Labor and Delivery the Second Time

A year ago today, June 13th, I went into labor with the Pookie. I didn't deliver him until June 14th, but in honor of the anniversary of going into labor with him, I finally finished and am posting his birth story. True to myself, it is long and wordy. But hopefully entertaining. While the labor and delivery of the Pumpkin felt like a sitcom, I would say that the labor and delivery of the Pookie was much more of a drama. There was a lot that went on, as I apparently don't have easy labor and deliveries.

After all my back and forth over how I wanted to try to deliver the Pookie, I decided to try for a VBAC. With Londo and our doctor on board, I started to prep for labor. My goal was going to be to go as long as I could without any pain medication in the hopes that that would help me get beyond the 8 cm where I stalled with the Pumpkin. I had hoped that I would be able to labor at home for a good long while. After all, each labor and delivery (just like each pregnancy) is different, right? So what are the chances that my water would break as early as last time, necessitating our heading right to the hospital because I'm positive (again) for Group B Strep?

At 5:30 am on Saturday, June 13th, the Pumpkin came into our bedroom, said "Hi Daddy, hi Mommy," climbed in our bed, grabbed tight to Londo's head and fell back to sleep. Since I was awake, I made yet another trip to the bathroom. When I climbed back into bed, I felt something odd. I thought to myself, "How could I have peed my pants? I just went to the bathroom!" I got back up, felt a little something more, made some sort of frustrated noise/exclamation, and hurried to the bathroom. Londo asked what was wrong. I said, "I think I peed my pants."

But we both knew. Even pregnant, I had not been peeing my pants unless I was sneezing or laughing or gagging (while brushing my teeth--ugh!). But just getting into or out of bed? Nope, that wasn't what was going on.

My water had broken. It was absolutely clear a few moments later. I admitted it to Londo, who had been lying in bed wide awake just waiting for me to admit it. But I did not have any contractions yet. So I wasn't in a hurry, even though I was positive for Group B Strep*. Londo was up and moving as soon as I gave him the word that it was my water that had broken. Londo was trying to hurry me, and I was taking my time. So we were off to a good start. hehe.

First I called the doctor's office, which connected to their paging service. The doctor who was on call was my primary doctor, and he called back promptly--and sleepily. He said to head over to the hospital, as we knew he would. I called my mom and asked her to come over and stay with the Pumpkin until my inlaws could drive up from their house 5-6 hours away. Then Londo called his parents and told them I was in labor and could they come up. This was the plan, so no surprises other than the boy was coming a week early (I was totally expecting him to be late, like the Pumpkin was). I finished packing my bag, while the Pupmpkin watched some TV and Londo got some last minute things.

Once my mom got to our house, we headed to the hospital. As I said, I hadn't been in a hurry and I hadn't rushed my mom either, but I had started feeling the contractions. We didn't get to the hospital until close to 8:00 am, and I was starting to get contractions pretty regularly every 10 minutes at that point. We checked in, and they brought me back to a labor and delivery room. They hooked me up to the monitoring machines, where I stayed for an hour lying in bed.

As I was lying there, my contractions slowed down and came less frequently. Once they let me off the machines, they said it was okay for me to walk around to help the contractions going and the labor into the active phase. I spent the next 6 or so hours walking with Londo around the hospital's third floor, stopping back in the room for 15 minutes every hour to be monitored. We did a lot of walking. My legs were hurting. My feet were hurting. My back was hurting. I was starving since the last time I'd eaten was a couple scoops of ice cream at 8:00 pm the night before**. I'm sure Londo was hurting too, but he didn't dare complain. However, my contractions? They were weak and only regular when I was walking. I still wasn't in active labor. I was in the kind of labor they normally send you home during, except my water had broken so I had to stay there.

Finally, after miles of walking and many popsicles, I was getting regular, strong contractions every couple of minutes. I was finally in active labor and 2 cm dilated. Still, I kept walking as much as I could. At this point, I was just walking around the maternity ward, up and down the same hallway. When my contractions were close enough together that I couldn't go more than a few steps without doubling over in pain, Londo and I thought for sure I must be very dilated. We headed back to the room, in slow painful steps. When my doctor next checked me, I was only 4 cm dialated.

I continued to labor standing and walking around my bed. When I lied down, the contractions slowed, or at least didn't keep progressing. I lied down, stood and walked around that bed for another hour or two. During which I dilated only a half cm to a cm.

At this point, I was so tired and hungry, on top of real strong contractions that made it hard to do anything but lie down. And even though I was barely progressing, the contractions were becoming overwhelming. I went back and forth as to whether or not I wanted an epidural yet. But it came to a point when I was just overwhelmed and asked for the epidural.

The anesthesiologist came pretty quickly. I wish I could say that I was doing better in no time, but I wasn't. Because it only worked on half my body. So my left side felt much better, but my right side was still having intense pain. They had me lie on my right side for a while, hooked up to the machines and in great discomfort, saying that it should help the drugs get into that side of my system. I laid there for a about an hour without it taking on my right side. Londo started insisting that the anesthesiologist come back to see what could be done. I was really concerned about the idea of him taking the epidural out and reinserting it, but the nurse said he might be able to do something else that would help it. The anesthesiologist came back after another half hour, he turned up the dosage on the drugs, and my body was flooded on both sides with sweet relief.

I felt a ton better at this point, but I started wondering if my contractions were slowing down and/or get weaker. When the doctor checked in on us, I mentioned this to him. He showed me on the monitor that I was still having pretty strong contractions. But I was barely progressing. I was 6 cm dilated, and just not getting any further.

When your water breaks, the doctors say that you have 24 hours to labor before they start talking about c-sections. This is due the risk of infection, which increases once the water breaks. In the case of women who have Group B Strep, they have us on antibiotics, but they are still very concerned.

So the clock was ticking. It was getting late at night. I believe it was around 10:30, maybe close to 11:00 at night when my doctor finally said he thought it best to do a c-section. I did not want to hear this, and I questioned him about it. He pointed out that I just wasn't progressing and showing no signs of starting to. In addition, like what had happened in my last labor (though I had forgotten about it until it started happening in this labor), the lip of cervix had been swollen and getting worse. The doctor simply didn't think I would be able to deliver vaginally. But I knew we still had time until the 24 hour mark, so I asked him to give me another hour to come to terms with giving up on my attempt at having a VBAC. I also joked that I was hoping to make it until the 14th, so the baby wouldn't be born on the 13th--an unlucky number and sucky birthday when it's a Friday. He agreed to check back in an hour.

At that point, my inlaws had been with the Pumpkin for hours, and Londo had called my mom to come to the hospital to be on stand by. You see, perhaps the worst aspect of getting the c-section when I had the Pumpkin was the recovery time in the recovery room. Even though I had a nice nurse who checked in on me, Londo was hurried off with the baby to be cleaned off in the nursery and I was left pretty much alone. It was like a desert in my mouth, I desperately wanted to sit up, and I had no idea what was going on with my baby. I didn't get to nurse my daughter until about 2 hours after her birth. It was really an awful 2 hours, I was determined that it would not go like that if I had another c-section. So I had asked my mom to be with me in the recovery room, as well as asked for Londo and the baby to be there so I could breastfeed much sooner after the birth.

Back to the Pookie's delivery... My mom had been in the waiting room for a couple hours. When the doctor left my room, I asked the nurse if she could send my mom back. Once the nurse had finished checking my vitals, she asked my mom to come back. Londo, my mom and I started talking about the impending c-section. I was trying to come to terms with it, but to be honest, I was still hoping for some way out of it. Some way to make the labor progress, either by design or by luck. As I said, I was tired and hungry and feeling kind of woozy. In fact, in the five minutes we were talking, I was starting to feel what I would call a bit delirious.

The doctor came back in the room. I think he'd been gone 10 minutes or less. He looked at me and said, "I can't give you that hour to think about the c-section. You have a very high fever and we need to prep you now."

Apparently, when the nurse was checking my vitals, Londo pointed out to her that I was spiking a fever. When she left the room, she notified the doctor. My fever was 101 point something, and rising fast.

And that was that. I did want that VBAC, and I was so disappointed that I was having another c-section. But let me tell you, I was totally out of it. I felt, well, feverish the entire time they prepped me. All the arguments I wanted to make for the VBAC no longer were significant. I was definitely getting an infection of some sort causing the fever, and I DID NOT want to risk the baby.

It took about a half hour to prep me and get me into the surgery room, which was all a feverish blur to me. When I got in there, my fever was 103.5. Not good. Oh, and I was really nauseous. When they transferred me from the bed they wheel you down on to the surgery bed, I threw up all those popsicle and ice chips. Even though they put the anti-nausea medicine in the IV, I still felt nauseous. And then there were the uncontrollable shivers. Again. This time, they were really bad, probably because they gave me a lot of the anti-nausea medicine. When my doctor was just about to begin the actual surgery, he looked at me over the curtain and asked me to try really hard to control the shivering because they had to start the surgery. I did my best, which apparently was good enough.

Londo was supportive through the whole thing, even though I know he was really worried about me and the baby. You never want to see a loved one with a really high fever, but I'm guessing you especially don't when it's at such a critical time of health for mother and baby.

The surgery seemed to take a long time, and I had troubling going to my happy place in my mind (the beach, if you were wondering). They got the baby boy out, but I didn't hear any cries right away. I asked Londo if he was okay cause I didn't hear him. He said he thought so, was pretty sure. Thinking back, I'm wondering why they didn't announce his birth or in some way immediately assure us he was born and healthy. I don't think they did that for the Pumpkin either, but we heard her right off. I wonder if this is true for all births, all c-sections or what.

Anyway, it was a healthy baby boy! He was born at 12:38 am on June 14th, weighing 7 lbs 12 ozs and 21.25 inches long. We just barely made it to the 14th, and really, it hardly mattered once my fever started spiking.

They cleaned him up a bit, and gave him to Londo, who waited next to me. They closed me up, cleaned up and were just about to take me to recovery when they realized the needle count was off. Did I mention they had prepped the room in a hurry because of my spiking fever? Yeah, well they had written on the board where they track these things that there were 8 needles, yet there were only seven counted after the surgery. GREEEAAAT! There were only 7 needle packages counted, but they still had to be sure. So they called down to radiology to bring up an x-ray machine to make sure there wasn't some extra needle still inside me.

My shivering was dying down, and my nausea was getting better, but I can't say I was comfortable. Still Londo was there with the baby until they finally got the x-ray machine up, which seemed like forever with everyone just kind of waiting there. They took the x-rays, and I had to wait there with the doctor and nurses until they called up the results. They didn't find anything, and I was cleared to leave the room.

They wheeled me back the recovery room, where Londo was waiting with the baby and my mom. That time waiting in the surgery room was actually okay, because by this point I was not shivering and not really nauseous. My fever had come down, and I was able to sit up right away. Londo handed me my beautiful baby boy, and I was able to nurse him right then. If I recall correctly, I didn't realize that they would let me nurse him then, so I was thrilled when the nurse suggested it, adding that there was no rush to get him cleaned up more and didn't I say I wanted to nurse him as soon as possible. Yes I did.

I took my little baby boy into my arms and felt a surge of intense love. I nursed him right away, with him latching on like an old pro. I unbundled his little body from the swaddle so that I could feel him skin to skin. He was one of the two most beautiful things I had ever seen in my life.

Once he was nursed and I had a chance to bond with him, the nurse and Londo took the baby to the nursery to get his bath and do those things they do. My mom sat in a chair by my bed, keeping me company and making sure I had ice chips and a little water to drink. It was so much better than the previous recovery.

When they deemed me "recovered," my mom walked with me as I was wheeled to my own Mother and Baby Suite, where Londo and the baby already were waiting for me. I think it was like 2 something in the morning, and we were all totally exhausted. My mom didn't stay much longer. Then it was us three, in that room together, our family expanded. Our new addition settling in with his parents.

At that time, it no longer mattered that I didn't succeed in the VBAC attempt. My hours of hunger and exhausting walking of the hospital were nothing. My fever was a thing of the past. All of that had brought me my beautiful baby boy.

Worth. Every. Second.

*If you are positive for GBS, the doctors want you to get into the hospital soon after your water breaks so that they can get you on antibiotics. We knew this from the labor and delivery of the Pumpkin.

**I didn't eat before going to the hospital because of the likelihood I would need a c-section. I was not going to chance it considering how nauseous I had been on the operating table when I had the c-section for the Pumpkin.

Three Years Ago Today...

...I went into labor with my firstborn!

Once again, I am going to link to the Pumpkin's birth story, as I likely will every March 10th.

I have so much more to write and say and reflect on and answer from yesterday, but I am absolutely crazy busy at work. It is sucking all my time and brain power. Hopefully, I'll have some time tonight to write more. That is, after I make the cupcakes for the Pumpkin's birthday party at school tomorrow!

Health Care Issues Hitting Home

First, it's the Pookie's 2 month birthday! Things are finally feeling pretty good from my perspective, I hope he feels the same. I'll write more about how we are doing later, but I don't know how long my internet connection will last right now. So this will probably be short. Instead of complaining about the cable company and/or my lame computer, I will touch on my frustration with my insurance company.

When the Pumpkin was born, I had registered for the hospital online before her birth, even receiving a confirmation email. Of course, after she was born, they didn't have my registration information. And the couple of times they came by my recovery room to get the insurance information, Londo was out of the room getting food or something. Londo had the insurance card, and I was in the new mother overwhelmed stage.

The hospital ended up sending the full bill to a collection company instead of following up with us for the insurance information. Because we weren't busy or feeling crazy with our first brand new baby. When I was finally feeling coherent enough to deal with it, I figured out what had happened by talking with a very nice and helpful guy at the collection company. He was instrumental in helping me figure out why the insurance wasn't charged and how to get it run through the insurance. We had to send in a check for the amount of the birth (crazy expensive!!!), but we got reimbursed by the insurance company. Eventually.

This time, I made sure they had our registration and insurance information ahead of time. I didn't want to go through all that again. But of course it didn't go smoothly. Just this morning I had to call the insurance to find out why they weren't covering all of the anesthesia costs that they should be covering. It turns out that the claims for anesthesia were submitted incorrectly. They were submitted as a hospital visit, not under maternity. Huh? Whatever. They are going to resubmit them and pay more on them.

But that got me wondering about the doctor's charges (separate from the anesthesia charge) that we paid as we left the hospital (again to avoid having to deal with all we went through before). I'm guessing that those claims were submitted wrong, too. I am now going to have to call the insurance company again to check the doctor's claims too.

Is this their job? To submit claims correctly? To double check that the claims are correct? To cover our medical bills with as little hassle as possible? Isn't this why we and my company pay so much each month to them? We don't have the money to keep paying out of pocket things they should be covering!

I'm so frustrated, and I'm a little busy taking care of my newborn. Isn't insurance great? Urg!

Announcing the Birth of the Boy!

I'm so happy to announce the birth of my son! He was born Sunday, June 14, 2009, at 12:38 in the morning. He was born by c-section after 19 hours of labor, which begun with my water breaking at 5:30 in the morning, Saturday, June 13. I'm recovering pretty well, but I am exhausted, as is Londo. I will write up the whole birth story at a later date.

He was born weighing 7 lbs 12 ozs, 21.25 inches long. He was born with a bit of brown hair, dark blue eyes, and such an absolutely adorable face and body! He is breastfeeding, pooping and peeing like a champ. He makes the cutest little squeaky noises.

The Pumpkin got to meet him yesterday, and she was thrilled. When she was first brought in, she saw the baby in my arms and said, "Look, Mommy! It's a baby!" I said, "Yes. It's our baby. It's our baby brother." And she excitedly repeated that. A little later, she quite insistently asked to hold him. Londo sat her in his lap and her brother was laid in her lap (though mostly being held by Londo). She kept saying to everyone, "I'm holding the baby!" Or some variation. Then, she did not want to give him up, and threw a fit when we finally told her that her turn was done!

Londo and I are so incredibly happy and excited to have the Pookie join our family. He and I will be heading home tomorrow or the next day. Where the house is almost ready for him.

Feeling Pretty Ready

Now the question of how I we want to try to birth the baby has been settled.

We've finally settled on two names--in fact, we keep coming back to those two names--and both of us are even leaning towards the same one more than the other. We will keep those two as The Names until the boy is actually born, and then we will say for sure that it's one or the other.

We've gotten the changing table into our room and are close to having the space cleared out for the co-sleeper.

The nursery is still in the state of closeness that it's been in since moving the Pumpkin into her new room. I'm starting to try to explain to her that the nursery is now going to be the baby brudda's room. I don't think she quite gets it yet, but I've got ideas for how to help her get it--mostly asking her to help us get it ready for him.

I've been reading tips for how to introduce the Pumpkin to the baby brudda. I'm planning to take her shopping this weekend so she can pick out a present for him!

I've gone through all of the Pumpkin's baby clothes, blankets, swaddles and burp clothes. We have a bunch of gender neutral clothes and a few boy clothes, thanks to my wonderful coworkers who gave me a baby shower last week and thanks to my SIL giving me clothes from the twins (I saved the boy clothes in case I needed them in the future. See how smart I am?). I just need to put them through the wash over the next few days.

I've got to print out and fill in the paperwork for my leave, but I've at least mostly figured out what I need to do, and I have a message in to get my final answer.

Finally, and not less importantly, I got my toenails cut and colored! They are an adorable purple-y pink.

We just need to finish up the setting up and prep more for the VBAC we'll be attempting, and we are ready for the boy! Who I still don't think will come until we rip him out of my abdomen on June 22.

I want to post about the Pumpkin more, because I feel like I'm so obsessing about the boy and his birth. But I suppose that's completely normal, considering my due date is in 15 days! I'll be back to the Pumpkin soon. Cause she is completely adorable and a supergenius!

There Is an End in Sight

And I don't just mean my big hind end!

I have scheduled the C-section for June 22nd, 3 days after my due date. I have been leaning one way, then another, and finally going back to the original plan. And you all have been wonderfully supportive, informative and above all kind throughout my frustrations. A special thanks goes to those of you who have had to suffer through phone conversations with me, which were usually prefaced by, "Even if you don't agree with me, I just need to you to listen and support me." Everyone loves talking to an emotional, hormonal 37.5 week pregnant woman, right?

So if I go into labor before the scheduled C-section, I plan to try for a VBAC. If this one follows the Pumpkin's scheduling skills (she was 10 days late), we will go in on the 22nd to get the boy out. This is the plan. If anyone doesn't like it or agree with it, too bad. I'm done debating, researching and crying (at least over this issue). I will, however, delve into research on ways to improve the success of a VBAC. I fear that the highest chance of success means no medication at all, and I've been planning on the epidural. Oh boy.

Oh, and the scheduled C-section for the 22nd? The only time slot they had left at the hospital was at 3:30 in the afternoon. Apparently, I we waited too long to finalize the decision about the date* and that's all they have. Why is that a problem, I naively asked. Because you can't have ANY FOOD OR DRINK for 8 hours prior to the surgery. Londo tried to be all bright-side about it and said that I'd only be missing lunch. I had to point out that I'd be missing second breakfast, lunch, early/first afternoon snack and all the water and juice that keeps me from being a dehydrated misery. Good times!

The woman who schedules said that surely one of the women scheduled on that day will go into labor prior to that day and I could be moved up. I told her that I hope to be a woman who goes into labor prior to that day. I don't think I will be, but Londo thinks I will. Shall we start a pool for delivery date? I'm taking the 22nd.

*If I wasn't going to try for a VBAC, the doctor wanted us to schedule for the week prior. So we didn't schedule either date until I (yes, I) had made a final decision. Apparently most other people are able to make their decisions earlier.

Re-Planning the Boy's Birth

So I had that whole post about how I was leaning towards trying for a repeat C-section over my original intention of trying for a Vaginal Birth After Caesarean (VBAC). I thank you all for the wonderful responses I received, and I want to especially thank Ruta who gave me some good research which was really helpful and sent me down the right path for looking into both sides of the choice. I'll just say upfront, that we are going back to the original plan of trying for a VBAC if I go into labor prior to my due date. In fact, we will schedule a C-section for 3 days after my due date just to give us a window for trying for the VBAC.

Because the thing about looking into and asking about the risks associated with a VBAC is that you learn the risks associated with a VBAC. If you don't also look into and ask about the risks associated with repeat C-sections, you won't learn the risks associated with those. (This article Time magazine did on repeat Caesareans was really interesting (and spoke in layman's terms), if you are interested in some history behind VBAC vs. repeat C-sections.) Now, I've actually been able to look into both, and I truly feel that the risks are comparable. Let me talk about some of them.

The risk of uterine rupture is not to be ignored when trying for a VBAC. However, my research has now made me pretty aware of what the signs would be, and I do think the doctors and nurses would be able to tell that something unusual is going on. The window for reaction, as Jan commented about, is not a long one. Apparently, this is why the American College of Obstetricians and Gynecologists (ACOG) changed their recommendation from having doctors and anesthesiologists "readily available" to "immediately available." Where I live and the hospital where I will labor and deliver has a doctor from my practice there 24/7 and anesthesiologists there round the clock as well. So they are immediately available, which should cut the risk down.

In addition, there is apparently no conclusive evidence that a larger baby makes the risk of a uterine rupture greater. Although there is evidence that inducing labor can make the risk greater.

The risk of a maternal infection is always higher with a C-section. Although I know stories on both sides of the infection from family members and close friends, the stats show that it's higher with C-section.

The risk of hysterectomy is the same with both. How about that? I never really thought about that risk as something with a vaginal birth, but apparently it is.

Um, that's all I've got off the top of my head (and my memory of a goldfish). But overall, I just feel that there are risks on either side and the risks mostly are comparable based on my eligibility for a VBAC, my going into labor naturally (not induced) and my general health.

So then, it boils down to choice.

Londo is a big planner and wants to minimize serious risks to me and the baby, as well as any discomfort to either of us. He does feel that a repeat C-section would do this. He also feels that the doctors we've talked to and the research he has done supports this. BUT he has said this whole time that it is my choice. I know he will support me in the thick of things even if he would prefer I deliver another way.

So then, it really boils down to MY choice.

It's not just the research that leads me to want to try a VBAC. It is partly what the birth advisor we met at the hospital said: For me, it's less about wanting to try to deliver vaginally than it is my not wanting to go through another C-section if possible. That's absolutely true. Sure, I think the experience of a vaginal birth would be pretty cool, as well as really hard and exhausting. The idea of having my baby right there immediately after birth is so appealing that I just melt thinking of it. Being able to fully experience what my body was built to do also sounds fulfilling to me.

But even more, if I have the opportunity to avoid major abdominal surgery, it's direct recovery, it's mid-term recovery and it's sucky long-term recovery... Well, I'd like to try to avoid it. I've been comparing it to if you had to have major knee surgery, but a couple years later the knee is acting up again. The doctor says that you could try physical therapy and there is a 60-80% that it will be successful, or you could go directly to major surgery again. I think that most people would opt to at least give the physical therapy a try, right?*

Finally, my gut, my instincts, that tell me to try for the VBAC. If it doesn't happen, at least I tried. But I really feel like it's the right thing to do for me.

So the final plan is back to the original plan. We will schedule a C-section for June 22, the day my primary OB is at the hospital. If we go into labor prior to then, we will try for a VBAC. All our family and friends are in on the plan and will move on a dime when we give them the word that I'm in labor, or we tell them that we're heading in on the 22nd for the planned C-section. Either way, we'll get that baby out and have a beautiful boy within the month. Yikes!!!

I doubt anyone read this whole post, but I think this post is more for me to get all these thoughts and feelings on the matter written out more than anything else. I haven't been able to write much lately, and I think it's because I've been holding all this in... Okay, that's not exactly true, because I've been talking about it a lot. But the writer in me needs to write it out. So there it is, and now hopefully I'll be able to write about all the cute Pumpkin things that are going on and how much fun I had at the DC area May meet up!

*I gave this example to my dad, who jokingly said just hop using the other knee. I responded, "Well, I've got only one uterus!" We laughed, but we have the same sense of humor.

Planning the Boy's Birth

I always thought it was crazy to think you could actually plan a child's birth. But I believe in knowing as much as you can about the birth, trying to figure out what you think will work best for you, listening to the doctors/midwifes/duolas/relatives/friends whose opinions you respect, and then going with the flow once the labor process starts. Most importantly, I believe it's so important to be flexible and not be set on how it has to be because babies, your body and nature are going to do what they do regardless of what you expect them to do.

I really believe that my feelings about flexibility and not mentally insisting that labor and delivery had to meet my ideal expectations helped me adjust well to the Pumpkin's labor and delivery. The labor which started with what I had thought were Braxton Hicks until my water broke at the movie theater, continued with 16 hours of labor in the hospital and ended with an unplanned C-section for her delivery. I never mourned "what should have been" or felt robbed of any particular experience. I was truly fine with the whole thing and was simply happy that I was a healthy mother of a healthy baby.

Now that I get closer and closer to my due date (June 19, 2009), I find myself constantly thinking about the boy's upcoming labor and delivery. With this child, I'm at a completely different starting point, as a woman who is pregnant after having a C-section. Right from the get-go, I (with my husband) have a choice to make towards planning my labor and delivery that actually will influence the start of labor: Do I try for a VBAC or just go with a planned C-section?

I've known (mostly online) many women who have had successful VBACs. I thought it would be no big deal, really. It would be something to try, and if I could do it great! If it ended in another C-section, fine. Been there, done that, could do it again. I also thought it was important for the baby to start the process of labor to help prepare him for the world, although I'm not sure where I got that from. So I thought we'd plan a C-section for just after the due date to give us time to go into labor and attempt the VBAC.

So since my first OB appointment with the boy, I've been telling the doctors I'd like to at least attempt a VBAC. Most of the doctors mentioned that there were risks, but it was up to me/us if we wanted to try it. My primary OB, Dr. A, said the same and didn't disparage the VBAC, but something in his demeaner gave Londo and I the impression that he was not a big fan of the VBAC. The only real words of caution he gave was that if this baby looked to be a big one, he would be highly recommending a planned C-section.

Apparently, the risks during VBACs with a larger baby are greater than VBACs when the babies aren't so large. The Pumpkin was 9 pounds, 5 ounces, and both Londo's family and my family tend to have big babies. As Londo pointed out to me, we have to assume this baby is also going to be large based on our history and family history. Londo has voiced to me that he is concerned about attempting a VBAC because of the risks in general and the heightened risk of a larger baby. I said I would look into the risks of the VBAC more and we'd discuss it with the doctors more. I will not make this decision alone because we are a team, and if he is uncomfortable with a VBAC I respect that and will not brush it off. Yes, it's my body. But I'm his wife, and this is his son. What happens to me and this baby is of great concern to him, as it should be.

So yesterday, we happened to see a different doctor at our practice, Dr. W. After the ultrasound (the boy's kidneys still look good so the doctors aren't concerned, and that was my last ultrasound!), we had our appointment with the Dr. W, who delivered the Pumpkin. (We love this guy! We love all the doctors at this practice, but this guy safely got out the Pumpkin!) I told Dr. W, "My husband would like to talk about the risks involved with a VBAC." Dr. W confirmed what Dr. A said about large babies, and he went into the risks specifically.

Apparently, there is a 1 in 100 (1%) chance that the internal scar will rupture. I knew this, but still didn't think there was much to be concerned about. But then Dr. W went on to say that the biggest problem is that they would have very little idea that there was a rupture, because the signs of a rupture? Pain and blood. What happens during labor and delivery? Pain and blood. So how can they tell?

A rupture can lead to many different issues that could affect mother and/or baby. Most of which I can't recall at the moment (I currently have the memory of a goldfish), but the two that caught my attention were possibilities of a ruptured bladder (bladder apparently lies on next to the incision scar or something like that) or need for a hysterectomy. I kind of like my bladder the way it (normally) is, and a rupture of it that they wouldn't even realize happened sounds like it would suck. And I am still hoping to keep my options open for a third child. (I totally forgot to ask what repeated C-sections mean for another pregnancy, but I will next appointment.)

Still, I did not have an easy time of it during the C-section and recovery from it. I start to tear up when I think about having to go through the recovery again: the pain of the surgery, being laid up in bed, the months it took to for the incision to heal, the year or more until the itchiness of the scar started to get better... Well, it just sucked. And that doesn't even include the worst part of my entire labor and deliver, which was being the surgery recovery area for 1.5 hours without my child or anyone except the very nice nurse who was checking on me. That was probably the worst 1.5 hours of my life, and I'm not exaggerating. Some of it was purely my circumstances, such as the nausea during the surgery leading to them not giving me anything to drink for SO LONG even though my mouth was as dry as a desert!

So we talked to Dr. W about planning the C-section and the recovery from it. A main difference from a planned one to an unplanned one is that I wouldn't be exhausted from hours and hours of labor. That is actually a HUGE difference and I think would make the recovery (short term and long term) go so much smoother. Also, they would give me something for the possibility of nausea before I started feeling nauseous. In addition, my mother can be in the surgery recovery area with me, AND Dr. W said that they now do some of the newborn checkup stuff right there where I'd be recovering! I'm pretty sure he meant where I'm recovering from surgery, but we are going on a hospital tour soon where I will find out for sure.

We are giving birth at the same hospital, but now they have Mother/Baby suites where Londo could stay the night while MIL stays with the Pumpkin at our house. No sharing rooms! No waiting on the verge of tears for Londo to walk through the door in the morning! No worrying about how others feel when I have the baby room-in with me! No strangers glancing into my curtain while I try to breastfeed my infant!

Finally, a planned C-section means that we will (most likely) know the date of the boy's birth and make sure everything is in place (this is huge for my hubby who is a total planner). We can set up our support system, make sure that my mom is available to be in that recovery room with me, and ensure that my MIL is at our house (5+ hours from hers) to stay with the Pumpkin. We will (probably) not have to sit around wondering when labor will begin and worry about gushing water somewhere inconvient.

The idea of going through labor again doesn't scare me. I like the thought of possibly delivering vaginally. But the more I look into the risks, the more I look into the benefits, the more I think about our history and the likelihood that my labor will most likely end in a C-section anyway... Well, let's just say that we are heavily leaning towards a planned C-section. My biggest concerns with going through another C-section really seem to be mitigated by the circumstances of planning and the changes at the hospital.

I'm open to any stories, thoughts, ideas, facts, statistics or whatever you guys have on VBACs versus planned C-sections. I will listen to it all. Londo and I need to figure out what is right for us, but as I said in the first paragraph I believe in learning all I can before figuring what is going to work for us. And even then, nature might have something else in store for us!

Flashback to My Birth Story

Two years ago today, my water broke while I was in the movie theater, starting my labor with the Pumpkin. And you thought things like that happened only on TV!

For those of you who haven't read it, or those who might like to re-read it, I will now take you on a flashback to the Pumpkin's birth story that I wrote up last year...

~ dododo ~ dododo ~ dododo ~

Remembering Labor and Delivery

Remembering Labor and Delivery

Please excuse the lack of a Question of the Week this week. This is a very special week for Londo and me, so I'm doing some special things. One year ago today, I went into labor. One year ago tomorrow, our little girl was born. In the past year, our lives changed in ways we never would have predicted. I am feeling incredibly happy, without the words to express it. I'm feeling nostalgic about what happened a year ago (and everything since). I'm also completely amazed that we survived to tell the tale! ;-)

So tell the tale I will. It's long and I'm wordy, so bare with me only if you are up for it. The tale of the Pumpkin's birth is like something out of a sitcom. There is humor, frustration, drama, an EKG machine, a big needle and a knife. And it all started in an unexpected way.

My due date was March 1, 2007. I was prepared for the baby to come late, as I'd heard most first babies do and my mom's kids and my sister's daughter were all late (apparently your labor is often like the women in your family). I just knew she'd be late. Sure enough, my due date came and went with no real sign of labor. I'd had Braxton-Hicks on and off for a while, but nothing to indicate a real labor. As the days passed, I had non-stress tests, another ultrasound, and too many cervix checks.

I was very large, wobbly, tired and a bit cranky (this might be an understatement). But I was willing to wait for as long as I could until the baby was ready to come out. Our doctor would let me go up to two weeks after the due date, but not later. So I agreed to schedule an induction for March 15th. The end was in sight. If the baby didn't come on her own prior to then, she'd be coming out then.

The days wore on. I had been working from home for weeks, uncomfortable at the desk in our office, but at least I was in comfy clothes and not stuck in traffic anywhere. On Saturday, March 10th, Londo and I decided we needed to get out of the house and enjoy our extra days of freedom, and I was going completely stir crazy sitting around waiting for this baby to decide to come. Besides, we joked, one sure fire way to get the baby to come was go out and do ordinary things with friends like have lunch and see a movie.

So we met up with two of our close couple friends for lunch at the nearby diner, dessert at the bakery and then a movie. Walking around, I kept getting abdominal cramps. Braxton-Hicks, I figured. They weren't regular or consistent in any way. Just came upon me when I was walking a lot, so I'd stop and breathe a bit, and then continue on.

The guys really wanted to see 300, but the ladies were not in the mood for such testosterone. So we ladies went to Music and Lyrics. It was very cute, and I was enjoying it. But right at the climax of the movie, just when you know something big is going to happen so that the romantic comedy can end happily, I felt an odd sensation in my pants.

Huh, I thought, I better go to the bathroom and check out what's going on. So I got up quickly, grabbing my purse but not saying anything to my friends. I hurried as fast as my waddling legs could take me down the stairs of the theater. Over halfway down, I felt a gush. That's right, a GUSH! I immediately figured that it must be my water breaking. What the heck else could it be? And all I could think was I better get myself to the bathroom and over a toilet.

Once I was safely on the toilet, completely stunned at what just happened, I laughed nervously and realized the predicament I was in. I hadn't told my friends what was going on, and they wouldn't realize that it was anything more than pregnant woman needing the bathroom. The water kept coming in gushes, especially when I moved, so I couldn't simply clean up and go back out. Even though Londo and I had joked that I should wear a pad in case my water broke, we didn't really believe it would happen, and I had nothing more than a pantiliner on! Stuffing toilet paper down my pants wouldn't last me the time it would take to waddle back into the theaters and find Londo or my friends.

I had my cell phone! Aha! So I text messaged Londo "My w ater broke [sic]" and hit send. Only after I hit send did I realize that I had no reception in the bathroom. Urg! What was I going to do? What could I do. I stuffed as much toilet paper as I could down my pants, and waddled out of the stall carefully. I washed my hands, and the woman next to me noticed my face was all red and asked if I was okay. And of course I told her, "My water just broke. I'm not sure what to do."

She looked stunned but was trying to be helpful. Luckily, my friends entered the bathroom right then. "Are you okay???" They asked. "Yes, but my water just broke!" I answered. They expressed the incredulous disbelief/belief that you'd expect, and they ushered me out of the bathroom, making sure I could walk okay.

I was about to tell them that someone had to get Londo, and there he was standing right outside the bathroom door, anxious and excited. I told him, "My water broke." He smiled, "I know. I got your text message." (Apparently, our phones don't need cell reception to send text messages. Now I know this.) He got it at the climax of his movie, and he and his friends hurried out of the theater. He sent one of his friends to get our car, and the other got the ladies out of our movie (that's why they showed up in the bathroom!). He wrapped someone's jacket around my waist and helped me out to our car. Our friends all laughed at us, and we smiled and waved as we drove off.

We got home, called the paging service for the doctor, called our duola, took a picture of me and my big belly (I insisted on one last picture), called our parents and got our bags ready. The doctor told me to head to the hospital. It was about 4:30 when we got to the hospital. They hooked me up to machines and checked my dilation. Yep, I was definitely in labor and should stay at the hospital. Out of the triage room and into a labor and delivery room. The duola got there soon after we got into the room.

Now, I was not planning on an unmedicated labor and delivery, but because of my Seasonal Affective Disorder and because the due date was early March, I was worried about my energy levels. My biggest symptom from the Seasonal Affective Disorder is overwhelming tiredness, and I did not want to worry about my energy during this very important time. So we got a duola, and it was a fantastic decision. She had been great meeting with us 3 times prior to the birth, and all during the labor and delivery she was such a great support for both me and Londo. I highly recommend getting a duola to everyone!

So let's see. I was doing alright with the early labor in general, I think. We dimmed the lights and put on my favorite playlist on my iPod, which we hooked up to our portable speakers. I had planned to walk around a lot and I definitely wanted to labor in the big tub, since water is such a comfort to me. But every time I got up and tried to walk, the contractions would come more quickly and stronger (very similar to walking around earlier in the day). Just a simple trip to the bathroom for a pee took about a half hour. After using the bathroom and standing back up, I had one contraction on top of another. The duola asked me about the tub, and even though I looked at it with longing, I replied, "All I want to do is go lie down." This was not at all what I thought my laboring would be like, but when you are in the moment, you just have to go with what feels right.

After a while (time lost all meaning), I needed something for the pain, but I wasn't ready for an epidural. As we had talked over with the duola at a planning meeting, I asked for a narcotic. Nothing too strong, but something to take the edge off. Wouldn't you know that this didn't go according to plan either. Later my duola said that she'd never seen anyone have the reaction I did to that narcotic. At first, it did dull the pain enough for me to doze off and get some sleep. But after a while, it just made me feel out of it and unable to deal with the pain I did feel, which was plenty. Oh, and it made my heart rate and the baby's heart rate drop pretty low.

I was constantly monitored now. They said they weren't worried because we both had very regular beats, it was just on the low side, but they wanted to be safe. So they sent for an EKG machine. The guy who ran the machine hooked me up and did whatever it is they do. He deemed me fine, but they kept monitoring me. When a new nurse came on, she said checked the monitor and looked anxious for a minute. Then she said something like, "Oh, right. If the other nurses hadn't warned me that you have a really low heart rate, I would have been worried." At the time, the words meant nothing to me and just rolled over me. Days later, I remembered it and thought that she shouldn't have said something like that to a woman in labor. If the heart rate is so low that it would worry you, why is no one worried? If you aren't worried, don't say anything. But everyone was monitoring me, so I figured as long as it didn't drop much lower or do anything drastic, it was okay. For the record, my heartrate and blood pressure have always been on the low side.

I just was so out of it because of laboring in general, the fact it must have been the middle of the night, and the narcotic's woozy effect on me. My contractions were never regular and consistent the entire time, and I would often have two right on top of each other. They were getting closer together in general. And finally at one point, I had three back to back to back. Londo said he saw it on that monitor thing, that just as one was tappering off, another would hit. Three extremely painful ones in a row, and that was it. I said it is now time for the epidural. Londo nodded. The duola smiled and said it was great that I went as long as I did. The nurse was informed. The anaesthesiologist was sent for.

Londo had to leave the room, which was fine with us both because he hates needles, and I understand that this particular needle is very long. I wouldn't know, because I didn't look. Just numb me, stick me, and make it all better, k? Thanks! And it did get a lot better. You know, everyone said that the bad thing about epidurals is that you can't move around much for your laboring. But I already didn't want to move much for my labor. I was miserable everytime I shifted positions, and forget about walking! That one bathroom trip was way more than enough for me. Another thing people said is awful about hospital births is that you can't eat or drink anything but popsicles and ice chips. You know what? All I wanted in the world was popsicles and ice chips. It was heaven to me, especially because the popsicle sticks had really lame jokes for 5 year olds, which are my favorite kind! Londo and the duola read those to me and cracked jokes for me throughout the entire labor, which is how Londo and I deal with things and it helped a lot.

It was daytime again, and I was struggling along. The doctor checked my cervix and said I was still at 8 centimeters. Still? I had been there for 5 hours! I knew that wasn't a good sign. I looked him in the eye and said, "Are we looking at a C-section?" He said, "I'll give you one more hour to see if there is any progress, otherwise we are looking at a C-section." I asked if I could try laboring in another position, he said he didn't see why not. The position I was in wasn't doing anything. So the duola helped shift me into a squat. My discomfort at moving be damned, I wanted to try everything I could! I knew there were a lot of doctors who wouldn't have let me stall out for this long without already pushing a C-section on me. My doctor was patient and great about it.

But alas, there was no progress after another hour. And at that point, I was done. It had been 15 or 16 hours, and I was exhausted. The baby didn't want to come out, but I told her that we were more stubborn that she was, and if she wasn't going to come out, we were going to go in and get her. Because I was done, and it was time.

The prep was a blur. I remember being in the surgery room, but not getting there. I remember Londo coming in, looking extremely good in dark blue scrubs, and sitting down next to my head. I remember them strapping my arms down (which unfortunately vividly reminded me of the D&C I had for my miscarriage). And I really remember the nausea and the dry heaving and praying that I didn't really throw anything up, because I couldn't move anything but my neck and any vomit would not make it into the small receptical Londo had aimed near me. (I simply can't throw up unless I'm facing down into something.)

Mostly, I remember being scared and knowing that to deal with the situation, I need to go to my happy place. I looked at Londo as they were preparing the area, and I said, "I'm going to the beach, okay?" The beach is my happy place where I go in my head for relaxation and meditation techniques. Londo knows this and knew what I meant. He told me that I should and he'd be right there paying attention to everything. So I went to the beach in my head as much as I could. I tried not to pay much attention to the tugging and the sounds below the sheet which blocked my view. I heard the doctor say, "No wonder you were stalled. I can barely get the baby out through the incision!"

And then, I remember hearing this squeaky little bit of a cry. I turned to Londo, "Is that my baby?" His eyes glimmered, "Yes. It is." I started crying, and I started shaking. My body trembled uncontrollably, and not racked with sobs. It was apparently an effect of the anaesthesia or hormones or a combination. I spent the next however long trying everything in my power to get the shuddering under control. I'm not sure if I succeeded or not. But they did subside mostly. And I did overhear her height (21.25 inches) and weight (9 lbs. 5 ounces). She was a big girl--no wonder she wasn't coming out the natural way!

Then the doctor brought the baby over to see me. Oh my, the most beautiful little thing. All I remember is a red, squishy face, with the rest of her all bundled up. And Londo held her to me. I couldn't move, and there was no nursing her right away. I was still trying to control the trembles and keep from throwing up. Not the most idyllic moment, but such a relief that she was out of me and healthy.

I was taken into recovery, and spent a miserable hour or two trying to feel better. I begged the nurse to sit up a little and for an ice chip because my mouth was drier than I knew it was possible to be! She finally relented and gave me an ice chip. When it didn't make me nauseous, she gave me another maybe 5 or 10 minutes later--time still had no meaning. When that didn't make me throw up and I was feeling a lot better, she let me sit up a bit. I think this was the worst part of it all. I was alone behind a thin sheet partition, a desert in my mouth, a desparate need to sit up, and no knowledge of what was going on with my baby--I hadn't even gotten to hold her yet! I understood why, and I even realized I couldn't hold her or be any use to anyone until I recovered. I knew that my body was in a bad way during and after that procedure. I respect that. And I really wanted Londo to be with the baby, not me. But I was miserable and alone. I drifted in and out of sleep, figuring that was the best way to recover.

Finally, I was good enough. They wheeled me out of recover and down the hall. And who did I see in the hall? My dad!!! They stopped me, and he and my mom hurried over. How was I and how did it go and look through the window, there's my baby and Londo!! They wheeled me to the window, and Londo held up the newly bathed baby. My heart swelled. Okay, I was ready to go in my room so they could bring the baby to me, and they wheeled me in the post-partum room.

Soon after, Londo came in with the baby. Knowing my need was so great, he immediately put her in my arms. Overwhelmed with the urge, without even thinking, I quickly put her to my breast. She latched on like she was born for it (pun intended). Tears streamed down my face. My baby. I looked up at Londo and my heart swelled. I had prepared myself in case I wouldn't bond right away, especially after a C-section. I was fortunate in this regard. I felt the bond with the Pumpkin immediately. It was unlike anything I'd ever felt. She is my little miracle, and that whole labor/deliver/C-section/recovery was nothing, not even a blip, except as a way to bring this miracle into my life.

Worth. Every. Second.