Birthing Rachel

~ A very long-winded rendition of how our precious Rachel came into this world ~

     One week ago today I was at the doctor's office having my 35 week appointment. We had just had a tour of the obstetrics ward at the hospital the previous weekend, and I was uncomfortable with some of the protocols the nurse had presented us with, so I took the time at my appointment to go over our birth plan with the doctor and make sure he was on board with everything I wanted, as he has the final say over the nurses anyway. (Specifically she had gone on about how all VBACs had mandatory epidurals in case of emergency, after I had expressed that I really didn't want one. Our doctor said that was nonsense and I didn't have to have one if I didn't want it.) I felt very relieved after discussing my wishes with him.
     After a long day of running errands et cetera we came home and I had no energy to cook or eat dinner. We scrounged up something for Laura, and Josh was planning on going out for birthday beers and wings with his buddy later, anyway. Laura went to bed around 9:00pm, and I, exhausted from not sleeping well the previous night, went to bed shortly after. When Josh got home just before 11:00pm I woke up. In a warm puddle. I was confused at first, but then it dawned on me: my water had broken. MY WATER HAD BROKEN!!! I called down to Josh, "I think my water broke - for real this time! [as opposed to when I joked about it on April Fool's Day]." He came upstairs and observed conclusively that, "Yeah, you're soaked." I was wearing track pants that were soaked through, as well as a large spot on the bed. Thankfully I had the foresight to get a waterproof mattress cover a few weeks back in case of this very situation. I went to the bathroom and determined that yes, I was quite sure that this was amniotic fluid. Then I began to panic. It was like all my common sense had left me. We weren't ready for this!  We hadn't even done our maternity photoshoot yet! Or my belly cast! I still had 4.5 weeks left! Our bags weren't packed! What do I even DO right now!? I called my mom. "Mom? I think my water broke! What should I do?!" "Call the hospital?" She suggested logically. "Oh. Yeah. The hospital. Right." So we did. They said not to panic, but to come in to get checked out as soon as we could. I then went into shock... like, the real kind that you get after a traumatic incident to your body occurs. I was shivering and generally a wreck. We debated about going to the hospital in our town to confirm it was indeed amniotic fluid since it would be a HUGE pain to drag Laura and the dogs all the way to the hour-away hospital at which we were planning to have the baby - especially in the middle of the night. However, I was quite confident that I had not merely peed myself. So, we spent the next hour gathering up all the rest of things we thought we needed, and packing bags for Laura and the dogs, etc. We were finally ready to go just after midnight. We had called our doula, too, and she was going to meet us at the hospital.

     Josh dropped me off at the hospital at around 1:30am and then took the dogs and Laura over to my mom's house. Jenni arrived shortly after I did and stayed with me while we waited for Josh to get back. They performed a non-stress test on me and the baby, and I was having contractions already, though I couldn't feel them. They admitted me to the hospital and started me on Penicillin because we didn't know whether or not I was positive for Group B Strep, as I had only just had the swab test earlier that day. Then we waited for me to begin labour on my own. My doctor and I had agreed that I would have 24 hours to start regular contractions before any interventions were employed, as per our birth plan. So, we went to our room and tried to sleep. But it was too exciting for me, and I probably only slept for maybe an hour all night. In the morning my doctor came in and seemed very pleased with the situation. He knew I didn't want to be induced, and he was happy that the baby was a little premature because it would make for an easier vaginal delivery. He was very positive about the whole situation, and even said he wasn't too worried about Baby's maturity at this point and she wouldn't have to spend much if any time in the NICU. Yay! So, he checked my cervix and said I was still locked up pretty tight. That was a little disappointing, but not really unexpected. I had been having contractions overnight, but not at all regularly.
     After we all got some breakfast, we went for a long walk outside to try to get things moving. I had more contractions while walking about, but nothing really seemed to make them come regularly. Jenni decided to go home until things got started, since she wasn't really needed at this point. Josh and I napped a little in the afternoon, and continued waiting. It was rapidly becoming very boring. In between doses of Penicillin we even got permission to leave for a little while and went to have dinner at my mom's and visit Laura. Our doctor came back later and said that we could continue waiting overnight because it was silly to induce labour at nighttime if we didn't have to. Around 1:00am I started having a few somewhat regular contractions. They were about 15 minutes apart still, but were reasonably strong. After I had been having them for about an hour and a half, we told our nurse. She told me to just go back to sleep and save my energy. So I did. And then they stopped again. The next day was already quite busy for the obstetrics ward as they had 3 c-sections scheduled and an induction. They said they would get around to me when they could. I was grateful for the extra time to be able to start labour on my own and told them I was in no rush. By the afternoon of that second day, Josh in particular was getting antsy. We couldn't wait forever as there is risk of infection once the water has broken (especially since we didn't know the results of my GBS test), plus we had the rest of our family to think about. Josh is very anxious in hospitals, too, so when they finally said it was our turn, we took them up on it. It had been about 40 hours since my water had broken, which was far longer than we ever thought we would have been waiting.
     So we gathered up all our things and went down to the labour and delivery room. It took about 4 IV sites before they could get a good one, so we didn't start the Pitocin drip until about 3:45pm. The next several hours flew by. They started me on the lowest dose, and upped it by 1cc every half hour. It took about 2 hours before I was having regular contractions that I could feel. Our nurse felt my tummy and said we had skipped the mild contractions and were into moderate already. I was surprised by this and encouraged because I felt like I was handling them well. I could do this! My mom showed up soon after and took her turn in helping me through contractions. I was feeling them a lot in my back, and it felt great to have someone digging their knuckles into my lower back. Jenni showed up a little while later and my mom left. By then the contractions were becoming much stronger, but at least the nurse agreed and classified them as 'strong'. I was getting to the point of almost not being able to handle them when I noticed a burning sensation. I said, "Ow, ow, it's burning now!" And our nurse, in a somewhat panicky voice asked if it was burning in my back or front.
"In the front, along my scar line."
"Okay, get on the bed right now. We're turning this off."
Eek.
She turned the drip off and said it should be out of my system in about five minutes. She called the doctor to tell him our progress. I think it was around 10:00pm at this point, and we had been labouring for four or five hours. I continued having contractions after she turned it off, however, they were much more manageable, and didn't feel like my uterus was going to rip open. The doctor showed up a little while later to check our progress and discuss options. When he checked me again, he heartbreakingly announced that I had still not begun to dilate. How could I have been having that strong

of contractions - strong enough to cause burning at the scar site - and still not be dilated at all?? I was crushed. Basically our only option left was to go to section. I couldn't keep having those contractions from 0 to 10cm, not if they were already threatening uterine rupture. I had a good cry about it while Jenni discussed with the doctor some of the things I had hoped for should we have to have another section. The doctor agreed to comply with all of them, so I felt a little better after that. We waited in the delivery room for the surgeon to get there, and I continued having contractions, which at that point were just depressing since they weren't worth the effort anymore. Having the half hour to process the situation was helpful, and I felt much better about it by the time it was time to go to the OR. We got all prepped and started the surgery just after 11pm (48 hours since my water broke). Josh was there with me, and was allowed to take pictures. They lowered the drape so I could see the baby being born, which was kind of a blur, but I remember seeing her out on top of my tummy and no one had announced the sex yet!

"What is it? What is it?" I asked.
"It's a girl!" said the doctor, and he and the surgeon held her up.
"Look, there is a true knot in her cord." He added.
I looked over, and indeed, there was a full blown knot in my baby's cord. ?!! "Isn't that dangerous?!" I asked.
"Well... yeah." He replied. "If she had been born vaginally and it pulled tight, that could have been trouble."
Oi.
  So, there she was, beautiful and kicking and screaming, and receiving 9/10 for her first APGAR score. Because she was a month early, there was some question as to whether I would be able to hold her right away, but I really wanted her on my chest, skin-to-skin, if possible. And it was. I was sooo happy to hold my baby right away. This had been one of the most scarring things for me about Laura's birth. She was so little! One of the first things I thought was that she was smaller than Laura. I also immediately thought that she did not look like newborn Laura at all. Her fingernails were long. Everyone in the OR was taking guesses as to how big she was. They all guessed over 6 pounds. Josh's guess was that my uterus' capacity was 5 pounds 14 ounces - Laura's birth weight - and that is why I went into pre-term labour. I agreed.
     After Josh and I both had a chance to hold her and bond with her a little, Josh and she went away. I was given a 'tour' of the placenta afterward, which was something that I had wanted with Laura, but didn't happen, so I was glad I was able to make the specific request this time. It was pretty neat. I really wish we had gotten a picture of the knot in her cord. One of the nurses came back to the OR specifically to tell me that she was 5 pounds 7 ounces and 19 inches long. Longer than her full term sister!
     I went to recovery for a little while and then was wheeled back to our room around 1:30am where I got to try breastfeeding. I was completely
 exhausted after not sleeping well for two nights and also just having surgery, and could barely stay awake. Rachel was spending a few hours in the nursery since she was only 35+6 weeks gestation, so we got to sleep a little. At about 4:30am I woke up and really felt the need to be with my baby, so I asked Josh to go get her. The NICU nurse said she could just stay with us, she was doing completely fine and didn't need to be there. Yay. :)