Tuesday, May 31, 2011

Birth Story Part 2: Push Comes to Shove

If you read part one of Snow Pea's birth story, you know that my labor was induced a week after my due date, and that after a slow progression I had reached the point of labor when I was ready to begin pushing.

Once it was confirmed that I was fully dilated, my nurse began focusing her checks on Snow Pea's position. She was at about +1 when I became fully dilated, and things were looking good. The nurse could see my baby girl's head and I was excited when she told us that it definitely was covered in hair! I myself was born with quite a puff of white hair, so hearing my daughter would be too made me feel connected to her, confirming that we had at least one thing in common right from the start.

In addition to seeing all of her gorgeous waves, the nurse could see that Snow Pea was attempting to fit through an opening in my pelvis that was a bit more narrow than her head, which looked like it was beginning to cone in order to fit. Chad was a teeny bit concerned about having a cone-head baby, but the nurse quickly reassured him that her head was made to do this and we could have cute hats on her for pictures for the few days it normally takes for baby's heads to look a little rounder. After laboring down for an hour to give her little noggin a chance to move a bit farther down, I got into position and started pushing.

Contrary to what I have been led to believe by TV and the movies, there was not a lot of commotion during the pushing stage. It was just me, Chad and my nurse. We were actually both surprised by just how relaxed this part of the process really was. There weren't even any stirrups involved. Chad was by side holding my head as I curled my body into each push and my nurse gently tried turning and easing Snow Pea's head down. As they counted me through, I put every bit of focus and energy into sucking in one big breath and holding for a count of ten as I pushed, then blowing it out and repeating it two more times during each contraction. Most of the contractions anyway. Every once in a while we'd take a break so that I could rest or so that the nurse could check in with my OB, Dr Casual, who had been in touch with her all day.

I was doing exactly what I needed to during the pushing and Snow Pea was handling it perfectly, her heart rate never once went outside the guidelines. She was never distressed or tired and neither was I. We were both feeling great. The problem was no matter how well I pushed, or how much my baby tried to wiggle, her head just wasn't coming down. I tried laying on my side for a few pushes, because a change of angle can often do the trick, but that didn't work either.

After almost 2 hours of pushing and another shift change, I got word from my 3rd nurse that Dr Casual had arrived at the hospital. I was shocked and happy to hear he was there. When I had checked in the night before, we had been told that the on-call OB would be delivering the baby and since Dr Casual was not on call that weekend, we probably wouldn't see him at all until my post-natal check up in 6 weeks. But there he was, calmly strolling into the room as if he had been hanging out in the hospital all day. He sat down and casually said "Hey guys, how's it goin?" exactly the same way as he had at the start of every prenatal appointment. We chatted for a bit and then I began pushing again.

After a few pushes, Dr. Casual told me that Snow Pea just wasn't coming down. He said that my pelvic inlet was narrow and my baby's head was not. Further complicating things, my tailbone has a rare trait in that it curves into my pelvic cavity, making the area even narrower and providing a nice bump for Snow Pea's head to get stuck on. Then he and the nurse uttered the word I had been dreading: cesarean. He knew though how much I wanted to avoid surgery if at all possible, and gave me the option of attempting a vacuum assisted birth. My labor was going perfectly and she would just slide out if he could just get her head past the lip that my tailbone had created. I agreed to it and almost instantly the room changed.

The nurse started breaking down the bottom half of the bed as more nurses and neonatalologists began crowding in. Suddenly there were three new people standing around my bed as Dr. Casual attempted to remove the internal monitor that had been attached to Snow Pea's scalp earlier in the day. When the monitor was being placed, Snow Pea's hair had caused some trouble, frequently knocking it loose and setting off the monitor's alarm each time it lost signal. Finally after setting off the alarm at least ten times, a nurse had re-attached it more securely, maybe too securely because now Snow Pea's hair caused trouble again. This time instead of being knocked loose by her mane, it was tangled up in it. Dr. Casual was gently trying to untangle it for quite a while before it finally came free, but not without taking a few hairs with it. We all chuckled at Snow Pea's "first haircut", as Dr. Casual began getting all of his tools ready.

Getting the vacuum into a good position proved challenging as well because of the coning on Snow Pea's head. It works best to have a flatter surface to attach to and more and more of her head was becoming pointy and swollen. Her hair also continued to make things difficult because it was so thick, not the ideal smooth surface for this procedure. But Dr. Casual knew how much it meant to me so he continued adjusting the instrument until he was able to get it right. Then it was time for me to push while he pulled. With the new and expanded team of medical staff in the room, it was beginning to feel and look a lot more like the "holy crap I am about to have a baby" delivery I had seen on TV. Chad was my biggest cheerleader but the rest of the team was also coaching me through each breath and contraction, telling me to "push down through my bottom" and to "get mad". If I hadn't been so focused on what I was doing, I would have laughed. But with the threat of c-section looming over me, I was giving each and every push everything I had.

I could tell that Dr. Casual was doing the same as he tried to simultaneously pull the baby's head down forcefully and gently. There were a few times when we was tugging and the vacuum shot free of Snow Pea's head and sent him flying backward from the force of it. We did quite a few pushes with the vacuum and my army of cheerleaders. All the while I fought back the fear that I was somehow doing it wrong and I was going to fail at giving birth. Finally, Dr. Casual said her head just wouldn't budge despite all of our best efforts and it was time to go into the OR for a c-section.

I couldn't accept it at first. I looked at him pleadingly, begging to try something else. Another position, something, anything to avoid the surgery. He looked at me with a slight sadness and told me this really was the only option we had if I wanted a safe, healthy delivery and baby. Despite all the pushing and even being stuck, Snow Pea had never been stressed. Her heart stayed strong and steady, but the longer we put through this, the more likely she would become distressed. It was better to do a safe, planned c-section now than to keep trying and be in a truly emergency situation. Chad asked one of the nurses what we would be doing had this been the situation outside the hospital or in the 1800s. She replied that we would've kept pushing until a terrible outcome would have ultimately resulted. That was all that he needed to hear to know that he was ok with the doctor's decision. I, on the other hand, was still freaking out in desperation and disbelief that I was being wheeled into the operating room.

But one way or another, it was time for Snow Pea to be born, and I knew that despite how I had wished things would happen, what was most important to me was finally holding my sweet girl in my arms, happy and healthy. So I took a deep breath and signed the consent forms for my c-section. I had been born by c-section nearly three decades earlier, so it looked like being born with a full head of hair wouldn't be the only thing mine and my daughter's births would have in common. And now it was almost time...


Amaprincess said...

Thanks for the reminder that I need to finish mine =) Can't wait to read the rest!

Andrea said...

Great job Mama! You did everything you could! :)

Andie@multiplemama said...

I'm just glad to hear it all worked out! I still remember your tweets about TTC. Such a great ending to your journey! Congrats and hugs.

Alex Wong said...

It includes the birth story part 2 with push come to shove. In addition to seeing all of her gorgeous waves, the nurse could see that Snow Pea was attempting to fit through an opening in my pelvis.

Kevin said...

You have done great job for your chid..

botiquin said...

After reading your blog I remember my mother's prayers and they have always followed me. They have clung to me all my life.I like your blog.

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