Friday, June 19, 2009

Remick's Birth Story

As you may know, I had hoped for a vaginal birth with Remick. I had really awesome prenatal care and for a long while felt pretty confident the VBAC (vaginal birth after cesarean) would happen. He was due on June 7th. For a solid two week period before his due date and up to my next appointment on June 11th, I was sure that every little cramp, every strange feeling down there was the beginning of something. But, when I went to the midwife's office on the 11th, my hopes began to dwindle when I learned that in fact I'd had no effacement of the cervix, no dialation, and the baby's head hadn't descended at all. In sum, my body was not showing signs of entering labor. The biggest risk of a VBAC is a ruptured uterus, which is a fairly catastrophic and serious event, but extremely rare. The chances of it happening however, are much higher if labor is induced. Therefore, they will not induce labor in a woman attempting to have a VBAC, so you either go into labor on your own, or you wait until your body is no longer nurturing the baby enough anymore to leave him in there safetly and then have a C-section.

My midwife's advice on the 11th was to try some homeopathic method of ripening the cervix, but to schedule a biophysical profile on Monday June 15th, which is an ultrasound that checks on the baby and the functioning of the placenta and amniontic fluid. This is basically a test of how safe it is to go on waiting for labor. I was also scheduled to have a "non-stress test" which basically charts the baby's heart rate over a 20 minute period, after having consumed some juice. I ended up doing the non-stress test on Sunday at the birth center because of scheduling stuff on my midwife's end. The baby looked great. So I fully expected that when I headed into the doctor's office on Monday for the biophysical profile, they'd tell me that everything looked fine, and we could wait until the end of the week before scheduling a C-section.

That wasn't exactly how things went down. The first thing that the technician measured was the amniotic fluid, which she immediately told me was "very low." They consider anything about a 5 okay, and I was at 2. The baby wasn't moving, which can be part of a normal sleep cycle, but the amniotic fluid level freaked her out a lot, and she gave up trying to get him to move, while she paged the doctor on call. This freaked me out a bit, since she mentioned "the doctor might want to schedule a C-section for today. "Today?" The doctor ordered another non-stress test, even though we had just had one the day before. Again, everything looked fine. The doctor popped in at that point to see the chart and I could tell she was relieved to see a healthy heartrate.

We met with her in her office (after waiting forever which turned out to be because she was reviewing my health records.) She told us that though the baby looked fine, the level of the amniotic fluid was a very serious concern, since it protects the umbilical cord. She said, "the baby could be fine today and change position, crush the cord and you could end up with a still-born baby tomorrow." C-section it is.

At that point it was 11:15. She scheduled the surgery for 2:00, which meant we had an hour and 15 minutes to get home and hug Makili and pick up a few things. (I started freaking out about Makili, which has turned out to be a pretty constant concern of mine in the last few weeks, but I'll get into that in another post.) It was a whirlwind time, we drove home as quickly as possible and I did get lots of hugs from Makili. We threw stuff in a bag and turned around, arriving 15 minutes late.

The nurse, Carletta, who greeted us was a super-cute older lady, who seemed to be clearly tickled to help me, since she was normally in charge and not allowed a whole lot of patient care. She told me that they had assembled a "special team" for me who would be of the mindset to help someone who had wanted a home birth. Practically every person who came in to see me or introduce themself apologized that things hadn't gone the way I had wanted. She also told me that they wanted to try an experiement on me - giving me the baby to me immediately instead of sending the baby to the warmer for the first five minutes. Of course I was fine with this. She took her time getting me ready, which was exacerbated by the fact that we had arrived late. Pretty soon, the phone started ringing and the anesthiologist and the OR wanted to know where I was. My midwife showed up with a beatuful rose from her garden. I stuck in my hair for lack of a better idea as to what to do with it, which made everyone laugh.

Soon we met with the anesthiologist, who was a bit of an ass, and promptly chided me for not having signed up for a C-section in the first place, since that was the safest option. (Go look up the uturine rupture rates for VBACs vs. the general public here.) BUT he did redeem himself a bit, when I asked where the music was in the OR and he promptly went and found an I-pod and a speaker system, and even chose a worthy first song, some upbeat Sinatra song which created a good atmosphere. I think every OR, especially ones where the patient isn't under general anesthetic ought to have music playing. It creates the kind of atmosphere where good things happen.

Anyway, soon after being given the spinal and laid out in the "cruxifiction pose" as I call it (your arms are stretched out to the side and hooked up to various things - pulse reader, blood pressure cuff etc.), Raph and Val, my midwife, were ushered in behind the curtain that they hang right in front of your face. And right about then and there it occured to me that I was having a baby. You really tend to lose sight of that at some point, even if you can imagine it at all. Even when it's your second time around. But right then I realized that within minutes I would have a baby lying next to me. And I was instantly excited.

The nurse anesthetist offered to take some photos of the baby being born, which are some of the coolest pictures ever, and was pretty cool since Raph was not interested in seeing that happen again. (He described it last time as seeing me cut open looked like vegetable soup.) They said he was crying before he was even out of me. Before I knew what had happened, Remick was bundled and lying inches from my face. Everyone was guessing how much he weighed and how big his head was, since they didn't take those measurements until hours later. It was so celebratory. I was so happy. We watched him stick out his tongue and smack his chops over and over again for the 20 minutes we were in there while I was stitched up. And before I knew it, I was back in our room with a baby nursing his little butt off. Again, it was an incredible celebratory mood. I was so happy.

A little while later, Makili, Grammy and then Annma all showed up to celebrate with us. Makili was wide-eyed and really not sure what to think. He was rather quiet for a full 10 minutes and was fascinated by watching Remick nurse, but was mostly not sure what I was doing laying there and with a room full of people watching him. He kept saying "baby eat" or "it's okay baby" when Remick would cry. In this way, Remick was welcomed into the world. Like they say in one of our favorite books (On the day you were born), we are so glad you've come.


beckarecka said...

Beautiful. I am so sorry it wasn't the birth you had hoped for, but it is such a wonderful story itself and I am so glad that the staff did all they could to respect your wishes and offer you the pieces that they could. And the pics the nurse anesthesis took are AMAZING. Blessing to you four and I hope your recovery goes well.

Dawn said...

What beautiful pictures, especially the ones of your children together.