birth story

A candid story (the long version) of how our Tilly Bear made her way into the world....

April 9 at about 3am I woke up thinking my water had broken.  The sheets were wet, but not soaked.  Here's the first bit of comedy for the day- I woke Reg to ask him to smell the bed to see if it was pee. Hey, I hadn't peed myself yet, but figured it was a definite possibility.  Once we decided that no, it was definitely not pee, I realized that I had a new ache in my lower back.  Labor pains?  We weren't sure.  So we sat calmly in bed for about 30 minutes trying to decide if I was in fact in labor.  Finally, I sheepishly called the hospital.  My OB advised me to come in (after I apologized for waking her!).  So we showered (and I shaved my legs, figuring if this was in fact labor, I probably wouldn't have the chance to do that again for some time- and wanted to be as presentable below the waist as possible!), fed the cat, tidied up a bit, and made our way to the hospital at 5am.  On the way we listened to the playlist we had made exactly for this purpose. I had been listening to it on my iPod on my way to every OB appointment, had been singing the songs to Mathilda for months.  The music helped keep me calm for a routine ultrasound and the "real thing".  We did a little rockin out to this song as we pulled up to the hospital- now super excited about what was about to happen!

We checked into triage- by this point I was definitely having contractions, but they were manageable, especially with a light back rub from Reggie.

530am: a triage MD confirms that I'm 3cm dilated, 75% effaced.  Not too impressive, but because my blood pressure and heart rate were unusually elevated and they detected protein in my urine, and my platelet count was low (all new, weird lab results) we were admitted to labor and delivery.

Once moved to our L&D room, we met our amazing nurse, Rhianna (as in the Fleetwood Mac song, Rhiannon, yes, one of my favorites. I took this name as a good omen).  She immediately told us that this was our day and anything that we needed she would try to accommodate- just let her know.  We requested an exercise ball, and one was brought to us within minutes.  Rhianna was calm, but excited for us and made us feel that we could trust her and were in good hands.  I can't say enough about this wonderful woman.  She contributed to making the labor experience the beautiful event that it was.  We had written a short birth plan (avoid medical interventions unless necessary, nurse as soon as possible, ambulate during labor, etc.- basics like that) and she reviewed it with us and was not only into it but completely on board and eager to help make it all happen. She even assisted in some labor poses when it was getting really rough around 6-7cm.

630 am: I am 4cm and 90% effaced.

8am: 6cm, 100% effaced.

The contractions were real now.  They lasted about 60 seconds with a 1-2 minute break between them.  Labor contractions were unlike anything I had ever felt before.  They are like a mountain- you feel them ramping up and up and the pain intensifies, then they hit the summit and begin to ease away.  When a contraction ends you feel normal again, no lingering pain.  I never got into bed or sat on a stationary surface- I cant imagine how people labor holding still.  Reggie and I walked around the room, or I sat on the exercise ball, or leaned into him, always in constant motion.  We used the breathing and positions we learned in Lamaze and in all those months of prenatal yoga.  I cannot stress this enough- those skills were absolutely invaluable.  I felt like together, with Reggie's help, I was able to manage the pain and stay calm.  We had our playlist going on the iPod, the lights dimmed, and it was otherwise nearly silent in the room save our breathing.  I felt like if I screamed or yelled out, I would lose control and not be able to get it back and then really be in pain.

10am: 8cm, 100% effaced.

At this time, Mathilda's head was not nearly in place.  My labor had been fast and furious and we had not received any pain medication yet, but it was looking like our girl was not ready to make her entrance to the world.  As it turns out, my water hadn't broken, so my OB suggested breaking it in order to remove the cushion that may be keeping her suspended higher in my pelvis.  Only way to know if it was her head size or not that was preventing her from dropping down.  Plus, it is the pressure of the baby's head on the cervix that allows for dilation of those final 2 precious centimeters.  Because of the risk of cord prolapse if the baby's head did not drop after my water was broken, my OB suggested I get an epidural so if a cesarean section was needed, anesthesia would already have access. I hesitated a bit, but when the anesthesia team arrived a few minutes later- wow was I ready!  I questioned the doctor's age- and was right- turns out he was only a 2nd year resident.  I asked for a fellow (none available as it was a Saturday) or attending (available, but tied up in surgery) and decided to allow this newbie to go ahead with the procedure.  Pain lets you accept what you would previously have considered unacceptable!  Once the epidural was in place (an absolutely painless procedure by the way, confirming my belief that if you feel it- your labor ain't that bad!) I nearly cried as I was able to speak a sentence without feeling a contraction!  My OB broke my water (also painless and easy) and Mathilda's little head dropped right down into place as hoped for.  The OB said she'd return in 2 hours or so and I'd likely be ready to push, and suggested I try to rest.  We didn't sleep but lay there, listening to my prenatal yoga music, just anticipating our girl's arrival.

12:30pm: no progress.  In fact, not only was I still 8cm, but Mathilda's face was leading the way- not the crown of her head.  Unfortunately, a clear indicator of a need for a c-section.  Determined to do this the natural way, we decided to wait a few more hours to see if she would adjust herself.  And I used the time to check this position in my Lamaze book- which confirmed that yes, must deliver with a surgical birth.  My OB laughed at us and said she knew I'd need time to make these decisions when she overheard me talking about searching for papers on induction for macrosomia on PubMed.

2:30pm: no change.  We agreed to the c-section, called our families, and set off for the OR.

Here's where it gets less than stellar.  Being awake for surgery is awful.  ORs are not friendly or pretty. Having been taken from our warm, dark L&D room to this bright, offensive sterile environment was not fun.  Nor was being splayed out with a sheet blocking my view of everything.  Reggie was there, but positioned in a way that I couldn't see him.  The procedure doesn't hurt, I didn't even feel the pressure they prepared me for.  However, hearing the sounds of surgery, the staff talking, it is very isolating and frankly, scary.  I sang to myself in my head to try to stay relaxed. Beatles songs. blackbird singing in the dead of night, take these broken wings and learn to fly, all your life, you were only waiting for this moment to arise....

Tilly's first photo- she is being held by our wonderful nurse

Mathilda was born at 4:05pm and I immediately got "the shakes" and a feeling of great pressure in my chest and shoulders.  Apparently, this is not uncommon- I started to really shake- my arms, teeth, etc were chattering away.  I could hear Tilly's little cry, the announcement of the time of her birth, her weight and height, but could not see her.  The shaking continued- it was so uncomfortable, I wanted to get out of that OR suite as quickly as possible.

first family photo

Turns out I wasn't done yet. Complication #1- my uterus wouldn't stop bleeding.  They administered multiple medications but apparently to no avail. I could hear them saying the uterine tone was "terrible".  Thankfully, the bleeding stopped, but as a result, my blood count had dropped quite a bit, so I wasn't able to get out of bed for a day.
We were moved not back to L&D but to the PACU with Mathilda.  She was so cute and pink and puffy.  It was surreal.  One moment this creature is living inside of you, and the next, she is a real human, out in the world- breathing, eating, living. I don't think I'll ever get over that.   One of my worries was that we'd have trouble with breast-feeding, and this fear only intensified with the c-section because I couldn't nurse immediately after her birth.  But she was brought to me as soon as we settled into our new room and the nurses suggested I try nursing, which was, thankfully, an immediate success.
Complication #2-  Along with the low platelets, protein in the urine, high blood pressure and tachycardia, I was now having abnormal creatinin measurements, apparently indicating a kidney problem.  I had a 12-lead EKG which revealed my heart was normal, and over the next 12 hours had labs taken about 8 times.  I was now not producing urine, and the other symptoms remained, all a mystery to my doctors.  It was determined that I had likely developed pre-eclampsia or a related, but more severe, HELLP syndrome.  The consequence (other than the already experienced symptoms) of both is maternal seizures. The treatment is large doses of magnesium, which as luck would have it, is a uterine relaxer.  It was determined that the risk of continued uterine hemorrhage was greater than the risk of seizure.  It sounds scary, and my family was justifiably freaked out.  However, by this time we had been up for about 14 hours and had this lovely, perfect baby girl to take care of.  I just wasn't worried by the rest of it.  I trusted my doctors- managing these problems is, after all, their job.  Luckily, within another 24 hours everything had resolved and I was able to go to post-partum, get out of bed, use the bathroom (woohoo!), and enjoy being with our little bean.  And really, she was and is the most perfect, adorable, amazing creation.

And so, lovely Mathilda Frances, arrived to change the world!