Isaac's Birth

On the day before my due date(Wednesday, Aug 23), I had an appointment with a midwife (not my primary one) and everything was good. The baby's heartrate was good, my blood pressure was good, I was 3 cm dilated and 80% effaced (woohoo!) The midwife offered to do an induction, which to this day I am not happy about. The thing is, both midwives were going to be out of town during the weekend and there was a chance that I would go into labor while they were gone. I didn't want to be at the mercy of just any obstetrician with a hobby for unnecessary surgery. As rumor has it, there are several OBs with a penchant for surgery. Yikes! The induction was scheduled for my due date and I had a favorable Bishop's score. At any rate, I decided to go forward with the induction. The next morning, we made a few phone calls and lined up Nana to take care of Caroline. Todd drove me to the hospital at 7 AM and I headed up to Labor and Delivery. Todd took Caroline back home and waited for Nana to arrive (she had just returned from a vacation at that morning at 3 AM).

Once I was admitted to the hospital, I really started to panic. I was at a hospital and I was a PATIENT! Not just any old, run of the mill patient. I was considered Pre-OP. That is, being in labor means that you are considered to be on the verge of surgery at a moments notice. I was very concerned by this turn of events. I considered going home, but I feared going into labor over the weekend and getting stuck with surgeon (I mean Obstetrician, but OBs are surgeons...) The nurse went over lists and lists of complications (informed consent) of the different procedures thaat they do. For example, epidurals carry certain risks, like a precipitous drop in blood pressure, followed by drop in fetal heart rates, necessitating a cesarian section and so on. I didn't really need or want to hear about the risks. I knew what they were. What concerned me most was being in the hospital to give birth. Caroline was born in a free standing birth center. There was no patient bed, like you are used to seeing at a hospital, but a regular bed. There was some medical equipment and such, but it was out of the way. This hospital room was a high-tech operating room. Okay, I know it wasn't an operating room, but it is how I felt.

The delivery room had its own mini-NICU off to the side, which also scared me. Seeing the NICU bed scared me into thinking that they would take my soon to be born baby away from me. Of course, I knew that there was always the chance of something going wrong necessitating a quick delivery and newborn resuscitation. However, such an event is unusual, but more likely if you deliver in a hospital. Outside a hospital setting, the interventions are fewer and I think in most cases babies are born in better condition. There are situations which need careful monitoring in a hospital. And if problems arise in a birth center, it is always advisable to transport to a hospital. At any rate, here I was, in a HOSPITAL as a PATIENT and I was really uncomfortable with that. I don't recall ever truly being a patient, and the lack of control as a patient really bothers me.

My midwife came in to talk to me and I relayed my concerns to her. She said that once the pitocin induction was started, I would need to be on a fetal heart rate monitor. However, if my labor picked up on its own, they could stop the pitocin and I could walk around without the monitor and such. I agreed to begin the induction and an IV was inserted (ouch!) and the pitocin drip was started. The nurse started the pitocin very slowly, up the amount by a little every half hour. The contractions started within 10 minutes. They were wimpy contractions. I kept trying to tell my body to pick it up! These contractions are going to get us nowhere fast! The contractions were regular and annoying because they hurt, but they didn't hurt enough to push a baby out. Todd arrived shortly after the induction was started. It was really strange laying there in the hospital bed waiting for labor to really start. We talked about mundane things. "Did you call so and so?" "Did I put that load of clothes in the laundry?" And so on. I told Todd to go an get me some food, because I was starving. Of course, since I was a pre-surgical patient, I was NPO, as in nil per os or nothing by mouth. The whole NPO business during labor is quite controversial, because you are essentially stop intake (food and water) during a very physically taxing event. I've heard labor compared to running a marathon in terms of the energy required. Just try telling a runner that he can't eat or drink during a marathon. Such advice would be considered laughable. Go into a hospital and you will see that this is required of ALL women in labor. I think that not eating during labor increases your chances of having a c-section, because maternal exhaustion is one of the reasons c-sections are done. The reason for NPO is aspiration pneumonia brought on by emergency surgery. This is, however, extremely rare and I have yet to see where its incidence necessitates NPO for everyone. But I digress. Todd went and found some snacks for me. Everytime the nurse left the room, he would slip me some M&Ms or peanutbutter crackers. Then, rumor came back that the hospital provides free jello (okay, I know its not free, but I'm trying to stay on point here). I asked for some jello and scarfed it down like I had never seen food before. Man I was STARVING! I think that the being NPO made me even more hungry. While in labor with Caroline, I snacked as neccesary, first on chinese food (which wasn't appetizing at all) and then on some granola bars and yogurt. Food wasn't a huge deal to me when I was allowed to have it. At this point the contractions were picking up such that I had to stop and concentrate on my breathing to get through them. They hurt, but I knew they weren't doing much.

At lunchtime, when everyone left to go eat, my midwife came back in to visit with me and she check me to find that I was 4 cm dilated. Not bad for 3 hours into an induction. Though considering that I had come to the hospital dilated to three, I was hoping for some more progress. She talked to us about breaking my bag of water. At first I said "no" because I felt it was an unneccesary intervention. The midwife said that it would be fine either way, but I might be in labor a lot longer if she didn't break my water. Plus, since my contractions were pretty strong and regular at that point, she could break my water and take me off the pitocin and I could move around more and walk the halls. I agreed to it. The baby's head was really low at this point, so there was not a big gush of fluid or anything. It was more like a steady trickle. Once my water bag was broken, the contractions became much more intense. The nurse took me off the pitocin drip and I started to walk the halls with Todd. We walked by the nursery and saw all the freshly birthed little babies. They were so cute screaming in their own little plastic boxes. Wait a second... did I miss something? Why weren't these babies with mom, since they had clearly just been born? I asked Todd about it and he went and talked to our L&D nurse. He found out that rooming in is only allowed if the pediatrician okays it. WHAT? We aren't allowed to keep babies we birth with us? Yep. It was hospital policy. Babies stay in the nursery where they belong. The nurses bring them around every few hours so that mom can nurse. If babies get hungry while the nurses are busy then they get a bottle (if you formula feed) or a pacifier if you breastfeed. And if they don't take a pacifier (Isaac doesn't, even though I want him to), then they just cry. It's soo sad. Todd phoned our pediatric practice about faxing us permission to keep our baby after the birth and they gave him the run around. Eventually, he spoke with the someone who said they would fax the form, etc. So, while we were walking the halls, my contractions were picking up in intensity and slowing down in frequency. We tried everything to get them going again. I sat on the birth ball, walked around stayed upright as much as possible. Eventually, my contractions completely stopped. At around 4 pm, we told the nurse to start the pitocin again and so there I was back in the bed, on the monitors, attached to different machines, measuring my blood pressure, providing fluids, and detecting the baby's heartrate. As soon as the pitocin was started, my contractions started back. They were coming every three minutes and they hurt. I had to breathe through each of them. I started joking about getting some drugs to help me out and at this point, I knew I was in the thick of active labor.

I told Todd I wanted to watch something on TV, because we don't have cable at home, and when it is available to me, I like to watch it. We flipped through a few of the channels and found nothing but Jerry Springer and a murder mystery (something like American Justice) where a really creepy guy killed 10 people or something. So, I sent Todd went to blockbuster where he bought a few of their previously viewed DVDs and while he was gone, he ate some lunch. I endured contractions by myself for close to an hour. I knew that I was approaching transition and that it was going to get worse before it gets better. I kept hoping that Todd would get there soon, because I didn't want him to miss his son's birth. Eventually, he came back and showed me the DVDs he bought. I remember one of them being "The Wedding Crashers" and he put the movie in so that we could watch it. My contractions were too bad at this point for me to even notice the television. I told Todd to turn it off and he did and we focused on my 1-2 minutes apart contractions. I started telling him that I needed an epidural NOW! Drugs! Anything! I wanted all the drugs in the hospital. Todd and the nurse ignored my requests for drugs, because they knew that the baby would be born soon. The contractions were so bad that I was yelling through them. Todd started talking about the baby. Big mistake. I told him and everyone else I saw that did not want a baby. Nope. I was done with this whole "labor thing" and I was ready to go home. So Todd told me that it was okay, I didn't have to have a baby, but I needed to breathe with him during the contractions. The nurse checked me and announced that I was 6 cm dilated. Oh no. Last time, it took several more hours to approach full dilation. The nurse asked if I felt like pushing, I nodded. A few minutes later, the midwife checked me and announced that I was in fact 8 cm dilated. I could feel the baby moving down and I knew it would be over soon. My midwife told me to try pushing. I said "Are you sure?" and she said that since I had given birth recently, there was a good chance that my cervix would stretch the last 2 cm during pushing. I started pushing and pushing and within a few minutes, the baby crowned and he was born very quickly. My midwife handed him to me and I laid him on belly because the cord was quite short. As soon as the cord was cut I brought him up to my breast so he could nurse. He cried as he took his first breath and then he nursed for at least 10 minutes. The placenta came out fairly quickly and an my perineum was intact, so no stitches. Once the placenta came out, the nurses took Isaac to the mini-NICU and weighed him (8lbs 5 oz) and put erythromycin in his eyes.

Once they had him dried off and weighed, they wanted to take him to the nursery. What???!!! So, Todd inquired about the fax that was sent authorizing us, the parents, to keep our child with us. "What fax?" Apparently, the fax was not sent. Todd called the pediatricians' office and of course, they are closed. Todd got the rounding pediatrician at the hospital on the phone and asked about rooming in with Isaac. The pediatrician said "no." I don't know much about what else happened, but at that point we severed our relationship with this particular pediatric office. The nurses worked on finding us a new pediatrician that would allow the rooming in. Within an hour, we found a new pediatrician that allowed us to keep our son with us. I had no idea that rooming in was a special request that needed formal approval from a pediatrician. Why was it such a big deal? Once we had authorization to keep our son, I handed him to Todd and got up and walked to the shower, so that could clean up and feel refreshed. After birth, I always have natural "high" that gives me all the energy in the world to do things. Yes, I showered within an hour of Isaac's birth. I shocked all the nurses with my insistence on the shower. They didn't resist much and they helped me cover up my IV site with a glove. After the shower, I went back to the bed which had gotten some new linens and laid down. I told Todd that I was hungry and he said that he would get me whatever I wanted. I distinctly recall saying "one of everything, please." The nurses gave him some vouchers to use in the cafeteria and he brought back a tray full of food. Fries. Cheeseburger. Some chicken thing. Chocolate. A soda. And so on. I took one bite of each thing and just could not stomach any of it. I was STARVING but nothing looked good to me.

Soon after that, we moved to the postpartum part of the floor. I had a private room, but it was much smaller. It was still very nice. I received an itemized copy of the hospital bill and my insurance was charged $750 a night for this room. Wow. I could get a suite at the Ritz with an ocean view for that much. Oh well. The first night Todd was walking the halls near the nursery and he said that it was full of babies screaming. Why, again, did the hospital make such a big deal about us keeping Isaac? After 2 nights, we went home. My dad and stepmother helped us get everything home and we arrived to a very clean house and dinner prepared by Caroline's Nana. It was great. Caroline ignored me for a while, because I'm sure the separation stressed her out. Within a few days, things were back to normal.