The Birth Story Part 2: Induction

I think for a little while (at least) I will be going to a Monday, Wednesday, Friday posting schedule. Right now I'm trying to balance a very accommodating baby, finishing up a few things from work, knitting the occasional few stitches and posting here. I'm not quite in a place yet where I can do it all to the same level I was doing it before. So rather than stress about things, I'm going to back off a bit on all of them (except the baby, of course!) so that I can have the opportunity to do all of them as I would like to.

Back to the story...

Induction for me meant a lot of things. When you're dealing with some of the problems that I was having, it means an IV with more than a few chemicals swirling through it. Since there was no way to tell that I was not going to become pre-eclampsic, the first thing it meant was magnesium sulfate -- an anti-convulsant drug to make sure that I didn't seize during delivery. Since I was strep B positive, it also meant that I needed to be dosed with penicillin to make sure that I didn't pass that to the baby in the event of a successful vaginal delivery. And, since I was being induced, it also meant pitocin -- the chemical that is used to stimulate the uterus to contract.

Interestingly enough, before we got the IV hooked up, the fetal heart and contraction monitors started to identify the fact that I was beginning to have regular contractions on my own. This was a strange thing to hear, since I honestly couldn't feel them at all. But the nurse told me that wasn't necessarily a bad thing.

Probably the worst experience I had with the labor and delivery process was getting my IV set. I've had IV's before, without any problems, but Northwestern has a policy of using some really large gauge needles for their IVs. While my primary nurse (an absolutely wonderful woman) took a short break for lunch, another nurse was supposed to get my IV in. Hospital types love my veins -- they are huge, many and easy to find. The temporary nurse figured it would be no problem. But she tried putting the it in the first vein and couldn't get the whole shunt past a valve. I nearly passed out -- the process triggered a vaso-vagal response and even lying down I got close to blacking out. We had to wait a while until she tried again. Same arm. Second failure. She called another nurse who "never misses" who started on my other arm. Two more failed attempts. By this time, I am beginning to feel a little bit tortured and a little dizzy. And I'm bleeding. I can tell even John is getting anxious, though he's trying to be calm to help me. I was doing my best to be good natured -- clearly no one was trying to make things difficult for me. At this point, mercifully, the nurse decided to call an anesthesiologist -- he goes back to the first arm and without any effort at all and almost without me being able to tell, gets my IV in and going. John and I both breathe a little better and they get the penicillin started.

Next up, the epidural. Now, I wanted one of these anyway, but because of my possible pre-eclampsia issues, they can't wait to do it for too long. If I do develop signs of pre-eclampsia, my platelets could go down and make it impossible to do. This is important, because it's very possible that I could have problems progressing in the induction, and if I needed a C-section, it would severely limit my anesthesia options (I would find out only long later that most people would have expected me to have to have a C-section). So after a discussion of all the possible side effects, it gets decided that once my IV is in, the epidural comes next. Given my previous response to the IV, the nurses are concerned that I'm going to have more vaso-vagal problems and black out. I have a little wave of trauma when they tell John he has to leave because it's a sterile procedure and hospital policy is not to allow non-hospital people in the room at those times. In spite of everyone's concerns, the epidural goes in without a hitch, and they get everything started and let John back into the room. At this point, I have come to believe that anesthesiologists with good hands are a gift from above.

The epidural makes me feel a little bit sleepy, my legs a bit heavy, and I start to feel more relaxed. They do some tests to make sure it's working well. Everything looks good, and I'm alone with John and our labor and delivery nurse again.

Now it's time for the real drugs to start. First, the magnesium sulfate. For most people, this drug is miserable. It prevents seizures and lowers blood pressure, but it also can cause nausea, blurred vision and a feeling of being overheated or like your skin has been turned into a giant heating pad. As one nurse told us later "mag moms" are tough to care for since they are so uncomfortable, usually. I was extremely lucky. For me, it wasn't too bad at all. The heat on my skin was oddly pleasant and combined with the epidural I just started to feel a bit drowsy and warm.

Then we moved onto the pitocin. And my labor had officially begun -- 7 PM July 16th.

At this point, John finally had the luxury of enough peace of mind to go home and get some things for him and for me. It was going to take some time for me to dilate. I was unable to feel my contractions, and I had the soothing sound of the baby's heartbeat and the assistance of a very kind and attentive nurse to keep me company. My blood pressure and vital signs were being monitored constantly. And as my contractions progressed, the nurse worked with one of the resident obstetricians to schedule the time for breaking the amniotic sac. The point of no return for me and the Z baby.

John returned with a bunch of things and the nurse helped set up the bed for him. At 10 PM, I was 4 cm dilated and just starting to feel the contractions (very mild, less than menstrual cramps -- and at this point my epidural was beginning to wear off a bit... which was fine with me because I actually wanted to know something of what they felt like). They broke my water (a strange and somewhat graphic experience that I won't share here to spare myself the strange search results that the discussion would generate -- email me if you really want to know) and my contractions started to get more regular and stronger (but still nothing that bothered me all that much). Not too long after that, another anesthesiologist came in to up my epidural a bit. And then I started to get a little more drowsy. John fed me some ice chips to help keep me hydrated for a while, but eventually we both decided some rest was in order.

I sort of floated in and out until about 4:30 AM. It's sort of amazing how it all floated around me. We had a change of nurses at midnight (another exceptionally wonderful nurse who would be with me through delivery), my pitocin drip was increased, the contractions got longer and stronger and periodically I'd get a cervical check to see where I was. I felt cared for, and John's presence made me feel safe and protected. All things considered, I was happy. Very tranquil. Not what I was expecting at all. My blood pressure was completely under control and everything was going the way it was supposed to. It all looked good for a vaginal delivery. Which gave me peace of mind. Listening to that little heart beat on the monitor, I began to get excited about the prospect of meeting my baby. The fear delivery was gone.

It was about 4:30 when I got the most pleasant surprise of the whole evening. My OB arrived -- not the OB who had got the induction process started, who I was expecting, but my OB. The one who made me feel comfortable and who had been working through my problems with me. If anything could have made my blood pressure lower and my peace of mind higher, this would be it.

At 5 AM, I was fully dilated and it was time to start pushing. I had some difficulty getting all the breathing and pushing to work together, and my contractions weren't as regular as my OB wanted them to be, so it ended up taking about 2 and a half hours to push her out -- pushing, as I discovered, while it was not painful for me because of the epidural, is hard work. Not helped by the fact that she was rotated about 180 degrees from the best possible position. The thing that helped me get it all together was a mirror that allowed me to see the progress. It was incredibly motivational to see the baby's head crown. And to hear her constant and steady heartbeat as I worked at what I was doing. She just kept letting us know she was doing well.

I didn't actually see her get pushed out, but I got the image I wanted. John got to watch her emerge into the world. The big tears and the happy smile on his face were amazing. I'll remember the look in his eyes forever. We had done it. Our baby girl had made her journey into the world. John just said it was amazing watching the doctor get her out, get her mouth and nose suctioned and get her "necklace" disengaged -- her umbilical cord was wrapped around her neck three times (no one made a big deal out of this -- apparently I had a very long cord). And then, right around 7:30 AM there was the big cry -- a lusty baby voice filling the air. Probably one of the most beautiful sounds I've ever heard.

She got whisked away to the pediatrics team that had come in (it's amazing how much staff co-ordination is going on... once I got close, my doctor and the labor and delivery nurse had them called in) and John rushed to get his camera. We have some wonderful short videos of her first moments. Some beautiful pictures. My OB collected her cord blood I didn't have any real problems with the "third phase" of labor. My OB massaged my uterine area a little bit and then that was over, too. The only thing that remained was a little stitching -- I had a small amount of 2nd degree tearing, but no serious damage (as I type, a little less than a week later, I am mostly back to normal in this part of my anatomy).

I wasn't paying too much attention to that, though. I just kept listening for the baby, waiting to get to hold her. That part took longer than I thought it would, but there's a lot to check out on a new person, especially one who came a little early. It was a magickal experience to hold her for the first time. She started to show signs of wanting to latch on right away, but also was settling down now that she was all warm and swaddled. John and I were in love. There has probably been no moment in my life where I felt I had accomplished something so major and so profound.

And the best thing is... I couldn't have asked for a better birth experience if I'd had put the birth plan together myself. I never had time to create one, and, truth be told, when I started having problems, I figured it wasn't worth the effort since I wasn't sure that I would have many choices anyway, but I pretty much got everything I wanted and then a little bit more.

Tired Mom Finally Gets to Hold the Baby

Friday: The Hospital Stay