Wednesday, August 10, 2011

All around the world

When Derrick closed the door to the car, he said to the newly named Paul Stefan, "now we can introduce you to some real music." The Red Hot Chilli Peppers, "All around the world" blared as we drove to the 163; then it was Jimmy Eats World, "The middle." Somewhere along the way I realised I just wanted to cry and chalked it up to the hormones.

Monday I showed up at my OB's a couple of hours early, having looked at last week's appointment card. After a quick check (2 cm, 60-70% effaced), Dr. Melin asked if I'd like to be induced. I said I would, so she set up an appointment for me for 2 that afternoon. I was a ball of nerves the rest of the afternoon, barely able to pack, or even think about what to take. Fortunately, a friend

Derrick took me to the hospital at about 2:30 pm. We got checked in and settled in and I was hooked up to an IV and monitors, and then I just sat around for about an hour being monitored. I was having a few contractions, and the baby was responding to them, but I could barely feel the tightening. Finally, around 4:30 they started me on pitocin, on the lowest setting. For the next six hours or so they increased my pitocin in excruciatingly small increments until I was finally having regular (2-3 minute apart) contractions that were mildly uncomfortable (and by mildly uncomfortable I mean I've had worse gas discomfort). Derrick slept and I read "Do Androids Dream of Electric Sheep" until about 11:30, at which point Dr. Melin showed up and broke my waters.

Once my amniotic sack was broken, the contractions became pretty painful (as expected). Dr. Melin and the nurse (Sharna) both suggested before that I might want to dial back the pitocin or get some pain relief, i.e.--get an epidural. Being stubborn and still too freaked out by the thought of a needle going into my spine to consider an epidural, I sucked it up and just dealt with the pain. This time I tried a bunch of different positions--squatting, kneeling, standing (really, marching during contractions. I'm sure I looked ridiculous, but Derrick was smart enough to not even crack a smile in front of me) and, of course, the exercise ball). I didn't use Derrick as much this time around, which I'm sure his hands appreciated! He did give me a few back rubs, which felt really quite good, at least for a few minutes. I think because I'd been through labour before I had more confidence in my ability to deal with the pain, so this time I tried more positions and did more self-comforting (which is what I'm going to claim my "vocalising" and yelling at myself, "this isn't that painful!" really was). Having Sharna as my nurse was wonderful. She was supportive, telling me I was doing well and that the pain was normal and natural, and I don't think she ever offered me an epidural.

At around 2:45 I started feeling the need to bear down (not just to poop) and was pretty sure I was close. We were also having a hard time keeping the monitor over the baby's heart at that point. I don't remember having to move the monitor as much with Sylvia, but this time there was a definite progression of the position of the heartbeat from the middle of my belly to the top of my pelvis. Eventually the monitor was just about useless for monitoring the heartbeat because it would not stay in place for more than a couple of seconds unless I was holding it, and even then I was moving it around to find the heartbeat. Anyway, by that point I was pretty sure I was close, so I told Derrick to get the nurse and have her check me. Sharna came in and waited through a contraction and then checked me and said I was fully effaced but only dilated to about 5 cm, and said it could be anywhere from another hour to another four hours. At that point my heart just sank. I was so sure I was at the very least further along and the thought of another four hours of potential labour made me question whether or not I could get through the rest of the labour, at least without pain medication.

I got up and moved between positions again and, during a couple of contractions on the birthing ball, again felt the urge to bear down. This time when I got off the ball there was blood on the towel, so Sharna checked me again at about 3:20. She seemed quite surprised to find that I was fully dilated; I was very relieved. She turned off the pitocin and called Dr. Melin and then had me get into position...and then wait for the doctor to arrive.

Waiting through contractions, trying *not* to push is definitely not my favourite activity. I did a lot of heavy breathing and a lot of yelling, "don't push, don't push, don't push!" as if I could control what my body was doing (hah! I did manage to only push a little). I think crossing my legs would have been about as useful. I did have everyone in the room in stitches a couple of times at my very exaggerated sighs of relief at the end of contractions. Oh, was I relieved when Dr. Melin walked into the room. I pushed on the next contraction (which came pretty quickly) and screamed and swore as I pushed out the baby's head. Once his head was out, I pushed out the shoulders, then Dr. Melin told me to pull out my baby. So I did. I pulled his slippery body out of mine (let me tell you, that's a weird sensation) and plopped him down on my belly. and said, "hello there." Paul just squinted and squirmed in response, and cried his little mewing cries.

It was 3:51 in the morning.

They left Paul on me for several minutes while cleaning me up a little and letting the cord finish pulsing. Dr. Melin asked Derrick if he'd like to cut the cord. He said no, then did it anyway. His duties over, he went off to rest. Dr. Melin commented that he didn't look at all overdue, which makes me think the later, ultrasound based due date (8 August) was the more accurate one. After I pushed out the placenta, Dr. Melin stitched me up, mildly chastising Sharna for not turning down the pitocin and reminding her to pull out local anesthetic for the stitches. Apparently it's very unusual for women to give birth with no anesthesia at all around here--maybe so unusual even my very supportive nurse midwife forgot to pull out a local for me (though it's not like it really matters. There aren't many nerve endings in the vagina, so it's not like a local is truly necessary). I have to say, as bad as the labour pain was (and Derrick is probably right that the pain was worse this time than last time) my fatigue was worse. If I hadn't given birth as quickly as I did, it's much more likely I would have opted for an epidural, just so I could rest. So, I'm glad we didn't turn down the pitocin.

After I was cleaned up and peed, I was taken to a recovery room, offered some solid foods (if yoghurt can be considered solid food), and left alone with my baby and my husband. Nobody woke me for meals or for checks of my vitals; all of that was taken care of when I woke naturally. Sleep makes such a difference in recovery. Dr. Melin told me this would be an easier delivery and an easier recovery, and she wasn't kidding. I'm sure that experience played a part in that I knew what to expect and how to minimise some of the unpleasantness, but hospital policies (especially letting me sleep!) were also helpful. I loved my nurses--helpful and friendly and caring, and just so good with my baby and with me. I doubt I'll ever be as good at swaddling as the first nurse, Rosie.

Derrick's parents brought Sylvia in to meet her brother, which was a little exciting. She really wanted to hold him, and really wanted to nurse like he was nursing. It's more than a little nerve-wracking to have the older child near the younger one, especially one who is so interested in her sibling. It's also interesting how different Sylvia feels now that I have Paul for comparison. Her body is so much bigger, so much sturdier, and, skinny as she is, has so much more heft and so much more fat under her skin. I was tired out by the visit pretty quickly, so Derrick's parents took Sylvia out, and Derrick went with them to rest some place more comfortable. My mom showed up just a few minutes after they all cleared out. Apparently she was awake when Paul was born because Wayne's day started at about the same time I was having Paul. I let her hold Paul for a while, then kicked her out so I could sleep.

I spent most of the day sleeping or feeding Paul, and really, I felt pretty good by the end of the day. I didn't sleep too much that night, though I got more sleep than I did the first night with Sylvia. The night nurse told me Paul was jaundiced enough he'd probably have to be checked in 12 hours (or at about 4 pm) before he could be released. A few hours later he was released though, as was I. We spent the bulk of the morning going through the paperwork to be released (which was annoying, but far less annoying and shorter than Indiana's). The major hold-up was actually naming him. We got down to two names--Paul Stefan and Paul Frederick Lewis. Both Derrick and I liked the two names about equally, so we flipped a coin and named him Paul Stefan.

Welcome home, kid.

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