Friday, August 20, 2010

Eliana's Birth Story

Eliana's Birth Story

Here's my story, shortened, and maybe why I feel as strongly as I do about avoiding induction when necessary-

I went in Friday morning at 38 weeks (although knowing what I know now about ovulation and EDD's, I'm 99% sure she was only 37 weeks) to have my blood pressure checked and without any further testing they said I had to go to the hospital that morning. My dr wasn't there yet so it was another dr I'd never met making that call. I tried to explain that work was extrememly stressful (Hello! Personal Banking during the recession!) and that my boss's boss was on her way from Seattle to meet with me.... I could hardly sleep the night before I was so stressed.......and that maybe we should read my blood pressure later. But no, they insisted I had to go now. I didn't know enough to be my own advocate so I said ok. In hindsight I should've had the option for bedrest and bp monitoring- not just ushered off for an induction. My work stress should've been taken in to account. A 9am meeting with the big boss from Seattle over some touchy stuff doesn't make for a great 8am bp reading.

Once we got to the hospital it took 2 hours for them to even get me and Eliana on a monitor and once they did I got, "uh, baby looks great, why are you here?" Then they took my blood pressure and said, "oh yeah, it's a bit high." But never did it seem emergent like they acted at the dr's office, and still I never got the option to go on bedrest for a few days. It took two 12 hour sessions of cervidil (looks and is used like a mini tampon with a really long string) and laying nearly flat (ow!) the whole time. I was allowed to get up to go pee and to walk for 30 minutes between the cervidil sessions. I had contractions the whole time; some minor, some painful enough I couldn't sleep. After the first cervidil there was literally NO change. I was thinking, "how can I be having all these contractions but nothing is happening!" Looking back I think, wow, my body was clearly saying it's not ready. The message your baby sends to your body when it's ready to come wasn't happening because Eliana was definitely not ready. Then after the 2nd cervidil I was slightly softened, but that's it. Still pretty much no change. My favorite nurse just chuckled and said, "why don't they just send you home to rest for a few days since nothing is happening?" But it was almost like since the ball had started rolling no one wanted to stop it and I didn't know enough about the process and my rights to stop it myself. In the wee hours Sunday morning (two days into labor by then) we started Pitocin and by 5am my water broke. The contractions were strong but I could breathe through them ok and decided to get the epidural around 9 or 10am. I had thought about going natural, but quite frankly I was exhausted from 2 days of laying in a hospital bed and having constant contractions. The whole process had been anything but 'natural' for me. And for someone like me who was up working and moving every day of my pregnancy, it was horrible having to lay flat for so long. I wasn't allowed to get out of bed unless I had to pee, even though Eliana had zero signs of distress. I also wasn't given a room with the jacuzzi tub and was never offered one. So, other than peeing I was flat on my back with the fetal monitor on 24/7 for 2 1/2 days. It was hell.

Getting the epidural itself was excruciating. Like to the point that I thought, "Um, that hurt a hell of a lot more than any of my contractions. Why am I doing this???" Dr. Worth, the anesthesiologist, said it went in weird and it doesn't normally hurt like that and he wasn't positive it would work at all. Ohhhhh great. It did work, mostly, for about 4 hours. The Dr had to come in and adjust it every hour since it would all of the sudden stop working, but I at least got to doze for a while. I woke up somewhere around 2pm and thought someone was trying to kill me. I went from sleeping peacefully to all of the sudden dilated to a 7 with strong contractions and deep stabbing in my lower back- but like on my insides. Lovely back labor. I grabbed the sides of the bed and literally couldn't breathe. I remember staring at the ceiling and just thinking OH. MY. GOSH. ! Dr. Worth came back and tried to fix the epidural but it was a no go. Nothing he could do helped and I realized then that this was going to be all natural (as 'natural' as pitocin contractions can possibly be) as I was now at about 8cm. Now at this point my mom (who was going to be in the room with Craig and me) was at my grandfather's funeral.......I know, bad timing. I held Craig off on calling her but realized these last few cm were going quickly and if she didn't get there fast she'd miss the whole thing. She got there about 30 minutes later and at that point I felt this even deeper, stabbing pain in my lower back. Within minutes I was like, "I need to push, I need to push now!" The nurse came in and said, "I just checked 15 minutes ago and you were only a 9..." I insisted she check again and sure enough I was a 10 and ready to go. She ran in the hall and grabbed Dr. Bohannon(whom I'd never met) and the pushing games began. This whole time my mom is standing over me reminding me to breathe because I kept freezing up from the pain, and trying to talk me through the pain. I couldn't even scream it hurt so bad. I was still on my back with monitors on. The pain was more than I ever could have anticipated. I didn't know that standing or squatting would've helped A TON with the back labor. The nurse said it was "normal to feel some lower back pressure even with an epidural". It's like she wasn't understanding that the epidural didn't work. It wasn't 'some pressure', this was full on labor and back labor no less (which my mom had with her babies, too)! It felt like I had no break between contractions, not even seconds, they just kept coming and coming (thank you Pitocin!). Anyway, the Dr was in the room and the nurse started counting me through the contractions and telling me when to push and when to breathe (a method of labor that many civilized countries have abandoned, by the way) and within 30 minutes little Eliana was out! I pushed hard and furiously because I honestly thought if I couldn't get her out fast I might just die right there on the bed. I didn't even want to touch her head, I was afraid it would break my concentration and I just needed it to be over with. I couldn't enjoy the thought that I'd meet her soon or even process the fact that my baby's head was within reach. The pain and process was horrible. I can tell you there definitely was no epidural. Ring of fire? OH yes. I felt the tearing, I felt everything. I even felt the dr stitching me up afterwards and I started crying and she looked at the nurse and said, "uh, I thought she had an epidural?" To that I replied, "uh yeah, that didn't work, I can feel everything!" She gave me a shot of something down there and finished the stitching with less pain. It's like no one was actually in the room or on my service long enough to know that 1) yes I did get an epidural around 10am, 2) the epidural stopped working sometime before 2pm, and 3) I could feel EVERYTHING- including those stitches on the tear that just seemed to be insult to injury. Give the poor woman a break, a little lidocaine never killed anyone! I didn't scream so maybe they figured I was just being dramatic about the epidural not working, but once they knew I could even feel stitches I got more empathetic looks. It was confirmed later by the anesthesiologist that it never fully took and definitely was off for the last 3-4 centimeters of labor. So basically in over 50 hours of labor I got a 4-5 hour semi-break.

After all this I was exhausted and poor Elly was too. She was lethargic and had no interest in me or nursing. She didn't make eye contact and I felt incredibly disconnected from her. I believe this was from the whole induction process, including the epidural drugs being pumped into Eliana and me, despite the fact they didn't 'work'. By the time she actually came neither of us had anything left. There wasn't excitement or 'bonding' the way I expected. We were simply too pooped. After birth she was quickly grabbed, given her vit k and hep b shot, weighed, measured, bathed, and given the eye crap (NONE of which I should've allowed them to do immediately and most of that not at all. I was so clueless). She was also only 7lbs which is very small for anyone in Craig's or my family. We tend to have babies that are between 8.8 and 11lbs. Then we were moved to another part of the hospital and had to stay for 2 more days because of Eliana's jaundice (another issue with induced babies). I wanted to go home SO bad but once again didn't know my rights as a patient enough to fight for myself. 5 days in the hospital for a vaginal delivery of a healthy baby is absolutely ridiculous. Her bili levels were never even close to 'brain damage' level,  and I felt like the dr's were just covering their backsides and using up my double insurance.

Once home on Tuesday we had to do the Bili light from Harrison Home Health for the rest of the week. I mean, this was not an ideal situation. 5 days in the hospital and then we finally get home and we're stuck to a cord in the wall. I never really saw the point anyway since we were told (by Harrison) that the maximum the bili-light would help was 15%, the other 85% is from breastfeeding.

Nursing was a major issue. She couldn't latch successfully even once and I wanted to give up. I was afraid I was starving her, especially after a couple nurses said I had to give her formula and "it's not a big deal if I don't nurse" (really? not a big deal?). The support and tough love that breastfeeding moms need in the first few days wasn't there with the hospital nurses(although the lac consultant was extremely nice and sweet, just too busy), but fortunately was available from my mom and cousins. On day 3 she finally latched (with a shield) and the next morning my milk was in and we never looked back, although had to use a shield the entire duration of our nursing relationship. She did have about 1oz of formula at the hospital, given to her by a nurse, but that was it. Then sharply at 2 weeks to the day, the colic started. Blood curdling screams from about 5pm til 1am, 3am....basically all night. She was up eating every 1 1/2 hours and often every 45 minutes. It was literally the ONLY time she didn't scream. I was lucky to get 2-3 hours of sleep at night. Nothing calmed her; swaddling, rocking, bouncing, car rides, sound machines, eliminating dairy completely from my diet,etc. The Happiest Baby on the Block methods. You name it, I tried it. Shortly after the colic started she also had GERD. The colic lasted in it's glorious severity for a full 4 months, the GERD was treated with Zantac and by 6 months she seemed fine. I kept dairy out of my diet for a full 3 months but noticed literally no difference so went back on dairy after that.

When I'd see moms out and about or at a dinner party with a newborn I felt slightly jealous and wistful and wondered what that must be like. I was a prisoner in my home for that 4 months. People would ask us over or to dinner and I had to try and explain, without crying, why I would be sitting home. Well meaning and opinionated people offered all their advice and what I 'should' do, but nothing worked. I just braced myself every day and tried to get through it and prayed that I wouldn't hurt her in my frustration and exhaustion and waited for the day she'd outgrow it. It was a very dark 4 months for me.

All this to say, I wonder in my own heart how many of our struggles could've been alleviated if Eliana was allowed full residency and not evicted 3-6 weeks early. For colicky babies they say it's often like they need another couple months in mom to develop their nervous system and ability to self soothe. Surely more time in me would've helped Eliana. With Gerd it's an issue with a valve above the stomach not closing properly and allowing acid to wash back up their throat. I also feel this might've been resolved with more time to develop in utero. You might disagree with me, these are just my own personal feelings and ponderings.

So anyway, obviously next time around I will try to be as healthy as I can and allow my child to stay in as long as possible.

I also want to make it clear I have nothing against Dr.'s, nurses, etc. I love my current Dr. and I respect her knowledge and position. I just simply feel that women need to educate themselves and realize that there are almost always options. We have rights as patients even if we're never told what they are- it's our job to learn them. Obstetricians are trained surgeons. A friend put it this way, "would you use a cardiologist instead of a regular MD just in case something happened to be wrong with your heart? Obviously not. But using an OB (who is a skilled and wonderful surgeon) instead of a licensed or nurse midwife is like doing that." I feel truly blessed that I didn't end up with a C-section after all the interventions I faced. Maybe it was a good thing my epidural didn't fully take so they couldn't just wisk me away to the OR when I things weren't 'progressing fast enough'.

And as far as the whole formula in the hospital situation, obviously that was frustrating and probably not handled the best way by those particular nurses. What I've found through months of educating myself and being a part of La Leche League, is that sometimes in the medical community they like formula more than breastmilk simply because it's predictable and easier to track. When a baby is nursing there's no real way to know exactly how much they're getting or the caloric content of that day's milk. It's about trusting your body to do it's job and trusting that your boobs and baby will communicate about the baby's nutritional needs. With formula you can measure, count calories, and track easily. This feels safer for some practitioners/nurses even though they know that breastmilk is clearly best. I can't necessarily fault them for liking something they can keep track of, however that is a sad reason to negate the importance of breastmilk. Any supplementing in the first few weeks can be detrimental to milk supply! Find a pediatrician who is very supportive of breastfeeding and that will help a lot. Have a network of breastfeeding support BEFORE you give birth. I could go on about this, but I think you get my drift. Feel free to read the other breastfeeding posts on my blog.

There is so much I didn't know before I had Eliana and I think that is often true for first time mothers. It's important that we be educated and know our options.
I LOVE the DVD The Business of Being Born and there are awesome books out there as well. My two favorite birth books are Ina May's Guide to Childbirth by Ina May Gaskin and Baby Catcher by Peggy Vincent (my entire immediate family read that one after Eliana's birth). And of course there's a lot of websites.
Don't rule out a homebirth or VBAC just because you think you might be high-risk- you might be surprised :) Learn your options. Even in a hospital birth, there are options.

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