Well, the sweeping of the membranes worked! Since coming back from my appointment with Sally at around 4 pm on May 13th I was having intermittent mild contractions. They were nothing major though to make us think we would have a baby soon. I had a lot of energy & accomplished much around the house (see my earlier blog entry). The contractions even slowed down around midnight. When my husband briefly woke up from his sleep & asked me how I was feeling & whether I was still having contractions, I snapped at him not to bug me because they have stopped & I was so disappointed. I fell asleep, but remember tossing & turning often. The strength & frequency of the contractions gradually intensified & by 4 am I could not ignore them any longer. I got up & checked to make sure my hospital bag was packed, then I took a long warm shower & made a split-second decision to wash my hair to be as clean as possible prior to going to the hospital. There was no guarantee I would not end up with another C-section & I realized it could be a while before I washed my hair again. By 5 am the contractions became uncomfortable & I woke up my husband. I could not talk through them any more so we've decided it was time to head to the hospital. I called Sally & she approved of the plan. My hubby's Mom was up to check on me frequently. She prayed fervently for most of the early morning prior to us leaving. I was happy Gerritt was still asleep & we didn't have to deal with his crying as he saw us leave.
The drive to the hospital was easy since there was no rush-hour traffic yet. We found the Family Beginnings Birth Center at the Group Health Cooperative Central Hospital easily & were officially admitted at 5:45 am. I changed into a hospital gown & then sat in bed in a semi-reclined position since the nurse was trying to start an IV. The sitting still was really uncomfortable since my body craved movement, but I was determined to be a good patient. 3 different nurses attempted to start my IV & were unsuccessful. A female anesthesiologist eventually placed one near my left antecubital fossa after applying warm blankets to both of my arms.
After IV placement & drawing my blood for a platelet count, the nurse checked my cervix & announced I was 8 cm dilated. This hasn't surpised me at all since I was 9 cm dilated when I arrived to the hospital while laboring with Gerritt. Apparently, I am blessed to have a high pain tolerance since by the time I think the contractions are uncomfortable, I am almost fully dilated. However, I remember asking about an epidural while the nurse was trying to start my IV. I was told I could have one at any time since an anesthesiologist was available on site 24 hours/day. I just wanted to make sure good pain relief was available should I change my mind while attempting a natural vaginal birth after Cesarean (VBAC).
As my labor progressed, I remember being really thirsty & asking for juice often. I sat on a birthing ball briefly but spent most of my time kneeling on the floor while leaning over the bed. The nurse encouraged me to get off the floor so I was soon kneeling in bed while leaning over the bed's headboard. While resting between contractions I noticed Sally & a midwife student arriving. I was fully dilated at 6:54 am & started pushing while squatting on the bed & leaning over the bar in front of me. Initially, every time the contraction came I would tense my shoulders & extend my body over the bar, so Sally encouraged me to guide my energy downward instead. My bearing down efforts were spontaneous & I was making deep grunting sounds I didn't know I was capable of making. It felt like my body was in an autopilot mode & I was along for the ride since my urges to push & my need to grunt while holding my breath were completely involuntary. My legs started to go numb from the prolonged squatting, so I leaned back slightly & put my feet in stirrups. Every time the contraction came, my legs were flexed & drawn up by the nurse on one side & my husband on the other (to open my pelvis wider). After a while my contractions started to slow down (the resting or latent phase of labor) so I had a worrisome thought about possibly needing a Pitocin drip. I was really dreading it since I knew going "natural" while on Pitocin is not so easy, however, Sally reassured me that even though my contractions were further apart now, they were also more intense & lasted longer. My bag of waters never broke on its own, so I was pushing out what looked like a white balloon thanks to a large mirror in front of me. My Russian labor & delivery nurse (interestingly enough also named Yelena) was joking that Sophia would be very fortunate in life since she was being born "wearing a shirt" (Russian saying "родилась в рубашке"). Finally Sally decided to rupture the amnionic sac so that I could see Sophia's head as she descended down the birth canal. As I pushed with every contraction I saw a small part of Sophia's head. I never thought I would make it that far so I stared in the mirror in front of me in amazement. The lights in the room were dimmed & the only light that was on was aimed at my perineum. The head slid back as each contraction went away, which was disappointing. Two steps back, one step forward... However, after a while Sophia's head did not slide back but stayed down & I was able to touch her hair for the first time. I realized I would be holding her in my arms soon.
The head's crowning was one of the most intense experiences (the transition or crowning phase of labor). I haven't complained of pain up until that moment. As my tissues were stretching to accomodate Sophia's head, I felt intense burning & stinging in my perineum (the "rim of fire"). I remember complaining how much it hurt & that I couldn't go on. When I saw my perineum in the mirror I could not imagine it stretching any wider. I felt a tearing sensations on top near my urethra (at 12 o'clock) as well as at the bottom (at 6 o'clock). Warm wet washcloths applied to my perineum helped tremendously. It was difficult to push against the pain, however, I knew getting the baby out was the only way to relieve it. Sally offered to relieve my pain using a pudendal block & I agreed (pudendal block consists of injections into both sides of vagina to block pudendal nerves). However, by the time Sally opened sterile packages & drew up a local anesthetic into a syringe, Sophia's head was right at the vaginal opening & there was no room at all for Sally to insert a single finger into my vagina, let alone a needle. Sally was massaging the stretching tissues & applying a lubricant. She said that the baby would be born with one or two more pushes, & that's exactly what had happened. I remember having a really strong urge to push & then Sophia's head was out. It happened quickly & I was so shocked I forgot all about the pain. Sally moved the umbilical cord out of the way & turned Sophia's head to the side (she was in occiput anterior position). Sally encouraged me to give another small push & then Sophia's body slipped out at 8:41 am. She was placed on my abdomen & lifted up her head to look at me. A myriad of emotions hit me all at once: surprise, happiness & relief. As my eyes filled with tears, I put my arms around Sophia & kissed her head. I kept saying, "She is here! I can't believe it! I did it!" The nurse was rubbing Sophia to wipe off some of the vernix & to stimulate her breathing. When she started to cry, her color changed from bluish to pink. As blood stopped pulsating through Sophia's umbilical cord, Sally cut it. I delivered the placenta at 8:49 am, & then there was more pain as Sally massaged my uterus to stimulate it to contract thus stopping the bleeding. I didn't like it much & tried to push Sally's hands away unsuccessfully. Thankfully, the bleeding stopped quickly & Sally proceeded to repair my first-degree perineal tear at 6 o'clock. I required a total of 6 stitches. I hardly felt the local anesthetic & stitching as I was so preoccupied studying Sophia's features. She was beautiful & smelled so sweet. I will forever remember that newborn baby smell. The nurse checked her vital signs & measured her. Sophia weighed 8 lbs 3 oz & was 20 inches long. Her head circumference was 14.2 inches. I was on IV fluids with a small amount of Pitocin for about an hour after labor to firm up my uterus, then they were discontinued. Total labor took 3 hours & 4 minutes (counting from the time of hospital admission). Sophia Christine Hong was here at last & we were overjoyed!
Overall, Sophia's birth was relatively fast, easy, & by-the-book, so to speak. It was such a powerful & positive experience. I felt on top of the world & that I could accomplish anything in life. I was happy to have avoided another C-section. I also felt a big sense of accomplishment at being able to have a vaginal birth of my dreams. I had no expectations & did not even write a birth plan this time, so Sophia's birth was a pleasant surpise. Her birth allowed me to heal from the psychological trauma of my last C-section & made me feel complete as a woman. She is truly my miracle baby!
It is difficult to guess why my 1st birth wasn't successful. I ate the same & drank organic raspberry leaf tea several times a day just like I did throughout this pregnancy. The only thing that was different this time was my diligence about my body mechanics. I made sure to never cross my legs & to always widen my pelvis by spreading my legs & lean forward when sitting in a chair starting in the 2nd trimester. I learned about this via the Spinning Babies: a wonderful & educational website designed by a midwife & dedicated to optimal fetal positioning to ease childbirth. One of its principles states that "the baby will always get in the easiest position for birth - whenever the baby finds it possible to do so." A woman's job during pregnancy is to create such an opportunity. I worked on relaxing & stretching my pelvis by doing a prenatal yoga video & pelvic rocking several times a week. I've also learned from the website that the baby's head rotates more easily during birth when the amniotic sac is not broken too soon. Gerritt's labor started with my waters breaking at home. Could it be that his head didn't have a chance for optimal birth position due to an early amniotic sac rupture? Questions, questions...
"I want women to know that if you’ve had a cesarean birth, an induction, or an epidural, that doesn’t mean you’re not going to bond with your baby... or you can’t love this baby, or any of that. Humans are incredibly adaptable. But why adapt if you don’t have to — if you can let your body do what it was designed to do? I believe that the connection between overuse of intervention and postpartum depression is enormous. If women experienced the ecstasy of birth, they would have the high that would get them through the hormonal changes of the next week. Your body and your inner wisdom give you that high." ~ Christiane Northrup, MD, a visionary in the field of women’s health & wellness & a board-certified obstetrician/gynecologist
"Suddenly, through birthing a daughter, a woman finds herself face to face not only with an infant, a little girl, a woman-to-be, but also with her own unresolved conflicts from the past and her hopes and dreams for the future.... As though experiencing an earthquake, mothers of daughters may find their lives shifted, their deep feel...ings unearthed, the balance struck in all relationships once again off kilter." ~ Elizabeth Debold
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