We went to the Boulder Police Dept and had our car seat bases installed properly, I had my stitches from my melanoma excision removed that afternoon, and then that evening I attended the last of my birth prep classes, this one was about breastfeeding. I had also heard a story on NPR on the way to the breastfeeding class about women's labor and delivery soundtracks, and it prompted me to call John and ask him to start compiling some songs (some relaxing, some funny, some sentimental) for us to have a birthing soundtrack. All of these things came in VERY handy come the events that unfolded on the next day.
August 4th
9am: I felt more "leaking" again right before our appointment. I had started noticing some leaking a few days earlier, and I had in fact called our doctor's office about it, but since it was the weekend the doctor on call (not my regular doc) said if it was my water breaking/leaking it'd be a lot more than I was describing. If it was heavy then she said to go to the hospital; if it was more intermittent then come into the office Monday. Well, after the first couple times it happened that weekend (which had prompted my call) it seemed to stop. So I held off on any action. Then I noticed it again on Wednesday night, before my regular doctor's check up the next morning. Thus, upon arriving at the office for the appointment and noticing the leaking again, I *had* to ask the doc about it. She checked my pH and it was normal, which didn't suggest any amniotic fluid, but she also said she'd look at it on a slide and do an ultrasound just for good measure to check my amniotic fluid levels.
9:30am: The doctor met us in the ultrasound room and told us the result of the slide showed some amniotic fluid was leaking! She then measured my fluid levels on the ultrasound and said I was very low for where I should be, so that I had indeed been leaking fluid and that's when she told us that I was gonna have the baby today! :O This is where John and my shock began, as we had been all packed up and ready to go to Boulder and stay in a hotel there for 8 days for me to attend a workshop for work. I wasn't even to the 37 week "full-term" stage either, so I immediately asked if I could get put on bed rest or something to wait at least until I was full term. She said that the risk for the baby to get an infection was higher than any issues with me delivering early at this stage and that most doctors will induce a person past 32 weeks if they have a fluid leak. My AFI (Amniotic fluid index) was a 6, and it should be 10-20, so that was enough to make my doctor send me to the hospital. Besides that, she said I was already 2-3 cm dilated, so that this baby was ready to be born! [I had been 1 cm dilated the previous week at my last doctor's check up, but didn't think that meant too much at that point, other than it made me realize the delivery was coming around the corner!]
10am: John and I went back home quickly to grab our hospital bag and anything we'd need for the next couple days. I was still going through the shock of what was about to happen, and I was trying to let go of what had been my original plans for the day and accept this new plan that was now before me. I called work to let someone there know to spread the word that I would not attend the workshop, and that I'd be out. I called friends and family to start spreading the word that it was the big day. John helped me with this too. Everything at this point was pretty surreal.
10:30am: We arrived at the hospital and since we'd already pre-registered we just went straight up to the birthplace. Since my doctor had called them and I was coming there to be induced, I was immediately taken to a birth and delivery room. Thus, I bypassed the triage room, which I would have normally had to go to be monitored until I was far enough along in my labor to be admitted to a delivery room. After having taken the birth class and toured the birthplace, I had in my mind a vision of how the labor would have gone normally, and the triage room was the first stop. Oh well, straight to my own room wasn't too shabby. Upon being admitted into my room, John unloaded our bags and stuff, and I got hooked up to a fetal heartbeat monitor and a contraction monitor. To my surprise, I was having regular contractions that were 5 minutes apart and about 1 minute long...the standard rule of thumb for when to go to the hospital! Since I didn't notice them, I will admit that I felt a moment of silent cockiness, thinking that if I can handle these contractions that I'd be able to easily handle the rest of labor without meds. Just a for a moment. :)
"So far so good"
12:00pm: The doctor ordered me to start on Pitocin, the drug that would intensify and start my contractions for the induction. The doctor had told me that being induced does increase my chances for a C-section, as well as may lengthen the overall labor time, not to mention that I would have to be constantly monitored and hooked up to the IV for the Pitocin, and thus my birth plan to use the jacuzzi tub, walk the halls, etc for pain management was already starting to fade into a mere dream. Rather, I was in the hospital bed, or limited to standing right next to it. Every time I needed to use the bathroom John had to help me unhook from the monitors and drag my IV dispenser rack thing in with me. I felt pretty tied down. The Pitocin took a bit of time to start working, but it did eventually start making my contractions closer together...about every 2-3 minutes. They kept my levels low (no more than 9, can't remember the units) since I was contracting on my own. Nonetheless, I still wasn't feeling the contractions! The magnitude of them was looking pretty impressive on the monitor, so again I had more of the silent cocky feelings, but don't worry, the real labor would begin soon enough.
Getting my rest while I could.
3pm: My doctor arrived to insert an internal contraction monitor, because they were thinking the external one was giving me more credit than due on the strength of my contractions. :( This involved breaking my water the rest of the way, and after this point I finally started to feel the contractions. I was not any more dilated at this point, so they figured my contractions had not been as intense and "helpful" as the monitor had indicated. I was glad to have that external monitor off though, given it was digging into my basketball of a tummy, which almost hurt more than anything else up to that point. Over the next few hours my contractions grew stronger and more painful. I initially spent some time on an exercise ball next to my bed, but the ball sizes they had were not quite a fit for me (one that made me squat too low and the other that made me feel like it was ejecting me). I spent time sitting on the side of my bed, leaning on John while he put pressure on my lower back (thank goodness I'd just had my stitches removed and the excision was fairly healed at this point), but the bed was just high enough off the ground at its lowest setting that I couldn't put my feet flat on the ground. Not being able to use the floor for pressure on my feet started to bother me. I was running out of position options, and I ended up in bed laying on my side as the contractions really started getting strong. And VERY close together.
6pm: About an hour before, I had been dilated to 4 cm, which is usually suggested as the minimum dilation for getting an epidural to avoid needing any other procedures during delivery (C-section, forceps, vacuum, etc). I did NOT want any of those procedures, and thus I had hoped to wait as long as possible for the epidural, if I needed it at all. Well, let's just say my cocky feelings from earlier were long gone, and as I laid there with back-to-back contractions I knew that it would be hard for me to go all night doing this and have energy to push at the end. The doc had said typical first time labors last 12-18 hours, and an induction could last up to 24 hrs. Considering that I couldn't do most of the pain management techniques that I had learned about in birth class and had hoped to try since I was confined to the bed, I began to seriously consider the epidural. Nonetheless, I said I would give it more time. I would prepare to breath through the next contraction as I saw the values start to rise again on the monitor, then I'd breath and moan through the contraction, and look forward to the break in between. However, I would find myself saying "nooooo!" when I saw the numbers start to go right back up, even before the numbers had gone all the way back down and I'd had any relief from the last contraction ending.
6:30pm: The lack of a break between my contractions made the pain nearly continuous and very exhausting. Thus, I finally asked for the epidural. The anesthesiologist came fairly quickly, although honestly time was going pretty fast for me so I don't know how long it really took him. The insertion of the epidural wasn't too bad, other than the sting from the initial numbing shot, and then the sharp nerve pain that ran down my right leg when he "brushed a nerve". Other than that, it began to work pretty quickly so that my contractions were a thing of the past. I then began to start feeling like I was cheating. But at least I was able to relax and get some rest while I was waiting for the rest of labor to continue. One of the thoughts that crossed my mind during this "waiting" period was that I just hoped my baby would be at least 6 lbs. Given the weekly baby update emails and book chapters I'd read, they said my baby was probably about 5.5 lbs or so this week (36 weeks), and I just wanted to make sure he was a healthy weight and not too small--not too much of a preemie.
"Finally, some relief!"
7pm: I had hoped to have been at least 5 cm dilated by the time I asked for the epidural, however I was still at 4cm right after I got the epidural! All those contractions and nothing! They were just too close together to be helpful, and thus they reduced my Pitocin a bit to try to get them to be a bit more apart. At this stage, I figured for sure that I'd have to have a C-section at the end of everything, since I was progressing so slowly.
9pm-ish: I was still progressing slowly...around this time they said I was just barely at 5cm. Again, I figured that a C-section was surely in my future. Either way, I was still feeling good with the epidural, so I continued to rest.
10pm-ish: The nurse, my doctor, and I were all surprised to learn that I was up to 7 cm dilated! Not sure what caused the rapid improvement, but at this stage there was more hope to not have a C-Section. My doctor suggested that I roll from side-to-side to change positions and maybe help let baby move down. Since I had an epidural, I had to make sure to switch back and forth so that one side of my body wouldn't get numb and the other not.
11:30pm-ish: I was up to 9 cm dilated now, so things were looking good that I may have the baby overnight and not need a C-section! However, my contractions were really starting to hurt again now. When I was laying on my left side, I could feel them in my lower left abdomen. When I moved to my right side, I could still feel them in my lower left abdomen, as well as across my lower left side of my back. Counter pressure and massage of my lower back helped, but it was still pretty intense again, even with the epidural! The strange thing was that my right side still seemed pretty numb, but my left side less so, even when I was laying on my left side (which should cause more of the numbing to drain to my left side). After switching sides several times, the nurse asked if I wanted to up my epidural strength a notch, and given my discomfort I finally decided to let her hit that special button. I then laid on my left side, hoping more of it would drain to the left side, and once the extra meds kicked in so that my contractions were not hurting anymore I fell asleep from about midnight to 2am. John also got a nap during this time on the oh-so-uncomfortable couch in the delivery room.
August 5th
2am: The nurse woke me up to check my progress. The lights had been dimmed so much for John and I to sleep the past two hours, that I was really drowsy and most of the rest of the delivery does seem like a dream to me. Either way, I couldn't believe it when she said, well you're ready to start pushing! For some reason I thought there'd be more fanfare and stuff when I started pushing, but for me it was just me, John, and the nurse for that first hour or so of pushing. It took me awhile to figure out what I was supposed to be during for each push, but I was determined to get him out quickly. I didn't want him spending too much time in the birth canal and either getting stressed and/or a major cone head! I pushed for a total of an hour and 45 minutes, and really time went pretty fast again. John would get me ice chips in between contractions and put cool cloth on my forehead. He also had burned a CD of the songs he'd compiled the night before and put that music on during the pushing phase. It began with Enya and other relaxing music. My right leg was completely numb, all the way down to my toes, even though I'd been sleeping on my left side. My left leg was numb, but I could still control it on my own. My epidural was really lop-sided I guess! Anyway, I can't imagine how it must have felt to be John having to hold up my totally dead leg for the pushing! Luckily the feeling started coming back to my legs as the pushing continued.
3am-ish: The doctor showed up again and was all scrubbed up ready for the big show. There were more nurses that started to show up too, for the final birth, including the nursery nurse since he was pre-term. I had a mirror to watch with, and was occasionally able to see his head so I knew that I was making progress, even though it seemed to be such little progress with each push. Toward the end of the pushing I just really wanted him out, and in between contractions I kept doing "grunting" pushes as my doctor suggested I could do to help him along. At one point the doctor said "This is NOT a small baby!", and that's when she indicated I'd need an episiotomy to help with the delivery. There went my fears of him being too small and premature! I knew things were getting close when my doctor got into place (blocking the mirror view I had up to that point). Coincidentally, the funny song John had put on the CD came on at this point..."Push It" by Salt N Pepa. I had a good laugh, and so did the nurses and doctor. I knew that John had put one more song on this CD after Push It, and we had both independently thought about how nice it would be for our baby to be born to it. "Stolen" by Dashboard Confessional, which was the song played at our wedding. Knowing the possibility of him being born to our wedding song was just a few minutes away gave me even more reason to keep pushing it!
3:44am: "You have stolen my heart"....as this song was ending he crowned and his head and shoulders were delivered. This part seemed to happen pretty fast, which is good because it was pretty painful. I wasn't sure if his head was out, but I just kept pushing anyway. Once he was out, they put him on my chest immediately and stimulated him until he began crying. My baby was laying right there before my eyes! He was very alert in that first hour or two of life. He laid on my chest and just looked at me with those gorgeous eyes, and I knew right away that he was an "Evan". John and I had not fully agreed on a name prior to his birth, but Evan was at the top of our list and it felt very right when I looked at him. We had already decided that the rest of his name would honor John's father Allen, and at that moment after his birth agreed it should also honor John himself by using both Michael and Allen as his middle names. We discussed right there in the delivery room how Evan Michael Allen rolled off the tongue very nicely and that it was the perfect name for our new son.
After Evan's first bath, just over one hour old.
Our little Evan was born at a very healthy and full-term weight of 7 lbs 8 oz! He was 19 inches long and his head was 13.5 cm in circumference. He was able to nurse his first meal within that first hour of life, and he latched on pretty well and even burped for me. I had wanted to avoid meds in order for him to nurse well and not be drowsy, so this made me very happy that he was alert and able to feed well. He had a 1 minute Apgar score of 8 and a 9 at 5 minutes, so he was a very healthy newborn baby. We couldn't have been more happy and blessed!
Our little bundle of joy :)
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