Saturday, May 3, 2014

She's here! Greta Susi is here! (birth story and many emotions included)

On April 29th, our rainbow baby, our daughter, our second child was born - and everything was perfect.

She came a week late.  She weighed 9lbs, 4.5oz.  She was 20 inches long.

Probably the most remarkable thing is that she was born just one day shy of (the day before) her brother Wolfgang's birthday.  In fact, she was only about 12 hours shy of being born at the exact same time of day as Wolfie.  Ben and I were talking before she came and wondering how we would feel if she was born on his birthday - which of course, we'd love.  But I also remarked that if she came the day before then they could be "next to" each other, but we'd still have a special day for each.

She's been home for a few days now and it has been remarkable to say the least.  I probably underestimated the amount of simple anxiety I would have over things like how she's breathing, her body temperature, whether she's getting enough food or is dehydrated, etc.  I think when you have lost an infant, a lot of those simple anxieties are highlighted a little more.  I'm sure I'm not the first parent to check every five minutes to make sure my baby's chest is still rising and falling like normal...but it just feels like I'm in a category all my own on things like that.  

And despite any worries I have, she is perfect, beautiful, healthy and totally worth all the worry in the world.  

Birth Story ahead!  

I was 39 weeks and 4 days when I went in for a routine ultrasound on a Friday.  Everything looked great except that her fluid was a little bit on the lower side of things.  Normal amniotic fluid levels are between a 5 and a 10... and mine was at a 4.5.  Our amazing doctor gave me a couple of choices but was up-front about the risks and odds of each.  He said I could either go home and drink plenty of fluids over the weekend and try to get my levels up myself.  I'd then have to go back on Monday to check on things... but that if my fluids had not improved or if they'd even gotten worse I could be limiting my birthing options at that point (a slight hint that a cesarian might be necessary).  Or, I could go home a pack and head to the hospital right then to get hooked up to some IV fluids and also just go ahead and get an induction going.  This was recommended because he felt that she was already big enough (more than big enough) and that we has already discussed my plan to not allow this pregnancy to go further than 41 weeks because of our previous loss at 42 weeks.  Since 41 weeks was just 10 or so days away, he offered it up as an option.  The thought of going home to rehydrate on my own and then possibly failing in that endeavor and endangering the life of my baby frightened me... so I called my husband and away to labor and delivery we went!

We got in on Friday afternoon and were met with a whole host of the most amazing midwives and nurses.  They got me settled and on a little fluid drip, and checked my cervix - which was 3 cm already but very high and hard to reach... and almost not effaced at all.  One of the midwives, Mika, applied the Cervadil (a cervical ripener) and the process began.

Before anything was rocking and rolling, I was met with some disappointment, though.  I had the opportunity with Wolfie to labor in the birthing tub, or attempt a waterbirth so long as the Pitocin drip had been stopped and I was contracting on my own.  When I asked about the tub when I got there I was informed that this would not be possible for me, as given our history it would just be so much easier to manage and monitor me and the baby without the tub.  This was never communicated to me during my pregnancy, and I had been using a lot of positive visual imagery involving waterbirth to work through my anxiety about the birth - so I was really hoping for it.    A bummer, but safety was our goal - so after lamenting about it for a few minutes, I was on-board.

Overnight, I started having contractions.  On a scale of 1 to 10, I'd say they registered in at a 2 or 3 on my pain scale.  The next day, the Cervadil was removed and since I was contracting, they had me walk around the hospital to see if I could just continue on my own.  After walking and birth-ball bouncing for about an hour, it was clear that my contractions were waning - so they started me on the Pitocin.  They gently nudged the dosage every half-hour, and this went on for hours.  But the the 2nd evening, I was up to a fairly high dose of Pit but like one of my midwives said, "You're not even batting an eyelash at these contractions."  So they decided to bump me down to a low dose overnight, allowing my system some time to breathe and then bump me back up in the morning.    Unlike the 1st evening, it was clear that I was exhausted and sleep-deprived.  They gave me Ambien to help me sleep... which can I just say is UHMAZING.  I didn't just sleep, I went out like a light... like 3 glasses of red wine OUT.   During the night I dreamed about a clear mask over my face and a horrible smell.  I grabbed at the mask and lifted my mouth out of it and took gasps of clean air, then placed the mask back on my face.  So, apparently at some point I was laying on my side and while Greta was not in distress or anything, they thought she could do with more oxygen, so they put the oxygen mask on me.  When I woke up I had to ask if it was a dream or not.  Oh, Ambien... you're a hell of a drug.

The next morning, they checked me and I was at 5cm... but still hardly effaced at all.  They started bumping up the Pitocin again but literally nothing was happening.  They got almost all the way back up to the dose I'd had before but my contractions were nowhere to be found.  That afternoon one of the midwives came in and said, "OK, I don't want you to worry or anything but we need to have an awkward conversation, sweetie."  Uh oh.  My mind immediately went to cesarian.  Crap... she's going to recommend surgery.  My heart raced.  "I think the best thing right now, is let's do an ultrasound and check those fluid levels.  If everything is OK, then I really think the best thing to do is send you home to allow you to get some real rest, let your body reset it self, and see how the next week goes.  Who knows, you may go in to labor on your own now that we've sort of 'primed' you."  Thank goodness!   My Ob came in to do the ultrasound, and my fluid levels were way up.  They unhooked me, discharged us... and we went home with a baby still in my belly.

The following week was a strange dream.  Ben had already taken off of work since we had no idea that an induction could fail.  At that point it was awkward for him to go back just for a few days so he just stayed home with me.  We walked a million miles, ate spicy eggplant parmesan, and did everything in our power to get her to come on her own.  

Greta had other plans.  At 6 days past my due date, I went to the midwives and also for another ultrasound to check on Greta.   Everything was beautiful.  It was clear that she was calm and happy in there.  My cervix was still at about 5cm, but it had lowered quite a bit - still not very effaced but lower and easier to reach and for baby to lower to be born.  Ben and I discussed our options - clearly given losing Wolfie we were in no emotional position to continue to wait it out and risk going to 42 weeks again.  We opted to schedule another round of induction for the following day (putting me at exactly 41 weeks).

We arrived at the hospital at 8am and they got me prepped.  No Cervadil this time - straight to the Pit.  Again, they slowly eased me in to it... but it was clear that things were going to be different.  My body started responding immediately.  Contractions were happening - and they were actually painful enough that I had to stop and focus.  I had developed a little technique of kind-of traveling outside myself and telling my body and my mind what to do.  If you were in the room with us you would have seen me gripping the side of the bed chanting over and over, "pressure pressure pressure pressure good pressure, bring the baby down, bring the baby down, open up, open up, open up, relax, relax, relax, relax".

At some point during the afternoon, though, the chanting stopped and the slow breathing control began.   Even though things were intensifying, both Ben and I still thought that she would not be born very soon.  Mentally I was preparing to be in that state for hours on end.   Shortly thereafter they started backing off of the Pitocin.  My contractions continued to build... I was doing it on my own!  They had just removed me completely from the Pitocin when our midwife came in at 5pm.  It was right then that it felt different - as scared as I was to take the next step in this painful journey, I had to be honest with her and tell her that I really felt like pushing.  She checked me - I was at about 9.5 cm dilated and almost completely effaced - "Your cervix is like almost gone... go ahead and push!"

I checked the clock with each contraction.  20 minutes or so went by with me holding my knees back on my own.  The baby was getting lower.  My water still had not broken.  They put up the squat bar on the bed... but I just used it to put my feet up.  After pushing a couple times this way, they offered me a little twisted sheet to use as a "rope" to hold on to with my arms so that I could also "curl" my body upwards and really get to work.  Once the rope was handed to me, things got real.  

One or two pushes in using the rope and Ben said, "I can see her head... in the bag of waters.  I see her hair swirling around!"  "Really?!" I said.  The midwife said, "Reach down and feel her."  I reached down and felt what I can only describe as a bit of a water balloon, Hah!  It was joyous.  I burst into tears.  "Oh my god I want to hold her!" I exclaimed.

I didn't know it then, but there were only 7 or 8 good pushes left.  At one point, the midwife said, "She's almost here, she's right there." and I looked down at her between contractions.  She was holding up a tissue to shield from my bag of waters.  My waters still had not broken, but on the second-to-final push they did.  When they did, the baby stayed put.  Normally in birth the baby comes down and out a little when you push and then back in a little when you rest.  But when the water burst, she stayed... she was crowning! 

The crowning was a new level of pain.  My midwife could see this and said the most profound thing I've ever heard, "This is your new normal.  Just get used to this new normal and adjust to it.  You can do this."

I let go of the rope as I couldn't take it anymore.  I was beside myself with pain... but still somehow present in all of this.  I let the sensations establish themselves for a few seconds.  I felt the burning, I reached down to add some counter-pressure on my own during my final push.  I knew this push would be the last - I just knew it.
Reaching deep inside, and forcing all my will-power over the edge of what I thought I could not handle (but did), I curled up, I curled inward, my mind went blank.

The next thing I remember is opening my eyes to the most beautiful sight any mother could ever see... her newly born baby laying on her stomach, looking right up at her, crying with opened eyes, reaching out to be held.  

Many many many joyous exclamations, many many tears, many many declarations of disbelief for how easy and quickly this went.  So much love. 

 It was 5:47pm.  I had only pushed for about 45 minutes...only 15 minutes or so of which was really very intense.  We had done it.  Greta is here.