Friday, April 24, 2009
Tirzah's Birth Story
So, I arrived at the hospital at 6:15 pm after my water broke on Monday. It broke just after the last daycare child left. I had stood up, declared that I was NOT going to eat spaghetti for supper and that I'd be going somewhere else. :) A little defiant. I headed to the bathroom, where my water promptly broke (no, I didn't do it on purpose, lol). It was a very funny moment. Contractions were mild and not in a regular pattern, but they were coming. By 7 pm I was hearing that I was 5 cm dilated and I was hooked up to monitors. Baby sounded very happy.
Kristin arrived around 8 pm, and I was still 5 cm. We walked the hallways and I had some good contractions. Then I got in the shower, and that helped a little, but it was still not in a pattern and still not good STRONG contractions. At 10 pm my Doctor showed up and I was still 5 cm. I was a little frustrated at this point. I need some progress!! We really wanted to avoid pitocin. Since I was at a risk of hemorrhaging, pitocin would be more effective after delivery for preventing hemorrhage if I didn't have it during labor. Still, my doctor agreed to give me a "whiff" to see if it would help bump things along. That was started at 11, bumped up at 11:30, and at 12:30 am I was *still* only 5.5 cm. At that point I knew what was coming next. Malachi's labor & delivery had been all med-free, with no interventions. This one had been froth with interventions right from the start--I had to have iv antibiotics because I was group b strep positive, and then with the pitocin, I was well on my way. Honestly, though, I had been "on the fence" during my whole pregnancy about whether I wanted to go med-free. Malachi's delivery was painful, particularly during pushing, and my recovery was SO terrible. No matter how I'd tried to relax, I struggled to prepare myself mentally for a med-free delivery. I knew too much--I knew that the pain was coming, and the fear factor there just couldn't be erased. So at 12:30 I decided that there was no point in waiting, I needed to decide on an epidural and get it and quit riding the fence. After all, I knew I wanted it at that point, it was just a matter of when. By 1 am I was visiting with the anesthesiologist. The epi was painful or else I was a big baby. I cried. :( It was over and I looked up. Where was Mitch?? No one knew. Within about 10 min he finally showed back up--at some point during the epi he felt himself getting woozy. He barely made it out the door and the few steps to the lounge (our room was right next to the family lounge) before passing out on the couch. He said he hurt his shoulder as he fell. Poor guy! I know next time to kick him out, that's for sure! The epi started working right away, and I was sure that would be the last of my pain until an hour or so after delivery when it started to wear off. I was extremely relieved.
Because of the epi I had to lay on my side and be rotated regularly to keep the medicine working evenly and to keep baby happy. Kristin kept notes for me and kept track of how often I was flipped so we wouldn't let that go too long. I was flipped at 1:45 am, and she also noted that I was very chatty. I guess they were feeling very tired. :) At 2:05 am I was barely reaching 6 cm--terrible progress--and was flipped again. Contractions picked up a little pressure. At 2:20 I was flipped again, and at this point both Kristin and I noted that the baby's heart rate was decelerating--significantly--during contractions. I started to worry again. It's one thing if you're ready to deliver, but with a whole night of contractions ahead, how long would they wait before saying that baby was in distress?? I questioned the nurse about how low is too low and how long is too long. She said they were concerned, but not ready to do anything yet--it was borderline but not too low, and recovering quickly afterwards. She put an oxygen mask on me--a first for me--and I took very deep breaths to try to get as much as I could, I just focused on my breathing and kept everything else blocked out. My contractions continued to grow in pressure. Only 20 min later at 2:40 am I screamed out that there was a LOT of pressure and it HURT. I was 9.5 cm. The nurse told me to "blow through it." I knew what that meant, that it was time to push and she didn't want to deliver the baby. It seemed like one long, endless contraction at this point and I was miserable in pain. So much for being done, huh? I yelled that they needed to bump up the epidural and the nurse replied, "You're almost done now!" I replied, "I am NOT, I know what comes next!!" It made me mad, and I still wish they would have listened. Oh well. I was crying so hard that the oxygen mask wouldn't stay on at this point. What a difference between this birth and my "Bradley birth" with Malachi.
It felt like they were taking an eternity, but my Dr. was in the room very soon and I was on my back and pushing before I knew it. 3 contractions--9 pushes--and she was out at 2:54 am (14 min later). Face up. What a stinker!! My first question to the doctor was "Is she really a girl???" Yes, she was! From there on out everything was beautiful. The epi was still working and I was glad--I had a 2nd degree tear that required stitching. I was able to enjoy looking at my daughter. I was shaking uncontrollably (had been since I started pushing), and had to put a wash cloth between my teeth to keep them from banging together. Looks great in the pictures. :) I had been taking alfalfa supplements along with my prenatal vitamins and iron supplements, hoping that having my hemoglobin levels up and my vitamin k stores up would help with bleeding afterward. Someone in the room asked, "How's the bleeding?" My Dr. said, "There is none." I said, "Now I know you're lying!" Well, so there was none *extra* I suppose. The bleeding was very minimal, and I'm so grateful. In that respect, recovery continues to go really well. My bottom is obviously sore. I was also relieved that while she is a good sized girl, she is well under 9 lbs. 8 lbs 4 oz is a good size. Her apgars were 8 and 9. We tried nursing at 3:20 am, and she latched on with no problems but kept stopping to "complain." There were a few comments about this likeness to Malachi, but I insisted that we shouldn't say that just yet.
Our first day together was a little rough. I *had* to send Mitch home to sleep, but it meant that I didn't get as much rest as I should have. It was a difficult day. The night was even worse. By 4 am I realized that something was really wrong with her eating. I called the nurse for help. The nurse asked when was the last time she had nursed for at least 5 min. She hadn't latched on and stayed on for 5 min EVER. She had a great latch--no problems getting on--but she would only take a couple sucks then pull off again. She seemed SO uninterested. I had tried every "trick" known to breastfeeders. Not only have I done this 6 other times, but I also read the books during my pregnancy just to brush up. We had tried "priming the pump," and every different position (some creative new ones too) available. The nurse was also at a loss. I didn't get more than 2 hours sleep all night, so I was running extremely empty. At 6 am I called Mitch and asked him to bring me my pump.
So day 2. At 10 am I met with a lactation consultant. We figured out that she would suckle a pacifier because we could hold it in her mouth and keep her from pushing it out. That's what led us to try a nipple shield. I pumped some milk and gave it to her with a syringe while she suckled. I could get about a tsp to a tsp & a half of colostrum each time I pumped. That worked. Between feedings if she seemed interested I would offer her a chance to latch on without the shield. Mitch spent the day with me and I got about 2 hours of sleep that afternoon. By that night she was doing a lot better. I could get her to latch on and stay on around 4 min, plus I could hear her swallowing while she ate. So we went through the night without doing the nipple shield. There's no way I would have been able to stay awake through those feedings otherwise. I was beyond tired. On the other hand, her rough start was starting to take it's toll.
Day 3. She hadn't peed since 5 pm the day before. Her cry was really hoarse, and I was sure she was dehydrated. I stepped up the pumping/syringe feedings. I had her naked in the sun too. Since she was face up, she was sporting a big bruise on her forehead and I knew we were headed for bililights. Thankfully her number came back at 11, so the doctor was willing to send me home as long as I headed to the doctor the next day (I already had the appointment scheduled). She was down to 7 lbs 10 oz, she'd lost 8% of her birthweight, and they were concerned about that, too. Finally at 11:30 am we were headed out the door. It took a while once we got home to get settled. At 12:45 pm she finally had a pee--that was a long 19 hours!! (She had been pooping the whole time--the new newborn diapers these days have a stripe on them that changes colors when the baby pees--so cool!). It was 80 degrees here yesterday and my house was miserably hot. Miserable! I was so relieved when it was bedtime. She got up about every 2 hours through the night.
Day 4. We had to be out the door at 8 am and didn't get up until 7:15. Oops! That was a little chaotic. Eden went with me to "help." She wasn't impressed with the pokes though and held her fingers in her ears while they poked Tirzah's heel for the bilidraw. At the doctor we heard the verdict: 14. Since she's still so young, and we're heading into a cloudy weekend, and she's a lazy eater, the best course of action was to go home with a light. She is so content and easy-going, she doesn't mind eating then going back to bed. Even awake. She is taking it in stride. I hope this temperament continues!! I am not sure what her weight is at. The first time we put her on the scale it said 8 lbs 4 oz--that's impressive to go from 7.10 to 8.4 in 24 hours. So we weighed her again. This time it said 7 lbs 4 oz. Hmmm. We did it 2 more times (7.15 and something else), then went to the peds department and tried their scale. It also had two different weights--one was 8.1. So Dr. Tjaden decided we were probably within an acceptable range and we gave up. :) The weather today is a bit cooler, and tomorrow is supposed to be cold and nasty. After that it will get better again. I got a long 2-hour nap this afternoon.
Everyone seems to be adjusting well. Malachi had a tough night last night, but hopefully things will settle back to normal soon. He's got Grandma and Grandpa here right now and I guess we are all a little spoiled by their presence. :) Malachi loves the baby--really loves her--but seems a little hurt that I'm not snuggling him as much as I used to (or even at all right now). Hopefully I will heal soon and get back to normal. Right now I can't pick him up at all, and I'm just not "available" much for cuddling either.
Pray that Tirzah will get the hang of eating, will gain weight, and that her bili level will be respectably low come Monday morning. Usually we expect it will be, but Malachi sure did surprise us (that was a disappointing time), so now I guess I won't assume anything. Now I've spent way too much time on here and need to go wake her for a feeding (jaundice makes them really sleepy, and I've been trying to keep her eating every 2 hours). Thank you!!