at 3:30 am, went to the bathroom to pee again and noticed bloody show. I was feeling excited that this was it. But I still wasn't in any pain so I figured I'd just wait and see what happened next. I decided to sleep on the couch to not disturb her. I grabbed a pen and notepad and started to keep track...

3:36
3:46
3:59
4:08
4:16
4:26
4:36

They were definitely contractions and coming about every 10 minutes. I wasn't sure if I should wake up Pam yet, because although they were uncomfortable, I felt fine.

She woke up to use the bathroom and I said "hi!" and she came into the living room. I said "So, I've been having contractions all night." She asked "Really?! Are you okay?!" And I explained that I was fine. We went back to the bed to try and sleep but couldn't really. She timed them at

5:12
5:16 for 30 seconds
5:21 for 45 seconds (this one felt stronger than all the others)
5:27 for 34 seconds
5:31 for 45 seconds
5:36 for 54 seconds
5:44 for 36 seconds

We decided to stop timing them and try to get some rest. They were stronger but still totally bearable. Still felt less intense than my usual period cramps, so I wasn't worried at all.

I was able to fall asleep for a little while, mostly dozing on and off (while still aware that I was having contractions) and woke up around 8 am starving. Pam made me oatmeal, eggs, and toast. I gobbled it up and then went back to bed. I noticed I wasn't having any more contractions. When I woke up around 10:30 am I still noticed I wasn't having any contractions so we decided to go grocery shopping to walk around. It was raining and we had lots of "severe rainstorm" warnings so we had to pick some place indoors! We went to Whole Foods and then had lunch at BJ's (Outback was closed and I burst into tears in the parking lot.) After that we walked around Valco Mall for a while. I'd been having an occasional contraction, but nothing in a regular pattern and nothing stronger. There was one while at the mall that made me stop walking for a second, but then it passed so quickly I was fine.

We came home and I was so super sad that everything seemed to have stalled. I wondered if we should call Judi but we decided not to since there wasn't anything really to do. We also decided to not tell anyone that anything was happening, so even though I'm writing this now I won't publish this entry till afterwards. ;)

Had dinner, took a bath. And still the occasional random contraction. I decided to break out the breast pump and try some nipple stimulation. It wasn't very fun at all. I did 5 minutes on each side and then was hit with a pretty strong contraction. And since then, the ones I've felt have been MUCH stronger. In fact, the last 4 I've had while typing this have forced me to get up and walk around the apartment practically doubled over in pain.

I insisted that Pam try to get some sleep in case it fizzles out again and she has to go to work tomorrow. I'd hate for her to be up all night with me when I'm totally fine. Yes the contractions I'm having now are way worse, but I'm dealing okay! I think I might go take another bath. I'm tired, but definitely not able to sleep through these. I haven't been paying attention to the time, but I've had 2 more pretty painful ones. They are coming on so strong so quickly. There isn't a build up like there was earlier. These are like BAM pain!

I ended up taking a bath and the contractions were coming on so strong that even the warm water wasn't providing any relief. I started to cry and imagined how difficult this was going to be. Already it was so much more painful than I expected.

I woke up Pam around 2:30 am, and told her I needed help because it was so bad. She started to time the contractions and I had to pace back and forth between the livingroom and kitchen each time one hit me. Around 5:30 Pam called the midwives and talked to Serena. She asked Pam how I was coping and a few other questions. Pam told her I wasn't coping well at all and she suggested I try to relax between each contractions. Pam said they were coming between 2-4 minutes apart and was instructed to have me rest and focus between them. So we lay down in bed and I tried to relax but it was really hard. The contractions started to slow down and space further apart. Pam was using the website www.contractionmaster.com instead of looking at a watch or writing down times she just had to press a button on the computer at the start and end of each contraction and the website calculated how long they were and how far apart. The fact that my contractions slowed down meant that I wasn't in active labor yet. It was so discouraging. I couldn't wrap my head around the idea that I wasn't close to the end. It was overwhelming to realize how far away I still was, and I started to second guess everything I had planned.

I was really surprised how painful it was. I knew I needed relief from the pain and none of the techniques we learned came even close to helping. At one point I was crying and walking around the livingroom and leaning on the kitchen counter each time a contraction hit and I went to look for Pam. She was in the bedroom scanning the pages of the Birth Partner book trying to find some help in the pages. I could see that she was starting to get overwhelmed and had no idea how to help me. She was trying so hard to stay strong but I can't even imagine how very helpless she felt because really there was nothing to do and I was clearly not dealing well. Breathing, focusing, moaning, nothing was working. I told her I was done. That I was ready to leave and go have the baby. That I couldn't go on like this. She reminded me that we couldn't arrive at the birth center yet because I wasn't in active labor. That we had to spend more time at home. I had pictured these hours at home before leaving to the birth center so completely differently. In class we talked about spending the early labor hours baking and doing puzzles and all that fun stuff. Why wasn't I experiencing that?! Why was I already in so much pain? I'll never know.

Pam called the midwives again around 9:30 am and told them that I was ready to give up. At that point I was so upset that I wanted to just drive to the nearest hospital. Serena told us to come in and they'd check me out. Pam loaded up the cooler with our snacks and drinks and got all our stuff ready. I felt like time was moving in slow motion. We finally made it down to the car and headed to SF around 10:30. The car ride wasn't as awful as I had feared it would be. My contractions seemed to slow down even more and I only had about 6 during the 30 minute ride. When we got to the birth center we walked in and I went into the exam room where Serena and Evalee took my blood pressure and a few other stats and watched me have a few contractions. I was close to hysterics at this point because it was so unbelievable to me that I wasn't at the end yet. Judi came in and I could hear her telling them that I had to relax. So I had to lay down on the exam bed and Pam sat in the chair next to me. It was awful. Finally I got up and gave a pee sample and they told me I had to eat something because there were keytones in my urine. I had a handful of pretzel sticks and some apple flavored Recharge drink. But I kept feeling like I'd throw up if I ate and had no appetite. I was exhausted and feeling SO frustrated that it was so hard. I didn't understand why it was a million times more painful than I imagined.

After a while they suggested that we go to the hospital to get a morphine drip so that I could get some sleep. They were worried I wouldn't have the energy needed for when active labor started. I was worried about that too, and welcomed the idea of actually DOING something. So around 1:30 pm we drove the few minutes to the hospital and Serena and Evalee met us there. I got a bed in the triage area of the labor ward, and we all sat there in the little curtained off section while I got hooked up to the monitors and all that crappy stuff, including an IV so I could get some fluids. My contractions kept coming on strong and painful. Everyone was trying to help me breathe through them and focus, but it was impossible. The nurse took my blood pressure and they got a few high readings. I was going to get switched to a better bed once one opened up, so Serena and Evalee left to get some sleep since they'd done a birth that morning and needed rest. They promised everything was going to be fine and that once I got some rest I could return to the birth center and all was good, and made sure we knew to call them for any reason and they'd come back.

But then once they left and I was moved to a bed things changed. Because of the high blood pressure the midwife on staff at the hospital said I couldn't get the morphine and had to be admitted to a real room. I could care less at this point. I knew in the moment that we walked into the hospital that the course of my labor was going to drift drastically from what I had hoped for.

The midwife decided it was time to get me checked to see how dilated I was. I was really happy when she said baby was at -2 station and she could feel it's head. I was 4 centimeters and completely 100% effaced. It would have been beyond devastating if she said I was only 2 or something. We went across the hall and I was settled into a labor and delivery room at 3:30 pm. (I totally have no sense of what time it was...I'm checking the monitor paper strip readout for times as I write this!) They told me that since my contractions were slowing again they wanted to give me a little bit of Pitocin to jump start them again. And again I knew what was coming. Through tears I said "okay" and looked at Pam. Now I was on the road to all the cascading interventions that I really planned to avoid. I knew that if I got Pitocin to agument my labor I was going to want the epidural. It was a moment of clarity and understanding that it was out of my hands. I made a mental decision to just do whatever I needed to do and kept my eye on the prize. I felt oddly okay with giving up and felt more upset over having to convince Pam that I was seriously okay with it all. She was scared that I'd end up regretting it and wasn't sure if she was supposed to try and stop me or something. We had a good cry together and knew we just had to stay strong and take it step by step and that it would all be okay in the end.

They asked if I wanted to take a bath and I said yes so they got the tub ready for me and I got in. After I got out of the bath I started asking for pain medication. They hadn't started the Pitocin yet but I told them I wanted the medication before the contractions got any worse. The midwives and nurses on staff were very reluctant, they knew I was a Sage Femme transfer and knew a medicated hospital birth was the last thing I wanted and they were committed to supporting me as much as possible. So even though I was the one who brought up getting an epidural, they suggested I try Fentanyl which is a narcotic that would help take the edge off the contractions. It's given in super small doses and can be given again every hour but only up until a certain point because if it's given too close to when the baby is born it affects the baby.

So we tried that, and I think I got 3 doses before making it very clear to them that I seriously wanted the epidural. It was hard for me to see Pam as I said these things because she knew how very much I didn't ever want that. But I explained to her that I knew exactly what I was asking for and that I really was okay with it. And I was. At that time I knew with complete clarity that I welcomed the relief that I'd be getting, despite everything I'd ever hoped for.

I asked the nurse to call the anesthesiologist and it took forever. EVERY thing was taking forever. I was hungry and they urged me to eat now before I got the epidural and couldn't eat. My sister and Brianna and my mom and dad were all making their way to the hospital, and Pam went downstairs to meet them and get me some food that my mom was bringing. But then the anesthesiologist was there and explaining everything and I texted Pam to come back up to me. At about 8:00 pm I finally got pain relief! The epidural wasn't nearly as terrible as I assumed it was. Really I was so looking forward to not feeling the contractions and sleeping! I had to get a catheter put in. When it was done and I was feeling better my family came in and we sat around. Pretty much everything I never wanted was happening. And I was totally oddly at peace with it all. The #1 thing I was feeling was total exhaustion. I was just so tired and knew I'd never make it through pushing a baby out if I didn't get some rest.

Pam made everyone clear out of the room at 10 pm. We turned off the lights and tried to sleep, but it just wasn't happening. My blood pressure cuff took a reading every 15 minutes. My pulse meter thing on my finger kept losing my pulse and the alarm would go off. Nurses kept coming in to take my temperature and fix my finger pulse thing. The Electronic Fetal Monitor kept losing the baby's heartbeat so they had to readjust it. So pretty much I got maybe an hour of sleep in little 10 minute increments. Pam was sleeping on the bed in the corner of the room.

I started to feel some contractions and pushed my button a few times to get an extra dose of the medication. Then it started to hurt even more. I was totally surprised by this, and when the midwife (at this point there was a shift change and our new midwife was Michelle. She was awesome and kept saying "Jolly good then!" we liked her right away) came in to check me I asked why it was hurting so much and she explained that the baby had moved so far down that I was going to feel the pain since the epidural doesn't work once the baby is so close to coming out. (I remember looking at the clock as midnight passed and realizing that baby would be born on January 20th and be an Aquarius.) Then around 12:30 am she said I was 10 centimeters and could push if I wanted to. You'd think hearing this would be so exciting, but again, all I felt was exhaustion. I never once felt the urge to push. They suggested we try an hour of Passive Descent, meaning we'd wait and let the baby slowly make it's way down on it's own.

An hour and a half went by. I still didn't feel like I needed (or even wanted) to push. But I knew that I had to do it soon or the baby would never come! I asked what options I had for pushing positions, knowing I didn't want to be laying down in bed. They offered a few things and I decided to try the squatting bar but since I couldn't actually get up and squat they had me put my feet on the sides of the bar and pull on a sheet that was tied like a rope around the top of the bar. So that's what I did. My mom, sister and niece came into the room and I started to push around 2 am.

I was in a lot of pain again from the contractions and was getting upset that the epidural wasn't working anymore. I asked for more help and they explained that we could get the anesthesiologist to come back and adjust the dose but it would just prolong my labor even more. And I understood that completely and decided I'd just start pushing.

And so I pushed. And pushed. And pushed.

And the clock kept ticking on. Sometimes I was able to feel the contraction and tuck my chin and lift my pelvis and pull the sheet and push the right way. Other times the contractions were so painful that I had to cry out and couldn't concentrate enough to push. I remember asking Pam to help me but again there was nothing she could do. Then the awfulness would pass and for the next contraction I'd be able to push. Each contraction I got about 3-4 pushes, and sometimes they'd urge me to push one more time and sometimes I could. Other times I'd decide on my own to do one more push even if I didn't feel the contraction any more.

And still the minutes were just moving by in slow motion. An hour of pushing went by and I was super discouraged. I didn't know how I could push any longer. I was afraid of pushing for hours and hours on end, and afraid that if it came to that they'd make me have a c-section. I was even more afraid that I'd agree to it.

They kept saying I was doing a great job. That they could see the baby's head. That I was so close. My water still hadn't broken and they would tell me that they could see it bulging out. The midwife said it was going to burst all over any minute, and eventually it did. Man that was a lot of water!! I couldn't believe how it just kept gushing out of me with such force!

They brought a mirror over and I tried to see but it just upset me even more because there was hardly any head to be seen!! I still knew it was going to take longer. It was so frustrating to know I was doing such hard work and didn't see any results.

I was SO tired. In between contractions all I wanted to do was sleep. I remember closing my eyes even. And I was hot, so hot. My mom was fanning me with a paper plate and then my hair would get in my face and it was so annoying but the cool air felt so good! My sister had the video camera recording and Brianna was every once in a while saying "You can do it Aunt Katy!" Pam, of course, never left my side and continued to help me by holding my knee and foot where they had to be, and with her other arm she helped lift me under my neck to curl and push correctly. The midwife would sometimes put her fingers in me where I had to push. It was helpful to feel that and know where to direct my energy. My mind was boggled by the fact that I was still feeling such terrible pain.

I had to keep being reminded to lift up my pelvis so that the baby could fit under and come out. And when I did I felt (and saw) a difference. The baby's head was showing more and more, but still time was going by slowly. 2 hours had passed and I'd been pushing the whole time. They kept saying they could see hair on the baby's head. All I could see was a tiny sliver of wrinkly scalp.

At one point they wanted me to stop pushing because my heart rate was up too high, and that was torturous. Then they said I was looking pale and they gave me some oxygen twice for a few seconds.

And then, a little after 4 am the machine couldn't distinguish between my heartbeat and the baby's. They fiddled with the monitor pads on my belly and still couldn't be sure they were picking up the right heartbeat since mine was so fast and it was confusing them. The midwife explained what was happening and said "We'd like to attach an internal monitor to the baby's head if that's okay." And I said NO. And she said "Okay, well, we'll see if we need to..."

Let me tell you. That next contraction came and I PUSHED with so much determination that all of a sudden in the mirror I could see that the baby was finally crowning. The room seemed to explode at this point. "Ok stop pushing!!" Everyone seemed to be busy and there was such a hustle and bustle. I knew the baby would be born any second. I kept looking in the mirror. And then I started to push again and I felt the head come out and heard them saying they were unwrapping the cord from around the baby's neck. It unwrapped so easily, and then I pushed again and Pam reached down and grabbed the baby and then it was on my chest and I was holding my baby and it was so warm and smooth and slippery and so amazing. I was in total awe and shock. I didn't say anything. I didn't even cry. I just stared at the baby in amazement. I finally tore my eyes away and looked at Pam. She was teary and telling me how proud she was of me, and she thanked me for being so strong. We spent a million hours staring at our baby. Eventually someone asked if it was a girl and we checked and she was definitely a girl! I was so tired still. It was like everything around me was moving but I was on pause.



She was so quiet and content. Only cried a few little peeps. And she started to root almost immediately and sort of crawl up and over to my breasts. She was ready to nurse right away.

Somewhere in the midst of this the midwife was checking me and said I had 2 tiny bilateral labia tears. She needed to stitch me so that they wouldn't fuse together and so I got one stitch on one of them but she left the other one alone. I also had a minor hematoma. The stitch hurt, so she gave me a numbing shot but that really hurt too! I remember being so acutely aware of what was going on down there despite the fact that I was 100% focused on my baby. I just kept stroking her back and arm. I'll never forget that feeling of her skin. It was the softest thing I'd ever felt.

Oh, and we can't forget about the placenta! It was time to push that out and I was surprised how I totally could feel it coming out. I thought it would just slip out practically unnoticed. It didn't hurt at all, but I did feel it. The midwife showed us the placenta and the sack where the baby lived all that time. It really was fascinating! She said the cord was about 10 feet long. I don't know if she was exaggerating or not, but it definitely was long! We waited till it was done pulsing before clamping it, and it took such a long time. She kept commenting on how long it was taking. Pam and I each felt the cord pulsing, and that was cool. Finally it stopped and Pam not only got to cut the cord, but she clamped it too! They pretty much let her do everything that we were hoping she'd get to do at the birth center. It was really awesome.

Overall we felt so very grateful for the care we received. The staff was amazing and really made every effort to please us and ensure we had a positive experience. With each shift change the new nurses would come in and tell me that they had read over our birth plan. I kept telling them that it didn't matter, that already so much was thrown out the window but they were all determined to stick as closely to it as possible. We never called back Serena, and it wasn't intentional, we just felt so throughly well cared for and it didn't cross our minds to ask for more support. I know she would have been there for the birth if we called, but it was okay.

Also, the moment my head was clear enough to have a thought I was starving. My stomach was grumbling and I was hit with crazy hunger. Pam held the baby skin-to-skin and I ate.


They weighed the baby and did some other tests and stuff. We were all in shock when they said she weighed 9 lbs 3 oz!! 20 and 3/4 inches long, and head circumference of 36 centimeters. Her APGAR scores were 8 and then 9.

The baby doctors came in and examined her. They said she had to have blood drawn for glucose testing since she was labeled LGA- Large for Gestational Age. They wanted to test her blood every few hours but I told them I'd only consent to twice. We were really unhappy that she had to be poked and prodded. The second result came back really high and they thought it was a mistake so they did one more. Poor little girl was crying so hard!! And they did the vitamin K injection and Newborn Screening test. So many tears. :(

My mom, sister and Brianna left in the wee hours of the morning and then it was just me, Pam, and our baby girl. It still seems so surreal. We've been walking around in a dream-like haze these last 4 days!

After a while we decided it was time to pick a name. We looked at our lists again and made the decision:
Makena!
Born January 20th, 2010 at 4:13 am


The name Makena (pronounced like the name Mackenzie but with "ah" at the end) means "filled with happiness" and it's just perfect for such a dream come true baby!

We are over the moon with love and joy. There is so much more to write but my darling daughter is starting to wake up and my boobs might explode if I don't feed her soon!