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Sorry it took so long for me to post this, I had to edit out all the names and such! I know it's really really long, but I wanted to remember EVERYTHING. I hope you enjoy it!
The story of William's birth begins at 37 weeks gestation, when we found out that he was in the frank breech presentation (butt first rather than head first). Since our hospital's policy does not allow for vaginal breech births, the implications were immediately clear: if we could not get him to turn, he would be delivered by Cesarean section. I was pretty crushed by this news. I had been planning for a drug-free, doula-assisted labor and delivery, and I could sense all that going out the window.
The first ultrasound that confirmed his position was not able to tell us whether the umbilical cord was wrapped around his neck. The technician could only tell us that that cord was "near" his neck, and also that my amniotic fluid levels were rather low. These two factors contributed to Dr. P's decision not to try an external version, where the fetus is manipulated into a head-down position by pushing on the mother's abdomen. Instead, she encouraged us to try several home remedies which might help Will turn on his own. We scheduled a follow-up ultrasound one week later.
For the next three weeks, I stuck to a fairly regular combination of treatments and exercises. I had a moxibustion session, with an acupuncturist in town recommended by G, my doula. While I reclined on her table, she burned a Chinese moxy stick near my pinkie toes, which is an acupuncture point that increases blood flow to the pelvic region and supposedly gets baby to be more active. After the treatment, I bought two moxy stick of my own and performed the treatment on myself every evening.
During one of my pre-natal massages, G did a guided relaxation treatment with me, in which I bathed myself in a glowing light and directed energy towards my baby while visualizing him in the correct position. I found this very relaxing and used it many times in the following weeks to help myself get to sleep, or to calm down when I was feeling stressed.
I started going swimming in the mornings, at the new public pool, and did handstands in the water. I found the swimming to be very enjoyable and will try to keep it up once Will is a little older. Will would kick a lot during the swimming, which encouraged me to stick with it.
A few other exercises at home completed my regimen: going on all fours, doing pelvic tilts, and lying inverted on an ironing board, or with my butt propped up with pillows. I also went to a friend's house twice and laid on her inversion table. I shone a flashlight and played music into my pelvis. And lastly, I drank water. Lots and lots and lots of water. Dr. P said that it could help increase my fluid levels, and if the repeat ultrasound was better able to tell us the location of his cord, having more fluid could increase the chances of being eligible for a version.
While many of these things seemed to encourage Will to move, none of them worked to get him to turn. I knew this before going for the repeat ultrasound, but we went anyway, and sure enough, he was in the exact same position. The fluid levels were increased, but the cord situation was still unclear. I am very glad, however, that we went for the follow-up, because for the first time we got to see his face. We also saw his feet, tucked securely next to his head. Dr. P joked that he would look funny when he was born, because he would put his feet into that same position due to having been stuck that way in the womb for many weeks. This would turn out to be true, and DH got a great photo.
Reluctantly, we booked the C-section for Friday, May 8th, hoping that the home remedies would kick in and get him to turn before then. I tried to keep up with everything, although somehow I knew it wouldn't work, so maybe I was only trying half-heartedly at that point. In my mind, I stopped visualizing the drug-free vaginal birth, and started thinking only about the C-section.
I was worried that Will would be taken from me in the first moments of his life. I was afraid that I would be too drugged and groggy to really bond with him. I had a hard time accepting that all the preparation I'd done for a drug-free birth would be wasted. I let myself feel bad about it for a few days before I decided that the only way to deal with it would be to accept it and move on. Once I had decided that I would survive the C-section SOMEHOW, I started to read about it. I went back to all the chapters in my baby books that I had skipped, and read about the type of anesthesia I would receive, what the incision would look like, how the surgery would progress, and what would happen to Will. I wrote a list of questions for Dr. P.
As a last-ditch effort to turn Will, I visited a chiropractor to perform the Webster technique, a pelvic alignment designed to make more room for baby. In the waiting room, I found a magazine with an article showing step-by-step illustrations of the C-section surgery, which I asked to borrow. The treatment itself was relaxing, except for the part where she massaged my round ligaments. I found it to be rather painful, and later in the evening I had some painful cramps in my abdomen. I was a little scared by that, but Will continued to move and kick - but of course he didn't turn.
At my last pre-natal appointment with Dr. P before the big day, I brought my list of questions and my magazine article, and we talked about all my concerns. I was very reassured that everything would be okay, but I still managed to lose my cool and cry some. Dr. P gave me a hug and told me that I would be taken good care of. In that moment, I gave in to my instinct and put my total trust in her. I knew that the C-section would go smoothly, and that Will would be healthy, and that I would get to see him and bond with him just like I wanted. And as it would turn out, all of those things happened.
On May 8th, 2009, at 5:30 in the morning, DH and I arrived at the hospital. The car was packed with a bag for me, a bag for Will, a bag with reading material and camera equipment, and the car seat. We left everything in the car except for the camera bag and my purse. After we parked, DH used the bathroom on the first floor while I sat in the waiting area, nervous but excited.
We took the elevator to the second floor, Labor and Delivery, and as I picked up the phone to get buzzed in, the doors swung open. The nurse at the desk was expecting us. Since we were pre-registered, I didn't have to fill out any paperwork. She asked me a few questions, gave me a hospital bracelet, and then we were led into the triage area, where we met my nurse, H. We would discover that she too was pregnant, and had Dr. P as her OB! I was given a hospital gown to change into, which I did, and since I was wearing sandals, I also asked for some socks or slippers. They gave me a funny-looking pair of brown socks with non-stick tread on both sides, but they did the job. My own clothes and shoes went into a white plastic bag marked "patient belongings." I got an IV in my right arm, held down with special foam pads, and some tape. I got a second bracelet, on my left arm, with information about my blood type. Fluids were started in the IV, and I gave H my "birth preference" cards that I had prepared ahead of time: one for her, one for the baby nurse, and one for the anesthesiologist. I also signed a few consent forms for the C-section.
Then we were left alone for a while, to give the fluids time to enter my blood stream. DH took a picture of me sitting in the bed. H came back and I was put on the monitors, one for Will's heartbeat and one for my contractions. Will's heartbeat was great. The contraction monitor didn't pick up anything - not surprising because I wasn't actually in labor. But I did actually have some contractions while sitting in the bed, and H readjusted the monitor so we could see them. I had two more before I was taken off the monitors, since Will looked great and there was really no reason to keep them on.
Soon, DH was given a pair of scrubs to change into, and once he did, I took a picture of him. H shaved off some of my pubic hair. I wheeled my IV pole into the bathroom to have one last pee as a pregnant lady. While I was in the bathroom, my best friend called from England and left a voice mail on my phone. I was thinking of calling her back, but suddenly Dr. P arrived, and the room became a flurry of activity. Apparently Dr. P had another patient in labor and dilated to 8 cm!! I remember hearing her ask one of the nurses whether that woman's membranes had ruptured yet. I didn't hear the reply. An ultrasound machine was wheeled over to my bed, and a quick scan revealed that William was indeed still breech. The C-section was on.
Next I was introduced to G, my anesthesiologist. He was a large man with red hair, a deep voice, and a very commanding presence. He read the "birth preference" card, and seemed more than willing to accommodate my desires, chiefly that I have everything explained to me as it was being done, and that I avoid being given any drugs that might make me drowsy during the first few hours of Will's life. G explained the entire procedure very thoroughly, including all the drugs that might be administered, and recommended a course of action to follow. The spinal would contain an anesthetic to make me numb, and a pain-killer to help me through the first 24 hours. The remaining medications were deemed "optional." Since some people experience itching as a reaction to the pain-killer, benadryl could be given, with a side effect of drowsiness. Nausea during surgery was another possibility, since the doctors would be inside my abdominal cavity doing a lot of pushing and tugging. So there are some anti-naseau drugs that could be offered, too. I opted to avoid everything "optional" unless it became necessary.
DH and I were led down the hall to the operating room with Dr. P and H. G went off to give the laboring woman an epidural. DH was given a hat, which I helped him tie, and a mask, which Dr. P showed him how to put on. Then he had to wait on a bench in the hall while I was brought into the operating room to be prepped for surgery.
The operating room was bright and full of people and machines. There was Dr. P, and H, and another nurse for Will, and a technician, and eventually an assisting doctor (Dr. W) and G. There might have been two nurses for William, I can't remember. I climbed on the bed and was positioned Indian-style, crouched over my belly. I started to cry a little bit, because I was sort of in shock that Will was actually about to be born, and one of the nurses held my hand while I told her that I was sad I wouldn't get to push my baby out "like that other lady." She said something reassuring as G started his work.
First he looked at my spine and used his fingernail to mark the place where he would inject the local anesthetic. I never saw any of the needles. The local anesthetic was slightly painful, and I whimpered to myself while simultaneously chastising myself for not being able to handle this tiny bit of pain. Then the spinal went in. I felt a twinge in my left foot as it did, and it made me recoil a little bit, so I apologized. I was leaned back and positioned flat on my back in the bed as my body slowly started going numb, starting in the feet and moving up. I could feel my legs being repositioned. G placed my arms out to the side, but fortunately they were not strapped down.
As I grew more and more numb, things started happening. There were two areas of activity: near my head, where G talked to me, hooked me up to a number of machines, and started testing my level of numbness, and down near my pelvis, where Dr. P was asking one of the nurses to shave me some more, and someone else was scrubbing my abdomen down. I also had a catheter inserted. At that point I basically stopped paying attention to what was going on down below, and focused only on G. His voice was deep and reassuring, and it helped keep me somewhat calm. I was attached to a blood pressure cuff, on my left arm, which periodically squeezed and hissed. I had a pulse oximeter, and some chest leads to track my heartbeat. G had a curved needle that he used to test how numb I was. He repeatedly used it to prick me, starting somewhere on my abdomen and moving up to my shoulders, asking whether I could feel it and how much it hurt. Eventually I couldn't feel anything. The curtain was raised between me and the action. Dr. P introduced me to Dr. W, who was wearing glasses. Someone said something about William and Dr. W having similar names.
G began giving a running commentary on everything that was happening on the other side of the curtain. He told me that Dr. P had performed her tests to check that I was totally numb, and then explained that I was likely to feel a lot of tugging and pressure, but no pain. Then he told me again that they were testing my numbness, and I asked "Didn't they do that already?" and he replied that they had actually already made the first incision. I felt a moment of panic because DH wasn't in the room yet, and I asked where he was. Suddenly he was there, holding my hand, and I said "I love you" as the doctors got down to business.
At this point I heard Dr. P talking. She told me they were cutting through the fascia, and then I heard her tell Dr. W about the magazine diagram I had brought into the office. Then I started to feel the tugging and pressure. I know I was asking "is he out yet?" over and over, because the pressure was very uncomfortable. G said that it would feel like Dr. W was laying on my stomach, essentially because he WAS. I groaned some, again feeling like a wuss for expressing any discomfort - this from a woman who had hoped to deliver vaginally without drugs!
When he was about to be born, someone invited DH to watch. Initially I hadn't really wanted him to watch, but now I didn't mind. Soon he was out! Dr. P called out that he was peeing and pooping! I felt embarrassed, but relieved that the horrible pressure was over. I asked "is he still a boy?" and they replied "YES!" Dr. P also confirmed that Will had a nuchal cord. All of this happened in the span of a couple of seconds, before he was briefly lifted up and I could see his face over the curtain. I will never forget that moment. He had a little bubble coming out of his mouth and he just looked fresh and new, and also peaceful. He wasn't crying or breathing yet.
Will was handed off to the nurses, and DH followed, camera in hand. He was placed in the warmer to my right, a few feet away. I could see him, but only a little bit. A slow minute passed, then another, and then the room filled with his tiny cries. I started to cry too, I think it is impossible not to cry when you first hear your own child cry. It was overwhelmingly beautiful.
The nurses worked on William, giving him his Vitamin K shot, which made him cry a little more, and his eye ointment, which didn't give him goopy eyes like I feared. They called out his weight: 7 pounds, 10 ounces. Confident that he was okay, and that DH was with him in his first moments of life, I turned my attention back to G, who continued to explain what the doctors were doing. Eventually I started to feel nausea (probably when they were externalizing my uterus), and actually dry heaved a couple of times. I told G I wanted the anti-nausea medicine, which I was given, while someone else held a plastic bin near my mouth in case I did actually throw up. Fortunately I did not, and soon the nausea subsided.
When the doctors were finished sewing me up, G explained that I was going to be lifted from the operating table to a recovery bed, and that it would feel very strange. I remember thinking from J's blog, "it will feel like you're falling, but you're not." The bed was on my right, and they tipped me to the left to get enough arms around me to move me over. It did feel like falling, but it wasn't unpleasant. As I was being shifted, I caught a glimpse of the table I had been lying on, which was covered with fluid and blood. I made a comment about this, and I think someone responded with "Oh that's nothing," but I can't remember.
They wheeled me into the recovery room, which was dimly lit and filled with more machines. There was a warmer for Will like the one in the operating room, but they didn't use it. Someone held Will while H performed her post-operative checks. The machines were all hooked back up, and I was given a cup of ice to munch on. It was so nice to have that ice. H probed my abdomen, which was very uncomfortable, and I groaned some more. Then she asked me to wiggle my toes, which I did. Feeling was slowly returning to my lower body. Within a couple of minutes, Will was placed on my chest, where we started trying to breastfeed. He latched on for about 25 minutes, which I think impressed all the nurses. I just couldn't stop looking at him. DH sat in the adjacent chair and read a magazine. The nurses were behind a curtain, talking quietly to themselves, but I wasn't really paying attention to what they were saying. I was annoyed at all the wires and tubes, which kept getting in the way.
For a couple of hours, we sat quietly in the room, and H would periodically come in, look at my vitals, probe my abdomen, and ask me to move my legs. The scrub tech came in and asked if I wanted to keep the placenta. I didn't want to, but I asked if I could see it. H brought it over in a bowl, put on some gloves, and picked it up to show it to us. After a while, I asked if we could put a diaper on Will, and the nurses agreed. They dressed him in a diaper, a white kimono shirt, and a hat, wrapped him in receiving blankets, and handed him back to me for the trip to my post-partum room. I felt vulnerable being wheeled through the halls to the elevator, but I had my baby, and we didn't see anyone. Upstairs, I was introduced to my new nurse, J. At first I thought she seemed a little aloof, but over the next two days I would come to greatly appreciate her help.
In the postpartum room, they rolled my recovery bed next to the adjustable bed, and I had to scootch myself onto it, on my back like a crab. It wasn't so bad. Once again I was hooked back up to the monitors: blood pressure, pulse ox (this time on one of my toes, so it wasn't in the way), IV saline and pitocin to get my uterus to contract. J examined us both, listening to Will's heart and bowels, and taking his temperature, then palpating my uterus some more (much more gently than H!). There was also a nurse assistant whose job it was to check my vitals (blood pressure, and temperature measured in my ear) and empty my catheter (while keeping track of my fluid output). DH took a photo, me in the bed with Will's little head sticking out of the pile of blankets and gowns.
We stayed this way for the rest of the day. I was allowed to eat some liquids - broth, yogurt, and jello. DH didn't get anything, and we didn't realize ahead of time that the hospital has a policy not to let the baby room-in alone with a C-section mom for the first 24 hours. So I called a friend and asked if she wouldn't mind coming for a little while, so Will could stay with me while DH went to get some food. She agreed, and around 3:30, arrived to say hello. We talked for a while and DH walked to Subway to get himself a sandwich. When he came back, he and my friend chatted while J helped me get Will breastfeeding. Then my friend went home and I had some more food - mushroom soup broth. I remember eating everything I was given, hoping that it would help me recover faster.
Sometime that day, I got out of bed for the first time. J helped me get into a sitting position on the side of the bed, and I rested there for a minute before actually standing. We walked into the bathroom, where J had me sit on the toilet while she carefully cut away my fancy mesh underwear and gave me a new pair with fresh pads, doubled up. I was bleeding pretty heavily. She also used a peri-bottle to gently rinse my vagina with warm water, which felt really good. After that, I had nothing but the highest regard for J, who took excellent care of me.
DH stayed the first night, on a fold-out chair bed. My night nurse, R, was a woman who had had 4 C-sections herself, and commented that she just loved taking care of planned C-section moms. At some point during the night, I took a short walk down the hall and back with R, pushing Will in his plastic trolley. Getting in and out of the bed was a royal pain in the ***, but it was worth it if it helped speed my recovery. DH watched basketball on the TV. When it was time to sleep, I had them push Will's trolley next to my bed, so I could get him out of it without having to get up. It didn't work so well, with all the wires and tubes still attached, but we managed. I carefully kept track of all the times Will ate, using the little worksheet I'd been given. We did okay with the breastfeeding. It was hard to get him latched on with the abdominal incision and compression dressing to worry about, but I didn't give up. I don't think I slept at all, because when I wasn't feeding Will, I was watching him. I still couldn't believe this tiny being was mine!
The next morning J returned. DH went home to check on the chickens, and I was by myself with Will for the first time. J did her morning assessment, and I was finally freed from all the wires and tubes. First the IV, then the pulse oximeter, then the catheter, and finally, the compression dressing on my incision were all removed. It was so liberating, even if it did mean I would now have to haul myself out of bed to use the bathroom. Getting up and down was getting easier, and J made sure I got my pain meds on time, which definitely helped.
When DH came back, we pushed Will into the nursery to have his blood tested (heel stick) and to weigh and bathe him. The nurse dropped a little bit of glucose water in Will's mouth, to keep him calm during the heel stick. There was a piece of paper with 5 small circles on it, each of which had to be saturated with his blood. It was a little stressful to watch him cry, but I managed. Dr. P came in while we were there, to check up on me. I wish she had come just a few minutes later, because after I'd been on my feet in the nursery for a while, I started to get light-headed. They were still finishing the heel-stick when I mentioned something to the nurse, who had DH get me a chair post-haste. Then my vision started to go white and I heard a light ringing in my ears, and when I said that, they got me in a wheelchair and pushed me back to my room and put me in bed. DH stayed with Will, who ended up not getting a bath, because DH knew I wanted to be there for it.
While I was resting, William also had a hearing test, which he passed. Soon we were visited by Dr. M, Will's pediatrician. She checked Will's hips for any problems that might have resulted from his breech position, and found everything to be fine. The lactation consultant, B, came by and watched me nurse Will, offering tips. I had been given a complete set of Medela pump parts, and a hospital-grade pump had been left in my room next to the bed, but I was reluctant to use it. After a while I was getting tired of being constantly poked and prodded. DH stayed long enough to see a basketball game, then went home. Will and I were on our own for the night.
The night nurse was so nice. I was sort of surprised that it wasn't R again, because at some point in the night I did see her there, but it didn't matter. I was actually able to get some sleep, despite waking up several times to feed Will and go to the bathroom. I tried to walk around the room whenever I could, to help speed the healing process, and also to encourage my bowels to start doing their job again... I had been passing gas, but no bowel movement since before we checked into the hospital!
The next morning, I was feeling pretty good. I took a shower, and dressed in my own clothes, and at that point it was pretty obvious we were ready to go home. The nurse gave us our discharge papers, and we signed some stuff and turned in Will's birth certificate form. Lastly, I talked to Dr. P on the phone. She told me to be careful on day 5 post-partum, that it was common for a lot of women to lose it emotionally. It was reassuring to hear her voice.
I had told the nurses that I was worried I hadn't pooped yet, and they checked my chart and saw that Dr. P had approved a suppository. I'd never used one before, but it was pretty obvious as soon as I put it in that it was going to do its job. I have to admit, it was AWESOME. Within 45 minutes, I had the urge, and I had the nicest poop ever right before the nurse called to have someone come show us to the car. DH pulled into the loading area, and took down our bags and all the random extras we accumulated during our stay. I dressed Will in his going home outfit and we put him in the carseat. We strapped him in and soon were on our way home, now a family of three!