Tuesday, October 20, 2015

Samuel David's Birth Story: A VBA2C

Since I was having a vaginal birth after two c-sections (VBA2C), and not all doctors and nurses are for that, I wanted to make sure that I had everything set up ahead of time that I could to ensure a successful VBA2C. At one of my appointments a few weeks before I was due, I brought a copy of my birth plan for my doctor to sign, so that if any nurses had questions or problems with it, they could see that my doc was okay with it. (For example, I wanted to be able to eat and drink during labor, but I guess it's against hospital policy for a VBAC momma. My doc was okay with it though.)

We also kept going back and forth as to whether or not we would use a doula to support us during labor and delivery. We were originally going to just use the volunteer doula at the hospital, but my friend convinced me to get a doula outside the hospital in case the volunteer on call was with another momma. We ended up finding Nancy Pone a few days before I went into labor, and she was wonderful, as you will read.

Well, onto the start of birthing our fourth child, Mr. Samuel David. As with Nora's birth, I started having contractions early on, but (luckily) this time it wasn't only at night for a week straight, leaving me near delirious come birth-time. It was on and off, and quite often during the day. On Friday, as per usual, my cousin, Linda, came over to visit. I started having contractions around 2pm before she came and started timing them on and off. At that point they were anywhere from 5-11 minutes apart, and were a little stronger than before, but I could still talk through them just fine. She didn't stay too late so that we could get some rest that night though.

We went to bed, and I started timing them again around 9:30pm, as they were getting more painful, and I couldn't sleep though them, and since they were coming anywhere from 6 to 15 minutes apart, I wasn't really sleeping in between them either. Adam slept most of the night, except for the two times Nora came in at 4am and 5 am to tell us she had to "go potty in the potty." I kept timing them on and off throughout the rest of the night and into the morning. When we got up that that Saturday morning, I told Adam to call my mom to come get the kids. I didn't think it was time to go in yet, but, I knew it would be at some point that day, and I wanted to be able to labor at home without a toddler or two crawling across my aching belly.

We spent the morning watching Doctor Who and relaxing at home. Adam actually ended up re-wiring an outlet in the office and setting up some internet thing in the office while I sat and watched. He kept wanting to retreat to the office to play video games, since there wasn't much for him to do at that point. They were starting to get stronger to the point where I couldn't talk though them, but there wasn't anything I wanted him to do at that point to relieve any pain. I just wanted him near me. Just his presence made me feel more at ease. He brought me peaches to eat and water to drink as I asked, and that was all I really needed. Shortly after noon, I decided to stop timing them, as it was getting annoying and difficult for me to get the timer on my phone started and then try to concentrate and relax my way though a contraction. So at 2pm when I started feeling like I wanted to be at the hospital, I don't really know how far apart they were, or if we were at the "5-1-1 rule" to go in or not. But, I started to get the shakes, and thought that was a good sign to go in. I texted Nancy to let her know that we were heading in, and Adam texted my mom to giver her an update, and then we were off!

I remember having a contraction as I was trying to walk down the couple of steps from our laundry room to the garage, but on the car ride to the hospital (not that it's that far!), I think I only had one. I'd heard that sometimes changes in surroundings slowed labor, but I was hoping it wasn't going to slow it down too much. I also remember walking though the ER doors and a security guard coming up to me asking if I wanted a wheelchair. I held up with "one-minute" finger, and he said something about waiting until the contraction was over. Once it was, I decided to take the wheelchair up to the L&D floor, which I remember deciding against with Nora, but the pain was worse this time around.

Once we got up to our room, the nurse, Barb, hooked me up to the monitors, and said she needed a 20 minute strip on the baby, then she could take me off the monitors. She checked me, and I was at 3cm, which kind of disappointed me, especially since my "purple line" had said I was at 10 cm (ha!) a couple days ago. I thought I would at around a 6 and be closer to active labor instead of still in early labor. So we focused on trying to get a 20 minute strip of the baby's heartbeat so that I could get off the monitors and move around more easily. This we found to be a difficult feat, since the bands that they use to hold the monitors on my belly didn't actually keep them in the right places. However, Adam was a pro at holding them in place through my contractions (and when I wasn't contracting), and getting a solid 20 minute strip in just over 20 minutes.

Once the monitors came off, Nancy had us start some belly dancing to help labor progress. She really wanted me to get my hips into it swinging and swaying them side to side. Adam danced with me and held me through contractions. They were painful,but manageable at this point. We found this really helped me progress, because when Barb came back to check me, less than an hour after she checked me before, I had gone from "thick" and 0% effaced to 80-90% and 4 cm.  Hearing that brought my spirits up after the disappointment I had from the first check.

We kept dancing and moving to help shake the baby down and out of me. We did have to take a break to get an IV placed so that I could get some antibiotics since I was Group B Strep positive. Part of my birth plan stated that they could not do any blood draws, and that if they needed any blood it needed to be taken when the IV was placed. Adam mentioned this to Barb. Nancy mentioned this to Barb. I mentioned this to Barb. Serveal times each. She insisted that she didn't know why they would need to draw any blood. "Are you sure?" was repeated several more times. She doubled checked, and still assured us that the hosptial did not need any blood samples.

Since I wanted it numbed before the IV was placed, Barb had another nurse come in who was more familiar with placing IVs when numbed. Well, the numbing didn't work in the first spot, and the vien didn't cooperate either. So they numbed another spot, and tried there. That vein wouldn't cooperate either. I don't do well with needles and was trembling (on top of the contactions) before this all started, it didn't get any better after having been poked so many times either! They finally decided to call in, I kid you not, the SWAT team. Yep, the SWAT team. I don't know what it stands for. I never asked, but they were pros. One try, and the IV was placed without a problem.

Once that fiasco was all over, and my nerves were calmed a little we continued to dance, but I got tired of that quickly, and Barb suggested I get in the bath once the first round of antibiotics was finished. I liked this idea a lot. I knew I couldn't have a water birth that I dreamed of since I was pregnant with Danielle, but at least I could have some relaxing labor in the tub. It did help me relax through the contractions more, so much so that I had to tell Nancy when they were coming so she could time them, because she couldn't tell by my demeanor. I wasn't in there too terribly long though, because I started feeling too hot and almost suffocating-like.

After I put my lovely gown back on, Nancy would squeeze my hips through contractions while Adam helped me stand, but it was this point that the contractions started getting to be much stronger than I ever remember with Nora. I worked through several on the verge of tears, thinking in between the contractions that I could handle it. But, eventually told Adam I wanted the epidural I couldn't do it anymore. The nurse, now Shelly, of course, wanted to check to see how far I was to make sure I wasn't past the point of being able to get one. I wasn't. I hadn't changed much since the last check. The baby was lower, but I was still at 4 cm and 90% effaced.

The contractions were getting much less manageable, and I knew the epidural would take a while to get with paper work and waiting on the anesthesiologist to make it up, so I asked for phentenol right away in my IV. Plus, I knew it would help me relax through the epidural placement, since each contraction I was trying so hard not to cry and be miserable.

This is the point where all hell broke loose in anger from not only me, but Adam and Nancy as well. Shelly, the nurse that had taken over for Barb, realized that Barb missed in my chart that I was a VBAC mom. That meant that the needed blood. And while, I think they let me go a while without bringing it up, once I asked for the epidural, they said in order to get it, I needed to have blood drawn. I was beyond livid. I don't think there is a word in the English language to describe how furious I was! I cried tears of anger and fear of going through what I went through with the blood draw from Nora. While Shelly tried to apologize, she didn't seem to understand what she was asking of me. She wasn't there when the lab tech butchered my arm at Nora's birth leaving me with a welt for days. She wasn't there when it took two nurses and a SWAT team to finally get an IV placed only hours earlier. But she had the upper hand. She had the epidural. She said the anesthesiologist wouldn't even come up until labs were drawn. So I consented. But, I said they had one shot at this. I said if they didn't get it the first time, there was not second chance. I said I wanted the phentenol first. And I said they better call in the SWAT team the first time. And she did. And it was actually an okay blood draw.

Shortly thereafter, the anesthesiologist came up to place the epidural. He must have been the same one from Nora's birth, as from what I understand, there's only one anesthesiologist there that likes his patients laying on their side instead of sitting up. I was thankful for that, as I think it made it easier on me. Now I could just lay and relax in bed. It was getting late, past our normal bedtime, so I was tired.

Eventually, Shelly came back to do another check, and to give me my second dose of antibiotics. Looking back at my notes from Nancy, I was at 6 cm and 100% effaced. With that I decided to try to take a nap. With Nora, Adam had kept coming in and out of the room, and each time he would, I would kinda wake up and look for him. This time he just laid on the couch and watched House, while Nancy and I took naps. I remember at one point Nancy asking Adam to turn the volume down, which helped me be able to get more rest. 

After about an hour and a half, Shelley came back to check me again. She said I was at 8 cm, and my bags of waters was bulging. She asked if I wanted her to break it. I said no, but then through the epidural, I felt like I was suddenly peeing, and I heard Shelley say, "Oops." I wasn't upset though, as I figured that if it was bulging that much, it would probably have popped soon anyway. But, then she changed her answer on how dialated I was. Apparently, the water breaking pushed me up another cm to a 9. I was definitely okay with that! 

Shelley went to her computer next to my bed to update my file or whatever, and within a few minutes, I told her that I thought I felt the urge to push. It wasn't something I expected to feel at all! With Nora, I was told that it was time to push, and then I was told when I was having a contraction, so that I knew when to push. But this time, I could feel my son actually decending into the birth canal. It was amazing! I could feel lots of pressure, but no pain. By the time Dr. Nelson, the on call doctor from my clinic, arrived, my baby was just about ready to be born. She was amazed that as he was crowning, he was turning his head side to side, and commented on his strong neck muscles. It only took about 10 minutes of pushing before Samuel David entered the world! He cried loudly, as he was placed on my chest, and I tried to nurse him. At first he just wanted to cry, but he soon found my nipple, and started nursing like a champ. 

These are the notes that Nancy took for me during Sam's birth. I had to refer to them a couple times for the order of events since I finally finished his story over a year after his birth, but I still remember those moments very vividly. 

Sarah gibson
Conx occ night
9:27 830, 3-12 min
215 leave hosp, strong shaky
3:50 -tight cm 3cm, "thick" cont monitoring 20min
440 - 80-90% eff, 4cm, baby stn 0 nurse: Barb
545 nurse alicia IV
Trembles starting
630 - bath!
715 Pee -standing hip squeeze - Shelly on
730 90% 4cm baby low
800 fentinol/IV/labs
830 ep
930 pencill #2, check: 6cm, 100%?
NAP! (Or stay up and watch House for Adam :)
11 - switch to left side...check, cervix soft 7cm
1130 checked 8, water broke during check 9 bleeding
1150 dr nelson in
1212 pushing
1222 born

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