Birth story - Part 2

I guess I've sort of built this post up a lot. So I should let you all down slowly... This post isn't going to be as exciting as it initially may have sounded. That being said, this post is very important to me. To be honest, this isn't something that women typically talk about. It's okay to talk about long and difficult labors, c-sections, hemorrhaging, NICU stays for infants, and the complications that follow these types of deliveries. It seems to me, however, that our society is less comfortable talking about what I went through. And so, in honor of this blog - talking about such forbidden things (mental illness) -  and because I think that this was one of the triggers to my own depression, I'm going to tell you about what happened after our sweet baby girl was born.

When my doctor spoke next she said "Christie, you've torn. I need to check you before I get the gynecologist on-call to do the repair." This didn't really surprise me, I always knew I would tear. I figured it would be a second degree tear, but the fact that she would need a gynecologist to do the repair surprised me.

"How bad is the tear?" I asked.

"Third degree," she replied.

Okay, worse than I thought, but not as bad as a fourth degree tear, I can live with that. The gynecologist came in and examined me as well. That's when my second "REALLY? NOW?"-moment happened.

"I'd like to give you some Fentanyl while I repair your tear," She said after examining me.

"REALLY? NOW??" I've just gone through my whole labor and delivery without a drop of analgesia, and now you want to give me a pain-killer? I thought about how stupid that was: I'd specifically gone through labor without anything, for my child's sake. Now it was going to be all for naught, because they wanted to give me a strong narcotic that would pass into my breastmilk - albeit in very tiny quantities - anyway. I tried to say "no" but they insisted that it would be very painful and that a narcotic would be beneficial. "Aren't you going to give me a local anaesthetic anyway?" I asked.

"Yes," she replied "but it isn't going to help very much at all"

I gave up and let them push 100 mcg of Fentanyl. She was right. Even with the Fentanyl on board the pain was excruciating. Maybe worse than labor, maybe not quite, I can't really remember, but worse than I ever imagined.

As she started the repair, the gynecologist started to give me instructions, "Now, with a fourth degree tear..."

"I thought it was only a third degree tear," I interrupted.

"No," she replied firmly, "it's definitely fourth degree." I must have heard incorrectly.

The repair took an hour to complete. I didn't have to go to the operating room, likely because of the gynecologist's expertise in this area. I was very blessed to have her. She was actually a locum doctor from Calgary, the very best pelvic floor specialist in all of Alberta. She "just happened" to be on-call in our town that morning. I marveled, in weeks that followed, that God would have me tear so badly, and then provide the very best person to do the repair.

I barely got to hold my daughter during that time, even though I asked for her over and over and tried to convince them that the pain would be less severe if I could have her to distract me. I think that they were concerned the Fentanyl might have made me too loopy and drowsy to hold her without the potential of dropping her tiny fame. Trust me, any potential loopiness from the Fentanyl was strongly counteracted by the severity of the pain I was experiencing. I didn't even make it through the whole repair before I was asking, please, for another dose of Fentanyl. They gave it to me willingly, and that dose, piggy-backed on the previous one, relieved the sharp edge of the pain.

Perhaps worse than the length of the repair was the fact that throughout the whole procedure both physicians were giving me a ton of information on this type of tear. They talked about caring for the tear, follow-up visits, possible complications, the need for pelvic-floor physiotherapy (who's even heard of such a thing!), and even touched on what the next pregnancy-labor-delivery might look like for me. Here's a bit of information on 4th degree tears, if you're curious http://brochures.mater.org.au/Home/Brochures/Mater-Mothers-Private-Redland/Recovering-from-3rd-or-4th-degree#5

The general consensus had been that my daughter's shoulders had caused the tear, due to the fact that I had been unable to keep my body from pushing through that final contraction. I felt so guilty, and I kept apologizing... to A., because I'd felt like I'd ruined my body; to my whole medical team who had coached me so well throughout my labor, for not being able to do the one thing they'd asked of me; and to the gynecologist, because I'd taken up her time and because I could not stop my legs from shaking uncontrollably.

I cried a lot, for days, after that. I don't think that I can explain, in a way that would make sense to anyone, why this was so unbearable for me. The months, maybe years (we have yet to see), of healing ahead of me overwhelmed my mind. The guilt hit hard whenever I thought of that moment when I said "I'm not, I'm not... I'm not pushing!" The idea that I had forever ruined my body kept coming back to haunt me, even when A. and my mom assured me I


hadn't. I hurt. A lot. Nursing my daughter was harder for it. I couldn't sit up, so I had to learn to nurse her side-lying right from the start, and not having as good control of her head from that position made learning an already difficult skill, that much harder. I believe that this was also the beginning of my depression. Not that it was the complete cause of it (it's just not that simple), but that it was the start of the cycle of guilt, anxiety, pain, remorse.

I discovered a few weeks later what the look of horror had been on my doctors face: She is a fairly new family practitioner, and had seen only a couple severe tears during her residency. One such tear had spontaneously dehisced (opened) weeks after the repair. She was likely shocked by the extent of the tear and reminded of the severity of potential complications.

One thing I was glad of: The birth of my daughter and the fourth degree tear I had endured remained completely separate in my mind. I had given birth to a beautiful baby girl. I had torn very badly. Those two things, the good and the bad, did not coexist in my mind. Because of this, I never once blamed her - her abnormally large head, her shoulders, or her weight (8lbs, 6oz)- for the tearing of my body.
 

Little N's Birth Story - Part 1

Today is Baby N's 1st Birthday. I can't believe how much has happened this past year and I am so happy and blessed to be this little girl's mom. I thought I'd do a special little post about her birth today. It comes in two parts (you'll understand why in my next post), so here is part one:

My due date was January 22, 2013 and I was sure, throughout my pregnancy, that our baby was going to come early. Finishing up my preceptorship was stressful enough, and I had been having mild contractions every day since about 28 weeks gestation. So when my due date came and went I was frustrated and very anxious to finally have my baby in my arms. The fact that my Canadian Registered Nurse Examination (CRNE) was scheduled for February 6th did not help my patience, either. We kept busy though, and A. and I made a ton of giant cinnamon buns just days before Little N arrived. Can you say nesting?

My mom had planned to come about a week earlier, but because I wasn't showing any signs of going into labor, she decided to stay in Edmonton a little bit longer to help my grandparents. She arrived on the 26th and I am convinced that had she come earlier, Little N would have also made an earlier appearance: My mom wasn't here more than 5 hours before I knew I was in labor.

And that's the way I stayed, contractions coming every 5-7 minutes lasting anywhere between 30-90 seconds for about 18 hours. My sister-in-law had given me a recipe for an at-home induction method, and I had cleared it with my doctor. I went into labor on my own, but after 18 hours of "bule bule" contractions (my mother's Swahili term for meaningless contractions) I decided to take a third of the recommended cocktail. Hoo-boy did that get things going: About 22 hours after early labor had started, the contractions were coming hard and strong at very regular intervals and, at around 2330, we headed to the hospital.

When the nurse initially checked me I was 3 cm dilated - not as far along as I wished I was, but enough that they considered me in active labor. The first two hours were manageable enough, I spent that time in the tub, my mom reading a funny little book called A Book of General Ignorance and A. pressing on my back through contractions and giving me sips of water. Eventually, though, the tub just wasn't soothing anymore and I needed a change. At 0300 the nurse checked me again, and I thought "if I can be at 5 cm, I think I can do this." Sure enough I measured at 5 cm. The worst part of my labor was the following 2 hours. When Amy, my nurse, did her assessment, she also put me on the fetal monitor for a few minutes and noticed the baby's heart rate was high, about 170-180 bpm. But neither she nor the on-call physician could tell if baby's baseline HR was that high with some decelerations (a bad sign) or lower with lots of accelerations (a good sign). Knowing my daughter now, how active and excitable she is, I'm willing to guess it was the latter. To be safe, they kept me on the fetal monitor and gave me a bolus of 1L of fluid. I was stuck lying on the bed in what is, I'm sure, the most uncomfortable place in the world to labor, with cords and lines attached to my body. It was miserable. I did try some nitrous oxide (laughing gas) at one point, but it didn't help the pain at all. It only made my mouth dry and my head spin. At one point I looked at A. and said "I don't think I can do this." He was amazing and so encouraging. Both my mom and A. were wonderful. My mom pretty well stayed at my back pushing on it through all of my contractions - I had terrible back labor- and A. stayed at my head, stroking my face and encouraging me through each contraction. I had been leery of having two support people, but they worked so well together, didn't get in each others way and did exactly what I needed them to do. I went through labor without any drugs and no major melt-downs, I believe solely because of their support. Our physician checked me again at 0350 and again I thought "6 cm, please 6 cm." That's the way it was throughout my labor, I would wish for a number and be spot on.

I have talked to a number of other moms and it seems like there's a moment in every labor when things get so ridiculous that you just want to shout "REALLY? NOW??" I had two such moments. I'll share the second one in Part 2, but the first one happened at about 0500 in the morning: I had gotten up a couple of times to use the washroom, but just before 0500 I felt like I had to empty my bladder again. I got up, the contractions were right on top of each other at this point. "Transition" I thought with both relief and fear. Much to my chagrin I couldn't seem to void. I was half-dragged back to bed, doubled over with the pain of another contraction and I suddenly felt like I had to push. Of course I knew what they would say, "not yet, let us check you first, before you push." I knew it was a bad idea to push against a not yet fully dilated cervix. But the urge was so strong I thought "I'll just push a tiny bit" and as I did my water broke, gushed really, all over the floor. The clear fluid another signal that Baby was likely not in distress. They helped be back into bed, our doctor checked me again, I was just barely shy of 10 cm dilated. She told me that before I pushed she wanted to make sure my bladder was empty, and before I could say or do anything she was inserting a catheter. "REALLY? NOW???" I didn't say it, but I wanted to shout it. I did ask, incredulously "What are you doing?"- not that I didn't already know. But I barely got the words out before she was done, so really, she did a very good job.

And then I was ready to push. For me, pushing was a relief. I felt productive. It helped the contractions feel less intense. Pushing was good. I was finally off the fetal monitor, so I was able to try out a variety of positions, which was also wonderful. I kept hearing the nurses and the doctor saying "Wow, she's strong." "For a first time mom, she's really pushing well." It wasn't just meant to be encouraging. It seemed to me that they were honestly quite surprised and impressed. I don't think anyone in the room thought it was a bad omen, I certainly didn't. As I progressed through the second stage the doctor reminded me "When the head is delivered, you need to stop pushing, I'll let you know when you can start again." The last ultrasound, just the previous week, had shown a nucal cord. So I knew our doctor would want to get it untangled before the body was delivered. "Okay," I nodded. The nurses and the doctor talked easily throughout this stage, encouraging me through each contraction. The doctor remarked that our baby had a lot of dark hair, and I thought "She's lying... has she seen this kid's parents?" We are both fair and were both bald as babies. She also told us that she wouldn't tell us the gender of the child, she would let us discover it for ourselves. That was kind of neat, and a different approach than I'd heard of before. When our baby's head was delivered I heard the caution "Okay, now you need to stop pushing." I looked at Amy and panted along with her. That was supposed to keep me from pushing. Then I heard it again: "Stop pushing, you need to stop pushing." I remember saying "I'm not, I'm not... I'm not pushing." Then suddenly at 0544 our baby was delivered and I remember seeing a look of absolute shock and horror on my doctor's face and I thought briefly, "Oh no, the cord!" But before I could really panic, she was in my arms, crying. She had good lungs, good color, good tone. I checked her over. She looked beautiful. Perfect. And sure enough, a good amount of light, reddish hair. I kissed her, noticing two matching stork-bites on each eyelid, and spoke her name over and over. The look of terror on my doctor's face left my mind.  And until she spoke again, I was blissful.

Baby Measles, Late Nights, and Dancing

I just read J's Christmas post (hopefully she'll put it up soon) (here it finally is!) and I was totally humbled. Humbled because of the joy in her words and the freedom she is now experiencing.

I didn't have an altogether easy Christmas season. Not that I've been deep in the throws of depression again, just that stress and anxiety have pulled at me a little stronger over the last few weeks than I thought - than I hoped - they would while sharing Christmas with family. I had about four good hard meltdowns in just over two weeks and I'm on the brink of another one today.

As I sit here typing, I am listening to my daughter crying and to her father trying to calm her and I am spent. We are all sick this week. A. and I both have a pretty nasty cold and our dear little girl, has Roseola, "baby measles." It's no big deal, apparently every baby gets it, but she is miserable. She has not slept well the last few nights and, as a result, neither have I. This morning she woke up at 0230 and we snuggled, she nursed, we played, we watched some TV, and she cried and cried. Finally I woke A. up at about 0500 and he did his best to support us, but she wouldn't go to him, wouldn't eat, wouldn't nurse, wouldn't snuggle, wouldn't take a bottle. Just cried. Finally I got some "Praise Baby" music up on YouTube (my wonderful mom introduced us to it) and she and I slow-danced in the middle of the dining room until she fell asleep.

Sometimes I think things should be easier now. I shouldn't have meltdowns, I shouldn't feel so down... I should be better. I know that everyone has bad days, but it feels like a glimpse back at my life a few months ago, and it's a little scary. But then I realize, after staying up half the night with my daughter, that I am better. No longer to I feel like running, screaming, shaking, drowning... I feel spent and sad, sometimes anxious, often lonely, but much more in control. And the good times are so much better. I can even get up with Little N. at 0230 in the morning and smile at her, talk and sing and dance with her. And that is good.

This was written January 19th, 2014. Took me a little while to get it up.