Tuesday, June 14, 2016

Eliza's Birth Story

I've sat down about 400 times to write this and found that I either get too emotional to finish or something more pressing requires my attention (a baby, a toddler, a dog, a husband, a cookie, a glass of wine...) But I feel a sense of urgency to get this down on paper now, before time starts to blur the memory and emotion of Eliza's birthday. So here it is.

May 25th, the day I posted about being pregnant forever, I had an early morning routine OB appointment. For whatever reason, my doctor suggested I have an ultrasound before I left the office, mostly to check on the size and status of the baby. I was going to get the ultrasound and head home; we would discuss "options" at my appointment the next week (my doctor really wanted me to have the baby before she left on vacation, and while I was hoping to avoid induction, I appreciated her enthusiasm and desire to be the doctor who delivered our girl). During the ultrasound, the tech found that my amniotic fluid was low...not dangerously low, but low enough that she called my doctor back in to talk to me.

The doctor expressed concern that the low fluid level could mean the placenta was no longer functioning properly and requested I come back on Friday, May 27th to check the levels again. She told me that no matter what, she wanted the baby out in the 38th week because the risk of her staying in with dropping fluid levels outweighed her making an appearance 2 weeks early. She asked me to talk to Zach and call back that afternoon to schedule an induction for either Sunday, May 29th or Tuesday, May 31st.

I was mildly concerned about the low fluid, but mostly feeling a mixture of relief and apprehension over knowing we would have our baby within the week. I also had to take some time to come to grips with the fact that I would probably need to be induced, something I had REALLY wanted to avoid. Zach and I settled on the Tuesday induction date with the hope of me going into labor naturally before then.

With the induction scheduled, I felt a sense of urgency to get things pulled together before we had this baby, so I went into full-on prep mode...I cleaned the house, did laundry, finished packing my bag, got my nails done (priorities), did last-minute errands, etc. Friday rolled around and I headed back to the doctor, sure that the ultrasound would find that my levels were holding steady and I would simply come back on Tuesday to have the baby. I walked out the door with a quick "bye, love you!" to Zach and Zoe, thinking I'd be back home in under an hour.

The ultrasound revealed that my fluid levels had dropped even further, bordering on "danger zone" level. The tech left to get my doctor and sent me back out to the waiting room. A few minutes later a nurse came and asked me to come back to a little private sitting room where she took a deep breath and said "The doctor would like to go ahead and do a C-section; there's a 12:30 slot available so we'll need to get over to the hospital now. Go ahead and call whoever you need to."

I think I must have just stared at her for a second before saying something eloquent like "Ok. Whoa. Wait a minute. Why do I have to have a C-section? Can I try to labor? Is the baby ok?"

The nurse didn't have any answers (super reassuring) so she left to consult with my doctor while I was left hyperventilating in this tiny little room. I called Zach, but I don't remember that conversation. I called my mom, and I only remember her telling me to breathe (helpful and necessary). In the meantime, I kept being interrupted by 3 different nurses popping their heads in to take my water bottle away (no more liquids before surgery), ask me if I'd eaten, ask me when I ate, and ask me what I ate (yes, 7:30, donuts...just kidding, it was oatmeal. I wish it was donuts). Finally the original nurse came back in and said "Come with me, the doctor will talk to you about what's going on".

I nervously entered the examination room and my doctor greeted me with a profuse apology for the confusion and explained in the fly-by conversation she had with the nurse, she confused my situation with another patient (she had 4 patients set to deliver that weekend). She reassured me that I could definitely labor safely and we would avoid a C-section unless absolutely medically necessary. We talked through a few more of my questions/concerns and she confirmed that she did indeed want me to be induced that day, but she left the final decision up to me whether we would risk waiting another 2-4 days. Zach and I agreed it wasn't worth the risk of my fluid dropping even more and potentially putting our sweet girl in danger. We were having a baby...that day.

My mind was racing at this point and I asked my doctor if I at least had time to go home and get my bag, drop off the car seat, eat a donut, etc. She said she would prefer I didn't and wanted to get started right way. I then voiced my concerns about being induced with Pitocin and requested we try the gel instead (this is what was used to successfully induce with Zoe in Germany). I had been adamantly against the use of Pitocin and had voiced this to my doctor throughout the pregnancy. She looked at me and said "Don't be afraid of Pitocin. I won't abuse it." and that kind of closed the door on that conversation. I wasn't upset, just more disappointed and a little afraid. I trusted my doctor, even though things weren't going the way I had hoped.

Everything started moving really quickly then. They got a wheelchair (so unnecessary) and wheeled me from the doctor's building to labor and delivery where I was checked in and given a room. I was left alone for a few minutes to call Zach and my mom back and talk logistics about my parents' arrival, Zoe's care, and getting Zach (and my bag) to the hospital. In those few solitary moments I broke down in tears over the fact that our family was about to be forever changed and I hadn't had a chance to say goodbye to Zoe. It sounds so dramatic, but I tear up even writing about it. All I wanted to do was scoop up my first baby girl in my arms and squeeze her so tight, tell her how much I loved her and how excited I was to see her be a big sister, and kiss her goodbye. I was heartbroken over not having that opportunity.

At around 10am my nurse (Nancy) came bouncing in, handed me a gown, hooked me up to my IVs and said "Ok, do you have a birth plan?"

I hesitated, slightly annoyed at her chipper-ness and desire to discuss my "plan" when everyone knows that things rarely go according to plan when giving birth, before saying "well...not really. I wasn't planning on being induced...or any of this..." and she didn't miss a beat before replying "Ok, but that means you had an idea of how you wanted this to go, so let's talk".

Looking back, this was the greatest gift she could have given me. To push past my initial response and dig deeper...she didn't have to do that. She could have accepted what I said and moved on. Nancy was a God-given gift and I will never forget her.

I took a deep breath and thought about how my ideal situation would be to go into labor naturally, labor at home as long as possible, and arrive at the hospital with plenty of time to have options about how the rest of the labor and delivery went. My "plan" had been pretty similar to my plan with Zoe...just see how it goes, keep an open mind, stay flexible to all options. I had an epidural with Zoe and I wasn't opposed to getting one again, but I also knew what I could handle after my experience with Zoe and I was comfortable with trying to see if I could deliver without pain meds or an epidural. After giving birth to Zoe my midwife had said to me "Your next delivery will be a piece of cake", and I chose to believe her.

With this in mind and the reality of my situation in front of me, I said "Ok, well based on my experience giving birth to our first, I would prefer as little medical intervention as possible" (which is laughable because at this point I'm in a hospital bed, wearing a hospital gown, with an IV pumping antibiotics and synthetic oxytocin into me whilst hooked up to a blood pressure cuff and fetal monitors. But no, let's keep it as natural as possible you guys.) But Nancy, God bless her, didn't laugh or raise her eyebrows or show any sign of skepticism. She simply said "Ok, then that's what we'll do. Here's my rule: if you want to talk about pain medication, you have to ask me twice. The first time you ask, I will not respond. You must ask twice. I will not offer it or bring it up to you. Otherwise, I'm here to help you get this baby out. Let's get you on the exercise ball, keep you moving, try to get things going." I agreed, we talked about a few other things that were important to me (delayed cord clamping, immediate skin-to-skin) and that was that. She said she'd be back in 20 minutes to check my progress and up my Pitocin. 

In the meantime, Zach was getting Zoe settled with our dear friend Laurel who dropped everything to come watch her until my parents arrived, and then got a ride with another friend to the hospital, where he stayed with me for about 30 minutes before taking the van (with carseat) back to our house and returning with his own car. (He also had to leave me at the hospital in Germany as labor was starting, so this felt normal to me). In the short time he was at home switching out cars and grabbing last-minute things I forgot to pack, he FaceTimed me with Zoe so I could have my moment with her before she became our oldest instead of our only. This was the most precious gift and I choked back tears and laughter as she asked me "You gots PJs on? You gots a shot?" and I told her how much I loved her and how I couldn't wait to see what a great big sister she would be. I felt so much better after having that chance to talk to her...it really helped ease my mind and quiet my emotions as the contractions started to pick up. Shortly after that call I texted Zach and said "get here please, these are starting to hurt!"

At the 40 minute mark, a new nurse came in and let me know that Nancy was on a break and she was here to check my progress. She looked at my monitors and said "Well I'm not going to up the Pitocin because you seem to be responding well and I know you wanted as little intervention as possible." And she walked out. Again, Nancy...amazing. She had spread the word and they were all working together to be as supportive as possible. (Side note: for Pitocin, they start you at a 2 and it can go all the way up to 30, as needed, to help move labor along. For me, from start to finish, they never went past 6. I'm sure this is partly because I was responding well, but also because I had voiced my desire to have minimal intervention and Nancy took that seriously. Based on how fast and furious my contractions came on, I'm very very thankful I wasn't given a higher dose than I had.)

Once Zach arrived, I told him "I remember this pain. I'm already scared knowing how much worse it's going to get..."

Side note: Zach is a champion when it comes to support during labor. From that point on, he was the voice in my ear that talked over the voice in my head, offering me encouragement and support when the pain started to overwhelm me. He got ice chips, sat with me, rubbed the cramps out of my calves, offered to massage my back, and kept a close eye on my every move, ready to offer support in whatever way he could. He later said to me "Hey, through all of that you only cursed once!" and I, having a very foggy memory, asked when (after congratulating myself on this personal victory). The blood pressure cuff that checked my BP at 20 minute intervals was a huge nuisance and in a moment of pain and frustration I apparently said "Get this damn thing off me" (which he did, and we were scolded by the nurses. Woops).

I spent most of the next 4 hours on the exercise ball, bouncing and rocking and breathing through the contractions, which were painful but still manageable. At 2pm my doctor came in and said it was time to break my water since my first round of antibiotics was successfully complete. I really didn't want this to happen either, but after some more discussion, Zach and I agreed to move forward with it. So my water was broken and I moved back to the exercise ball and asked Zach to pull up Netflix so I could distract myself with some episodes of Fixer Upper (thank you Chip and Joanna).

In a matter of minutes my contractions got much, much more intense. I looked at Z and said "this was a terrible idea." I'm not sure if I meant having a baby in general or having my water broken or not having pain meds, I just know I was in pain and a LOT of it. Zach buzzed the nurse and Nancy came right in. I said something like, "I think I want to talk about pain management..." between contractions and she quickly responded with "Ok, how about we check your progress? You'll have to move to the bed for this."

Once I was on the bed I immediately was in much more pain. Laying down while having contractions was agonizing and I wanted nothing more than to get up out of the bed. Nancy checked me and said something like "whoa, ok you're ready! This is the part where you will want to give up; just listen to me and we'll work through it" and I remember saying something along the lines of "I can't do this!" as I fought to keep control of my breath through each contraction. I could hear Nancy telling me that I was in transition and everyone hits the "I can't do this" point and I just needed to hang in there, and I could hear Zach saying "when you got to this point with Zoe, she was here in less than an hour. You can do this." (when I got to that point with Zoe, I got an epidural...) Nancy got down in my face and looked me in my eye and said "Ok, I need you to turn on your side and lay this way for 3 contractions, and then we're going to turn on your other side for 3 contractions. That's going to move the baby down. You can do this."

Those 6 contractions...there are no words. I held Zach's hand as tight as I could, closed my eyes, and counted my way through each one. By the 6th contraction, I had forgotten all about the rule to ask twice for pain meds (I'm on to you now, NANCY) and was ready to push. This was simultaneously happening so, so quickly and lasting forever. It was incredibly intense, and that is an understatement. At some point my doctor had arrived and I realized "oh my gosh, this is happening". I remember again saying "I can't do this, I can't do this" and hearing reassuring things from everyone in the room (none of which registered with me). The next few minutes were a blur of pushing (which was actually sweet relief from the pain of the contractions) and desperately wanting to be done pushing. I remember at one point looking up and saying "WHY ISN'T SHE COMING?!" and then she was delivered in the very next push.

That moment was the sweetest moment of relief and joy...when they put that naked little screaming sweetie right on my chest where she immediately peed and then stayed snuggled in my arms for the next few hours (this was such a gift as I was only able to hold Zoe for a few minutes before they took her to the NICU). When Zach and I had talked about meeting Eliza, one thing I told him was that I really wanted to be present for the moment when we met her, because with Zoe it was such a blur that I felt like I "missed" the experience of seeing her and holding her for the first time. With Eliza, I was given the opportunity to fully soak in every part of those moments and I am so thankful for that time.

Eliza Rae entered the world at 3:34pm on May 27th, about 5 hours after induction began (not a bad way to go, all things considered). She weighed 7lbs and was 19.5 inches long. She was (and is) absolutely perfect, with the longest toes and fingers and the sweetest dimples from her daddy (the moment I realized she had dimples...oh my gosh).

Shortly after delivery my doctor asked me "Ok, having given birth naturally and with an epidural, what will you do next time?!" and I'm all like "THERE WILL BE NO NEXT TIME." but that's probably not true...just maybe it's terrible timing to ask a woman who has JUST GIVEN BIRTH to consider doing it again, regardless of the experience.

My experiences giving birth in Germany and in the States were vastly different, but I wouldn't say one was better than the other and I'm not ready to say what route I'll take if/when we have another baby. At the end of the day, we held a precious, perfect baby girl in our arms and that really is all that matters.

The past two weeks have been filled with immensely sweet and incredibly challenging moments, which I think is probably par for the course when adjusting to life with a newborn and toddler. I am soaking up every sleep-deprived moment because I know just how fast it will go. My heart is so full when I look at our little family of four and I am so very, very thankful. Welcome to the world, adorable Eliza Rae. We are already so crazy about you.