Tag Archives: induction

Samuel’s Birth Story

This is the story of how Samuel Clarke Frazier came into the world πŸ™‚ It ends at that joyous moment, so there is no dwelling or rehashing of the difficult time that followed – just a history of the moments leading up to one of the happiest points in my life. However, it is a birth story. It is graphic. On other blogs I have seen the authors put up birth stories and readers complain that words like ‘cervix’ and ‘discharge’ spoiled their breakfast. Well… expect that and more, if you stick with this post, you may know me VERY well by the end (although note: it is safe for work, and suitable for my students to read and still respect me afterwards).

We left off when the hospital had called. I had been merrily distracted by an awesome ‘shower in a box’ but as soon as the phone rang, all the emotions hit me: fear (perhaps terror), panic, excitement. At that moment, all I could think was ‘I am not ready… I just need another day…’. I answered the call, and the nurse told me that the hospital was not sure they could fit me in that day after all – but she would call and let me know later if it was a possibility. She could call us, but if we had not heard by 9, we could call her.

Ugh. Talk about a mood changer. OK, I might not have felt ‘ready’ but I did not want to delay this. I cried, so Wes got me out of the house to a gorgeous little Italian in Bellaire (where I ate about 3 bites of pizza and boxed the rest) and we got ‘Rock of Ages’ on DVD to distract ourselves. 9 came… no phone call, and at 9.00 and 1 second I dialed the hospital. Come on in they said! Come in for 11. Woo-hoo. That was a difficult hour to kill, but we changed and packed and tidied and faffed and left ridiculously early.

We got to the hospital at 10.50 and were not turned away! This was it… it was happening! Then began wait after wait… waiting for a room, waiting for a nurse, waiting for the cervadil (I am not complaining, I utterly accept that on a labor ward, the woman NOT in labor is the least of their priorities)… the upshot was, it was 2 am (yawn) before the induction began.

Induction part 1: Friday night: Cervadil.

Induction of labor

Waiting for the first stage

Cervadil is a gel they put on your cervix overnight, to ‘ripen’ it (nice terminology, always reminded of ‘the reaping’ in The Hunger Games). Hopefully it thins the cervix and dilates it, meaning the pitocin has less to do – some women respond so well they go into labor, but that is not the purpose per se. The cervadil basically looks like a long tampon, but a doctor has to insert it (boo). Unfortunately, my doctor (the resident for that night) was very heavy handed – placing it and then pushing, and shoving more. I did get quite bruised, from the heavy-handed insertion, otherwise it would have been utterly painless. Once it was in, it was painless (I couldn’t feel it at all) and time for lights out.

Cervadil in, and no discomfort

Many hospitals give a sleeping pill at this stage, but I was not offered one (I don’t know if this is because my OB practice is as hands-off / anti-interference as possible, or because I had told them that minimal intervention was my choice) and I did not want one. Slept like a log anyway, until I was woken up at about 6 to see how it had worked.

Bed for the husband in hospital with labor

Wes’ cot

I was pleased to see my OB, Dr. Boswell, in the morning. We love her, and she did the examination to see how the cervadil had worked. The result? No effacement, no dilation. Nothing. No change. Boo. I was disheartened, but Dr. Boswell was upbeat and said it was just time to start phase 2: round 1 of pitocin.

Stage 2: Saturday morning: Round 1 of pitocin

IV for pictocin

IV line for the pitocin

The turned the pitocin on at about 9. As I had wanted to try to labor without an epidural (even on pitocin) they started, as promised, at the very lowest dose: a 2. I waited, with some fear, for the hugely painful contractions pitocin is supposed to give, but… nothing. So after 30 mins, they upped it to a 4. And I waited… and nothing… this carried on all day, until at 2 pm Dr Boswell came back. She asked how I was feeling, and I gave a very merry “Wonderful! I feel great!” but her response was “Rats. I was hoping you would be in a lot of pain by now”. She didn’t think the pitocin was working – we could see my uterus contracting on the monitor, but no nice rhythmic contractions, nothing that seemed productive. And no pain meant that clearly, nothing was really happening. I asked if getting up and walking would help, but she said, not at this stage. I was welcome to, but resting for actual labor might be better.

So… I waited… and waited.. and we upped the dose every 30-60 mins. When the dose was at a 12 (not very high, it goes up to 20), at about 7 pm, Dr Boswell recommended the pitocin be turned off. You could see that my uterus was contracting constantly, with no break in between, but I could not feel it. I was still spending my time reading, watching TV, texting, Skyping my Mum. Basically: completely ineffective contractions. They checked my cervix: no effacement, maybe a fingertip dilation. Again: basically zilch.

Here, I am very grateful to have been with The Women’s Specialists of Houston. Not only did the doctor leave me alone all day (very few internal examinations… in fact, just one, with an intern who again was extremely heavy handed until she bought tears to my eyes) but many doctor’s would have just upped and upped the pitocin, labelled it a ‘failed induction’ and gone for the C-section. Dr Boswell said that this can occur for a number of reasons and that the game was not up yet. She said that nerves / tiredness / stress / hunger (I had not been allowed to eat before being admitted) can cause pitocin to fail: she wanted me to have a relaxing evening, with a big meal, and a good sleep. She also said that pitocin causes the cells that trigger contractions in response to pitocin to be expressed on the wall of the uterus, therefore they can work better on a second attempt, but you need a rest so your uterus doesn’t get ‘exhausted’ (yes… really). So, feeling doomed to failure I agreed to take a break. At this stage, I began to feel quite depressed about the whole thing: I had really wanted as natural of a labor as possible, and this felt anything but. My body just felt like a passive vessel for medical intervention: I felt nothing, I felt my body was doing nothing. Still, when Dr. Boswell suggested one last intervention to help tomorrow’s pitocin: a foley balloon, I agreed to try it to help avoid a C-section.

Stage 3: Saturday pm: Foley Balloon

A foley balloon is another method of helping dilation, but it is mechanical rather than pharmaceutical. Basically, they insert two balloons into you, one in your uterus between the baby’s head and your cervix, one just outside the uterus resting on the cervix. They fill the balloons with water and hope the pressure mimics the pressure of a baby’s head descending in labor, and so causes your cervix to dilate. Bleugh. I will say, Dr Boswell absolutely gave me the choice of having the balloon or not. She also sad that she would stop at any point when it was uncomfortable, and if we could not fill the balloons with the recommended amount of water without discomfort – we just wouldn’t. She saw no point in discomfort, nor wearing me out more. She is awesome.

The insertion was about as pleasant as it sounds – luckily Dr Boswell is a wonder at doing these procedures and it was just unpleasant / uncomfortable more than anything. At least, that was the physical side, emotionally I felt a bit like I was sick of being prodded and poked and my body not being my own. But hey ho. Dr Boswell saw all my bruising from the heavy handed intern examinations and offered me ice, which was nice, and sympathy, which I think was nicer πŸ™‚

But once it was in, actually, no problem. I could not feel it at all, and ended up like this moments later:

Foley Balloon not hindering sleep.

It was weird getting up and going to the bathroom with it in… but otherwise, it really didn’t bother me.

At 6 am (why so early?? Why??) Dr Boswell (phew) came to remove the foley balloon. It was simple and painless – she drained the water and it kinda slipped out. Moment of truth time: had it done anything? Had it made any difference?? YES! I was 4 cm dilated! This is the stage they will often admit you to hospital (if you are not being induced), and evidence that my body might actually respond to something.

Stage 4: Saturday am, Pitocin round 2

Nice day to have a baby?

So, we were all go on the pitocin. They worked the same way as before: starting low and increasing the dose until it was effective, but not letting it get so high my uterus got exhausted (for real… they actually said this… hence the need for an overnight break and some food). Dr. Boswell came to wish us goodbye 😦 So sad to see her go, but she handed us over to her colleague Dr. Dryden with promises that she was ‘wonderful’ and ‘very experienced’ and had delivered both of Dr. Boswell’s babies. Dr Boswell said not to start the pitocin until the change of nurses shift at 9, so that the nurse can monitor the whole reaction of my uterus, and see it’s responses and patterns. She warned me that the time was probably coming to break my waters, she emphasized that given all the excess fluid, no one, but no one was to break my water except Dr. Dryden, in case of a prolapse. Then Dr. Boswell left for some much needed sleep (she had been at the hospital all Saturday and on call all Saturday night).

Waiting… waiting… by the time the nurses had switched and done their rounds, the pitocin was started at 10… again, I could not feel much, although it did feel a little bit more like rhythmic menstrual cramps. Dr. Dryden came in at 10.30 and determined it was time to break the water. I liked Dr Dryden (and she did a wonderful, wonderful job at the birth and after) but she was quite different to Dr. Boswell – I felt everything was an option and my choice with Dr B.; with Dr. Dryden felt more that things were going to be done her way. But I did like her and felt quite comfortable around her – plus she did the most wonderful job of the actual delivery so am eternally grateful for that. I got a bit antsy when she mentioned breaking my waters – we had been taught in Bradley that this increases the risk of C-section because once your water is broken, if the baby was not out in 24 hours, it was an automatic C-section. Wes asked if this was the case and Dr. D said ‘No, you are absolutely not on any clock’ so we agreed – again, I have a feeling that was going to happen anyway πŸ˜‰

Dr. D. pronounced me still 4 centimeters and broke my waters. It took all of 2 seconds, I didn’t feel it at all, and then there was just a horrible hot gush. Ugh. Dr. D left, the nurse upped the pit and left Wes and I were left to our own devices. Before the nurse left she mentioned again that she could give me wireless monitoring so I could get up and walk – AS REQUESTED IN MY BIRTH PLAN – but you know when you are in pain and all you want to do is curl up and laze around? Yeah, I was there. All I will say is that breaking the waters is darn effective. Immediately, I began to feel contractions. Painful, but spaced out. I practiced my Bradley relaxation techniques to get through them – they came about every 2 minutes. Whether they are more painful than non-pit contractions I will never know, but I will say that you do get thrown straight into later stages of labor – for example, straight into 2 mins apart, painful contractions, which is often not the case with natural labor.

At about 11, the nurse came in and told me that she had read my birth plan and was here to get me walking. I wasn’t really given a choice, but in a good way. I had given them detailed reasons why I wanted to walk and use the birthing ball (pain relief, good positioning, speeding up labor) so the nurse played hard ball and made Wes walk me up and down the corridors. Again, a highly effective way to get labor kicked up a notch. The contractions got more painful and about a minute apart. Again, although painful, it was bearable as I could get a complete pain-break as these photos taken 30 sec apart show:

Labor contraction

Contraction


Break from contraction πŸ˜‰

I tried the birthing ball, which pre-labor I was convinced would be the best place for me. It hurt more, hurt my tailbone and I practically kicked the thing out of the room. I also, with Wes’ help, tried squatting, which was equally as miserable. Walking it was.

Then I needed the loo. No. 2. Wes told me I would have to buzz for a nurse, but I didn’t see why. I buzzed and the nurse said “wait! Wait for me’ which I tried to do, but she was ages coming. Ages. I was in pain, in labor and I needed to go. I tried to wait, but eventually, I figured I would either go on the floor or in the loo, so I might as well use the loo.

Waiting for the nurse so I could use the loo! Gave up and used it anyway, much to her chagrin.

The nurse busted in while I was going (see? Labor is just so not dignified – and yes, I was with it enough to be horribly embarrassed) and chastized me. She told me that needing the loo was often a sign that the baby was coming and she was cross I might have had the baby in the loo. What was I supposed to do? Holding it was not an option!! She had to come quicker if she wanted me to wait! So, she wanted an exam afterwards to see if the baby was coming. So – at 11.15 what amazing progress had I made? 4 cm, maybe 4.5. UGH. Back to labor.

When the nurse left, the contractions got really bad. They just didn’t stop one on top of another. The pain was bad (but I could cope with it):

Ow. Ow. Ow.

Then I needed the loo again. Really, like upset tummy needed to go. I buzzed for the nurse and waited and waited and buzzed and begged them to come (I was close to going anyway, but torn between my discomfort and being told off again!), when she came she wanted me to use a bedpan! No freakin’ way! Gross. So, I pointed out that just a few minutes ago I had been 4.5 at most and so really, no baby was going to be falling out of me. She agreed and let me use the bathroom (although she insisted on being in there with me! When I had an upset tummy! Told you: labor is not dignified).

While in there, I had a mental breakdown. The pain was horrific, and I was not progressing. I could deal with this pain, but given that I was dilating 1 cm every 2 hours, and had 5.5 cm to go – not for another 11 hours. Plus, if this was early labor, how bad would transition be? F that, I’ll take the pain relief. So, I asked for the epidural.

It was administered quickly (within 5 mins) and within 10 I had gone from this:

Ow. Ow. Ow.

To this:

Bliss.

As soon as the epidural had kicked in – about 11.45 the nurse wanted an exam, so they could ascertain in the future whether the epi had caused me to stall. I was annoyed: what was the point? I had been at 4.5 forever, and so finding out I was 5 was not going to help. I acquiesced, a resident Dr was called, and I grumpily let her announce that I was “9.5, maybe more, there was just a lip, and the baby was coming NOW”.

What? What the F-ing F? Some 40 hours to get get 4 cm, then to 9.5 in 40 minutes? So looking back, this:

Ow. Ow. Ow.

was transition. We had been taught in Bradley that transition was the most painful time, and the time the women find it most emotionally difficult and cry for the epidural. Our plan had been for Wes to step in at that stage and talk me out of it.. however, we just had no idea we were in transition. We thought it was too soon. I was annoyed that I had an epidural so late: I was moments away from giving birth when I got it, and most of the hard stuff had been done. I could have had a non-epidural (one can hardly call all the cervadil, balloons and pit natural…) birth, but hey ho. While I was annoyed that we had managed this slightly wrong, I was also pleased that I was enjoying this last stage. Plus, most of my fears about an epidural were unfounded: I could feel my legs, I could use my legs and I could certainly feel the contractions.

The nurse took a picture of us as a 2-some, promising to take the same picture but with the baby between us, when he was out (we never got this latter picture as everything went a bit Pete Tong, but hey ho)

Last picture as a 2-some

Doctors were called, and it was time to push. I declined the mirror and pushed – again, the epidural did not affect my ability to push as I could certainly feel quite a lot. I could tell the nurse when my contractions were coming, and she often had to help me hold off on pushing the urge was so strong, so that I could let the pressure build. Pushing went pretty well, Firework moved quickly – so quickly, they had to chase him with the little monitors.

After about 30-40 mins we could see the head, then poor old FW got stuck 😦 I had been warned about a very narrow pelvis and nothing seemed to get him past it. We tried squat bars, different positions, breaks, laboring down, I even let them get the dratted mirror. After 2 hours of pushing, they called Dr. D. She watched a few contractions and coached me. I actually said “It is OK to use forceps if you need, or cut me” but she didn’t think we needed that yet. She put her hands inside me (owww… just owwww… the epidural seemed to be doing F all at this stage) and said that FW was a slight transverse – he was facing the wrong way (up, not down – ah back labor also explains the yell for the epidural earlier) and slightly sideways. Again, I am grateful I was with the Women’s Specialists, many OB’s would have gone for an emergency C-section at this stage. Not Dr. D. Mindful of my ‘no C-section if possible’ [and now it does seem silly I was so adamant about that] scrawled all over my birth plan, she just turned him manually while he was inside me.

That. Is. The. Most. Pain. I. Have. Ever. Experienced. I swore violently – then apologized. But Dr. D was doing absolutely the right thing, using each contraction and push to slowly stretch me and rotate FW. I began to worry that FW was in danger as his heart rate was dropping, but Dr. D was wonderfully calm. I even said “if you need to do a C-section, do it!” but she said “I don’t need to see him now. I do need to see him soon, but he is OK now” and quietly called some extra pediatricians in. Once Dr D had figured out he was the wrong way and stuck in my weird pelvis it was all quick quick. Another 30 mins or so of pushing, with her help, and my beautiful boy was born:

He was handed straight to me:

and taken off for some checks as he had been stuck for quite a while. All the checks were done in the room, and Wes got to help, although he mostly took photos:

FW had become Sam! The long pushing didn’t affect him at all. He took a while to cry which freaked me out (I got slightly panicked over that) but his apgar scores were 8 and 9 and his lungs, when he decided to use them, were certainly powerful enough πŸ™‚

Sam was little enough that I only had a minor second degree tear which Dr D and an intern stitched up, while Sam was assessed. Sadly, as I was quite ill, I didn’t get Sam back after that 😦 But, that is not this story. This is the story of how the lovely Samuel Clarke Frazier came into the world at 16.32 on November 4th 2012, weighing 6 lb and 15 oz. A wonderful, wonderful day:

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Samuel’s birth story

This is the story of how Samuel Clarke Frazier came into the world πŸ™‚ It ends at that joyous moment, so there is no dwelling or rehashing of the difficult time that followed – just a history of the moments leading up to one of the happiest points in my life. However, it is a birth story. It is graphic. On other blogs I have seen the authors put up birth stories and readers complain that words like ‘cervix’ and ‘discharge’ spoiled their breakfast. Well… expect that and more, if you stick with this post, you may know me VERY well by the end (although note: it is safe for work, and suitable for my students to read and still respect me afterwards).

We left off when the hospital had called. I had been merrily distracted by an awesome ‘shower in a box’ but as soon as the phone rang, all the emotions hit me: fear (perhaps terror), panic, excitement. At that moment, all I could think was ‘I am not ready… I just need another day…’. I answered the call, and the nurse told me that the hospital was not sure they could fit me in that day after all – but she would call and let me know later if it was a possibility. She could call us, but if we had not heard by 9, we could call her.

Ugh. Talk about a mood changer. OK, I might not have felt ‘ready’ but I did not want to delay this. I cried, so Wes got me out of the house to a gorgeous little Italian in Bellaire (where I ate about 3 bites of pizza and boxed the rest) and we got ‘Rock of Ages’ on DVD to distract ourselves. 9 came… no phone call, and at 9.00 and 1 second I dialed the hospital. Come on in they said! Come in for 11. Woo-hoo. That was a difficult hour to kill, but we changed and packed and tidied and faffed and left ridiculously early.

We got to the hospital at 10.50 and were not turned away! This was it… it was happening! Then began wait after wait… waiting for a room, waiting for a nurse, waiting for the cervadil (I am not complaining, I utterly accept that on a labor ward, the woman NOT in labor is the least of their priorities)… the upshot was, it was 2 am (yawn) before the induction began.

Induction part 1: Friday night: Cervadil.

Induction of labor

Waiting for the first stage

Cervadil is a gel they put on your cervix overnight, to ‘ripen’ it (nice terminology, always reminded of ‘the reaping’ in The Hunger Games). Hopefully it thins the cervix and dilates it, meaning the pitocin has less to do – some women respond so well they go into labor, but that is not the purpose per se. The cervadil basically looks like a long tampon, but a doctor has to insert it (boo). Unfortunately, my doctor (the resident for that night) was very heavy handed – placing it and then pushing, and shoving more. I did get quite bruised, from the heavy-handed insertion, otherwise it would have been utterly painless. Once it was in, it was painless (I couldn’t feel it at all) and time for lights out.

Cervadil in, and no discomfort

Many hospitals give a sleeping pill at this stage, but I was not offered one (I don’t know if this is because my OB practice is as hands-off / anti-interference as possible, or because I had told them that minimal intervention was my choice) and I did not want one. Slept like a log anyway, until I was woken up at about 6 to see how it had worked.

Bed for the husband in hospital with labor

Wes’ cot

I was pleased to see my OB, Dr. Boswell, in the morning. We love her, and she did the examination to see how the cervadil had worked. The result? No effacement, no dilation. Nothing. No change. Boo. I was disheartened, but Dr. Boswell was upbeat and said it was just time to start phase 2: round 1 of pitocin.

Stage 2: Saturday morning: Round 1 of pitocin

IV for pictocin

IV line for the pitocin

The turned the pitocin on at about 9. As I had wanted to try to labor without an epidural (even on pitocin) they started, as promised, at the very lowest dose: a 2. I waited, with some fear, for the hugely painful contractions pitocin is supposed to give, but… nothing. So after 30 mins, they upped it to a 4. And I waited… and nothing… this carried on all day, until at 2 pm Dr Boswell came back. She asked how I was feeling, and I gave a very merry “Wonderful! I feel great!” but her response was “Rats. I was hoping you would be in a lot of pain by now”. She didn’t think the pitocin was working – we could see my uterus contracting on the monitor, but no nice rhythmic contractions, nothing that seemed productive. And no pain meant that clearly, nothing was really happening. I asked if getting up and walking would help, but she said, not at this stage. I was welcome to, but resting for actual labor might be better.

So… I waited… and waited.. and we upped the dose every 30-60 mins. When the dose was at a 12 (not very high, it goes up to 20), at about 7 pm, Dr Boswell recommended the pitocin be turned off. You could see that my uterus was contracting constantly, with no break in between, but I could not feel it. I was still spending my time reading, watching TV, texting, Skyping my Mum. Basically: completely ineffective contractions. They checked my cervix: no effacement, maybe a fingertip dilation. Again: basically zilch.

Here, I am very grateful to have been with The Women’s Specialists of Houston. Not only did the doctor leave me alone all day (very few internal examinations… in fact, just one, with an intern who again was extremely heavy handed until she bought tears to my eyes) but many doctor’s would have just upped and upped the pitocin, labelled it a ‘failed induction’ and gone for the C-section. Dr Boswell said that this can occur for a number of reasons and that the game was not up yet. She said that nerves / tiredness / stress / hunger (I had not been allowed to eat before being admitted) can cause pitocin to fail: she wanted me to have a relaxing evening, with a big meal, and a good sleep. She also said that pitocin causes the cells that trigger contractions in response to pitocin to be expressed on the wall of the uterus, therefore they can work better on a second attempt, but you need a rest so your uterus doesn’t get ‘exhausted’ (yes… really). So, feeling doomed to failure I agreed to take a break. At this stage, I began to feel quite depressed about the whole thing: I had really wanted as natural of a labor as possible, and this felt anything but. My body just felt like a passive vessel for medical intervention: I felt nothing, I felt my body was doing nothing. Still, when Dr. Boswell suggested one last intervention to help tomorrow’s pitocin: a foley balloon, I agreed to try it to help avoid a C-section.

Stage 3: Saturday pm: Foley Balloon

A foley balloon is another method of helping dilation, but it is mechanical rather than pharmaceutical. Basically, they insert two balloons into you, one in your uterus between the baby’s head and your cervix, one just outside the uterus resting on the cervix. They fill the balloons with water and hope the pressure mimics the pressure of a baby’s head descending in labor, and so causes your cervix to dilate. Bleugh. I will say, Dr Boswell absolutely gave me the choice of having the balloon or not. She also sad that she would stop at any point when it was uncomfortable, and if we could not fill the balloons with the recommended amount of water without discomfort – we just wouldn’t. She saw no point in discomfort, nor wearing me out more. She is awesome.

The insertion was about as pleasant as it sounds – luckily Dr Boswell is a wonder at doing these procedures and it was just unpleasant / uncomfortable more than anything. At least, that was the physical side, emotionally I felt a bit like I was sick of being prodded and poked and my body not being my own. But hey ho. Dr Boswell saw all my bruising from the heavy handed intern examinations and offered me ice, which was nice, and sympathy, which I think was nicer πŸ™‚

But once it was in, actually, no problem. I could not feel it at all, and ended up like this moments later:

Foley Balloon not hindering sleep.

It was weird getting up and going to the bathroom with it in… but otherwise, it really didn’t bother me.

At 6 am (why so early?? Why??) Dr Boswell (phew) came to remove the foley balloon. It was simple and painless – she drained the water and it kinda slipped out. Moment of truth time: had it done anything? Had it made any difference?? YES! I was 4 cm dilated! This is the stage they will often admit you to hospital (if you are not being induced), and evidence that my body might actually respond to something.

Stage 4: Saturday am, Pitocin round 2

Nice day to have a baby?

So, we were all go on the pitocin. They worked the same way as before: starting low and increasing the dose until it was effective, but not letting it get so high my uterus got exhausted (for real… they actually said this… hence the need for an overnight break and some food). Dr. Boswell came to wish us goodbye 😦 So sad to see her go, but she handed us over to her colleague Dr. Dryden with promises that she was ‘wonderful’ and ‘very experienced’ and had delivered both of Dr. Boswell’s babies. Dr Boswell said not to start the pitocin until the change of nurses shift at 9, so that the nurse can monitor the whole reaction of my uterus, and see it’s responses and patterns. She warned me that the time was probably coming to break my waters, she emphasized that given all the excess fluid, no one, but no one was to break my water except Dr. Dryden, in case of a prolapse. Then Dr. Boswell left for some much needed sleep (she had been at the hospital all Saturday and on call all Saturday night).

Waiting… waiting… by the time the nurses had switched and done their rounds, the pitocin was started at 10… again, I could not feel much, although it did feel a little bit more like rhythmic menstrual cramps. Dr. Dryden came in at 10.30 and determined it was time to break the water. I liked Dr Dryden (and she did a wonderful, wonderful job at the birth and after) but she was quite different to Dr. Boswell – I felt everything was an option and my choice with Dr B.; with Dr. Dryden felt more that things were going to be done her way. But I did like her and felt quite comfortable around her – plus she did the most wonderful job of the actual delivery so am eternally grateful for that. I got a bit antsy when she mentioned breaking my waters – we had been taught in Bradley that this increases the risk of C-section because once your water is broken, if the baby was not out in 24 hours, it was an automatic C-section. Wes asked if this was the case and Dr. D said ‘No, you are absolutely not on any clock’ so we agreed – again, I have a feeling that was going to happen anyway πŸ˜‰

Dr. D. pronounced me still 4 centimeters and broke my waters. It took all of 2 seconds, I didn’t feel it at all, and then there was just a horrible hot gush. Ugh. Dr. D left, the nurse upped the pit and left Wes and I were left to our own devices. Before the nurse left she mentioned again that she could give me wireless monitoring so I could get up and walk – AS REQUESTED IN MY BIRTH PLAN – but you know when you are in pain and all you want to do is curl up and laze around? Yeah, I was there. All I will say is that breaking the waters is darn effective. Immediately, I began to feel contractions. Painful, but spaced out. I practiced my Bradley relaxation techniques to get through them – they came about every 2 minutes. Whether they are more painful than non-pit contractions I will never know, but I will say that you do get thrown straight into later stages of labor – for example, straight into 2 mins apart, painful contractions, which is often not the case with natural labor.

At about 11, the nurse came in and told me that she had read my birth plan and was here to get me walking. I wasn’t really given a choice, but in a good way. I had given them detailed reasons why I wanted to walk and use the birthing ball (pain relief, good positioning, speeding up labor) so the nurse played hard ball and made Wes walk me up and down the corridors. Again, a highly effective way to get labor kicked up a notch. The contractions got more painful and about a minute apart. Again, although painful, it was bearable as I could get a complete pain-break as these photos taken 30 sec apart show:

Labor contraction

Contraction

Break from contraction πŸ˜‰

I tried the birthing ball, which pre-labor I was convinced would be the best place for me. It hurt more, hurt my tailbone and I practically kicked the thing out of the room. I also, with Wes’ help, tried squatting, which was equally as miserable. Walking it was.

Then I needed the loo. No. 2. Wes told me I would have to buzz for a nurse, but I didn’t see why. I buzzed and the nurse said “wait! Wait for me’ which I tried to do, but she was ages coming. Ages. I was in pain, in labor and I needed to go. I tried to wait, but eventually, I figured I would either go on the floor or in the loo, so I might as well use the loo.

Waiting for the nurse so I could use the loo! Gave up and used it anyway, much to her chagrin.

The nurse busted in while I was going (see? Labor is just so not dignified – and yes, I was with it enough to be horribly embarrassed) and chastized me. She told me that needing the loo was often a sign that the baby was coming and she was cross I might have had the baby in the loo. What was I supposed to do? Holding it was not an option!! She had to come quicker if she wanted me to wait! So, she wanted an exam afterwards to see if the baby was coming. So – at 11.15 what amazing progress had I made? 4 cm, maybe 4.5. UGH. Back to labor.

When the nurse left, the contractions got really bad. They just didn’t stop one on top of another. The pain was bad (but I could cope with it):

Ow. Ow. Ow.

Then I needed the loo again. Really, like upset tummy needed to go. I buzzed for the nurse and waited and waited and buzzed and begged them to come (I was close to going anyway, but torn between my discomfort and being told off again!), when she came she wanted me to use a bedpan! No freakin’ way! Gross. So, I pointed out that just a few minutes ago I had been 4.5 at most and so really, no baby was going to be falling out of me. She agreed and let me use the bathroom (although she insisted on being in there with me! When I had an upset tummy! Told you: labor is not dignified).

While in there, I had a mental breakdown. The pain was horrific, and I was not progressing. I could deal with this pain, but given that I was dilating 1 cm every 2 hours, and had 5.5 cm to go – not for another 11 hours. Plus, if this was early labor, how bad would transition be? F that, I’ll take the pain relief. So, I asked for the epidural.

It was administered quickly (within 5 mins) and within 10 I had gone from this:

Ow. Ow. Ow.

To this:

Bliss.

As soon as the epidural had kicked in – about 11.45 the nurse wanted an exam, so they could ascertain in the future whether the epi had caused me to stall. I was annoyed: what was the point? I had been at 4.5 forever, and so finding out I was 5 was not going to help. I acquiesced, a resident Dr was called, and I grumpily let her announce that I was “9.5, maybe more, there was just a lip, and the baby was coming NOW”.

What? What the F-ing F? Some 40 hours to get get 4 cm, then to 9.5 in 40 minutes? So looking back, this:

Ow. Ow. Ow.

was transition. We had been taught in Bradley that transition was the most painful time, and the time the women find it most emotionally difficult and cry for the epidural. Our plan had been for Wes to step in at that stage and talk me out of it.. however, we just had no idea we were in transition. We thought it was too soon. I was annoyed that I had an epidural so late: I was moments away from giving birth when I got it, and most of the hard stuff had been done. I could have had a non-epidural (one can hardly call all the cervadil, balloons and pit natural…) birth, but hey ho. While I was annoyed that we had managed this slightly wrong, I was also pleased that I was enjoying this last stage. Plus, most of my fears about an epidural were unfounded: I could feel my legs, I could use my legs and I could certainly feel the contractions.

The nurse took a picture of us as a 2-some, promising to take the same picture but with the baby between us, when he was out (we never got this latter picture as everything went a bit Pete Tong, but hey ho)

Last picture as a 2-some

Doctors were called, and it was time to push. I declined the mirror and pushed – again, the epidural did not affect my ability to push as I could certainly feel quite a lot. I could tell the nurse when my contractions were coming, and she often had to help me hold off on pushing the urge was so strong, so that I could let the pressure build. Pushing went pretty well, Firework moved quickly – so quickly, they had to chase him with the little monitors.

After about 30-40 mins we could see the head, then poor old FW got stuck 😦 I had been warned about a very narrow pelvis and nothing seemed to get him past it. We tried squat bars, different positions, breaks, laboring down, I even let them get the dratted mirror. After 2 hours of pushing, they called Dr. D. She watched a few contractions and coached me. I actually said “It is OK to use forceps if you need, or cut me” but she didn’t think we needed that yet. She put her hands inside me (owww… just owwww… the epidural seemed to be doing F all at this stage) and said that FW was a slight transverse – he was facing the wrong way (up, not down – ah back labor also explains the yell for the epidural earlier) and slightly sideways. Again, I am grateful I was with the Women’s Specialists, many OB’s would have gone for an emergency C-section at this stage. Not Dr. D. Mindful of my ‘no C-section if possible’ [and now it does seem silly I was so adamant about that] scrawled all over my birth plan, she just turned him manually while he was inside me.

That. Is. The. Most. Pain. I. Have. Ever. Experienced. I swore violently – then apologized. But Dr. D was doing absolutely the right thing, using each contraction and push to slowly stretch me and rotate FW. I began to worry that FW was in danger as his heart rate was dropping, but Dr. D was wonderfully calm. I even said “if you need to do a C-section, do it!” but she said “I don’t need to see him now. I do need to see him soon, but he is OK now” and quietly called some extra pediatricians in. Once Dr D had figured out he was the wrong way and stuck in my weird pelvis it was all quick quick. Another 30 mins or so of pushing, with her help, and my beautiful boy was born:

He was handed straight to me:

and taken off for some checks as he had been stuck for quite a while. All the checks were done in the room, and Wes got to help, although he mostly took photos:

FW had become Sam! The long pushing didn’t affect him at all. He took a while to cry which freaked me out (I got slightly panicked over that) but his apgar scores were 8 and 9 and his lungs, when he decided to use them, were certainly powerful enough πŸ™‚

Sam was little enough that I only had a minor second degree tear which Dr D and an intern stitched up, while Sam was assessed. Sadly, as I was quite ill, I didn’t get Sam back after that 😦 But, that is not this story. This is the story of how the lovely Samuel Clarke Frazier came into the world at 16.32 on November 4th 2012, weighing 6 lb and 15 oz. A wonderful, wonderful day:

39 weeks (really)

39 week bump

Wonder Woman pose

Week 39 and feelin’ fine. I made the point both OBs were slightly skeptical I would make and quite honestly have zero signs of labor. FW is settled down, my body is in the groove of pregnancy. This baby ain’t goin’ nowhere soon (well not for a few days until he is artificially ejected from his home.

39 week bump

39 weeks exactly

After some awesome responses, I am feeling much more chilled and much less anxious about birth. I have heard many, many successful induction stories (by which I mean no C-section). I am also less stressed about a C-section in general and only viewing it with the same apprehension I viewed having my wisdom teeth out with. Plus, turning the corner into the week FW will come has allowed me to focus on that and not the actual birth. Realistically, while the birth can be an awesome positive experience, it is just one day (or three apparently) in the kid’s life. And a day they won’t remember. So, now I am just looking forward to seeing what will happen and going with the flow.

Also, my relaxing was helped considerably by visiting two friends and their 2-week old daughter. While I don’t want to downplay their sleepless nights and adjustments, they were surprisingly… normal. Conversation was surprisingly… normal. Just with a baby there – who they were awesome at handling. I looked around and thought, ‘OK, I can do this. I can picture this life, it is all good’. I think I had heard too much about how simply terrible the first few weeks were, and had started to panic. Both parents were cheerful and engaging and the baby was awesome.

Also, Wes was awesome with the infant. He held her confidently and in a variety of positions, holding conversation and remaining unshaken when she cried. I am not *quite* at that stage. Ahem. In fact, I drove to their house thinking I would politely refuse to hold the girl using one of my usual excuses (‘I think I feel a cold coming on’), but decided that really… a week before my own infant was due… I should conquer this fear. I sat on the sofa and surrounded her with as much body as I could, stared at her nervously, intently and unrelentingly, and looked up with panic when she cried to the amusement of her utterly unphased parents. Yeah, I am sure I will get better at that when I have ‘my own’. πŸ˜‰

Firework is doing well. We went for our very last ultrasound. He is so squished in there (although I do appreciate that he is less squished, due to all the fluid, than most, and thus I am way more comfortable than most women at this stage) it was hard to get a decent picture. We got one, and due to it being slightly creepy I would normally not share it, but it was kind of a special moment. Not only did I actually recognize his face for once, but when it popped up and I said ‘there, I can see his mouth’, he smiled. OK, babies don’t smile yet in the way we do (although that is now being challenged, as is the supposition that they don’t cry in utero) but he did form a smiley face, and it was awesome. I *finally* teared up a little bit at an ultrasound (Wes regularly plays ‘perfect dad’ and gets emotional, but I don’t think I have cried since 12 weeks when they thought they had lost the heartbeat).

FW passed his biophysical with flying colors. My fluid has INCREASED ever so slightly (good grief, up to a princely 26.5) but I have no beef with that – it’s all stations go soon so no point worrying (they put our induction back slightly due to a scheduling conflict).

39 week 4D scan

Smiley boy

For me? I feel absolutely great and can still often forget that I am pregnant. I still run… er waddle quickly… up the stairs. And although tonight I randomly developed an incredibly sore throat I am hoping it will pass ASAP. I realised I never updated the weight progress. 25 lbs, which I guess is about it. I feel neither good nor bad about this – it just is what it is. I am pretty comfortable, walking is fine, I have tonnes of energy. I will miss being pregnant but am not terrified of the postpartum wreck of a body since we saw aforementioned friends at the weekend, and the Mum looked amazingly well and healthy. I am going to miss people’s faces when they stop me in the supermarket / elevator / hallway and ask me when I am due, and I say ‘Baby is coming in 3 days’. Their look of shock is priceless, and I gotta admit, I love when they stutter something along the lines of ‘Wow, you look amazing’. πŸ™‚ I have started to work from home for 1/2 of each day – the Dr recommended I get some rest (Wes all but insisted I get some rest) and it has been nice to transition to that slowly.

Wes is doing well – he is excited to meet FW and get start a new kind of life together. I loved that he went to get himself some T-shirts today and came back with a pack of baby socks because he ‘couldn’t resist’. I love that he is excited.

Parents and godparent are on standby for a call with news and info. And we have the final thing in place before FW was allowed to come: my Ma hand-knitted the most amazing shawl ever. It arrived yesterday (but we didn’t pick it up until today) and is absolutely beautiful. My Godmother knitted me something similar when I was first born and I not only still have it, but absolutely treasured it my whole life. I know FW will love his just as much.

hand knitted shawl

Amazing shawl from my Ma

This might be my last pregnancy post πŸ™‚ See you on the other side.

39 weeks (nearly) and preparing for birth

37 week bump

37 weeks 2 days

Well, hello 39 weeks. And now we have a date, I know I really am in the home stretch. Firstly a big, big thank you to everyone’s support after my last pregnancy update, given in the comments or on Facebook. When I wrote 2 weeks ago, I was very sad about not being pregnant for much longer. Many people were kind enough to write and say ‘I felt the same’ and even – ‘now I am a Mommy I STILL feel the same!’. Everyone adored their babies, but it looks like I would not be the only person to choose the baby and the belly if I could.

37 week bump

37 weeks 2 days

Hearing ‘you are normal’ or ‘your feelings are valid’ made a huge difference. Yes, I remain sad that I have – maximum – 5 more days left to be pregnant (more on that later). But I am much more cheerful knowing that feeling like that is fairly common, and a wonderful life ahead still awaits. I haven’t really addressed the issue further, except in one small way. Mostly, I just chose to be comforted by so many people’s kind words, but I have done a little positive visualization / positive list making about what I am looking forward to about the baby coming. Both have perked me up considerably.

38 week bump

38 weeks 5 days

The other thing I have done, is address my mental issues with the birth a little. I had hoped for a natural childbirth. I was going to fight to go over 42 weeks, if necessary. I wanted to go into labor naturally, to labor naturally, and to birth naturally, if possible. The reason why is not so important (come on, this is the girl who chose Tough Mudder – I like a challenge πŸ˜‰ ), but do know that I recognize natural childbirth as my personal choice – as much for my benefit as the baby’s. Very much ‘each to their own’ and this was my chosen own. However, it looks like things will not go that way. The polydramnios situation is not getting better 😦

38 week bump

38 weeks 6 days. Trying to make it stick out more!

What does this mean? Well, my fluid levels at 25-30 weeks were in the 95th-98th percentile, generally 25-28, but mostly around 25. Average AFI (amniotic fluid index) is 10-14 (dependent on week), and cut-offs for ‘high-risk’can be 20, they can be 25, depending on the country, hospital, person etc. So, I was just on that borderline or just at ‘worrying’ – as Dr Dildy, the high-risk OB put it “You’re not off the charts… you’re just not on a very good position on the charts”. Dr. Dildy said some places would not consider me high-risk, if their cut-off was 25, but Baylor (where he practices) is a little more conservative so does. However, more in a ‘needs to be monitored’ way than a ‘holy crap’ way. So.. they did just that. Monitored me and watched the baby closely with weekly biophysical profiles and all looked pretty good. Plus, we scored cute face pics from our very friendly sonographer. Those who know me well, how much to do recognize the expression below? What Clio calls my locking horns, digging hooves in expression.

37 week 4D scan

Ha! He may look like his father, but he has his Mum’s obstinate expression down to a tee! (37 weeks).

The problem came later on. Usually people’s fluid decreases, starting at around 30 weeks, going from an average of 14 to about 8-9 at 37 weeks. Mine did not decrease at all, it stayed stubbornly at 25. So, as the bell-shaped curve shifted more and more the the left, but my position stayed the same, I was more and more of an outlier. So, technically, I became more and more high-risk. I chatted to no less than 3 OBs (the one I didn’t like, Dr. Dildy who I really do like, and my OB whom I love). I did proper research (i.e. hit up PubMed and read real research papers, not just Google). And I ended up agreeing, of my own volition, that going past 40 weeks was associated with significantly higher risk. Significantly. My OB was actually happy to wait right up until 40 (some would have pushed for an induction at 38-39), so it seemed a good situation, because I felt she was trying to accommodate me and the baby and not just ‘get things done’. Induction is booked for 39 weeks and 5 days from today.

I am still scared of a cord prolapse. Because of all the fluid, the baby doesn’t want to fully settle deep into the pelvis, head down – there is a little gap between his head and the.. er… exit. When my water does break there is likely to be a lot of force to it, both because there is nearly 3 times the usual amount, and because it is under a lot of pressure (think of an overfilled balloon). So, it could force the cord out before the baby, the baby’s head would fall down into it, and the baby’s oxygen would be cut off. In hospital, this would just mean an instant and emergency C-section. If it is before hospital… well… we hope I get there pretty quick. The chances are just under 10% statistically (they are under 1% of you have a normal amount of fluid) so non trivial. But, hence, we hope that I won’t go into labor before the induction, and if I do, at the first sign of labor, rather that waiting at home until I am in ‘active labor’ I am to go straight to hospital. I am as at peace with this plan as I can be.

38 week scan 4D

Sleeping peacefully at 38 weeks. This baby is photographed more than Suri Cruise πŸ˜‰

So, in a nutshell, I have had to prepare for a different kind of birth. That’s OK, but I am someone who likes to be in control of what is happening to my body, and my baby, and generally my life. I am rarely good at handing over large aspects of my life to others and saying ‘OK, do what you will, I will go with the flow’. It tends to leave me in a cold sweat. If I have ever said to you ‘sure, I’ll come over and you can decide what we do / what we eat’ you know I like and trust you a lot πŸ˜‰ So, I have been preparing (for preparing is calming) for other plans.

I have tried to strengthen my uterus to be good at labor, in a situation where it may not be ideally ready: evening primrose oil, raspberry leaf capsules, dates. I have tried to help the baby prepare my uterus / get into a good position when HE may not be fully ready: bouncing on a birthing ball, squatting 20 mins a day, walking. I have been rehearsing birthing techniques for withstanding an epidural because pitocin may lead to a more painful labor than a natural labor (pitocin contractions MAY be stronger and harder, and pitocin, unlike its natural form oxytocin, does not cross the blood-brain barrier and give pain relief).

I am also preparing to be accepting of an epidural: the hard part of labor may be longer and if I need more strength, an epidural may help me conserve my strength. I am preparing not to resist the epidural just to be bloody minded – mainly I just want to resist it to the point where it will not slow down labor. And, I am preparing to accept a C-section with grace (the risk is doubled with an induction), and not feel disappointed, or like I failed, or miserable about it. Just to be grateful that it is an option in this day and age!

Oh, and I am packing my hospital bags! I finally did it last week. For me, 2 bags. One for labor containing snacks, gatorade (YUCK), hairbands, warm socks, snacks, my birth plan, protein shots (old habits die hard), a bikini. Snacks…

All encased in my new diaper bag:

And then for ‘postpartum’, hair & make-up stuff (WHAT? My Mum allowed no cameras into the room until her hair and make-up were done! Seriously!), pads, comfy clothes, reading materials, chargers (phone and iPad) and nipple cream / pads (snigger):

A ‘going home outfit for me (YES I AM GOING TO WEAR HEELS IF IT ISN’T A C-SECTION DAMMIT):

And best, best, best of all. For Firework, a ‘first day’ outfit (a little tiger one) and his going home outfit (Alabama T-shirt and shorts like his Daddy wears) + a random onesie ‘just in case’.

All ensconced in an old gym bag. We also have a much coveted and finally obtained Aden + Anais swaddle blanket, a nursing pillow (coz I just love my boppy) and a going home blanket with little racoons on, given to me by my mentor at work. Of course, these bags are packed for a dash to hospital and a regular birth. If we have an induction, we go in at 8 pm for a special gel, stay overnight, start pitocin at 7 am and keep it going for as long as I and the baby can take without distress (which could be 36 hours, but is likely less). So.. then I won’t have two separate bags. We’ll be less birth focused and more focused on just entertaining ourselves in hospital. If it gets to the day we’ll throw in some puzzle books and more entertainment.

Pretty exciting really.

36 weeks & maternity pics

35 week bump35 weeks

36 weeks – full term to some, but not to others. Which means, 4 weeks to go. Or 3, if my OB has anything to do with it. More on that later.

So, I have been having false labor a good bit this week – honestly? It feels crummy. Feels like moderate period pain, for days on end, complemented by some intense backache and the feeling like someone is stabbing my cervix. Luckily it comes and goes, most days, but it did keep me up from 4 am – 5.30 this morning. Boo. Optimistic that this meant my body was at least ‘preparing’ (I knew it wasn’t labor) I bounced into my OB’s office (actually, I crept in due to said pains) to be told I was 0 cm dilated. My disappointment must have shown in my face as my OB said ‘well, a fingertip, maybe a fingertip’. UGH. All this pain for Jack? I consoled myself with some pic ‘n’ mix. I was ~40% effaced though, and encouragingly, my cervix was ‘very soft’. I have been taking a lot of Evening Primrose Oil, so with absolutely no control group, I will chalk it up to that. That’s a Scientist for ya.

And FW is still head down. Good boy. Stay that way, please.

So, America is famous for not elective C-sections and inductions. I had, all along, been determined to avoid either, but then polyhydramnios reared its ugly head (UK peeps: I did call the NHS and they do check for this in the same way, its just pretty rare so you may not have heard of it). Weekly scans show Firework is fine. I am fine. So, I had hoped it wouldn’t change anything. However, when I casually mentioned it to an OB I was ‘visiting’ she said ‘well, there is no way I would let you go past your due date if I were your OB’. Eh, I didn’t like her anyway. (No, seriously, I really did not, she was way too thin and perky and made up and false be-nailed to be a decent OB. Trust me. Wes liked her, but my women’s intuition tells me otherwise). Ms perky-pants gave me no justification so I promptly forgot about it. And her.

So, I asked my high-risk OB, Dr. Dillard. He said “I wouldn’t let you go past your due date… in fact, I wouldn’t let you go past 39 weeks’. I was kind of upset because I quite like Dr. Dillard. He explained that risks go up considerably after 41 weeks, in a J-shaped curve, and “one could argue” the curve is shifted to the left in polyhydramnios so he’d go for it at 39 weeks. I scowled and pouted. I appreciated some sort of logic, but it didn’t seem like very good logic to me. I mean “one might argue” – WHO might argue? And does the shift to the left include those with birth defects / GD / underlying causes of poly? Which I don’t have? Hmmmmm. He did say “look, no one is going to kidnap you and chain you to a pitocin drip… and I am not your OB…”. Which gave me some hope.

Then I saw my usual OB today, Dr. Boswell. Thing is, I like and trust Dr. Boswell immensely. Most importantly, she looks like an OB should look: all scrubs and glasses and scraped back hair. But, she is also immensely knowledgeable, and very reassuring and genuinely doesn’t believe in intervening unless necessary (plus has a whole load of ‘crunchy’ interventions up her sleeve, which many OBs have not heard of). SHE raised the issue of induction. She said ’40 weeks’ but indicated by her ‘things get much more risky after 39’ that 39 was her ideal. Hmmmm. She did, however, offer very good reasoning. She said that the most common cause of ‘idiopathic’ poly was an underlying blood sugar problem. So, she treats poly patients like sub-GD patients. She said that the risk of shoulder displacement, and still birth went up a lot from 39 weeks. She said the words “if it were me, and my baby, I would go then”. UGH. UGH. UGH.

So, yeah, I do like and trust both Dillard and Boswell, and Boswell gave me pretty good reasons. So, I am thinking of agreeing to a 39 week + 2 day induction. Which is exactly 3 weeks from today. No entirely thrilled, so in the meantime, I am back on anything that might encourage labor. Evening primrose oil outside and in (! – sorry TMI) Dates, and lots of squatting (been a bit lax about that – I’ll go back to a full 25 min squat throughout the daily show). I should walk more. I should. I’ll try. Sigh. Any more tips welcome (I have ruled out pineapple).

Onto happier news – Wes did me a little maternity shoot, at bang on 36 weeks. Here is how it went:

36 week bump

36 weeks

36 week bump

36 weeks

And a spooky Halloween one:

36 week bump

36 weeks

Quite a different size from our 29 week one πŸ™‚ :

29 week bump

29 weeks

Anyone think he has dropped?