fat tuesday... a kind of anniversary

When ever this day comes around I think of sacrifice. And ashes. On foreheads. And the ritual deprivation that cleanses the soul. Not really, I think about the eve of Noah's arrival, that night in the family birth center. But I'll get to that in a minute. A friend mentioned this the other day, it's been baby fever everywhere lately. Congrats new moms, and hang in there mommies to be. So in your honor and because the day brings nostalgia, here's a birth story from an old website. He was born on Ash Wednesday. Sorta gave new meaning to the name Fat Tuesday.

best laid plans
The closer we got to Noah's due date, the less we thought about the problems we had earlier in the pregnancy. Except for the whole cervical incompetence thing, complications were minimal, so it seemed natural to form some expectations.

My birth plan wasn't too complicated. I wanted the support of both Todd and my mom in a natural birth without the aid of pain medication. Timing is everything, though; and we knew if Noah came early, plans might just go out the window.

I had gone back to work on February 10, and the plan was to work part time until the cerclage was removed on March 14. We figured another week or so would follow and Noah would be born. Plenty of time for my mom to arrive, right?

Tuesday morning, March 4, I arrived late to work after a morning of irregular contractions. By 11 o'clock, the contractions were ten minutes apart and soon I was on my way to meet Todd at the Birth Center (a convenient walking distance since I work at the hospital).

I joked a little with the nurse about needing to have the baby on my lunch hour so I could get back to work, but they gave me a dose of something that stopped the contractions. So I went home and Todd went to work. A few hours later, the contractions resumed, but again at irregular intervals. It wasn't until after 10 o'clock that night that I was feeling more than six contractions in an hour, so we got out of bed and headed back to the hospital.

This time, medication didn't work and contractions kept coming. They decided to admit me and remove the cerclage the following morning. There's no stopping this baby if he's determined to come out! Meanwhile, Todd and I waited a few more hours in the observation area. My bed wasn't so comfortable but at least I had one. Poor Todd tried to rest sitting in a chair, curled up on a small bench, even on the floor. No luck. He was exhausted.

early labor
I loved being pregnant with Noah--even with the challenge of bed rest. While I was home, I got a daily dose of Discovery Channel shows like Maternity Ward and Birth Day so between that and the labor and birth class, we were ready for any possible scenario in the delivery room. I just wasn't ready for any of it to happen that day. But there we were, at 6 AM, with a doctor I hadn't met before about to remove the stitch from my cervix. The next instant, it was dilated three centimeters. This is the real thing, alright. Labor officially begins.

We dug in and accepted the situation. True, we got caught off guard, but we might as well go with it. The priority for the moment was for both of us to catch up on sleep. We did just that, resting between contractions.

About eight hours later, when they told us that my cervix was dilated to eight centimeters we expected things to move pretty fast from there. Maybe it was the shift change and the introduction of a new nurse, or just the anxiety of being so close to the delivery, but my labor suddenly slowed. The new nurse was telling me I was only seven centimeters. Deirdre, the resident MD attending my labor, confirmed it.

don't push
They called Dr. Saner, my obstetrician, for instructions and she started me on pitocin. It didn't change much, so soon after, Deirdre came in to break my bag of waters. Still, my cervix had suddenly become stubborn. In fact it appeared a bit swollen as though it might hinder labor a while longer. The next thing I tried was standing, though with the intensity of the contractions at this point, it wasn't comfortable to stand more than a minute. I guess that's all it takes.

By around 5PM when Dr. Saner arrived, I could feel the urge to push intensify, but at last check, my cervix was not in a position for me to start pushing. Each time someone told me not to push, I thought, that's like telling me not to have a heart attack. I went from breathing through the contractions to being overwhelmed by them.

For the next twenty minutes, Todd stood by me massaging away tension wherever he could. At one point, I looked at Deirdre and said "I CAN'T" and she snapped into coach mode, drilling me through breathing and visualizing through the end of the contractions. Meanwhile, Dr. Saner convinced me that an epidural would ease the urge to push. I didn't feel like my body was giving me a choice so I agreed.

An anesthesiologist was setting up outside the door and I was still using all my energy trying not to push. The contractions were coming so close together that I knew my body was pushing whether I told it to stop or not. Again I looked up at Deirdre and shouted, "I feel a HEAD." Dr. Saner seemed to doubt it but checked anyway. The next voice I heard was hers, "Cancel anesthesia, we're having a baby!" Ten minutes and three contractions later, Noah was born.

On the topic of childbirth...
My mom says it was the worst pain imaginable, but it wasn't that bad.
The thought of having my mom attend the birth gave me an extra sense of security. Just thinking of all her experience was calming - so imagine the fear that struck when we realized she couldn't make it in time.
I didn't have time to regret our decision not to find a doula or midwife for labor support. Todd and I were on our own, knowing that my obstetrician would only come in at the time of delivery and that supportive nurses were subject to shift changes.

the resident
Relief came unexpectedly. She was hardly a maternal figure, younger than I am and a first year resident from OHSU. She came in and asked if I would permit her to attend the birth and I almost said no. Even though I understand that medical professionals need opportunities to learn, I wasn't so willing to be a training topic. Still, I considered any extra support at this point most welcome.

The resident, Deirdre, seemed friendly and soft spoken and had attended more than a few births. Most important, her shift started that morning so she was a constant presence, checking up on me until the following morning. We got to know each other during the preceding ten hours of contractions and she never questioned my desire to give birth without pain medication. I really started to appreciate her when labor got more intense and she was there to actively encourage me.
It took about eleven hours for my cervix to dilate eight centimeters, revert to seven, and, after having my water broken and introducing pitocin into my IV, dilating to eight again. Next thing I knew, I was standing and trying other positions that might help labor progress.

It wasn't long before I felt the urge to push but was told I couldn't or my cervix would tear. That's when I couldn't have been more grateful that Deirdre was there, talking me through the last few contractions, helping me fight the intense urge to push. When I thought my body was completely out of my control, she held on and gave me a focal point and just enough strength to get to the end of the contraction.

no coaches here, only active birth partners
If you had asked Todd before the birth if he was ready for the big day, he had no idea. We had gone to our labor and birth classes, read the books, and practiced some relaxation techniques, but was it enough? How would he react under pressure? What if I transform into an ax-wielding, hair-pulling, profanity screaming nightmare wife?

He didn't know it, but he was about to be thrown into action, ready or not. The results were pretty impressive. Todd hung in there, offering support despite the sleep deprivation that started the night before, and he remained attentive through the entire labor.

When we practiced relaxation massage (homework from the labor and birth class), we weren't so sure Todd knew what he was doing. No, really. But as labor progressed, he surprised me with his care. He held my hand, actively listened for what I needed, and was by my side to offer every comfort.

no cell phones in hospital rooms
Just about the only time Todd wasn't in the room was when he was calling friends and family. He would have stayed with me and made those calls but the hospital has that crazy restriction on cell phone use--something about interfering with monitoring equipment.

Most of the nurses didn't seem even slightly phased when Todd used his phone, but maybe that was just because they knew the cell phone nazi was coming on the next shift. As soon as she arrived, Todd had to make his calls out in the rain.