Isaac's Birth

After Addy was born, I had my heart set on a VBAC. I labored very quickly with Addy and pushed hard for two hours, just to have her head still stuck at a -1 station. When she was delivered via C-section, her head was crooked--the Dr said her head was tilted toward one shoulder so it wasn't coming through straight on. I was pretty disappointed at being "so close" yet so far from a vaginal delivery and got the baby blues pretty badly in the hospital. I was overwhelmed with the recovery and the hormones weren't helping either.

This time, my Dr and I decided to try for a VBAC if I went into labor naturally before my due date. We scheduled a C-section for the day after my due date (Sept 29th).

Monday, September 19 I had just carried up 8-9 loads of groceries up the giant stairs to our apartment, and put Addy down for quiet time. It was after 1 pm sometime. As soon as I closed my eyes to get a nap, I felt a contraction. After 90 minutes of contractions 9 minutes apart, I called the Dr.

I had just been in the office that morning as was 4cm and 70% effaced with a "bulging" bag of waters. The nurse said no we usually wait until contractions are 5 minutes apart--wait, no the Dr says to come in because your labor will go quickly.

I called Kit to come home early and got Addy's things ready. We dropped her off at a friend's house and got to the hospital just after 6pm. My contractions were hard, but not unmanageable. Filled out forms, got hooked up, checked (5 cm), and admitted. Around 7pm I had four contractions right in a row (like one minute in-between). The nurse came sweeping in and pushed me on my left side--she said my baby didn't like those four contractions in a row (I said--well, I didn't like them either!) and she gave me an oxygen mask and made me move to the left. In about 5-10 minutes the baby's heart rate came back. 

Pre-epidural, pre-water breaking--doing fine.

Filled out more forms, Dr. came in to check me, we'd only really been there about an hour. At  6 cm and she was going to break my water. Based on my first delivery I made sure to ask that the epidural would come quickly afterward--I knew the contractions would get ratcheted up to 11 pretty soon. I was assured he was in the floor and would be here soon.

When she did, she said, "Wow! Look at all this fluid!" Glad I could impress the doctor. A normal amniotic fluid index is between 8-18cm, mine was 20cm. And, I sure felt like a river, but it just kept coming and even my Dr. and nurse were impressed. I visibly watched my tummy deflate. Then I dilated to a 7cm within the minute.

The next 4-5 contractions were hard but I could breathe through them, then--just as I predicted--transition labor came!  Yay. My nurse was trying to help me breathe, and I was genuinely trying to breathe but I just couldn't sometimes. I was a a whimpering, whining, moaning mess. Really shaky. I kept asking for the epidural and about thirty minutes later  (!) when the Dr. came in he asked me my medical history so dang fast. Kit left for the procedure and I just whimpered and put my head into my nurses shoulder until my toes started to tingle. Since I was so close to delivery, the Dr. didn't give me an epidural "infusion"--he only gave me drips so I would still feel my legs but it would take the edge off. (If I hadn't been a VBAC, they might not have even bothered giving me the epidural because I was so close to delivery, but I had to have one in case surgery was needed.)

My nurse was running around the room getting things ready for delivery in between shattering contractions. She even turned on the delivery spot lights because she said we were so close. 

Just as I laid back and got some relief the doctor and a few nurses came in. The Dr. checked me (9cm) and the nurses put an oxygen mask on my face and pushed me to my left side. The baby's heart rate was low again.

Then I dilated to a ten, pushed for awhile and the baby came out just like in the movies!  Ha! Sigh, just kidding. 

Instead, more nurses came in. The doctor struggled a bit to put the internal monitor (a little wire that screws into his skull--more accurate than the belt monitor) on my baby's head--I didn't know it at the time, but Isaac had moved. A few minutes earlier his head was in perfect position. Then, when the Dr. was TRYING to put the internal monitor on the crown of his head (how babies normally come out), she felt his NOSE presenting. (!) She finally got the internal monitor on his forehead. I didn't know it right then, but AGAIN my baby had moved from the perfect presentation to something that was not ideal.

One nurse kept moving the baby heart rate monitor, trying to find the right one--thinking that his low heart rate was maybe mine, instead of his. His heart rate had dropped and was not coming back up. I couldn't see the monitor, but I knew more fast-walking nurses probably wasn't a good thing. Kit still hadn't come back in--they didn't have time to go get him. After about ten minutes of this, my doctor made the call to do an emergency c-section. She came up to me and said, "I know this isn't want you wanted but it's what we need to do." I said, "I know, I trust you." Then she walked away very quickly. (Drs and nurses don't run but they can walk really quickly.)

My doctor had said things like, "Make sure the anesthesiologist doesn't leave--keep him in the hall." and "Now. We need to go, now."  But, I was strangely not nervous or scared for me or my baby. I didn't really have time to be disappointed. I knew that they were making good decisions and I really did trust my doctor. I knew they weren't calling for a "Crash Cesarean" just for fun. 

Poor Kit, he left the room for me to get the epidural and fifteen minutes later saw them fast-walking my bed down to the OR.  A nurse came and told him they were taking me to surgery and to get changed, but then he later found out he couldn't go in. So he just sat in my empty delivery room waiting.

We got to the OR (more people walking around quickly), I remember the anesthesiologist saying something like, "can someone help me get the arm boards?" then looking around at the busy-ness just went and got them himself. My doctor pinched me hard and asked if I could feel it--yes, I could. Twenty seconds later she pinched again--yes I could feel it. Then she looked at the anesthesiologist and said, "is she numb yet? We need to start." Then he said they were putting me to sleep--and that's all I remember.

Next thing I know, I woke up and Kit was holding my hand. (Bless him.) I could immediately feel the tenderness of my incision. I couldn't move my legs. My throat hurt from where they had the tube in. I was very sleepy and as it turns out, very cold. My body temp was 93 so the nurse put a bunch of heated air-blankets on me. (Which I LOVED--where can I buy some?) I started to talk to Kit. I am a bit hazy, but he said later that I was all there, just running at 10% with long pauses and a lot of repetition. I said, "They put me to sleep." Pause. "But I didn't feel anything." [Pause. Looking around] "Where's the baby?"  [Seeing the baby. Pause] "Is he okay?" [Yes, he's great.] "What time was he born?" [8:42pm--it was about 10pm when I woke up] "Do I still have my uterus?" [Yes, you do.] "Did you get to go into surgery?" [No, I had to stay outside.] "Can I hold the baby?" [Yes, when you warm up a little bit more. Pause.]  "It was okay that I was asleep. Things happened so fast." [I know, they did.]

This was about fifteen minutes after he  was born, he still has the grey shade to his skin, but is pinking up nicely.

Kit told me that when the baby was born, his one-minute Apgar was 2. He was blue and didn't cry spontaneously. They suctioned him, gave him some pure oxygen, and helped him learn how a breathe a little bit. Then, his 5-minute Apgar was 8 and 10-minute Apgar was 9. After those first few minutes, he was vigorous and perfect.

About an hour after birth--no signs of grey remaining.

My doctor explained later a little bit about what happened. She said that we had VBAC attempt progressing well--all the way until the very end, when everything changed. She said there were several factors which made surgery necessary:

-The baby's heart rate plummeted in the minutes after my epidural--this was obviously the biggest reason. When she cut into me she saw the umbilical cord coiled down near his head. This is called an occult umbilical prolapse, which basically means that the cord got wedged near his head and as he started to descend into the pelvis, the pressure of his head kinked off the cord and he wasn't getting oxygen anymore. It's a medical emergency and the reason for the rushed surgery. If I had been at home when it happened I wouldn't have known and it probably would have been too late by the time I got to the hospital. The massive amount of fluid I had might have been a factor.

-The baby moved his head and wasn't presenting well. The doctor felt his nose (!) when trying to put the internal monitor in, then later when she took him out she said that he was face up at that point but had obviously moved around (most babies are face down looking at your back). 

-The baby had his hand up on it face and would have tried to come out with-his-hand wedged up there. A complex presentation.

exhausted from his big day

So EVEN if the heart rate was fine, we probably would have ended up pushing and having the baby wedged in there again, just like Addy. My doctor said that even though she didn't feel any notches in my pelvis and everything looked fine, that something about my pelvis makes my babies move at the last second so that they aren't positioned right.

There were tender mercies associated with being put under general anesthesia. Things were happening so quickly that it would have been stressful to be awake, especially when it took Isaac a few minutes to pink up and cry. I didn't shake or throw up or have shoulder pain like in my first surgery. I didn't have to listen to the urgency in the Dr's voices. I missed the first hour of my son's life, and I wish I could have been there, but when he was born it was so obvious that he needed to come out right away. And for me, it was more peaceful to wake up and have it over. 

Post-surgery around 1:30am in mother/baby room

turns out even if deliver surgically the adrenaline from the day makes sleep an impossibility! (Plus the cuffs they put on your legs to prevent blood clots inflating every three-seconds don't help either.)

In my first delivery, I felt a strong sense of sadness and failure. Everything had gone perfectly and (it felt like) I just couldn't push her out. Something about my body made it so even though I was dilated and pushing, she wouldn't budge. I had gotten so close and pushed for so long that afterward every time I thought about how it turned out I would start to cry. Everyone else gets to the same point and just pushes out their babies, why couldn't I? I wanted to be in the delivery room when they put the baby on my tummy. It's like having a baby cut out wasn't "earning it." What was wrong with me? With Addy, my recovery was normal, but not what I wanted and difficult for me emotionally. I was happy to have a baby but physically overwhelmed to be recovering from surgery. I think hormones didn't help, but the baby blues were definitely there. I didn't bond with Addy right away. I didn't want to hold her, I just wanted to feel better.

This time, I had a completely different emotional response. Since Isaac was in distress, it was obvious that I had to have the surgery to get him out quickly. The factors that made my labor unfavorable were different, but still present. I was prepared for the probable surgery, and afterward I haven't cried once about it! I knew what recovery would feel like. I have been obsessed with Isaac from the first second I held him and wanted him near me always. No signs of baby blues yet.

I'm glad that we tried the VBAC. Even though I didn't fully deliver my babies normally, I labored almost completely (getting my epidural midway through transition both times) with both of them. While incredibly painful, I'm glad that I got to experience labor! I liked knowing what it felt like, I liked managing the pain, I liked even feeling transition labor (obviously I didn't enjoy it in the moment). I liked that I got to feel my water break and be monitored and "waiting" just like everyone else. I liked that we had to wait until I went into labor to go to the hospital (it's just kind of exciting). 

I still have some labor envy of women who labor, push twice and deliver babies. My labor story is exactly the same--until the end when it's not. When you imagine giving birth to your children, you never imagine laying behind a curtain immobile with oxygen in your nose. 

First time walking outside the room, two days after Isaac was born.

Proud papa and a tremendous help and support to me.

Silver linings--my next births will be scheduled c-sections, at least I know that now. No more uncertainly.  I've never have to wait for the epidural while going through transition labor again!  Since my next births won't be emergencies, Kit can be there, they won't be traumatic.  And everyone has issues, I'm not the only one! A delivery (or recovery) without emotional or physical trauma is truly a miracle.

Truly grateful and blessed for a healthy child--he is a miracle to us. We love him and are so happy he is here--I couldn't imagine a second child, but now that he is here I can't imagine our family without him.