The More You Know...L&D Edition (Part 2)

Now that you know how Superman's birth went, let me tell you how I think it could have gone differently.

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What happened:  I was hooked up to fetal monitoring as soon as I was admitted.

Why I didn't like it: This meant that I was stuck by the monitors the whole time.  I had been able to walk around before I was admitted, but once I had the monitors on, I couldn't.  Walking is supposed to help with dilation and since I wasn't dilating, I feel like I missed out on a helpful strategy. 

What I would like to see happen this time: I want intermittent monitoring so that I can move around, walk, whatever feels right.

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What happened: I couldn't use the tub. The doctor said that I couldn't use it since my water had already broken and there was an increased chance of infection....which isn't true according to the midwife I met with on Monday.  I was allowed to take off the fetal monitoring straps to go into the shower for a little bit though. 

Why I didn't like it:  I think I may be part fish.  I love the water and am so much more relaxed when I am in it.  The shower felt good, especially when my husband put the sprayer on the part of my body where the contraction was, but I don't think it was the same as the bath at all. 

What I would like to see happen this time:  If available, I would like to be in the tub for much of the labor.  Thankfully I have been given permission to stay at home (even once my water has broken, as long as it is clear) until my contractions pick up.  I plan on using our giant tub during this time.  Then once I am at the hospital, I know that the midwives will let me use the tub, as long as it is free. 

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What happened: I got an epidural too early.  I figured there was no reason to be uncomfortable.  If I was eventually going to get one, why not do it as soon as the pain got a little bit much.

Why I didn't like it:  I was only about 3 cm dilated at the time.  The epidural slows things down so I then had to have pitocin to speed things up.   I believe (based on information told to me from a lactation consultant) that the pitocin delayed my milk coming in.  It is merely a speculation, but my gut says that this is correct. 

What I would like to see happen this time: I want help to relieve the pain of contractions without medication.  I am pretty sure I still want the epidural, but I want to wait as long as possible to avoid the need for pitocin.  We were given a bunch of techniques to help with the pain during our prenatal classes with Superman and I am hoping that some of them help.  The midwife will also be there to help make suggestions. 

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What happened: I started pushing when they told me I was 10 cm.  I didn't have the urge to push, but they told me if I wanted to start pushing, I could. 

Why I didn't like it:  There are a couple parts wrong with this.  First, my epidural may have been interfering with my ability to know when to push.  Second, I think I wasn't really fully dilated.  Many women dilate to greater than 10cm and it is more important to wait till you get the urge to push.  Basically I did a whole lot of pushing for no good reason.  That would be like me pushing now, 3 weeks before my due date- it doesn't do anything. 

What I would like to see happen this time: I want to wait till I get the urge to push.  I am hoping to utilize the epidural in such a way that I can still feel the contractions and get the urge to push.  I don't know how realistic this is, but I do know that it is possible. 

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You would think that I might have this very long and detailed birth plan given the fact that I want this birth to go differently than it did with Superman.  Interestingly, my birth plan is going to be pretty simple...with even less on it than I had with Superman. 

Why you ask?  Because last time I had a doctor delivering my baby.  This time I have a midwife.  I made this change just recently thanks to the recommendation of my ob.  She is going to be on vacation around the time when I am likely to deliver so despite the fact that she and I are on the same page (she wasn't the one that delivered S), many of the other doctors in the same office aren't.  Fortunately, there is a team of midwives in the same office.  They meet each week and coordinate regarding the patients that are close to delivering so that I won't hear one piece of information from one midwife and then hear something different from another.  This also means that a whole lot of the things that I want to see happen during labor are standard practice for them already! 

After my last appointment with one of the midwives I am actually excited about this labor.  I can't wait to see how things turn out this time.  While it may not go completely smoothly, I have no doubt that I will have fewer (if any) things that I will look back on and regret. 


So do you have any regrets from your labor and delivery of your child(ren)?   What do you want to see go differently with your next labor?  If things went really well, what (or who) do you credit for this? 

Can't wait to hear from you all!

The More You Know...L&D edition

I already know that this child's birth is going to be different than Superman's birth. It isn't so much that Superman's birth was horrible, but rather that it wasn't ideal.  I have learned about labor and delivery since then and I can see how a few changes could have made a lot of difference in how it went. 

I think it is helpful for me to share Superman's birth story first so that you can understand why I want to see things go differently this time around...so let's start there. 

Superman's Birth Story 

My water broke at around 7:30 in the morning January 1st.  I wasn't really having contractions yet, but when I called the hospital, they told me I should come in.  We took showers, packed the car, and then dropped the dogs off and got some McDonald's before we headed to the hospital arriving about 9am.

When I got there they confirmed that my water had broke (Duh!), but told me that I was only about 2cm dilated.  We walked laps around Labor and Delivery while we waited for our room to be ready.  By about 10am we were in the room.  I wanted to labor in the tub, but the doctor said that I couldn't because of the risk of infection (which is false, but I will go into that later).  Since I was also now hooked up to the IV and fetal monitoring, I was stuck in the room.  To help with the pain and encourage my cervix to dilate, I used the yoga ball and eventually tried the shower (for the pain).  Finally in the early afternoon my contractions started picking up and I decided that since I was planning on an epidural anyway, I might as well get one then before the pain got to be too bad. Unfortunately, it slowed the process down for me and a couple hours later they gave me pitocin to help me progress.  About an hour or two later I began to have some really severe pain in the lower left quadrant of my belly.  It appeared that I had a "window" in my epidural and we needed the anesthesiologist to fix the epidural.  He pulled it out a little bit and the pain went away.

Finally about 8pm they told me I was fully dilated to a 10 and could start pushing if I wanted to.  I (not knowing any better) said, "sure!" and I began the long, long effort to get Superman out.  I felt like I had no idea what I was doing.  I didn't think I was pushing correctly, but no one told me that so we just plugged along.  About an hour and a half to two hours into pushing the "window" came back.   It got so bad that I decided that I was done with pushing and gave up.  S had made zero progress towards being born at this point and I was told that his head was likely stuck on my pelvic bone.

The anesthesiologist came back and the doctor said that I had two options.  Turn up the epidural so I would be prepped for a c-section or try a narcotic.  He asked me if I thought I could push more if the pain wasn't there.  I told him that I thought so.  I can't remember exactly how it went, but basically he gave me 5 contractions to make some progress with Superman or I was going to need a c-section.

I don't know what that narcotic did exactly, but the pain went away, I could finally feel the pressure where I need to push, and S began to make slow, but steady progress.  Despite the fact that it took some time (2 more hours), I felt like I could run a marathon.  I couldn't get over how great I felt while pushing and excited that the end was near.  When he was close to being delivered, the doctor told me that the NICU staff was going to come in for the birth.  He was concerned that 4 hours of pushing had tired S out and they wanted to make sure he was okay (what they told me after he was born was that they were actually concerned that I hadn't been making progress because the cord was wrapped around S's neck. I was so relieved that this was NOT the case).  He told me that if all was well, Superman would be placed on my chest afterward, but if not they would need to take him.  Thank goodness he was fine.  At 12:05am, my husband cut the cord and S was placed on my stomach, where he stayed for the next hour and a half.

Superman did have a fever when he was born, but it was low enough that they weren't too worried.  When they finally gave him a bath, the fever broke, but at that point the pediatrician on-call was already told about the fever and a series of labs were ordered.  For the most part, this was not that horrible, except that they tested his sugar levels and they were low.  They were low again that morning so we were told that we needed to give him some formula to help get them back up.  Superman seemed to hate that stuff so he didn't drink much.  It caused me a lot of stress that morning that they were forcing me to give him formula.  However, in the end I was grateful to have some formula, because we ended up needing to use it to "top him off" on days 3 and 4 because my milk was delayed (did this with the help of a lactation consultant so that it did not impact my milk production- I do not recommend doing this without their help).

Now that you know the story, next up is all the lessons I learned and things I will do differently.  Stay tuned for that post next!!