Birth story

Her name is Ka.ra Eli.se.

I went to my appointment Mon, at which they did a biophysical profile scan. She wasn't as quick as usual to do the practice breathing and the amniotic fluid index was slowly decreasing (just over 9), and since I was 41+3 weeks, they figured why wait any longer. I was sent over to L&D around 4:30pm and put in a small room. Eventually I was checked in by the day nurse, who was then waiting for the doctors to come check me and start the induction. They were busy, so I got my night nurse and moved to a nicer bigger room for the rest of the time. My mother finally went home around 10pm after constantly saying how slowly things were moving and why couldn't they find the time to assess me and get on with it. I know how L&D works, and there's no point getting upset about stuff like that. There's always some C/S that needs to be done urgently, or a couple deliveries that need the doctors, or something potentially bad in triage to assess. She went to nap in her car, since there weren't enough reclining chairs for her and DH in the room. Then she dcided to go home till we called her to say things were getting more active.

I had taken a dose of milk of magnesia for feeling a little constipated earlier in the day, and between that and the excitement of knowing I was about to be induced, I started having diarrhea while waiting for things to start happening. The staff OB came along at 10:30pm to check my cervix, and said it was 1-2cm and 50% effaced. He wanted to start me off with a dose of prostaglandin gel, which was fine with me. I didn't want my membranes ruptured or to be put on oxytocin right away. He said he'd come in again at 7-8am to give the next dose. They put me on the monitors for an hour after that, and I started to have regular tightenings every 3-4min which weren't painful.

DH went out to get me some late dinner since I wasn't in active labour, and came back with a falafel and tabouleh, of which I only managed to eat the falafel. I walked around a little while he was gone, and then we hung out in the room and watched the channel with the education programs about baby care as the contractions got stronger. At 12:30am, during one of the contractions, I got this sudden sharp ouch-ouch around the cervix area that also made a couple popping sounds. Aside from it hurting, nothing much happened after that. My nurse came back in a couple minutes later, and we told her what we'd heard, and while she was there doing the intermittent monitoring, I started to feel a little warm fluid running over my leg/perineum. I told them that either I was becoming incontinent, or my water had broken with the popping noises. She didn't quite believe that was what it was, but gave me a pad and stretchy underwear to put on to collect some of the fluid for testing. Turns out I was right.

Over the next hour, the contractions became much stronger and closer together. I kept on having more diarrhea, which the nurse said was partly from the prostaglandin gel I'd been given. My intention was to do hypnobirthing and avoid an epidural, but I hadn't really been practicing the relaxation stuff much at home, what with the move and everything, and things went from being just a little bit of pressure to some really really intense pressure in the vagina and above my pubic bone, along with ache in my lower back, very quickly. I think sometime around 1am I suddenly felt really nauseous and had to run to the bathroom to revisit my falafel dinner. I had DH blow up the exercise ball for me, since I was only semi coping with the contractions when standing and leaning over something, and I really wanted to sit on the ball and brace my head on my arms on the bed. I did that for a little while, and then told DH and my nurse that I was swiftly reconsidering the epidural. She said she'd check me before calling for it. I was at 3cm and more effaced, but not completely thinned out yet. She called for the epidural at around 1:30am - I asked her if the resident on that night was any good, but she didn't really know, so I asked if I could have the staff guy come do it. Apparently he came around 2am, just as I was going to the bathroom yet again. I decided to wait and call Mum with the labour update till after epidural, as I didn’t want her to try to talk me out of it.

I positioned myself cross-legged on the bed for him, with my paper hat on. The doc told me to let him know when I was having a contraction, and I told him he’d be able to tell easily from my breathing pattern. The local needle hurt and the lido for skin freezing stung a little. After that there was a little pressure. I could tell from the sounds that he used loss of resistance to air and either did 2 passes or reinserted the obtunder at one point. My epidural space ended up being at 4.5cm and I had a fairly long-lasting right buttock paresthesia as the catheter went in. He said that was a good confirmatory sign – I’d never call it that! After the loading dose, I had a good right hemiblock, but not pain relief on the left as confirmed by the ice test. I turned left side down and he pulled back the catheter 1.5cm and gave more meds. My left foot started to feel a little tingly, but I still had most sensation above and left of my pubic bone. He pulled the catheter back again 1cm, gave me more meds, and it finally started to work. He offered more fentanyl, but I declined, saying I'd cope with the tiny patch rather than have extra narcotic that might have a minor effect on the baby.

I had called Mum while the first bolus was working and told her we’d been 3cm before the epidural if she wanted to come back in, but there was no rush. By 3:30am I was having a flatter tracing with some late decels. They checked me and I was fully dilated with the head well down. She did better with me side-lying, so we tried to wait for Mum to push. At 3:45am they said that we couldn’t wait any more, she needed to come out. I decided there was no point in calling Mum to tell her to hurry, because it could be dangerous getting her worried while driving in.

By then, my right leg was totally sensory and motor blocked after some lido in the top-up. The nurse started pushing with me, but I was apparently ineffective as I had next to no sensation down there. My legs were up in stirrups and they were making me try to do 3 10 second pushes per contraction. The OB resident came and started aggressively stretching my perineum to encourage descent. She got the kiwi in the room after a couple more decels, and with one prolonged one at 60/min, we decided to use it. I did three pushes with the next contraction and there she was at 4:08am.

We asked if she could be put on me for skin-to-skin if she came out vigorous, and that we delay vit k and erythromycin for an hour. We had a lovely screaming baby come and bond with us both. She promptly peed and pooped all over me and we hung out while my 1st degree tears/abrasions were repaired, which took the help of another resident too.

She got weighed and bundled at 30min, but DH missed taking the scale shot with her weight. I let them give the vit K shot then (got a nice cry out of her), and then she came back for more cuddles and staring at each other until they put the erythromycin ointment in at an hour after birth.

Mom showed up probably 15min after she’d been delivered to greet her birthday present. She wandered in with Tim Horton’s coffee in hand while the resident was working on sewing me up. I had a few little 1st degree tears and skid marks, but they were very oozy and quite the pain to repair. I have no clue how many stitches I have in there, but I think there are two little ones on the outside for cosmetic purposes, one on the labia, one on the hymenal ring. They decided to put in a very firm vaginal pack to help put pressure on the other tears and skid marks to stop the bleeding, since suturing them was actually making things worse. They rechecked my hemoglobin later in the morning, and it only dropped to 121 from 132, which seems pretty darn good for a pregnant woman. The vag pack stayed in for 4 hours and I got one dose of Ancef (that made my hand ache as it went in), and then they came back and pulled it out and said things were looking good.

They got me up to go to the bathroom about an hour after all the stitching was done (?). My legs felt ok until I tried to get back up off the toilet, when I noticed that my quads were still pretty weak if my knees were bent more than 90 degrees. I managed to leverage myself back up, and then stayed standing up at the side of the bed for a while to stretch my legs. At that point I was still feeling pretty good and on a high.

We were held in L&D till 11am, then went up by wheelchair to our postpartum room. It’s a good thing they hadn’t waited to induce me till Tues, because when I left, there were 7 inductions waiting, 4 from triage, 3 booked. And no rooms to put them in.

During the day as the epidural numbness wore off more and more, I started noticing the pain that no one had told me about: perineal swelling is not a fun thing. I could hardly sit down, though no one offered to bring me an inflatable donut to use. I used ice packs 3 times in the first 24 hours, and they felt pretty nice. Popped them in the gigantic mesh granny panties with the incontinence pad underneath, and then just wore them till everything was all melted. I was also put on standing Tylenol and diclofenac, and didn’t need anything stronger in the way of pain meds. The uterus contracting down never really bothered me at all.

My belly was nice and flat when lying supine right after the delivery. The uterus contracted down initially to about belly button level. By later that day, it was a couple cm below umbilicus. 5 days after delivery, it’s about 14-16 week size (4-5cm above pubic bone). I initially looked like I did when I was about 28 weeks pregnant, now I’m back to maybe 24 weeks – except I can squeeze into pre-pregnancy jeans! (With no hard uterus in there to be uncomfortable, I guess I can squish things a little more) I have a spare tire, but it’s not too bad. And no stretch marks!

Baby is still cluster feeding and hates being changed or bathed. Her face and head and neck are still a little asymmetrical from (I think) being squished in one spot in utero for so long. She finally let me get a little more sleep last night after I took her into bed with me to sleep lying on my chest.

Her weight dropped from 3255g at birth to 3040g at 48h, to 2970g at 4 days old. That's still well within the acceptable weight loss range. My milk sems to be coming in now. Hope all looks good tomorrow at the doctor's appointment.