Thursday, August 31, 2006

The Birth Story

Promise Grace Stewart’s Birth Story....according to her momma.

Wednesday, August 20, 2008 began a crazy spiral into the inevitable - labor. First it was a lack of sleep...apparently that rush of energy many women get before entering into labor arrived in the middle of the night for me...made sleeping tricky. That morning began the constant rush of soft poopie and bloody show. Not a lot, but I could tell that my days of pregnancy constipation were finally over! As I received a precious package in the mail from my mom and dad full of sentimentalities like my mother’s baby dress, my grandma’s pure silk baby dress and the wee lacy shoes and hat I had worn when tiny, I began to pray this little one would come soon....even though she was really only 36 weeks and 6 days.

Thursday, August 21, 2008 woke me up with contractions 10 minutes apart and significantly more uncomfortable than the Braxton Hicks contractions I had been experiencing since 28 weeks! As I went for the morning pee and soft poopie I was surprised to find my mucous plug on the toilet paper stained with fresh blood. Mmmm. The midwife in me was beginning to thoroughly assess the situation. Contractions had slowed, but the pain resonating in my lower back was incessant. I was curious as to how many centimeters I was dilated determined not to be that annoying “G1 P1” (first baby) preggos that went into the clinic every few hours to check their progress. However, I really wanted to be a part of the whole understand all the “signs of labor” I had been spending the year studying. So I asked my awesome midwife, Lois, to do a quick internal exam to give me an idea of how effaced (thick) my cervix was how far the baby’s head was in my pelvis....the verdict was 2 1/2 cm dilated, bag of waters intact, cervix 30% effaced with baby at 0 station...just at the ischial spines. The good news was that the cervix was really stretchy which could make labor faster....or maybe not in my case. :)

Friday, August 22, 2008
So the night yielded very little sleep...
I was awakened by contractions still 10 minutes apart and by my wee one kicking and scratching my cervix...peeing every hour or so relieved some of the discomfort and pressure, but sleeping was just not an option. So I ate. Then I headed to my scheduled prenatal exams and was also scheduled to do the health teaching on Family Planning. My brain was in the clouds but I managed to pull of 45 minutes of teaching on condoms, the pill, IUDs, and natural family planning giving out condoms and boiled eggs to those brave enough to answer my invasive questions about their sex life. Then I was able to shoot out 6 prenatal exams pausing for contractions until I felt like I needed to poop or puke....I went home at that point. I tried taking a nap, then I tried going for a walk. Then I tried climbing the stairs until Tim came home and rubbed my back, which was beginning to seize. My hips were feeling really sore so pelvic rocking became my best friend. Contractions were intermittent, which actually made me rather upset. More contractions = progressing labor. Lack of contractions = slower labor! BAH! Nonetheless, I was able to get some sleep in between the bloody pee breaks.

Saturday, August 23, 2008
My dear friend, An-An came over with some market groceries and she shared her labor stories (she’s got three beautiful children) and sympathized with my growing discomforts. She was so supportive and encouraging. She was certain the baby would come soon. I was not so convinced.
At 2 pm, Lois came to check me again and I sent Tim out of the house because I could tell labor was much too boring for him. There was really nothing for him to do but watch me ‘kiay-kiay’ (pelvic rock), moan and try to sleep. I felt so bad for him and I knew that once the baby was born, he’d be stuck in the house for days anyways, so he went (because I forced him) to the Kadayawan Festival, a holiday celebration truly Filipino in nature. He took awesome photographs and was followed around by a group of children, picture-takers, and curious onlookers. His every move was documented. He even thought about charging tickets to have his picture taken. He had a great time and it gave him something to do while I was in labor.
Lois checked me while Tim was out. Only 3 cm, but 70% effaced now with baby’s head at +1 station...she was dropping and my cervix was thinning. This was a good sign, but it still showed I had a very LONG wait ahead of me. Ouch.

The evening proved eventful. After an “intimate interlude” with Tim, my contractions became so overpowering I decided it was time to seclude myself in the bedroom. No noise, no distractions. I began to pace between contractions, pelvic rocking was no longer a good coping mechanism. By 5 pm I was having such back pain during contractions that I just couldn’t find a comfortable position for anything. Back rubbing was helpful, but I would ask Tim to rub it so hard that I could feel bruises forming on my lower back. He was such a good support and a trooper! But I was worried as the contractions were not consistent. They were pretty sporadic with some really rough while others just felt like a low back ache you’d have just before starting your period. This was not least from what I read in my textbooks. I have heard of this kinda thing going on for days and days, so I really began to pray. I was already tired, but God was already sustaining me.

My coping strategies changed drastically as labor progressed and by 7 pm, I was ready to sleep, but couldn’t. I gave myself an internal exam and was disappointed to find my cervix still at around 3 cm. I could feel the bag of waters and swept the membranes just to see if I could stimulate more regular contractions and started to do nipple stimulation to get the contractions stronger. It certainly worked! OUCH! I began to feel a little sick in the head, so I had some cereal and tried to stay focused. I texted Lois letting her know where I was at and she volunteered to come and stay the night just in case and noted that she would come over around 10:45 pm.

By the time Lois arrived, I was done. I figured I was only 3 or 4 cm still and was sure that I wasn’t progressing. I had been marching, squatting, lunging and moaning to cope with the pain while Tim worked on photos on his computer and smiled at me with each contraction. What a guy. He eagerly awaited Lois’ internal exam results and we expectantly listened to Promise’s heart beat. Steady at 136 bpm during and after contractions. Good baby. :) Then the internal exam. My skepticism growing, Lois asked me to guess how many centimeters dilated I was. “Ummm, 4?” was my response. Lois smiled and said, “A good, stretchy 7...almost 8 cm!” I started to cry...Tim did, too! We were close. I had been progressing all along! Praise God.

Sunday, August 24, 2008
Lois guessed the baby would arrive sometime during the early morning and suggested I just continue to stay active if I wanted. Tim made me some eggs and I did more lunges. Ate Elai, my other midwife arrived, gave me a hug, we joked and laughed...she went to bed...and then I began to not cope very well. Still happy and hopeful between contractions, all my energy and concentration were spent with each awful back laboring contraction. Nothing I did helped. I was not surprised by this, but mildly concerned that there was no way of stopping this freight train....I was going to have a baby and there was nothing I could do to stop her from descending into my birth canal and out...OUCH. Even those thoughts and every midwifery textbook I’ve read and the 50+ births I’ve attended could’ve prepared me for what was coming. If I had been in a hospital, this would have been the point where I would have not-so-kindly asked for some pain relief....laughing gas, anyone?

Then I hit a quiet point. Breathing deep through sporadic, hard contractions, I began to shake uncontrollably and then SOB...I mean, full out SOB like I had been hit with every emotion of pregnancy all at once. It was like a GIGANTIC release. It felt good and awful at the same time. That lasted a while. The song, “I have decided to follow Jesus” was playing non-stop in my head significantly louder at the part that says, “no turning back, no turning back”....made me giggle, but I realized just how much I needed the Lord to sustain me through this and His grace was the only thing that would guide our baby out. His promise to fulfill.

Then I had to poop. No poop. I gave myself another internal exam as I had just began to feel “pushy”....9+ cm and what I thought was an anterior lip (an area of the cervix not quite fully dilated), but Lois rechecked just to make sure and the cervix was gone....ready or she comes.

I sat on the toilet a good 45 minutes bearing down, but not pushing. The back pain was so intense it took my breath away and made me feel like an elephant would come out my sacrum at any point. I moved to the bed to push...nope...too painful and unproductive...moaning and humming I moved to hands and knees...DEFINITELY NOT....the pain was so harsh I couldn’t push at all. I got up and just did pelvic rocking while Tim squeezed my hips together as hard as he could, his arms trembling to sustain the squeeze. It helped a ton. But the pain was still excruciating...or so I thought....then it came time to REALLY push....I mean PUSH the BABY OUT....ummm. This is point where I began to say to Lois, “I can’t do it...I am too tired.” Encouraged by Ate Elai, Ate An-An who arrived earlier, and Lois, Tim got behind me and put his strong arms underneath my armpits to support my squatting to push. At the foot of the bed, I relied on Tim’s strength to hold me up while we prayed between each contraction and I screamed during each one. Each push felt like it was doing absolutely nothing. So I had to check after each good push to see if the baby was coming. After one disappointing hour, my water broke like a water balloon hitting the tile floor....Tim laughed. The fluid was clear, praise God. Baby started coming harder, lower, the pain worse...the pushing demanding to be more productive....harder and harder contractions came threatening to take every breath out of my body. My grunting became stronger and breathing through a contraction became a luxury.

My companions nodded approval with each push, encouraging me to push on and breathe through between contractions. An-An commented that with each push of mine, she was pushing, too! You could feel a strange force in the the inevitable coming....then I puked. Twice. Just Gatorade. Not so tasty. An-An gave me some water and I washed my mouth out...we were all good.

At one point, I remember squatting barely on my tip toes, my feet leaving the ground once or twice, Tim using all his strength to support my downward force. Lois informed me that the baby’s head was now visible, just slightly. I immediately went down and pushed again grunting through determined to get more head out...the hardest part was text book told me that. I was not surprised at the pain, I was surprised at how difficult it was to push effectively through the pain. The agony was just so debilitating! But as the baby’s head began to come and pass the pubic bone, there was a strange release and the pushing was just a little easier. In fact, I could feel she was coming so I put my hand down there to feel her head...warm, squishy and wrinkled, her head was 3 cm visible without pushing and I could begin to feel my perineum bulge producing a strange, painful burn. Pushing slowly, so as not to tear from the inside out, her head continued to come and just like all the textbooks said, the “burning ring of fire” began....little more head visible .....more burn...this is literally where I bursted into Johnny Cash’s classic....I did! It’s true. Singing in my moans was actually quite helpful! And then Lois announced, “Crowning! Slowly....slowly.” Breathing through each slow, small push eased my little one’s head out until I felt an enormous pop and release. Her head was out! And just a second or two later at 6:48 am, I pushed her body into the arms of waiting Lois, her body a tiny, grey and slimy mess. Tim began to laugh and I couldn’t stop saying, “my baby, my baby, it’s my baby!”

Lois handed me our little girl and we dried her off with special towels that my dear friend, Laura had given me. I semi-sat down on the tile floor with Tim supporting me from behind while we continued to marvel at this perfect little munchkin breathing totally on her own with just a little mucous in her nose and mouth. She coughed and sputtered and cried just enough to announce her arrival. She settled into my arms and we all gasped at how tiny she was. Lois asked me to give her the Apgar score. I got to say, “apgar of off for color, one off for cry, one off for muscle tone”, but by 5 minutes after birth, she was a 10. Perfect. Tim began to cry and the following moments were filled with examining our new little person. She was beautiful! We were surprised by her red hair, Tim’s shaped eyes and brows and my mouth, nose and ears.

I pushed out the placenta...Duncan style (the maternal side up) with some trailing membranes. Still holding our perfect goober, Lois and Ate Elai check me for a tear. Yup, a small one. First degree in the vaginal mucosa and lower labia. Just a small one. But it did need suturing. I was disappointed, but not too much. :)
Tim cut the umbilical cord, wrapped our precious one up and I moved to the bed to get comfortable. I was so incredibly stiff, but all the pain I had experienced was completely gone! Even the back pain subsided drastically! The only pain was in my area of tearing! Ouch!

Promise Grace immediately found my boob and started to suck. Hard! Owie! But I was so happy she was able to breastfeed without any problems. Ate An-An, Elai and Lois began to clean up the birth area and prepare me for suturing. I handed Promise to Tim and he and Lois bathed, clothed and examined her. Everything perfect. No problems, definitely only 37 weeks and two days old at her birth, but healthy, strong, and beautiful.

Ate Elai sutured me using a 2-0 vicryl. Fifteen minutes later, I was holding our little girl again, drinking MILO (it’s like the Filipino version of Ovaltine) and eating a bowl of cereal. Suturing was NOT fun. I had asked Ate Elai to explain to me every stitch she was taking and we discussed the procedure knowing that I had just completed my suture class just weeks prior. It was serious experiential learning! And painful! I have way more compassion for my patients now! I certainly won’t be riding any jeepney, tri-c or hobble-hobble anytime soon! How DO they do it here??

Ate An-An ordered McDonald’s delivery for breakfast as I was craving sausage Mcmuffins with egg...the breakfast of champions! And I took a nice long warm shower without getting dizzy (I’d only lost 100 ccs of blood) and slipped into not-so-sexy postpartum panties.

We all sat on the bed taking pictures, eating, weighing the baby (5 lbs, 10 oz.), getting a set or two of footprints and talking about the faithfulness of God. I wasn’t tired at all even though Promise was quite willing to sleep. Even Tim was able to doze a bit. I took some arnica, ibuprofen, and a tall glass of water and tried to forget the pain of delivery and the growing pain where I tore. Happy to be done, grateful to the Lord for 51 hours of labor finally over, holding on to the perfect fulfillment of God’s promise to us years and years ago.

The first three days after delivery were great! I was full of energy and got a lot done! We had visitors and even went to a friends house for dinner the day after delivery! Then, by day four, I hit a wall. Completely exhausted, struggling through breastfeeding, my milk coming in with a vengeance and two torn, cracked nipples. I thought I was going to die!

But here we are at day 6. My tear is healing. The blood has slowed. I am tired, but have great moments of energy. I leak wherever I go. Promise is fantastic and growing. She was already 6 pounds yesterday...never lost an ounce! Too small for her cloth diapers and newborn clothing, but she is a BIG eater and so very beautiful. I may never want to go through delivery again...adoption is looking far more likely than ever before! But besides this precious gift, I learned so much about midwifery, our patients in the clinic and the areas in which I lacked grace and compassion for my patients. I also became aware of the areas in which more warning and teaching are required when doing prenatal exams and in health teaching. I will never midwife the same way, I will never see myself or my husband the same way, and I will never look at another pregnant woman the same. What a journey. The thoughts and emotions vary from day to day, but the facts remain the same....the Lord allowed me to deliver a perfect baby. He gave me the strength to push when I had nothing left, and He lavished His love on me with this beautiful gift and an incredible and supportive husband to share it with.