Friday, July 24, 2009

The rest of the birthing story

WARNING: Just when you think my blog posts can't get any longer... they do, and this one is even sans pictures! Unless you have some time to kill and don't faint at the mention of blood, this blog post is not for you.

So, ummm, remember how that one midwife accused my placenta of being ground up and lazy? Well, I never liked that story because, with all that my uterus and its associates have accomplished in the past five years, it's probably the least lazy part of my body. Turns out it's not true anyway.

Here's the real rest-of-the-story, for any who haven't become completely disinterested in how that birth unraveled seven weeks ago. **note: this account is not for the faint of heart or weak of stomach. I spare only a few of the, at times, gory details

So. The labor progressed well in the jetted jacuzzi and Kyle and my midwife were by my side assisting in any way I needed. I guess I am an abnormally quiet laborer because they kept calling me an expert or champion and after yawning as a contraction ended the nurse commented that that was the most noise she'd heard out of me the whole time. Anyway, the water and gentle breathing and bearing down worked and after four and a half hours of labor (since the contractions started at home), I declared it time to evict that fetus from his comfortable abode! I recorded in my journal how the last five minutes transpired:

"I pushed as well as I could for four minutes and suddenly felt a gush of effectiveness rush to my perineum—all those previous contractions I couldn’t feel were getting my baby much closer, but I knew they were. All of sudden, though, I felt his head rush to crowning and yes, there was the “ring of fire.” I had pushed them out too fast and fiercely before to ever feel that burn. It was agonizing. I felt the fire and knew I was so close and Becky had the nerve to tell me to hold off for a moment. She was trying to give my skin a chance to stretch, but I thought she was taking crazy pills! This was the only point during the whole birth during which I felt enormous pain and discomfort—so much so that I yelled out in agony, “I can’t do this!” Becky asked Kyle if he wanted to catch the baby but I didn’t give him a chance to answer (I knew he didn’t want to anyway). I really couldn’t “do this” anymore and I pushed once more and out slid his head and shoulders into the water. After she unwrapped the cord from around his neck, the rest of him slid out and a moment later placed into my arms. I had done it! I brought that baby into the world! I was a miracle worker! It was amazing. So empowering. So profound. I gazed at the gooey, purple little bundle of perfection in my arms and looked up at Kyle, eyes brimming with pride and love for me. It was such a wonderful feeling—I can’t express it. Kyle noted later that the song playing during his birth on our cd was “Dearest Children, God is Near You.” And He truly was. The spiritual nature of birthing is undeniable. As I brought one of God’s children from His realm into this world, the veil was very thin. I gave everything of my mind, body, and soul to give him a peaceful welcome to his earthly life, and in the end it was so agonizing that I sincerely felt I could not go on any longer. As soon as that feeling came, though, I was saved from the agony. When I felt I could not bear it any more, I didn’t have to. It was over almost instantly, and then my reward was placed in my arms. If anything was ever a tender mercy, this was. I can’t describe how wonderful it feels to give everything your body and love have to give, sacrificing every comfort and convenience, and know that it is all part of bringing to pass the greatest miracle earthly life offers."

In the midst of soaking up this baby euphoria, I felt a contraction and knew it was time to deliver the placenta. No big deal. It had been a simple afterthought of effort with Ellie and Erik's births. On my first push, however, the bath instantly filled with blood. The umbilical cord clamp popped off at the same moment so I wondered if there was a problem with the cord, but no. I handed Charlie off to Kyle and got transferred from the bath to the bed. The midwife and nurse did not seem at all panicked, so neither was I. They were calm, but clearly acting swiftly. They administered shots of pitocin and I delivered the placenta. But I didn't stop there.

I could tell I was still bleeding in gushes and clots and my midwife said I was okay, but also that she could use our prayers. I was given shots of this and that drug to help contract my uterus and relieve pain. As the bleeding continued, she tried manual compression to apply pressure to the bleeding and manually removed a small piece of placenta. That was excruciating. It seemed the placenta had been completely expelled and my bleeding slowed considerably. I fell asleep, woke up to nurse Charlie, fell back asleep, and woke up yelling for the bean-shaped barf bowl. Why do they make those so small? No fun for Kyle. Or for me. Again I succumbed to that powerfully enticing urge to sleep.

An hour and a half after the birth, I woke up and a couple EMT people had arrived in an ambulance. When I had started bleeding again, the midwife immediately called the hospital. They rolled me onto a stretcher and into the ambulance and through the entire ride, the EMT guy kept bothering me with questions like "How long have you been married?" and other boring stuff I preferred to sleep through, which made him a little panicky or something. My responses were incomprehensible even to me, and I also recall being quite vexed that he kept disturbing my slumber.

Next thing I knew, I was rudely awoken in a bright, claustrophobic room and being attacked from every angle with ivs, catheters, questions about my family medical history, oh yeah, and "manual exploration" of my uterus that left me screaming, writhing, and pleading for drugs to numb the pain. I heard the word "hysterectomy" thrown around and then I was being suffocated by an oxygen mask. I felt starved for air and kept ripping it off. All the while I was yelling for Kyle and my midwife and wondering how they could have deserted me at such a time. The pain was enormous-- much worse than the pangs I had just felt in childbirth. Finally one of the seemingly countless masked strangers hunched over me got around to putting me "under." I readily inhaled the pungent chemical and was out.

A few hours later I woke up groggy beyond any groggy I've felt before (and most of the mornings of my life have been groggy). I managed to request the barf bowl in time and fell in and out of wakefulness for a while. When I was awake, I was hungry, nauseous, disoriented, frightened, and in a great deal of pain. I wanted so badly to know if I still had a uterus and I tried to ask my nurse, but I couldn't even form the words. I spent my awake time praying to fall asleep so I wouldn't feel the pain anymore.

When I woke up overcome by some combination of nausea and hunger ( remember I had completed an incredibly exhausting physical feat during the night and hadn't eaten since dinner), I accepted a saltine from the nurse, but only had the strength to take a nibble or two. Finally Kyle arrived. I was so relieved to see him, although not as much as he was to see me. He showed me our beautiful baby and placed him in my arms, though my arm couldn't nearly support him. I could tell Charlie was hungry but I hadn't the slightest energy to feed him. I was overcome by guilt, hunger, and pain. There was no way I could swallow that enormous ibuprofen and keep it down, though.

I did manage to inquire about my uterus and was happy to hear it had not been removed. If I would've been a little sharper through all of this, I would have realized that of course I still had a uterus because it was the SOURCE of all that pain I was feeling!

During that time I was helplessly fretting, I feared I'd had a hysterectomy, but still knew I'd have to be so grateful that I've been able to have three children already. Of course it would have been a loss, but even in my near-delusional state I recognized that it would have been just fine. I'm glad I didn't know at the time how close I had gotten to losing more than just my uterus.

As the sleepy drugs wore off and I gained enough strength to eat and take pain meds, things only got better. I ended up waltzing out of the hospital (none of that wheelchair business!) even before my 48 hours were up (which is how long mothers with no complications are usually required to stay). I was ready much sooner, but had to wait impatiently for all the cords and tubes to come out first. Even with all that happened, this was a much easier recovery than my other two births, simply because the waterbirth allowed me to maintain an intact perineum. No tearing=happy mom! Truly, aside from the exhaustion (inevitable) and iv pains, I had virtually no afterbirth recovery. Breastfeeding was another story, but at least the birth itself brought no trauma. Amazing.

According to the hospital report, what actually happened with the placenta and why is a complete mystery. My midwife said my placenta was healthy and supple, but inexplicably looked like the placenta of a crack baby. She has no idea why it looked so beat up, nor why a few pieces detached and were retained on the wall of my uterus. My bleeding slowed at the birth center because of the drugs and my uterus working overtime to stop the bleeding despite pieces of placenta that were leaving blood vessels open. Those retained pieces made it quite difficult for my uterus to contract and the blood vessels to constrict. Good ole' uterus did what she could, but eventually wore out and that's when the bleeding recommenced and the ambulance was called.

The surgeons performed a D&C (no, not the holy scriptures!), which stands for dilation and cutterage, which basically means they were using tools to scrape the walls of my uterus. Yeah, definitely felt like scraping. Seven times they scraped, but the retained pieces wouldn't budge. I guess usually it only takes one attempt. That's why we can only conclude that the condition was a more rare and serious one called placenta accreta. They switched tools and finally removed the pieces, but the bleeding continued, so they inserted a balloon filled with enough liquid to put pressure on the bleeding. If this had not worked, they would have had to resort to removing my uterus. By this time, I had lost two liters of blood, which they tell me was about half of my blood supply. Thus the need for all the ivs and a blood transfusion to keep me alive.

Nobody knows why any of this happened or if it will happen again. The good news: I am completely undeterred in my plan to have more babies, and yes-- with a midwife again (I know this midwife saved my life a few times before the docs took their turn--she was as skilled as they come, plus she helped me achieve what was, by far, my best and most beautiful birthing experience). The bad news: I will most likely have to birth in a hospital from now on, which in Utah means no water birth, which means I'll never have a birth experience as comfortable and wonderful as this was. Sad, but okay. All in all, I can only walk away from this experience brimming with gratitude. Life is beautiful. It's precious, it's fragile and, thankfully, it's not over yet!


Bethany said...

Wow, what a scary experience! So strange they never did figure out the reason, but I'm glad you're doing okay.

kamille said...

i LOVED this post. thank you! i love how even after a scary experience, you are so positive. most women would vow to never have another child. i love how you are not letting this experience scar you!

i also loved your description of the birth itself. it made me cry! what a privilege it is to be able to go through such immense pain and sacrifice for our little babies. it reminded me of the Savior and His Atonement. how special it is that we can come close, even if just minutely, to what he did for us. thanks for the reminder!

mmm.chocolate said...

Such beautiful transcendent moments coupled with trauma and pain and perhaps what was the lowest moment of your life too. Tif, I am so happy that this had a happy ending. I can't begin to imagine how frightening all of this was for you.

I had my second without drugs (though in a hospital) and hold this experience as one nearest and dearest to my heart. Even though it was so special to me, I was unable to have the third or fourth drug free. I guess we can't always have exactly what we want with the birth experience. But, they are all just so special. I'm so happy for you that you will always have this heavenly experience in memory and that you were able to record it so eloquently.

Anonymous said...

Thanks for the informative information - I enjoyed reading it! I always enjoy this blog. :) Cheers, [url=][/url]

Anonymous said...

Thanks for the informative information - I enjoyed reading it! I always enjoy this blog. :) Cheers, [url=]vaginal birth video clips[/url]

Anonymous said...

Thanks for the informative information - I enjoyed reading it! I always enjoy this blog. :) Cheers, vaginal birth video clips