Thursday, October 16, 2008

Joseph's Birth Story





Joseph Don Larson was 8 lbs. 9 and 20 3/4 inches long. He came by emergency C section at 5:31 am on Oct. 8. It was far from the natural childbirth I was hoping for, but we are so thankful Joseph and I fared so well.

Here are Joseph's stats from his 1 week appointment yesterday:

Weight: 8 lbs. 13 oz., 50%
Height: 20 3/4", 50%
Head: 40%

The nurse actually took us back to the scale to reweigh him yesterday because they just couldn't believe Joseph had gained back not only the entire pound he lost at the hospital, but 4 additional ounces in just 4 days! I was so proud of Joseph.

Summary of Joseph's delivery: Though he had been head-down during the last several months, Joseph had managed to move into breach position in the time between my last appointment and when we got to the hospital. Though I would have normally been a good candidate for a procedure to turn the baby in utero, the circumstances prevented that from happening: when we checked in, I was already fully dilated at 10 cm, and my water was about to break. There just wasn't any time. Since Joseph's brother was so big (10lbs 7 oz) a breach delivery seemed especially risky. And since the presenting parts were a shoulder and a butt, it wasn't ideal for even a breach delivery. So within a few minutes of discovering his breach position, we were rushed to the Operating Room and a C section was performed.

Okay, here is the extended version of Joseph's arrival. Skim-reading is permitted.

A friend and I threw a fun, very low maintenance "welcome to motherhood" party for my good friend Sarah (who delivered during the hurricane) earlier that night at a local cafe. It was fun and since it was only a few days before my due date, I was glad I didn't have to clean or bake. Loved it.

I got home around 11:30 pm, went to bed, and awoke to go pee like a bajillion times in the next 2 hours. At 2:40 am I finally realized that I was having contractions. They were too painful to lay in bed, but so infrequent and sometimes so mild that I wondered if I was actually in labor. We called a good friend to come stay with Ian around 3:30 am. Scott gave me a priesthood blessing which would give me great comfort and strength during the next several hours, and some peace as I remembered it over the next several days.

My contractions weren't often enough to confine me to the body ball, and so I was running around and asking Scott to make up the guest bed and to pack various (un)necessary items. Scott was sweet and calm, though he was very anxious to leave for the hospital. It was weird that I wasn't in more of a rush to go to the hospital because I was actually really excited to get there in enough time to labor in the hydrotherapy tub. A silly notion, because with my labor with Ian, we got to the hospital a mere 2 hours before he arrived. I should have known we would have even less time this go around.

Eventually I stopped doddling around 4:15 am and we left for the hospital. I only had one contraction on the way, and was pretty sure they were going to send me home because I wasn't in labor. But when Scott said something to that effect, I nearly killed him.

I had only one or two mild contractions during the insanely long check-in process. (Why should it take a laboring woman 10 minutes to check in when she has preregistered?) During this time, the check-in lady made obnoxious comments like "It seems all the time women who have really short first labors will labor for like 24 hours with the second child." Scott told her that was the wrong thing to say.

When I got to triage, the nurse told me my water was leaking and bulging. I took that to be an encouraging sign that I was actually in labor, and that they couldn't send me home. Then the nurse checked my progress.

I was fully dilated, and she could feel a leg. My baby was breach. I remember moaning "oh no! oh no!" and sobbing into Scott's chest. She told me what was already obvious to me: I could not allow my water to break there on the table. The baby would begin his decent in a potentially life-threatening way, and there wouldn't be any way to stop it. She ordered me to stay on the bed with my legs closed, and she bolted out of the room. I have never been so terrified in my life. Thankfully Scott stayed very calm.

My midwife came right in (she had just finished delivering another baby minutes before) along with a female OB named Dr. Sims, who was part of another practice. They and 3 nurses spent 10 precious minutes trying to get the ultrasound machine to turn on so they could confirm the baby's position. I prayed the triage nurse had really felt a hand. Finally they discovered that the outlet was faulty, and got the ultrasound machine on. The image was up for so little time that I didn't even get to see it. He was breach, but in such a way that it was a shoulder and butt presentation -- he was doing a back-bend. They did not feel confident doing a vaginal delivery, but I think they would have tried if I had insisted.

Though I had always considered a C section to be the worst possible option, and for that reason had decided on an unmediated, midwife-assisted birth with Ian and for this baby, in an instant I felt sure that this time, given the circumstances, I wanted nothing but a C section. And I wanted to be awake. (otherwise Scott would have to stay out of the room, and we would both miss the delivery completely.) They didn't sound optimistic about leaving me awake, which I expected. They said they would try to go with my request to be awake for it, but if my water broke before I could be prepped and medicated, they would deliver him vaginally as best they could. And if it came to worst, they would give me general anesthetic and take him out as quickly as possible to save his life. But even that may not be possible if the baby had started his decent.

I had felt the intense urge to push for several minutes by now. They told me to pant and "blow out the candles" and do my best not to push. It was a miracle that I was able to comply with these requests.

I instantly liked the anesthesiologist, who introduced himself as Kyle. Scott and I trusted him. I pleaded for him to leave me awake. He said he wanted to and would try. We wouldn't find out 'til later that no one thought it was even remotely possible.

They took me into the Operating Room, which was just down the hall. Scott had to wait in the hall. I was frantic wanting everything to happen as fast as possible, so that our baby could come by C section and everything would be okay. I willed my water not to break, and for me to be able to resist the urge to push. I wanted Scott to come be with me so badly.

They had me sit on the edge of the OR bed so that they could prep my back for the spinal anesthetic. Just sitting there was intensely painful. I was sitting on my baby's back and arm. My midwife Karen stood in front of me and held my face in her hands, and helped me focus. I leaned my head on her shoulder with every contraction. I didn't move when they pricked my back, and I was able to not push the baby out either.

Soon I was laying on the OR bed. Kyle asked if I could feel any contractions. I said they had totally stopped, much to my relief. He said they were actually still going strong, and that it was a good sign that the spinal block or whatever was working. At this moment, I finally understood something so many women had told me about: Glory be to the epidural. I totally understand why it is so incredibly popular! I couldn't feel a thing! A.Maze.Ing.

I was so much less terrified at this point. I knew that they could open me up in seconds if needed. The drape was raised just below my chin, and I couldn't see what was going on down there. I was glad for that.

Soon Scott was allowed to come in from the hall and join me in a chair up by my head. He held my hand and spoke encouraging words. I felt very relaxed and peaceful about everything at this point. I was shivering uncontrollably by now, which is apparently a very common affect of the medicine. This continued for the next several hours, but was little more than a nussance.

Kyle told me they were now pinching me with a very sharp object and asked I could feel anything. I said I didn't believe him, because I could feel nothing. He then said the time was 5:26 am, and they opened me up. There was a ton of tugging and pulling and grunting. Unfortunately, Scott stole a peak past the drape. I think he regretted it. The other OB kept saying to "Get Holly, Get Holly". I don't know if Holly ever arrived to help, but within 5 short minutes, at 5:31 am, Joseph arrived. He coughed, and was beautifully pink. They brought him to us soon after, and he was crying. As soon as I spoke a word to him, he quieted. I felt so happy, and so grateful I had been awake to experience that moment. The nurses got him clean right next to us, and I could see the nurse had written his Apgar scores as 8 and 9 and something else high. I was thrilled. He weighed 'only' 8lbs 9 oz. I was shocked.

They stitched my up, which took a bit longer. Then they wheeled us into an observation room (because we had been at the hospital for less than 2 hours total) and then to recovery, up a few floors. They were plum out of recovery rooms on the Labor and Delivery floor, so I recovered with women who had hysterectomies and with pediatric patients.

I found out later that after the u/s in triage, Joseph had continued to do contortions. By the time of the C section, he was fully in vertex breach position, or horizontal to the birth canal. He was so wedged in there that it took everyone's help to pry his body out. He soon had severe bruises running down his entire right side. My midwife and Dr. Sims agreed that a C section had been our absolute only option. And that if he had been in such a position at the time of the u/s, they would have immediately "put me under" and delivered the baby within the following minutes. What a relief that things went differently.

My recovery has been okay. In many ways it isn't so much worse than my vaginal delivery with Ian: intensely painful and immobilizing, but with slow improvements. Though I know a C section recovery will take much longer. I can't help but wish that I had gotten a normal vaginal delivery within 20 minutes of arriving at the hospital. With Joseph being 2 full pounds lighter than Ian, and having arrived at the hospital fully dilated after only like 6 bad contractions, I think I may have been doing jumping jacks and Walmart trips by now if I had avoided the C section. But slow progress is being made, and I can lift the baby and get him myself now. I was thrilled when I was able to change Joseph's diaper for the first time yesterday. Still, Scott and my mom do 99% of what is required to care for Joseph and Ian. I can't wait to feel up to doing more myself.

I am so glad Joseph is doing so well. He is perfectly healthy, so content, and sleeps constantly. We often have to awake him to eat after 4 hours or he would sleep all day.

We have no idea why Joseph moved into breach position, and why it was late in the pregnancy. But when I get frustrated that things didn't go exactly how I planned, one thing I remind myself of is Elder Perry's talk during General Conference where he quoted his mother -- "Come what may, and love it" I keep saying that to myself, and it makes me feel better about all of this though it was so far from my dream delivery.