Sally’s Birth Story: Part 3

12 Sep

In the early morning hours of Tuesday, August 23, I woke up to use the bathroom at some point. Don’t know the time. I was quite uncomfortable, and thought I had downed way too much Chick-Fil-A lemonade before bed and had really held it in for too long. I went and then got back in bed, and my bladder and sides of my lower abdomen felt noticeably sore. Sometime later—could have been hours, could have been 20 minutes, I have no idea—I again woke with the feeling I really needed to use the bathroom. It was 4 a.m. I kicked my poor orange tabby cat out of the bed and sat up.

Warning! Everything from here on out packs a whole lot of TMI.

I sat up, and something came out. First thought was, I really held this in too long! And now I can’t control it. Embarrassing! But as I walked to the bathroom, part of me wondered if it could be something else.

Remember, I have experience with my water breaking because of PPROM (preterm premature rupture of membranes) with Jane Darby. But this was definitely different. That was more of a trickle over time; this was a little gush. Still, not like the movies where it’s pure water and it all comes at once. In fact, I don’t recall the whole of it ever actually coming during labor, but I know it must have.

I went to the bathroom and, while I still wasn’t 100% sold my water had broken, I knew something was different. Something was changing. I gently shook Drew from sleep and said, “I think my water broke?” He didn’t need convincing, poor guy! He shot right up in bed and got moving.

I went to our living room, from where I have made many a call to Labor and Delivery, and phoned my doctor’s office after-hours line. That was around 4:12. Then I called a good friend from church to come stay with my kids. That was around 4:15. Almost immediately after talking to her, my doctor called back, telling me to go on in to the hospital.

I went back to our bedroom and kind of moseyed around a few minutes. I wasn’t really sure what to do. Also, I was a little out of it and it wasn’t quite registering in my head yet that my body was beginning to do interesting things. Contractions didn’t start right away, but I got crampy and sore pretty fast.

Drew was trying to hurry me along, and at one point he said I needed to go ahead and call the doctor and call a friend. I was proud to tell him I had already covered all that! Finally I put on my outfit for labor, something I’d picked out a few weeks before at Target: a maternity sports bra, maternity yoga pants, and a loose and lightweight pink workout top. I had to remove the tags; I had wanted to return the clothes just in case I didn’t get to wear them in the long run. But voila!: I was about to get my second chance at labor.

The contractions started somewhere in there. I wasn’t paying any attention to my water, but I’m sure it was still coming. We left the house about 4:30 when my friend arrived, and by that time I was having contractions that I had to focus through, breathe through, and really, really didn’t want to try to speak through. I was fully aware of what was happening and was actually able to recall what I’d learned about coping skills. In hindsight, I realize how quick the progression was to strong contractions, but at the time I didn’t make the connection. And to me there was no sense in timing them: this was most likely it.

Sweet Drew ran a stop sign or two in our neighborhood, and of course I got onto him. I guess he could tell it was game on, and he was nervous. On the way we called his parents, my parents and my sister, just to say we were pretty sure it was go time.

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Parking at St. Vincent’s

When we arrived to St. Vincent’s, we actually got one of the parking spots for moms in labor! That had never happened before with my other births. Drew says I hurried on in to the hospital ahead of him, and accidentally pushed the down arrow instead of the up arrow on the elevator. Whoops!

When we arrived to the birth suites, I was very coherent except during contractions. But I was consciously working hard to breathe the way I’d been taught, to open my hands instead of clench them, and not to exert energy by yelling out or screaming. Plus, while bad, they weren’t bad yet. I knew that now. Had this been Rose’s labor, I would have totally been freaking out. But I had new information in my tool belt. Also, Drew was doing a good job of reminding me what to do. I sure am glad he was there to help.

To a triage room we went. Man, we have spent lots of time in those little rooms. However, this was our quickest stay to date. They wanted me to put on a hospital gown, but I said I’d like to keep on my labor outfit. They wanted me to sit in bed, and I said I would, but that I wanted to be able to be out of bed to better handle contractions eventually. I stayed in bed the whole time with Rose, and I know now that really contributed to my discomfort. I was proud that with Sally, I actually advocated for myself in the midst of everything else.

Very quickly I had to give a urine sample, and the nurse tested me for amniotic fluid. She said she could tell my water had broken even before the test; at this point it was pretty obvious. When she read the test strip, she said, “Ohhh yeah. No doubt.” Also, I was 5 cm. I had been a 3 the previous morning in the office. So it was a done deal: baby on the way. I noted the date, August 23rd, her birthday.

I was wheeled down the hall, having some contractions on the way in the wheelchair, and admitted to room 333. 3rd child, 3rd girl, easy to remember. This was all right around 5:15.

Everything else in this story occurs over a short 42-minute timeframe.

Things were now thrown for a bit of a loop, but I have to say I handled it well. Because my water had broken, the prospects of being out of bed, moving around, walking, bouncing on the birth ball, etc., to get through contractions went out the door. So I got rid of my cutesy little laboring outfit and put on my cutesy little personal laboring gown. So glad I made that purchase. I’m proud of that gown and what took place while wearing it.

When there is no longer any of that water to cushion baby, chances of cord compression increase dramatically. The nurse had to remind me of this and confine me to bed, but when she did, I had a lightbulb moment, understood, and definitely complied without protest. I knew it was going to hurt even worse now because of being in bed.

But also, she warned me, when your water breaks, supposedly labor contractions in general are more intense, more painful. She let me know I didn’t need to be a hero, and that most people whose water breaks end up getting an epidural. Another nurse in the room said the opposite: “Oh no, you can totally do it, Katie!” I wonder if she didn’t think I wasn’t going to end up getting that epidural anyway.

So, through hard and fast and getting-much-worse contractions, the notion that this labor was going to be an anomaly—i.e. more painful than what most would bargain for—got in my head, and I told the nurse, “I’ll take that epidural then, thank you.”

Yeah, I gave in, sorta. Had I actually had time, I would have gotten that epidural. Period. I’m not ashamed, though, because it was rough, but now knowing what I know, I believe and hope I’ll be able to fend it off next go around.

For me, it’s not necessarily the contractions themselves that make labor hard. It’s the anticipation of them, the fact that you can feel them coming before they come, and knowing that as this goes on, it only gets worse and worse. It’s funny, but I learned this from Rose’s labor, one that was medicated and supposed to be pain free. Ha! It is the fear of, “Wow. This is actually going to get worse,” that gets me.

While all this was going on—again, over a very short time period—I could tell my labor was progressing like crazy. My contractions were hard and fast and nearly constant. I asked the nurse to check me again, which was probably only about 20 minutes since I’d been checked and determined to be 5 cm. Poor nurse; she was trying hard to admit me, get me to sign consent papers and draw my blood. None of that ever actually happened until after birth, by the way.

So she checked me, and I was 7 cm. I think my eyes probably popped out of my head, and I shot Drew a look. I knew that getting to 7 that fast wasn’t good if I wanted some relief. You don’t realize it, but before you get an epidural, you have to have your blood drawn, you have to have your labs cleared, then they have to pump you full of fluid for 45 minutes, then you have to hope the anesthesiologist is up and raring to go at 5:30 a.m., all before you get the drugs. (Again, something I learned from Rose’s birth.)

So when they told me I was already a 7, I looked at that sweet nurse and I said, “I’m not getting that epidural, am I?” and she said, “I’d probably start getting used to that idea.”

After I was told that, I feel like I accepted it and was ready to get the show on the road. I quietly gave in. Drew agrees. It’s like once you know you have no other choice, you just have to deal. So that’s what I did. And I was grateful that I had done a little bit of research; I thought it was my idea, but now I know I was prompted by the Holy Spirit!

All the while, Drew was reminding me how to breathe, rubbing my shoulders, and not letting me squeeze his hands so I wouldn’t be tense. He was amazing. He’s not for hire, but if he was, clients would be well pleased.

Only about 5 minutes after I was a checked and was a 7, crazy things were happening. I can’t really explain, and I can’t really remember honestly, but somehow I knew the baby was getting ready to come very soon. I asked to be checked again. Probably not calmly; I probably sounded like Linda Blair. The nurse was reluctant, because she had just checked me 5 minutes before. But she checked again and, boom!, I was a 9. 2 cm in 5 minutes. (I didn’t know at the time, but labor that fast and that hard can indicate a sort of problem. We’ll get to that.)

Everything got a little chaotic then, which I have observed to just be a standard thing when babies are about to come out of you. At least, it’s been chaotic at that point in all my births. Lots of nurses come into the room, and there is this feels-like-forever time period when you keep asking for the doctor and the nurses keep stalling. I knew my doctor was on her way, and I was so thankful and actually lucky that she was the one on call that night. Still, I don’t think anyone thought my baby was coming that fast.

While waiting on the doctor, a series of things happened. I definitely felt the need to start pushing against the pain. Some of the nurses seemed a little wary of that idea, but others told me to do whatever I felt like I needed to do. So I pushed against the pain. The contractions were, oh man, insane, and I did start yelling a little. Breathing through them I made really weird gasps for air. In comparison to Rose, though, I think it was all more controlled. Even in the midst of all this, I definitely was trying to be in control. Drew agrees, thankfully. I’m glad I have him for reference!

Also, because I was wiggling around so much, they were having a difficult time getting baby’s heart rate on the monitor. Truly, they hadn’t really gotten a good read on her ever since we arrived. Things were just so fast and so crazy. The nurses really wanted me to get on my side, to better get that heart rate, but, and I’m sorry, I flat-out refused. I just couldn’t do it. It hurt almost as much as the contractions to try to turn over.

At a certain point, I felt a very distinct and very sharp pain low on my right side. It felt like a stabbing or a ripping, and it wasn’t a contraction. It was separate. I hollered out, “What’s that?!” I think everyone in the room, including Drew, thought, “What’s what?” I tried to explain what I was feeling but was told it was probably just baby moving down through the birth canal. I have my own non-professional opinions about that pain, which didn’t go away until after she was born, that I will share shortly.

I don’t remember when my doctor arrived—maybe before some of this, maybe after some of this—but when she got there things just kept on as they had been. I was pushing against the pain of every contraction. Only, they put my legs in stirrups for official pushing.

I won’t go into detail here about what the pushing felt like. I don’t think I’ll have to write it down to be able to remember. I wouldn’t chiefly describe unmedicated pushing as painful, but moreso awkward. This was a distinct difference compared to my labor with Rose. This was a new feeling, and while I didn’t like it, I maintain that the pain of contractions is what defined the pain of my natural childbirth. All other pains associated—the pushing, the actual coming out of baby—really did pale in comparison. For those reasons, I’m willing to say that Rose’s labor was, maybe not as intense, but nearly just as hard and painful because of its 19 hours in length. That epidural didn’t work. Sorry. It didn’t. I’m so pleased to be able to say that!

Meanwhile, contractions were coming very hard, very fast (my doctor’s words.) Not normal; I didn’t know. I began to plead for help between them, something I did also when in labor with Rose. I tend to find whatever pair of eyes in the room is available—a nurse’s, Drew’s—and quietly look in them and just say, “Please help me.” Pitiful! I guess it’s just a standard response my body has to pain.

I was given oxygen, to perk up baby I suppose, because her heart rate was dropping a tad. At this point I wasn’t all there, because I didn’t really relate the fact that I also had oxygen with Jane Darby, which turned into an emergency C-section. Or, I just didn’t think to fret it. But when the nurses and doctor kept saying they needed me to work with them so they could find the heart rate, I knew something was up, and I asked for them to just go ahead and knock me out and take the baby with a C-section. Thankfully, I was assured it wasn’t like that; she was going to be okay.

Still, my doctor decided it was high time baby Sally was born. She needed to come out because of her heart rate. The doc quickly performed an episiotomy and let me know she was going to use a vacuum to get Sally out with my next contraction and next push. Later she told me the baby would have been out in 1-2 more pushes anyway, but that Sally needed to come out for her safety, and so she hurried things along.

Funny, because it was almost like being in the eye of the storm waiting for my next contraction. They had been coming so hard and so fast and it felt weird to sit there and wait for it to come. Drew said it was as if the room was quiet and we were all twiddling our thumbs. But that last contraction eventually came, and it was a doozy, let me tell you. It hit like a truck! I pushed against it before I even felt it because I knew it was knocking on the door. (So interesting how that works; definitely the most peculiar thing about contractions.)

I don’t know much about what a vacuum does, but the doctor used it and it worked. I heard someone call out “5:57” and Sally was here.

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First photo ever taken, 11 minutes after birth

When she came out, she was limp and not crying. I have, however, observed that none of my babies cried right away. Perhaps that’s an only-in-the-movies thing. Drew said he was also a little worried because Sally was so limp, but that he could see her little toes moving. I kept asking if she was okay, and my doctor kept saying over and over that she was just fine. She has always set the stage for calm and control during my deliveries; I can hear her reassuring tones even now, in all three of my labors.

Jane Darby: “Katie, we need to go ahead and get the baby.” Rose: “Katie, we’re here, we’re helping. We’re here, we’re helping.” Sally: “She’s going to be fine, just fine.” I do love my doctor.

Even so, the doc quickly cut Sally’s cord without asking for any assistance from dad, and they hurried her over to another place in the room to give her a thorough and pretty long look-over. The nurses said they needed to “make her mad” because her first APGAR number was a 5 (above 7 is what they want to see.)

Someone from the NICU, I was told, was there to check her out. I didn’t like the sound of that, but I was in super shock mode from what had just happened, and chose to trust the doctor and nurses who said she’d be fine. Jane Darby was whisked away immediately at birth; they weren’t whisking this baby anywhere, so I put my faith in that.

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7 lbs. 9 oz. 21 in., our longest and heaviest baby

While the doctor delivered the placenta, Drew and I kept looking at each other wide-eyed. Did that just happen? Is our baby really here? Was it really that fast? Weren’t we still asleep 2 1/2 hours ago? Did I really go all natural? Complete and utter amazement. We were dumbfounded.

My doctor mentioned she found a small blood clot on the back of my placenta, indicating a likely placental abruption. I am not very educated on those, other than to know they are really dangerous and typically diagnosed earlier in pregnancy. Basically, the placenta detaches and baby begins to lose its life support. My doc couldn’t (and wouldn’t) say for sure if that was the cause of Sally’s heart-rate drop, and the intense labor pain and progression, but she suggested it very well could have been.

She also said the abruption was likely either caused by the fast labor, or the fast labor caused the abruption. I, not being a medical professional by any stretch, guess it’s the latter. Also, I wonder if the major pain I felt on one side during delivery wasn’t me actually feeling something going on with the placenta. Perhaps not, but I’ve heard an abruption is extremely painful. Needless to say, I’m glad we are on the other side of that issue.

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Happy to hold Sally

Eventually, Sally was handed over to me and we had some lovely skin-to-skin time. I remember wondering if her head wasn’t shaped like a cone because she’d moved so fast during her escape. Holding and learning her, reflecting on our so-far crazy day and watching the sunrise over downtown Birmingham was a true gift to Drew and me. It was a high-on-life feeling that I’ll always find myself trying to remember and relive. In fact, it was almost addicting. I already knew within a few hours that I wanted to do that again!

Read Part 4

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