Wednesday, June 18, 2008

No Stress, Part Two (or The Way My Labor Went) - God is Gracious

NOTE: I typically edit the heck out of my posts. I can't take the time to do that. So, if my writing is something like that of an eighth-grader, please forgive me.

I don't mean to get all "holy-roller" on everyone (though most of my friends who read this blog are pretty "holy-roller" themselves), but I had to include "God is Gracious" in the post title for reasons which will become clear.



So, I knew that many of my friends would be curious to hear how our little man arrived. For those who I've failed inform, Ian Michael Graham was born on May 30th at 1:36 AM, weighing in at 8 pounds 2 ounces and standing (well, laying) 20.5 inches tall. He's just beautiful! See...




Anyway, Ian's arrival was another proof of a theory I have: When I really want something badly enough, God sends me... what He wants for me. For example, while I waited for my mission call, friends would ask, "So, Dianna, where do you want to go?" I would answer, "I'd love to go somewhere foreign, anywhere in Europe would be cool. I just don't like Spanish and hot areas." So, He called me to The Philippines - where most of the languages include a lot of illegitimate Spanish words, and the climate is very hot. Oh well! I loved my mission. I love my Ian infinitely more, so it didn't matter how he came.



After the Tuesday when I had my check-up and the two NST's, David and I made a date for a Thursday night NST at the hospital. We both had mixed feelings. Of course, we didn't want there to be distress for our baby and a reason to induce. We were anxious, however, for him to be here and to have the worry done. I just knew that, if nothing else happened, Ian was likely to pass mechonium and endanger himself that way.



So we packed up our bag, the birthday cake and fresh OJ, dropped the kids off at Annie and Joel's (David's parents), and headed up to AF hospital. Unlike Tuesday evening's NST, where Ian looked great, there were variables all over the place. His heartbeat would look great, and then he'd have a drop. It was frustrating, scary, sad, etc. Noone was screaming, "Quick, let's get her a C-section," but it was pretty clear after about an hour that we should just induce the labor. Again, I felt a ton of emotions - anxiety, disappointment, fear, guilt (that I was so reluctant to induce), etc.



I've been prejudiced against Pitocin for years, because I was convinced that most of the trauma following Sophie's birth was due to "Pit," as they say. I was wrong. My post-labor trauma back in 2002 was not the Pit, but sure is some fun stuff. First, they start off with just a little. The number was 4 something or others (ml's? cc's? I don't know). Anyway, I was tempted to show a shot of my birth plan and then describe each way we had to stray from it. It was so pretty. It had terms like "no IV's" and "intermittent fetal monitoring." Of course, these were impossible.



So, it went like this. They started me on Pit. Then they upped it, because, though my contractions started coming steadily, they weren't taking me out or lasting more then 30 seconds. David and I did some walking with the wireless monitor. Then we headed in to rest. The final number, I think, was "12" or "14" - one of those two. In other words, they started to give me the full dose of Pitocin. The contractions did start to take a lot of focus, and I started needing more potty breaks.



Oh, I should add that Heavenly Father loves me. The first gift he gave us: my cervix was dilated to 5 before we even started at about 9:30ish. I was halfway there at the beginning.



Due to the use of Pitocin and Ian's monitor variables, the monitoring was continuous. I did not protest. We were all worried. Our original hope was that the Pitocin would get me going and then I'd be able to labor naturally. I don't know how bad Ian's variables got, but my midwives decided instead that I should ride the full Pitocin wave.



At one point, probably around midnight, I felt my water break, and, in an instant, deep, burning pain swelled in my lower back. It wasn't clear to everyone, but I was pretty sure the waters had broken. From that point, my deep breathing turned to a crescendoing moan. Each contraction was about 45 seconds - 1 minute long. (I couldn't time them or anything - they were just long enough for me to hit forte by the peak of each contraction). Suddenly, it was clear to everyone that my water had broken, and the fluid was brown. (Big fat surprise!) It wasn't too scary, and the monitor looked okay. Soon after, it was declared that "the cervix (was) gone." (AKA, dilated to 10 and time to push). They asked, "Do you feel an urge to push?" I answered, "I feel a desire to!" (I guess I still had a sense of humor, or I didn't know how to describe what I felt). Well, actually the cervix wasn't quite gone. There was a lip on the cervix. We discovered this after a bit of progress free pushing.



I have a friend who has had a lip on the cervix with at least 2 of her births, and she said that it was terribly painful. She was not lying. The midwives took turns pushing back on the lip as I pushed with contractions. I could hardly restrain myself from screaming with each push. When the more experienced, less gentle midwife pushed, I couldn't help but grab her hand to try and stop her. I wasn't trying to be a bad patient. It was just so painful, and I was tired and feeling a little out of control at that point. Thank goodness, she, in her lack of gentility, succeeded in getting rid of the darn thing. Then the cervix was really gone. We thought that Ian's birth was imminent.



Still, my pushes showed little progress. Where was this guy? I had them place a mirror for me to help me with my pushing (SO worth it), and I couldn't believe that he wasn't crowning within minutes. Then, it became clear that he was posterior (not surprising to me with that back-pain). In the meantime, with the cervix gone, a nurse had to constantly search for Ian's heartbeat with monitor. He was okay, but the variables were as strong as ever. I asked from time to time how he was, and the answer was basically, "He's okay, but let's hurry and get him out."



Another gift from God - there was an OB present who had a magic touch. I don't know if it was to observe the newer of the two midwives, or if it was because this wasn't a routine labor and there was a decent chance that we'd need a C-section. Anyway, this lovely man, whose name I don't know, was asked to turn the baby. I was told not to push with a contraction. I cooperated, and this man, with very little effort, turned Ian almost painlessly for me. (Well, compared to the lip on the cervix stuff, most things would feel painless).



Within a few minutes, Ian started to appear. Then, the part of labor which always surprises me came. When they're crowning, it's just kind of scary. I felt like my body might rip to little shreds. I wanted to yell, "Someone please get some lubricant or something." (Sorry if I'm grossing anyone out). I tried to push, but there was a part of me that thought, "If I push too hard, I'll never walk again." I also think I was tired, and I was trying to follow "the rules" where you just push with the contractions. Yet, I could hear what seemed like the distant sound of a fetal monitor. This time, the heartbeat was slower than before. I could tell that his heartrate had dropped. There were no variables.



Finally, Mindy (the ungentle, expert midwife who I still feel like I owe an apology to) pulled out the perfect threat to "inspire" me. "Dianna, if he's not born in the next couple of pushes, we'll have to give you an episiotomy." I answered, so that it was clear that I wanted to cooperate (I still felt guilty about grabbing Mindy's hand), "If you need to, then do it." Then, the reality of an episiotomy hit me. The last time a doctor cut me, it was like a seamstress picking out fabric. One snip, and then I tore as far as you could tear. I heard the OB ask why they hesitated, and Mindy said, "She's had a 4th degree tear."



Then it all really hit me. Ian was in danger. There would be no C-section, but he had to come now. So, with the next contraction, I pushed and pushed. No baby yet. Then the contraction left, and I pushed and pushed anyway, and suddenly he was there.



He was so beautiful and long and...white. He was also wearing his cord every which way. The midwife who caught him had this manic look in her eyes as she unwrapped the cord from his neck, then one arm, then his waist, then his next arm. It was stunning. The fluid that he landed in was dark brown - there was a ton of mechonium. I know that David and I were convinced that he'd be life-flighted to UVRMC within hours for aspirating mechonium, just like his big brother.



There was an even bigger shock, however. There was a knot in the cord - a "true knot," they said. Somewhere along the line, when Ian was smaller, he swam a knot into his cord, and, though I don't believe it was pulled taut until he was born, it was a scary, ugly thing. When ever he stretched or when his body had pushed against the knot (in utero), his blood flow decreased and his heart-rate dropped.



Though I've already said too much detail, you know the rest about how gross and icky labor can be. And while the midwives attended to me and gave me instructions, etc., I stared at the incubator. There was no "waiting for the cord to stop pulsing before clamping" or "letting David cut the cord." Ian was brought to the incubator and the nurse and aspiration specialist worked on the white baby and get him going. But he moved and cried a strained cry. He was still with us. David asked, after the doctor had worked awhile, "Did he aspirate it?" The doctor was unsure, but they were going to give him some oxygen just to be safe. They wrapped Ian quickly and let me hold him for a quick second. Then he was off.



Two and a half hours later, he was with us. Hurray! Just having Ian alive was a gift enough, as many nurses and doctors said that knots often come with still-births. (Yes, it's a horrible thought.) Another great gift from Heavenly Father was that, despite his horrible distress in labor and the mud that he was floating in, Ian did not breath it. Once in the nursery, he was given a couple of IV's, but he didn't even need oxygen at all.



So I guess I don't get to have my "dream labor" after all. Oh well! I did ride the Pit wave without pain medication. (I'm not sure they would've given me any if I had asked. An epidural might've slowed down the labor, which was too dangerous). It was a very humbling experience, though. After Aidan's birth, I felt so empowered having gone unmedicated, and part of me balked a little at epidurals. I'm glad I didn't have one in this, but I couldn't judge anyone for wanting one. The pain, though all of it completely worth it, felt to me like one of the Gethsemane's of my life. It was very, very humbling.



So, God is gracious indeed. Though Ian's birth was the most ill-fated, his was the only of the three where the baby and I were ready for each other within a few hours. Despite this even more sobering period of anxiety known as "postpartum with a newborn," he's a good, healthy little guy. He's so sweet!!



Incidentally, (and I've already ruined this by telling everyone again and again), Ian is a Scottish form of John. I like the name John. I know a John who I like very much, but I didnt want things to go to his head or anything. (Love you, Dad!) Anyway, more than anything I like the meaning of John - "God is Gracious." He truly is.