Thursday, February 23, 2017

Isabelle's Birth Story

February 9th.  That was going to be our daughter’s birthday.  When our induction was scheduled for February 8th, I felt a weird twinge of annoyance or sadness that our baby would be born on an odd-numbered day.  It was something I’d never even considered or thought about, and I’m certainly not a superstitious person, so my disappointment surprised me as much as anybody.  Still, the prospect of getting rid of back pain and joint pain, finally facing the day I’d prepped for so long, and most especially, meeting our daughter for the first time; these are the things I was excited about, and they far superseded my annoyance at an odd-numbered birthday.

I got home from work on Wednesday evening (the aforementioned February 8th).  Ray and I finished packing our bags, I took Mabel to my parents’ house, and we ran some of Ray’s homework up to the school for him.  Our next stop was the hospital.  I suddenly got panicky about the single plain pita bread I was able to get down for dinner.  How was a plain pita bread supposed to fuel me for the upcoming unmedicated labor I was working toward?  But I was too nervous to eat anything more.

Up the elevators of the LDS Hospital, to the fourth floor – Labor and Delivery unit.  My nerves were so high, but so was my excitement. The day was finally here!  We were going to be parents tomorrow!  Ray and I just kept looking at each other in shock.  We met with my first nurse, Carlie, who would be attending to our CytoTec administration throughout the evening.  She was so sweet and comforting, and showed genuine excitement for us. Ray and I did our best to get comfortable in the hospital for a long night in, with our baby’s heartbeat as our background noise.  I was told that I had been having mild contractions throughout the evening, but I hadn’t felt a thing yet.

At 6am, my nurse let me know that my doctor would be showing up soon to break my water, and that in the meantime, I could order a light breakfast.  I was so grateful that my doctor was allowing me to eat – I didn’t feel prepared to take on a day of laboring with nothing in my stomach.  I ordered some French toast and fruit, and was able to get a decent amount of it eaten.

At 7:30am, Dr. Hannele Laine met us to really get the process moving.  I was still measuring at 1+ or 2 with about 60-70% effaced.  She broke my water – and can I tell you how odd of an experience that is? To be completely out of control of what basically amounted to a river flowing out of me was something I was not entirely prepared for.  But worse than that were the streams that continued to flow into the makeshift diaper I was given each time I moved.  I could not stop being horrified (and amused) by it all, and Ray couldn’t stop laughing at my discomfort.  My mom joined us soon afterward, ready to be a part of the action of her granddaughter (and panicky that she’d miss something important since water breaking meant baby coming!)

Ray, my mom, and I talked and laughed and prepped ourselves, and I’d get excited anytime I would begin to feel contractions.  After three hours, we were checked by our new nurse, Jamie.  She let me know that I was still dilated right about to a 2 with a bit more effacement.  It was not the progress I wanted, but it was progress.  At this point, we began administering Pitocin – the drug I’d heard horror stories about in regards to women trying to have a natural birth.  Pitocin is the brand name for oxytocin, a hormone meant to stimulate contractions.  All the stories I’d heard was that Pitocin very quickly throws you into the depths of hard labor – and so while I was wary to start hard labor, I was also excited to get the process moving.  It was 10:30am, and I was hoping for a baby to show up by the evening hours.

Jamie started the Pitocin off slowly, at a dosage of just two milli-units.  Every 30-40 minutes, she could come in and up the dosage by two more units, working slowly with my body so that I would be able to handle the oncoming contractions.  The process began slowly, but it was exciting to watch the contraction monitor and see any changes that would occur and begin to feel more intensity to my cramping.  The day moved forward and time was a weird blur to me.  At moments, I felt things moving so slowly, but I’d check the clock again and be shocked to learn it was noon, and then 1pm and then 2pm, so quickly.  Ray and mom passed the time by sending out updates, browsing the internet on various devices, checking the contraction monitors, and refilling my water.  I apologized numerous times for things being so boring – after all, progress was slower than we all expected – and tried to be an entertainment when I could.  Still, contractions continued to get stronger, along with a decent amount of back pain, and I had high hopes that the next time my cervix was checked, I would be far more progressed.

By early afternoon, it became apparent that progress was not happening the way it needed to be.  Eventually, my nurse installed an intrauterine pressure catheter in order to monitor contractions more clearly from inside the uterus.  At the time of insertion, the nurse stated that I was now dilated to a three – simply because inserting the IUPC caused the nurse to push on my cervix enough to open it a bit more.  The IUPC would give us an MVU (Montevideo Unit) measurement which would tell us if the uterus was contracting enough to open the cervix. I needed a MVU score of 200.  After twenty minutes, we got the first reading – 146.

Because I was already at a dosage of 20 milli-units of Pitocin – the most they generally like to do on unmedicated patients – and contractions were not powerful enough, the decision was made to shut off Pitocin entirely and give my body a break.  Apparently, the body can get flooded with Pitocin to the extent that it stops responding.  Flushing the system of the dosage and restarting at a base level can get contractions moving to become productive.  I was given an hour of rest off the Pitocin and allowed to eat something very light to keep up my energy level.

I was so grateful for the rest period as my contractions and back pain had become fairly intense at that point.  Eating something was also so appreciated – though I could only get down a few bites of fruit, cheese, and a roll.  My contractions continued throughout the rest period, though at a much lower intensity than before, and so we were encouraged that a rest and a second dose of Pitocin would move things along.  By this point, it was about 6:30pm, and I was ready for a bit more action.

Our second start of Pitocin began around 7:30pm along with another nurse change, Lynnette.  This time, we had permission to move up in intervals of four milli-units of Pitocin to reach a level of up to 30 milli-units, if needed (though fingers crossed, I wouldn’t need that dosage). Contractions began again, this time with even more back pain.  Ray and my mom were so helpful in providing back massages and counter-pressure.  I breathed through contractions just how I’d been reading for months.  I had renewed energy, though I must admit I was already a bit worn down from the long day.  We spent a few more hours upping the Pitocin dosage and breathing through the pain.  Around 8:30pm, our MVU score was only 99.  By about 11pm, and a dosage of 16 milli-units with the option to move up to 20 (for the second time), the MVU score was only 126.

I cannot convey my level of disappointment each time my cervix measured at a three without moving, each time we received an insufficient MVU score, each time my determination to work through contractions and breathe through the pain yielded no results.  I was so thoroughly exhausted and disheartened from the long day, the constant contractions, the continual disappointment.  I was writing pro-and-con lists in my head over and over.  How much more of this could I take?  How much more time will it take to open my cervix if we continue to up the Pitocin?  How much more pain can my exhausted brain and body handle?  If this is only early labor pain, how can I handle the more extensive pain and required energy of second stage labor?  Will my body even respond to higher doses of Pitocin if I haven’t responded so far?  Will the 24-hour ticking clock on my broken water run out before my cervix can open enough to make a difference?

My mom was encouraging, insisting even, that I finally get the epidural I had been working so hard to avoid.  She had a whole list of reasons why it didn’t make sense for me to continue as I was going.  She probably didn’t understand or recognize that I was making that same list over and over in my head, wondering whether getting the epidural might allow my body to relax enough to get my cervix opened.  But I kept hearing the whisperings of all those people who had told me that I wouldn’t be able to make it without an epidural – that labor was too hard, and I would definitely cave for the medicine.  I logically knew that their skepticism and mocking didn’t matter, but I felt so much like I was letting myself down by not smashing their skepticism to pieces.  And I thought of my dear friend who made it through three days of induced labor unmedicated and wondered why I didn’t have the same stamina.  All these thoughts ran through my head as my nurse stood there, wondering whether I wanted to up the Pitocin dosage back to 20, while my contractions were distracting me from the matter at hand, while my back pain was so distracting that I could think of nothing else but breathing at the peak of them.

I sat in silence on that hospital bed, Ray giving counter-pressure for my back labor, for what felt like an eternity to me, though I have no understanding of how long I actually sat there in debate with myself.  Finally, my exhaustion won out, and I agreed to get an epidural.  The next few minutes were a whirlwind, with the anesthesiologist, Dr. Harold Rust, coming in with jokes I’m sure he thought were funny while prepping my back.  I sat there in so much disappointment and frustration – and so much fear.

It’s funny; I had never been afraid of the labor process.  Women have been laboring and birthing babies since the beginning of time. I’d seen videos of tigers and elephants birthing their babies.  It was the most natural thing in the world to me.  I never even considered that my body wouldn’t be able to do it.  There was no fear in the natural process for me, even if it did mean some pain.  But being prepped for an epidural, that was terrifying to me.  I didn’t want tubing running into my spinal column.  I didn’t want foreign medicine introduced into such a vital area of my body.  I didn’t want to lose feeling in my legs.  I certainly didn’t want a catheter run into my urethra because I couldn’t feel the urge to urinate.  I didn’t want people adjusting my body, pushing my legs around or shoving towels under my hips, because I couldn’t do it myself.  I didn’t want to contemplate on the risks that come with deadening the feeling in half your body.  I didn’t want to think about what might come next if the epidural didn’t work…

The epidural was finally installed, after minutes of emotional agony, holding tight to Ray’s hand as Dr. Harold did his quick work and babbled on.  All of my mental faculties were in use keeping my brain calm, coping with the endless cycle of fears and anxieties on loop in my mind, trying to ignore the sensations of tubing and medication running through my spine.  I was shaking uncontrollably, and I was convinced (honestly, still convinced) that it was out of fear and anxiety even though Dr. Harold insisted it was a completely normal reaction to the medication.  But, I do have to admit, feeling the complete relief of contractions, and especially the back pain, was an entirely welcome sensation.  I completely zonked out within minutes of receiving the epidural and slept like a rock for the next two to three hours.

At some point in the middle of the night, I heard Lynnette come in and check my monitors.  She let me know that we were at a Pitocin dosage of 26 and still showing an insufficient MVU – my body was still not responding at all.  I knew what was coming and said it before Lynnette even had a chance – I was on my way to a C-section.  Lynnette said she was going to call Dr. Laine and get her advice.  But I knew it, I think even before I got the epidural.  The Cesarean operation was the only way my baby was coming out.  I laid in the hospital bed, my legs awkwardly propped around a peanut ball in hopes of opening my cervix further, so exhausted and so ready to be done with labor and so overwhelmed by all that had happened in the past thirty hours.  I didn’t have a chance to even consider a yes or no to a C-section – at that point, it seemed like the inevitable end to our birth story, the only answer.  Lynnette came back in soon afterward to let me know Dr. Laine was on her way in, and my C-section would be happening within the hour.

Through my middle-of-the-night exhaustion and epidural haze, I watched Ray get into scrubs, watched him debate about where to put his phone – he needed it handy to take photos and white surgical clothing protecting scrubs do not have pockets.  I was so grateful for his steady presence, for his love and his trust in me and my body, even as it was doing so little to produce our daughter for us.  He has always given me space to make my own decisions, and I was grateful for his steadiness while my brain felt like it was in a haze of emotional turmoil and exhaustion.

Dr. Laine came into the room, gave me the rundown on the surgery, and I signed paperwork agreeing to the Cesarean.  My hospital bed was rolled down the hall and into the operating room.  My body was lifted by a number of nurses onto the operating table and the protective screen was put up.  Dr. Harold came in, and I remember, even amongst all the emotions I was experiencing, feeling a bit of annoyance that this was the person sitting at my head, being my watchful eye.  Dr. Harold gave me a rundown, which I don’t remember at all, of all the medications being pumped into my body.  Ray sat at my head holding my arm, and all of my focus and attention was on his hand, on his comforting touch – the one thing I knew in the midst of this whirlwind of the unknown and unknowable.  I began shaking uncontrollably again; I could feel my head, shoulders, and arms (that is, all of the parts of me that were feel-able) basically jumping off the table.  Again, I’m convinced that this was out of fear, anxiety, and nerves even though Dr. Harold again insisted that it was a completely normal reaction to medication.  I began to feel nauseated, and Ray held a bag to my cheek as I threw up into it.  The nausea was soon gone after Dr. Harold pumped yet another drug into my body.  In the meantime, behind the curtain, I could hear a volley of actions and directions being tossed around the room as my body was prepped and the doctors and nurses began to perform what was mundane to them.  At one point, someone asked me if I’d like the opaque curtain dropped so that I could watch “the delivery” of our baby.  I believe I simply said no, but my real reaction in my head was, Hell No.

Soon, the announcement was made that the surgery was to begin and I felt a bit of pressure at my abdomen.  I kept my eyes trained on Ray’s face as a distraction from paying attention to the various pressures and tugging feelings I could sense happening to my torso.  (Though watching him was not always comforting as there were a number of times I saw the color drain from his face in response to what he would occasionally see happen on the other side of the curtain.)  At some point, I heard my doctor mention something about me having tight abs – a comment to which I think I must have said thank you, and I still feel an inordinate amount of pride regarding.  Perhaps because it was the first time I felt like my body had something praise-worthy to be mentioned in this whole process.  I heard Dr. Harold say that the delivery was about to happen.  There was an air of excitement in the room, and Ray prepared his phone to take some photos of our daughter being born.  Dr. Laine said she could see our daughter’s cheek, and Ray said, yep, she’s going to have them being a part of this family.  It was my first introduction to what my daughter might look like.  I felt the oddest sensation of my stomach being pulled out, emptied upwards.  I don’t recall a single snippet of what was said, but I saw the tears well in Ray’s eyes as our daughter was brought into this world, and I felt so much love for him and for our daughter in that quick moment. Dr. Laine held her just above the curtain, just for a moment, for my first glance of her, and I saw her tiny purple body and a large amount of spit or amniotic fluid or something else begin to fall from her mouth as she was pulled back over the other side of the curtain.  Our daughter was officially born, with my cheeks, at 3:24am.

I asked Ray to join our daughter in the next room as she was cleaned up, weighed, and measured.  And the operation continued on the table as we could hear the occasional crying out of my daughter in the next room.  The doctors made comments about hearing her strong cries, and I laid there on the table.  At some point, either out of exhaustion or the haze of medication, I zoned out to the point of near incoherence.  Ray brought our daughter in, and I could see a dimple on her cheek.  We took a couple of family photos on the operating table.  I struggled to remain present.  At some point, the operation was completed, and I was moved from operation table to hospital bed.  I saw bloody materials, and wondered what part of me was being thrown out – but it was just blood-soaked gauze.  We had a conversation about the placenta – I have no clue if I asked about it, or if someone asked me, but I fought against the haze in my brain to watch Dr. Laine present that amazing organ to me.  I have a very brief memory of seeing the tree of life that sustained my daughter in my uterus.  And then I was wheeled out of the operating room and back into my laboring room for recovery.  Even now, I can’t remember if I held our daughter while I was wheeled back.  Back in the recovery room, the first person I saw was my dad, and I was grateful and surprised to see him.  By this time, it was 4:30am, and it was such a kind gesture for him to be there with my mom when we were finished.

During our two-hour recovery period, Ray and I decided that our daughter would indeed be named Isabelle Ferne.  We had the name picked out very early on, but neither of us felt comfortable deciding upon it until we could match the name to her face.  Now we could.  I also got the opportunity to breastfeed Isabelle, and she latched on immediately and perfectly.  We officially had our daughter.  And we were officially unbelievably exhausted.  That day, Friday, is a complete blur to me.  We slept a lot, nursed the baby a lot, announced her birth to our family and friends and on Instagram and Facebook.  I was interrupted a lot for vital signs to be taken and instructions to be given.  I mostly remember doing my best to keep my eyes open and appear attentive while people spoke to me, but I was mostly unsuccessful.  But through it all, I kept glancing into our baby’s bassinet and marveling at this perfect little person who was now a part of our lives.

My labor and Isabelle’s birth was wildly different than what I had expected, anticipated, and planned for.  We thought that we had planned for a February 9th birthday for our daughter.  And in the end, we got a February 10th birthday, an even day, which ended up making me happy.  Isabelle Ferne was named after her Great Grandma Belle and her Great Grandma Ferne.  We received a phone call that Friday, Isabelle’s birthday, from Ray’s mom telling us that she had just realized and remembered that February 10th was Grandma Ferne’s birthday.  And I think that’s the most amazing miracle in this story.  Nothing turned out as we expected or planned.  And yet it still turned out far more perfectly than we could have dreamed.  God is in everything.  God is in Isabelle.  And we are so grateful to have her, and Him, with us.


Lavar and Michelle said...

You're amazing Ashley. One day I'll have to tell you about my labor as it is similar in many ways. I wanted to be like my sisters who were able to do natural labors and felt like I failed but the outcome of having that sweet baby in your arms is the most amazing feeling.

Emily said...

I'm just bawling... don't mind me ♡ I loved reading this. You guys will be awesome parents! Congratulations and welcome to the world Isabelle!!!

sara dalebout said...

I loved reading this! My first birth experience was exactly like this, the only differences were that my water broke at home and that they gave me something for the nausea before I actually threw up! I never wrote all of my experience down, so I've forgotten a lot. But while reading yours it all came rushing back. Thanks for sharing! Your baby is so beautiful and I'm so excited for you. Congrats!