Daniel is here!

We have our baby!

Daniel Scott Williamson was born at 11:16am on Wednesday, July 21.  After a 4-day stay in the NICU we got to take him home on Sunday.  More on all that later, but I'm happy to report that he's quite the healthy little boy now. 

We've started to get into a little bit of a routine now at home and I'm starting to see patterns in his sleeping and eating schedule.  I'm home with him during the day but Kevin comes home to see us at lunch and takes a few feedings in a row at night with pumped milk in bottles.  It lets both of us get some sleep and spend some time with Daniel.

Here's a picture of the little guy.  I admit we're slightly biased but I think he's super-cute:

Birth story

So, here's how events played out last week once labor started.  Get comfy, like the labor itself, the story is long!

First contractions

I went to work on Monday the 19th still feeling much as I had the past week or so, crampy but no definite contractions.  That night I felt the first distinct contractions, which started becoming regular around 11:30 or so. I was able to sleep intermittently through the night but not well. The contractions continued on through the morning and I timed them with my handy iPhone contraction timer app...yes, there is an app for that!

Off to the hospital...

As morning turned to afternoon we called our doula, Maria, to come over. She and Kevin rubbed my back during contractions and she suggested some positions that might help speed things along.   I should mention that the contractions were never really that painful, just uncomfortable, mainly in my lower back.  Firm massage and deep breaths really did make them quite manageable.  The main irritation was not getting to sleep.  If I had a pause button so I could get naps in I could have gone on much longer and felt okay.

By around 7 that night I'd been having contractions 1-2 minutes long every 5 minutes for at least 2 hours.  We'd been told to go to the hospital according to the 5/1/2 rule-once contractions were coming at least every 5 minutes, lasting at least 1 minute, for at least 2 hours, so we thought it was time to head in.  I thought after all this time surely active labor was well underway.

However, once we got to the hospital, my midwife, Cecily checked me and found I was only 2cm along. She suggested we walk around the hospital for a few hours to see if we could move things along but alas, I was still 2cm after that. During those few hours though I did manage to eat and then throw up some chicken noodle soup and green jello from the cafeteria, and yes that made a pretty yucky looking mess on the floor.  Green jello might not sound good to me for awhile.

...and back home again

The hospital won't admit a woman until she's at least 4cm, so Cecily recommended that I take an Ambien and go home. She said what I was experiencing was false labor, real contractions that weren't doing anything to dilate the cervix. The Ambien would help me sleep unless the real thing started, but in any event she thought I'd likely be coming back the next morning.  She said we'd know it was the real thing when I couldn't sleep and when I became really bitchy extremely grouchy.  Kevin said I didn't really ever get grouchy, she said, just wait!

We headed home frustrated and tired.  Tired as I was, I couldn't sleep because the contractions kept coming. I was half-asleep so not paying attention to how often they were but it seemed like I'd barely get to lie back down from the hands and knees position that was most comfortable and then they started again. Kevin would hear me moaning and reach over half-asleep to massage my back then fall back asleep again.

After a few hours I noticed an unpleasant side effect, I kept feeling like I had to, um, go #2, but to no avail. That made the contractions more uncomfortable, as if I didn't have enough to worry about with lower back pain now I had this issue to deal with too!

Back to the hospital, Wednesday morning

After a rather sleepless night we called Cecily around 7 and she said to head to the hospital.  After a quick breakfast of a peach, a tortilla with honey, and Gatorade, we were off.  I told Kevin on the way there that as committed as I was to the whole natural birth idea if I was still only 2cm I might have to really consider the epidural, not because the contractions were that bad but because after no sleep in 2 nights I was exhausted!  We had been so optimistic and excited on the way there the day before, but that day I was more tired and frustrated and not really even thinking that we might have our baby within a few hours.  I imagined we still had a long road ahead.

At one point I was in the middle of a contraction and Kevin reached over to rub my stomach.  That did not feel good but rather than explain that in more detail all I could get out was "Don't touch me!"  Kevin later said that was as grouchy as I ever got in labor.

Cecily checked me when we got to the hospital.  I was fully expecting her to say I was still only a few centimeters along so I was surprised and glad when she said I was actually 8cm along!  She predicted Daniel would be born by noon.

We quickly got to a room and Kevin and Maria got to work setting up the birth tub for me to labor and deliver in.  The nurses had me lying on the bed hooked up to a fetal monitor and on an IV for fluids since I was a bit dehydrated.  It was at this point that I experienced one of the hallmarks of the transition phase of labor as I threw up my breakfast.  At least this time it wasn't green jello all over the floor!

Daniel's heartbeat was showing a little low and when my water broke it was stained with meconium, indicating fetal distress, so Cecily called in a NICU team to be ready to care for him as soon as he was born.  Because of that, delivery in the tub was no longer an option but they said I could stay in and push till he crowned then deliver him on the bed.  Before I got in the tub Cecily checked me again to see how far along I was and I was fully dilated and at +2 station so stage 1 labor was over and it was time to push.

Time to push!

We cued up the Push playlist on my iPod and into the tub I went.  I wanted to push as I felt the urge rather than be directed to do it.  I remembered the pushing exercises we had learned in our Bradley classes and once I realized it really was just like trying to have a huge BM I figured out what to do.  The books had made it seem like this was the best part of the labor process because you finally had an active role instead of just withstanding the contractions.  Active maybe, comfortable, no.  Once I really got the hang of the pushing I was making these loud grunting noises with each push, no doubt scaring anyone in the nearby rooms.  Kevin later said I was turning red with the effort too.  I'm sure it was an attractive picture!

At one point Kevin was leaned near the front of the tub and I was in the opposite end and he said "you're doing great, you're really close!"  I thought if he could see something from where he was the baby must be starting to come out so I said "really, I am?"  Later he admitted he didn't really know and I had called his bluff, but then Cecily checked and then showed me I could feel his head.  It felt like a ripe peach, fuzzy and a little soft.  Turns out Kevin was right...lucky guess!

Shortly thereafter it was time to get out of my comfy tub and crawl over onto the bed.  Pushing was a lot harder there than it had been in the tub.  At the end I was sitting up in a modified squat with my back against the raised back of the bed, knees pulled apart and Kevin pushing back on one leg and a nurse on the other. They'd tell me to tuck my chin over my chest to add more power and I asked, how am I supposed to breathe like that?  Answer: apparently, with an oxygen mask strapped to your face.

By now the NICU team was assembled in the back of the room but I don't remember them coming in.  You'd think in such a state of undress that I'd have been very self-conscious every time another stranger came in but I didn't even notice.  You could have led a tour group through the room at that point and I might not have seen them!

After a few minutes Cecily said Daniel's heart rate was dropping and she needed to do an episiotomy to speed things up.  When she said that, I remembered reading that an episiotomy only saves about 5 minutes of time but looking at her face and at the NICU team in the back of the room I knew that was 5 minutes we needed to save.  All these people were there to help Daniel and none of them could do anything for him till I finished my job of getting him out.

Dr. Bradley's book says when the baby's head is crowned the pressure from the head keeps an episiotomy from hurting.  Dr. Bradley is a liar has obviously never been on the receiving end of an episiotomy.  I'm told I had some colorful language at that moment!

And here comes Daniel!

A few minutes later with one last big push Daniel's whole body came out in one big splash- head, shoulders, knees and toes and all parts in between.  Before I could reflect much on the moment Cecily was cutting the cord (which turned out to only be about a foot long) and Daniel was off to the back of the room with the NICU team.  I do remember that U2's Vertigo was playing, and one of the nurses noted that the time was 11:16 am.

With baby out it was time for stage 3, delivery of the placenta.  First Cecily pushed around on my stomach to check for clots, which was as uncomfortable as she had promised.  Then she pulled gently on the umbilical cord and out came the placenta, which looked huge.  With baby, placenta, and umbilical cord everything must have been squished in there like a clown car.  Next it was time for stitches.  I remember my legs were shaking, not because I was cold but just from the exhaustion of it all as if I had just run an all-out sprint. 

Through all of this I still hadn't gotten to see Daniel but they were suctioning his lungs because he was having trouble breathing.  He was crying well though and had good color.  His Apgar scores were 8 at 1 minute and 9 at 5 minutes, out of a max of 10, so he was in pretty good shape.

They swaddled him up and brought him over to me for about 2 minutes then he was off to the NICU.  I had really been looking forward to holding him as soon as he was born and even getting to try to nurse right away, but of course with the meconium problem that wasn't an option anymore.  I'm glad I got to hold him though, and within about 30 minutes the NICU team had taken pictures of him and made them into a little book which was brought down to my room.  I was looking at the pictures before Cecily was done stitching me up.  We got to see him in the NICU within about an hour, but I'll write about our NICU experiences in another post.

Post-game analysis

So, now that all is said and done, knowing how it would all play out, would I still go for a natural birth?  Absolutely!  I wish the whole process hadn't been so long (37 hours or so, but who's counting?), but an epidural on its own wouldn't have sped that up and if anything might have slowed it down.  Pitocin would have sped things up, but if natural contractions were causing fetal distress then the stronger ones Pitocin causes certainly would have.  Maria told me afterward that most OBs wouldn't have sent me home Tuesday night, they would have given Pitocin to speed things along.  Knowing now about Daniel's fetal distress that could very well have led us to an emergency C-section.

And as nice as it might have been to have an epidural during the pushing so I didn't have to feel it, could I have pushed as hard as I needed to to get him out quickly if I couldn't feel myself pushing?  Pushing in the tub would have been out as I would have had to be strapped to a continuous fetal monitor on an epidural, so I'd be pushing on the bed, a more difficult surface, and unable to feel my efforts.  My best chance to get him out quickly was to be able to feel and control my pushes.

Also, after I was done on the bed, I got up and was able to walk unassisted right away, though I did ride longer distances in a wheelchair the first 2 days.  I didn't need a painkiller stronger than prescription-strength ibuprofen either.  And when we decide to give Daniel a little brother or sister in a few years, I'll still have all the options available to me and won't bring in an additional risk factor of a prior C-section.  So for all of those reasons I'm very glad I was able to avoid that.

I'm also glad we chose to deliver at Baylor.  Much as I would have loved a birth center birth it turns out this baby needed to be born exactly where he was, with a Level 3 NICU just 7 floors up.  I'm also happy that I chose a midwife whose judgment I trusted so when she proposed a deviation from the plan, I was willing to trust it and not argue or question it.  Maria told me later that in several births she'd assisted with Cecily she'd never seen her do an episiotomy before so it was definitely not done routinely or for the sake of convenience.  It wasn't in my plan, but it was necessary.  Had she instead said we needed to get to the operating room and grab an OB for a C-section, I'd have trusted her on that too.

While things didn't go exactly as planned, I feel satisfied that we were able to follow our birth plan as closely as possible while taking all precautions to ensure Daniel's safety.  I know there's no medal for doing it all naturally, but if I had gotten the epidural I'd always have wondered whether I could have done it without one.  I don't have to wonder now, and from what everyone says, the second baby is usually easier than the first.  So if I could handle it this time I should definitely be able to do it the next time.

So after all that, now comes the hard part, taking care of a newborn...