Monday, February 1, 2010

Maddy's birth - part two

Sit back, this is a long one. Girl parts are mentioned - and what happens to them in labour. More warnings!! To read part one, scroll down to the entry below.

So... where were we? It's 5am, I have just had a top up on the epidural and I am fully dilated. The nurse asks if I want to push... I have no desire to at all. There is supposed to be a pressure that I just didn't feel. They checked, Maddy's station was still -1. Zero is at my pelvic bone, +4 is her head crowning. I had about 5cm to push her before she was out. So they let me rest, waiting for the desire to push.

And as I rested, Neil rested on his torture chair. I was actually impressed that he was able to sleep a wink! The nurses and doctors kept checking me, waking me (although I did get some sleep) so we were able to have many conversations about Neil's sleeping ability. Everyone was impressed.

We had shift change and a new nurse. Whose face I see, but name I can't recall... maybe Neil remembers. Nurse was awesome and supportive. At around 7am my doctor came in again (she had been visiting many times already). Coincidentally, it was Dr. Loiselle - the first doctor I saw after peeing on a stick and the only one I saw for the first few months - that was on call that night! She came in, looked around... and decided to break my membrane. With a painless gush my water broke. And Neil slept through it *grin*. They thought that would get the pushing started. And? Nope... still no desire at all. The epidural was turned way down so I could better feel the contractions, in hopes of getting me to push. And nope. We moved around, changing how I laid. And nope. So we waited. At about 9am they finally started me pushing. Nurse (damn, I wish I remembered her name!) told me what to do, where to push from and to and the route Maddy's head would have to take. And we started!

I had to hold my breath, bring my chin to my chest, legs spread wide apart (with Neil and Nurse helping to hold them) and PUSH for 10 seconds, while holding my breath. Then breathe, and push for another 10 seconds, and breathe and a final 10 seconds. Apparently I was using all the right muscles and things seemed to be going really well. Maddy was in no distress and she was starting to rock her way out. It was explained, her coming out wasn't one solid push - it was a rocking. Like getting your stuck car out of a snow drift. Push forward, she rocks back when pushing stops, but hopefully not to where she started. And slowly she was to move forward, under my pelvic bone, and out.

My contractions weren't super regular, so they added Sintocin to my IV (first IV ever... ick). As an aside, I HATE needles. Hate the thought of them. The IV in my left hand? That bothered me SO MUCH MORE than the needle in my spine. That I was ok with. Yes, another sign of weirdness on my part. So contractions were more frequent, pushing more often. I was pushing past the 10 seconds if I could and pushing a fourth rep, if I could still feel the contractions.

And I pushed. And pushed. And... pushed.

Nurse tried different positions of how I was laying, she helped me with visualization work, she was encouraging. Neil was nothing but supportive - he never left the room or my side. And two LONG hours later, Maddy was at +1. She needed to get to +4. She was still in no distress at all, but I was getting tired. Contractions were 2 minutes apart and I was pushing for 30-50 seconds. And the epidural? Worn off by then... the contractions were intense and it was hard to push through them. I have a vague memory of whimpering as I pushed. My doctor, and the resident - Dr Hussein who I had seen the week before and mentioned, came in to talk to me. I had the option of continuing to push. Maddy was just fine. Or I could have an assisted birth. Because she was still so high up, likely forceps. It's hard to make a decision like that when you haven't slept, were in crazy pain, and exhausted from pushing. But I just wanted to be sure Maddy was ok. So? We went with an assisted birth. Forceps.

The room became alive with activity.

The OB/GYN on call was brought in to do the forceps delivery. She brought in the Chief Resident. Because it was a forceps delivery, NICU had to be called in. Dr Loiselle and Dr Hussein were there. The new anesthesiologist (Dr Dupuis was off shift) was there, to top up the epidural. Neil was there. Nurse was there. And me? I am laying on my back, legs wide open and pushing with everything showing to the world. And I did NOT care a bit that my parts were showing. Although Nurse, afterward, when I was leaving the unit, commented that I was the first (and likely only patient she'll ever see) to apologize if I farted while pushing. I just felt so bad... farting in someone's face. Damn, I am so Canadian!

I didn't know this - or at least I don't remember hearing until after the forceps delivery team was in place. If this didn't work? It was time for a c-section. The thought of all this labour THEN the pain of a c-section after? Great incentive to get me to push the hardest I was able to.

The room was ready, and I looked down to one arm of the forceps... it appeared to be about 1.5 feet long. And it was moved into place. Second arm, moved into place. And I was told to push with everything I had. And I pushed once. Fast breath. A second one. Fast breath. A third one... then I was told to stop pushing hard and push small, almost grunt-like pushes... and then the last big push. And Maddy was out!

That is most of what I remember. I was exhausted and didn't have the best view. Neil has the other details. They are more graphic.

The NICU nurses grabbed her to assess her, Neil went over to watch her getting cleaned up and weighed. And the Chief Resident started stitching me up. And she kept working, and working and working. I have vague memories of her talking to the OB about how OHS had spoken to her, since she had a third needle prick injury in 5 years recently, from stitching someone up. And the OB saying something she was working on was an abrasion, not a tear. Resident said she found 2 edges and sewed. And I stared into the corner of the room, where Maddy was being assessed.

Finally she was laid in my arms (and they were STILL stitching - in the end 1 large stitch for the episiotomy and 6-7 small stitches for tears to the left and right). She was so small, so beautiful, such a perfect little one. Her little chubby cheeks were pink and rosy, her dark blonde hair showing a bit of a curl. Her hands though? So blue... which they assured me was normal. First blood goes to the core and head, last to enter the hands and feet. And the doctor commented that her hands and feet were wrinkled and dry - like that of a post-term baby. But she was still a few days from her due date. The questioned the dates... well, if she was late it was a few weeks post-term. And that is unlikely. As she was in my arms, her one hand peeked out of the swaddling. And this little blue hand? Gave up the finger. For an extended period of time. Yes, we have a pic!

Neil and I started talking about names. What did she look like? Neil's first pick was Astrid (I heard "Ass-turd" teasing in juniour high), mine was Nella (which he said sounded like a cookie - there is a vanilla wafer cookie called Nilla). We didn't like each other's enough to go with it. And, really, she was just Madeline.

And there will be a part three... I didn't realize I was so verbose. But I really want to be able to remember the details of the birth of my little one. Part three will be post-natal care and coming home. And? I need to get ready! We're taking Maddy on her first car ride (from leaving home) today!! Yes, there will be pics *grin*

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