Sunday, October 5, 2014

18 hours - Atalie’s Birth Story

Atalie, just moments after birth
She made it! She’s here! And now she’s already two six weeks old.How did that happen? As one day blends and blurs into another, I haven’t had the time I thought I would to blog about her birth story. This probably will be written over several days weeks, bits and pieces coming together as I sneak away to the office. In one of the books Steven is reading about babies, the author says everything they do is a reflex, they’re not making choices, but rather reacting to the new world they have found themselves in. Well, I think one reflex they fail to mention is the one where the baby wakes up and cries whenever mom eats or tries to write a blog post. Just sayin’. I can get a shower in, but write a blog post? Out of the question…

We ended up spending a total of 16 days in Shanghai from the time we had our 40th week appointment to when we caught a train back to Nanjing with our daughter in tow. Neither one of us expected to stay so long in Shanghai.  It was like a non-vacation, vacation. Thankfully, we were able to stay with friends and avoid living in a hotel during that time, it made the long stay much more bearable.

In my last post before she arrived, I shared that we were surpassing the 41 week mark and if I didn’t go into labor on my own I would be induced on Monday, August 25th.  At first, the induction was planned for Friday, but my doctor came back into town on Thursday and asked if I wanted her involved (she had been on vacation since the 4th and I had been seeing another doctor). I readily said, “yes!” and together we decided to push the induction back to Monday.  I really didn’t want to have a baby that came twelve days late, but since I had been praying for God’s timing, I really believe part of the reason Atalie came late was so my doctor could be there.

Sunday morning I started not feeling well and later that afternoon contractions started. However, they stopped by 8pm, which, though frustrating, was a blessing because I was able to go to bed. At 2:30am I woke up with contractions and lay there for an hour timing them. Steven then woke up around 3:30am and I told him we should probably start getting ready to go the hospital.  At that point my contractions were about 5 minutes apart. I was supposed to be induced at 7:00, but it was looking like I wouldn’t need that induction!

By 5:00am, after finishing up packing and showering, my contractions were getting stronger and closer together, about 3 minutes apart. I was also experiencing shaking and could no longer walk through a contraction. We called our doula to have her meet us at the hospital and caught a cab (which, fortunately, there were several parked right outside the apartment complex where we were staying).  

We arrived at the hospital at 6:00am and we were shown upstairs to the 7th floor to labor and delivery. They put me in a wheelchair, I think mainly because they didn’t want to wait for me to waddle in between contractions. Louise, our doula, showed up shortly after.  At this point I was thinking I must be pretty far into labor, maybe even active labor. However, a cervical exam totally burst my bubble and the doctor on call informed me that I was only 1 cm dilated.

Using the birthing tub to relieve pain and relax  (on a side note, this photo of me
with Louise will be featured in an article for a Shanghai-based family magazine
about Shanghai Doulas and their business providing doula services. Cool, right?)
Since we were planning a water birth, they got the tub ready and I climbed in. It was instant relief. They made me get out at 9:30am for a period of fetal monitoring (which showed the baby was doing great), and I got back in 30 minutes later. Also worth noting, shortly after arriving at the hospital, I started vomiting about every 20 minutes or anytime I had something to eat or drink. Talk about exhausting! That part was terrible (and really gross). Labor is bad enough without emptying the contents of your stomach three times an hour.

Around 11:00am the contractions started to really pick up in intensity. I remember looking at the clock a lot between 11:00 and 1:00pm, knowing that around 1:00 they would do another cervical exam. It was the worst pain I’ve ever had. And now the contractions were 2 minutes apart and lasting over a minute, which meant I had zero time to rest. The water helped, but it was still excruciating and it took several times of repositioning myself to get somewhat comfortable. Louise and Steven took turns applying counter pressure to my lower back during contractions (and somehow they both ordered food and ate during this time, too – I don’t really remember much of that). I tried to eat lunch, but ended up throwing it all up ten minutes later. I was vomiting so much, that after awhile Louise and Steven started commenting on how awesome my projectile vomiting was becoming. At some point around noon, my doctor came in and talked to me about how everything was going. It wasn’t much of a “conversation” as every two minutes I had pain ripping up my back and wasn’t really able to talk much; she was obviously used to it as it didn’t faze her in the least.
After the epidural, all smiles!

Around 1:00pm I got out of the water for another cervical exam. In my head, I told myself that if I was making progress, maybe around 5-6cm, I could keep going without an epidural. But if I was less than 4cm I wasn’t sure if I would be able to make it. Between the continuous vomiting and huge contractions every 2 minutes my energy was next to nothing and I was exhausted. I could barely walk from the tub to the bed. The doctor checked…I was still at 1cm, but dilating to 2cm during a contraction. Um, are you freaking kidding me? What has my body been doing for the past seven hours?!? My cervix was also swollen, which was probably what was making it hard to dilate. The doctor asked if I had been pushing (I hadn’t) as that can cause swelling. (Later, after Atalie showed up, we noticed a large contusion on the backside of her head and a dent on her left temple. Louise conjectured that Atalie was wedged in my pelvis and that it was probably the back of her head pushing on my cervix.)

Cue instant crying. That was it. There was no way I would be able to keep going at this rate. I didn’t hesitate in asking for the epidural, I was a hot mess of tears and sweat, shaking uncontrollably with makeup smearing down my face. I couldn’t even think straight; I needed some relief.

I don’t really remember much between the exam and when I got the epidural. I was lying on the bed, in the worst pain ever and there was a flurry of people in and out of the room. I do remember actually getting the epidural because it was one of the most awkward experiences I’ve had in a hospital (please lie on your side, in the fetal position and don’t move even though you are having a monster contraction). I got the epidural at 2:00pm and by 2:15 was already feeling relieved of the pain.  I was also at 2.5cm! Making progress. They gave me a “walking epidural” which meant I could still feel the contractions, but they were much less intense (more like pressure instead of pain). I could also walk, with assistance, which meant I could get up and go the bathroom and walk around the room when needed.

At 4:20pm, after getting up and using the bathroom, I was walking back to the bed when my water broke. Now that’s a weird feeling! I actually thought I had peed again as it trickled down my leg. The doctor on call was brought in to check my progress. I was now at 6cm! However, the rest of my water ruptured during the exam and it was a very dark green (which meant that Atalie had pooped meconium in the womb). All of sudden there were all these people in my room, an anesthesiologist, another doctor and three nurses. The doctor on call mentioned “C-section” to one of the nurses, another nurse stared at the meconium stained bed with her mouth gaping open and the anesthesiologist checked my epidural and informed me that, “your epidural still looks good. That’s a good thing since you will probably need a C-section.” Um…excuse me? Hasn’t the baby been fine all day? She had shown no signs of distress and she is 12 days late (it’s not uncommon for babies that late to poop before they are born, not out of distress, but because they are starting to function as they would outside the womb).

Louise was so supportive and encouraging! I would recommend hiring a doula,
she made the whole experience more  positive.
My doctor came a few minutes later to check on me. I asked her what my chances were of having a C-section and with a look of bewilderment she replied me, “Why are you asking that?” To which Louise informed her of the bedside manner and offhand comments made by the medical staff after my water broke. Let’s just say my doctor wasn’t very happy about their response (neither was Steven, he was upset at how they all reacted). She saw no reason to consider a C-section and to continue monitoring as usual with the intent of a vaginal delivery. I knew I loved my doctor, and the way she handled that situation made me over the moon for her. Seriously, she is a fantastic doctor and has amazing bedside manner. The next day we actually learned that Redleaf is using that whole situation as an opportunity to train their nurses and new doctors on appropriate responses and bedside manner in similar situations.

By 5:30pm (an hour later), my contractions started to feel different and Louise went and got the doctor on call – I was now at 9cm! By 6:30pm, I was still at 9cm and the baby had started descending and was at +1 station. My doctor returned, saying she wanted to go home for an hour or so to see her kids and then she’ll be back. She told me to rest because when she returned I was finally going to push. I slept until 8:30pm, and after waking up, I was fully dilated and the baby was at +2 station! Before pushing my doctor took me off the epidural (so I could self direct my pushing, meaning I decided when to push instead of being coached).

So tiny and so perfect
Pushing was the most empowering thing I have ever done. I’m sure those of you who have delivered babies can agree with me – it was amazing. Hard & exhausting for sure, but so amazing. I used the squat bar for a bit, but my legs were too tired to hold me up, so eventually I ended up semi-seated with support from both Steven & Louise. I pushed for just over an hour. Louise helped count me through contractions while I pushed. Being able to self direct my pushing helped me focus and feel in control, I really appreciated being able to choose when to push instead of being told. At Redleaf, they have midwives deliver the baby, so my doctor sat nearby overseeing both the midwife and me. She engaged with me and paid a lot of attention to me, helping me achieve the best outcome. The room was very calm and the attending staff were quiet (probably a little apprehensive after the earful they received earlier after my water broke). Later that week, Dr. Huebner told me it was her best delivery that week (out of five total) and was “beautifully done”. I think a lot of it had to do with having Louise there to help us. I felt calm and focused because I knew Louise would tell me what to do and Steven could be himself and fulfill the role of loving husband instead of coach.

At 10:10pm, after one final push, Atalie Joyce entered our world. They placed that tiny person on my chest and she was perfect. Because of the meconium in the fluid, she only stayed with me until Steven cut the cord and then she was whisked off to have her stomach pumped. Poor baby. After that experience she didn’t want to nurse for several hours. And she didn’t even open her eyes until much later on. I think she was just as exhausted as I was!

We wanted delayed cord cutting, and it took about 10 minutes for the cord to stop pulsating. Steven, of course, was super interested in the cord and was amazed as he watched it go from Atalie’s life source full of blood to a lifeless white cord. After he cut the cord, my placenta didn’t detach as is usual and I started bleeding a lot. I actually don’t really remember this part very well because my eyes were on Atalie, but I kept looking at Steven who had a very concerned look on his face. My doctor, who is usually calm and collected, started yelling at some of the staff (I guess they were just standing around not doing anything to help stop the bleeding). Finally, I got a shot of Pitocin, which started contractions to deliver the placenta and stop the bleeding. We found out later that I lost almost a liter of blood – kind of scary. No wonder Steven was worried – he watched all that blood pool on the table.

Our first family picture
Eventually, the staff trickled out of the room. We said goodnight to Dr. Huebner, who commented on how pleasurable it was to attend a birth where the husband was engaged and interested in what was happening. That’s Steven for you! For the next few hours, I enjoyed skin to skin as Steven and I marveled together at our new daughter. Louise accompanied us downstairs and waited until we settled in a bit before she said goodnight and returned home. And then it was just us with our new baby (and the night nurse, but I wasn’t very keen on her so let’s keep her out of this). The first night was a little rough, but we found a new rhythm in the hospital over the next several days. My recovery was slow at first; at least I thought it was. I felt so incredibly weak (taking a shower wore me out). After learning how much blood I had lost, I realized that my physical exhaustion was due not only to the fact I just had a baby but also because of the blood loss. Fortunately, I didn’t tear during pushing (yay!) so at least I also didn’t have to recover from stiches.

Even though I didn’t get my dream water birth, it was a very positive experience. I am so thankful that Atalie came late so my doctor could be there – she made a huge difference! Redleaf is a great hospital and beautiful facility, I am thankful that there exists a hospital in Shanghai such as Redleaf. 

And she’s here. She’s perfect. That’s all that matters.

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