Samuel’s Birth Story

Tags

birth story, Bradley, cervadil, epidural, foley balloon, induction, pitocin, Texas Children's Hospital, Women's Specialists of Houston

This is the story of how Samuel Clarke Frazier came into the world 🙂 It ends at that joyous moment, so there is no dwelling or rehashing of the difficult time that followed – just a history of the moments leading up to one of the happiest points in my life. However, it is a birth story. It is graphic. On other blogs I have seen the authors put up birth stories and readers complain that words like ‘cervix’ and ‘discharge’ spoiled their breakfast. Well… expect that and more, if you stick with this post, you may know me VERY well by the end (although note: it is safe for work, and suitable for my students to read and still respect me afterwards).

We left off when the hospital had called. I had been merrily distracted by an awesome ‘shower in a box’ but as soon as the phone rang, all the emotions hit me: fear (perhaps terror), panic, excitement. At that moment, all I could think was ‘I am not ready… I just need another day…’. I answered the call, and the nurse told me that the hospital was not sure they could fit me in that day after all – but she would call and let me know later if it was a possibility. She could call us, but if we had not heard by 9, we could call her.

Ugh. Talk about a mood changer. OK, I might not have felt ‘ready’ but I did not want to delay this. I cried, so Wes got me out of the house to a gorgeous little Italian in Bellaire (where I ate about 3 bites of pizza and boxed the rest) and we got ‘Rock of Ages’ on DVD to distract ourselves. 9 came… no phone call, and at 9.00 and 1 second I dialed the hospital. Come on in they said! Come in for 11. Woo-hoo. That was a difficult hour to kill, but we changed and packed and tidied and faffed and left ridiculously early.

We got to the hospital at 10.50 and were not turned away! This was it… it was happening! Then began wait after wait… waiting for a room, waiting for a nurse, waiting for the cervadil (I am not complaining, I utterly accept that on a labor ward, the woman NOT in labor is the least of their priorities)… the upshot was, it was 2 am (yawn) before the induction began.

Induction part 1: Friday night: Cervadil.

Waiting for the first stage

Cervadil is a gel they put on your cervix overnight, to ‘ripen’ it (nice terminology, always reminded of ‘the reaping’ in The Hunger Games). Hopefully it thins the cervix and dilates it, meaning the pitocin has less to do – some women respond so well they go into labor, but that is not the purpose per se. The cervadil basically looks like a long tampon, but a doctor has to insert it (boo). Unfortunately, my doctor (the resident for that night) was very heavy handed – placing it and then pushing, and shoving more. I did get quite bruised, from the heavy-handed insertion, otherwise it would have been utterly painless. Once it was in, it was painless (I couldn’t feel it at all) and time for lights out.

Cervadil in, and no discomfort

Many hospitals give a sleeping pill at this stage, but I was not offered one (I don’t know if this is because my OB practice is as hands-off / anti-interference as possible, or because I had told them that minimal intervention was my choice) and I did not want one. Slept like a log anyway, until I was woken up at about 6 to see how it had worked.

Wes’ cot

I was pleased to see my OB, Dr. Boswell, in the morning. We love her, and she did the examination to see how the cervadil had worked. The result? No effacement, no dilation. Nothing. No change. Boo. I was disheartened, but Dr. Boswell was upbeat and said it was just time to start phase 2: round 1 of pitocin.

Stage 2: Saturday morning: Round 1 of pitocin

IV line for the pitocin

The turned the pitocin on at about 9. As I had wanted to try to labor without an epidural (even on pitocin) they started, as promised, at the very lowest dose: a 2. I waited, with some fear, for the hugely painful contractions pitocin is supposed to give, but… nothing. So after 30 mins, they upped it to a 4. And I waited… and nothing… this carried on all day, until at 2 pm Dr Boswell came back. She asked how I was feeling, and I gave a very merry “Wonderful! I feel great!” but her response was “Rats. I was hoping you would be in a lot of pain by now”. She didn’t think the pitocin was working – we could see my uterus contracting on the monitor, but no nice rhythmic contractions, nothing that seemed productive. And no pain meant that clearly, nothing was really happening. I asked if getting up and walking would help, but she said, not at this stage. I was welcome to, but resting for actual labor might be better.

So… I waited… and waited.. and we upped the dose every 30-60 mins. When the dose was at a 12 (not very high, it goes up to 20), at about 7 pm, Dr Boswell recommended the pitocin be turned off. You could see that my uterus was contracting constantly, with no break in between, but I could not feel it. I was still spending my time reading, watching TV, texting, Skyping my Mum. Basically: completely ineffective contractions. They checked my cervix: no effacement, maybe a fingertip dilation. Again: basically zilch.

Here, I am very grateful to have been with The Women’s Specialists of Houston. Not only did the doctor leave me alone all day (very few internal examinations… in fact, just one, with an intern who again was extremely heavy handed until she bought tears to my eyes) but many doctor’s would have just upped and upped the pitocin, labelled it a ‘failed induction’ and gone for the C-section. Dr Boswell said that this can occur for a number of reasons and that the game was not up yet. She said that nerves / tiredness / stress / hunger (I had not been allowed to eat before being admitted) can cause pitocin to fail: she wanted me to have a relaxing evening, with a big meal, and a good sleep. She also said that pitocin causes the cells that trigger contractions in response to pitocin to be expressed on the wall of the uterus, therefore they can work better on a second attempt, but you need a rest so your uterus doesn’t get ‘exhausted’ (yes… really). So, feeling doomed to failure I agreed to take a break. At this stage, I began to feel quite depressed about the whole thing: I had really wanted as natural of a labor as possible, and this felt anything but. My body just felt like a passive vessel for medical intervention: I felt nothing, I felt my body was doing nothing. Still, when Dr. Boswell suggested one last intervention to help tomorrow’s pitocin: a foley balloon, I agreed to try it to help avoid a C-section.

Stage 3: Saturday pm: Foley Balloon

A foley balloon is another method of helping dilation, but it is mechanical rather than pharmaceutical. Basically, they insert two balloons into you, one in your uterus between the baby’s head and your cervix, one just outside the uterus resting on the cervix. They fill the balloons with water and hope the pressure mimics the pressure of a baby’s head descending in labor, and so causes your cervix to dilate. Bleugh. I will say, Dr Boswell absolutely gave me the choice of having the balloon or not. She also sad that she would stop at any point when it was uncomfortable, and if we could not fill the balloons with the recommended amount of water without discomfort – we just wouldn’t. She saw no point in discomfort, nor wearing me out more. She is awesome.

The insertion was about as pleasant as it sounds – luckily Dr Boswell is a wonder at doing these procedures and it was just unpleasant / uncomfortable more than anything. At least, that was the physical side, emotionally I felt a bit like I was sick of being prodded and poked and my body not being my own. But hey ho. Dr Boswell saw all my bruising from the heavy handed intern examinations and offered me ice, which was nice, and sympathy, which I think was nicer 🙂

But once it was in, actually, no problem. I could not feel it at all, and ended up like this moments later:

Foley Balloon not hindering sleep.

It was weird getting up and going to the bathroom with it in… but otherwise, it really didn’t bother me.

At 6 am (why so early?? Why??) Dr Boswell (phew) came to remove the foley balloon. It was simple and painless – she drained the water and it kinda slipped out. Moment of truth time: had it done anything? Had it made any difference?? YES! I was 4 cm dilated! This is the stage they will often admit you to hospital (if you are not being induced), and evidence that my body might actually respond to something.

Stage 4: Saturday am, Pitocin round 2

Nice day to have a baby?

So, we were all go on the pitocin. They worked the same way as before: starting low and increasing the dose until it was effective, but not letting it get so high my uterus got exhausted (for real… they actually said this… hence the need for an overnight break and some food). Dr. Boswell came to wish us goodbye 😦 So sad to see her go, but she handed us over to her colleague Dr. Dryden with promises that she was ‘wonderful’ and ‘very experienced’ and had delivered both of Dr. Boswell’s babies. Dr Boswell said not to start the pitocin until the change of nurses shift at 9, so that the nurse can monitor the whole reaction of my uterus, and see it’s responses and patterns. She warned me that the time was probably coming to break my waters, she emphasized that given all the excess fluid, no one, but no one was to break my water except Dr. Dryden, in case of a prolapse. Then Dr. Boswell left for some much needed sleep (she had been at the hospital all Saturday and on call all Saturday night).

Waiting… waiting… by the time the nurses had switched and done their rounds, the pitocin was started at 10… again, I could not feel much, although it did feel a little bit more like rhythmic menstrual cramps. Dr. Dryden came in at 10.30 and determined it was time to break the water. I liked Dr Dryden (and she did a wonderful, wonderful job at the birth and after) but she was quite different to Dr. Boswell – I felt everything was an option and my choice with Dr B.; with Dr. Dryden felt more that things were going to be done her way. But I did like her and felt quite comfortable around her – plus she did the most wonderful job of the actual delivery so am eternally grateful for that. I got a bit antsy when she mentioned breaking my waters – we had been taught in Bradley that this increases the risk of C-section because once your water is broken, if the baby was not out in 24 hours, it was an automatic C-section. Wes asked if this was the case and Dr. D said ‘No, you are absolutely not on any clock’ so we agreed – again, I have a feeling that was going to happen anyway 😉

Dr. D. pronounced me still 4 centimeters and broke my waters. It took all of 2 seconds, I didn’t feel it at all, and then there was just a horrible hot gush. Ugh. Dr. D left, the nurse upped the pit and left Wes and I were left to our own devices. Before the nurse left she mentioned again that she could give me wireless monitoring so I could get up and walk – AS REQUESTED IN MY BIRTH PLAN – but you know when you are in pain and all you want to do is curl up and laze around? Yeah, I was there. All I will say is that breaking the waters is darn effective. Immediately, I began to feel contractions. Painful, but spaced out. I practiced my Bradley relaxation techniques to get through them – they came about every 2 minutes. Whether they are more painful than non-pit contractions I will never know, but I will say that you do get thrown straight into later stages of labor – for example, straight into 2 mins apart, painful contractions, which is often not the case with natural labor.

At about 11, the nurse came in and told me that she had read my birth plan and was here to get me walking. I wasn’t really given a choice, but in a good way. I had given them detailed reasons why I wanted to walk and use the birthing ball (pain relief, good positioning, speeding up labor) so the nurse played hard ball and made Wes walk me up and down the corridors. Again, a highly effective way to get labor kicked up a notch. The contractions got more painful and about a minute apart. Again, although painful, it was bearable as I could get a complete pain-break as these photos taken 30 sec apart show:

Contraction

Break from contraction 😉

I tried the birthing ball, which pre-labor I was convinced would be the best place for me. It hurt more, hurt my tailbone and I practically kicked the thing out of the room. I also, with Wes’ help, tried squatting, which was equally as miserable. Walking it was.

Then I needed the loo. No. 2. Wes told me I would have to buzz for a nurse, but I didn’t see why. I buzzed and the nurse said “wait! Wait for me’ which I tried to do, but she was ages coming. Ages. I was in pain, in labor and I needed to go. I tried to wait, but eventually, I figured I would either go on the floor or in the loo, so I might as well use the loo.

Waiting for the nurse so I could use the loo! Gave up and used it anyway, much to her chagrin.

The nurse busted in while I was going (see? Labor is just so not dignified – and yes, I was with it enough to be horribly embarrassed) and chastized me. She told me that needing the loo was often a sign that the baby was coming and she was cross I might have had the baby in the loo. What was I supposed to do? Holding it was not an option!! She had to come quicker if she wanted me to wait! So, she wanted an exam afterwards to see if the baby was coming. So – at 11.15 what amazing progress had I made? 4 cm, maybe 4.5. UGH. Back to labor.

When the nurse left, the contractions got really bad. They just didn’t stop one on top of another. The pain was bad (but I could cope with it):

Ow. Ow. Ow.

Then I needed the loo again. Really, like upset tummy needed to go. I buzzed for the nurse and waited and waited and buzzed and begged them to come (I was close to going anyway, but torn between my discomfort and being told off again!), when she came she wanted me to use a bedpan! No freakin’ way! Gross. So, I pointed out that just a few minutes ago I had been 4.5 at most and so really, no baby was going to be falling out of me. She agreed and let me use the bathroom (although she insisted on being in there with me! When I had an upset tummy! Told you: labor is not dignified).

While in there, I had a mental breakdown. The pain was horrific, and I was not progressing. I could deal with this pain, but given that I was dilating 1 cm every 2 hours, and had 5.5 cm to go – not for another 11 hours. Plus, if this was early labor, how bad would transition be? F that, I’ll take the pain relief. So, I asked for the epidural.

It was administered quickly (within 5 mins) and within 10 I had gone from this:

Ow. Ow. Ow.

To this:

Bliss.

As soon as the epidural had kicked in – about 11.45 the nurse wanted an exam, so they could ascertain in the future whether the epi had caused me to stall. I was annoyed: what was the point? I had been at 4.5 forever, and so finding out I was 5 was not going to help. I acquiesced, a resident Dr was called, and I grumpily let her announce that I was “9.5, maybe more, there was just a lip, and the baby was coming NOW”.

What? What the F-ing F? Some 40 hours to get get 4 cm, then to 9.5 in 40 minutes? So looking back, this:

Ow. Ow. Ow.

was transition. We had been taught in Bradley that transition was the most painful time, and the time the women find it most emotionally difficult and cry for the epidural. Our plan had been for Wes to step in at that stage and talk me out of it.. however, we just had no idea we were in transition. We thought it was too soon. I was annoyed that I had an epidural so late: I was moments away from giving birth when I got it, and most of the hard stuff had been done. I could have had a non-epidural (one can hardly call all the cervadil, balloons and pit natural…) birth, but hey ho. While I was annoyed that we had managed this slightly wrong, I was also pleased that I was enjoying this last stage. Plus, most of my fears about an epidural were unfounded: I could feel my legs, I could use my legs and I could certainly feel the contractions.

The nurse took a picture of us as a 2-some, promising to take the same picture but with the baby between us, when he was out (we never got this latter picture as everything went a bit Pete Tong, but hey ho)

Last picture as a 2-some

Doctors were called, and it was time to push. I declined the mirror and pushed – again, the epidural did not affect my ability to push as I could certainly feel quite a lot. I could tell the nurse when my contractions were coming, and she often had to help me hold off on pushing the urge was so strong, so that I could let the pressure build. Pushing went pretty well, Firework moved quickly – so quickly, they had to chase him with the little monitors.

After about 30-40 mins we could see the head, then poor old FW got stuck 😦 I had been warned about a very narrow pelvis and nothing seemed to get him past it. We tried squat bars, different positions, breaks, laboring down, I even let them get the dratted mirror. After 2 hours of pushing, they called Dr. D. She watched a few contractions and coached me. I actually said “It is OK to use forceps if you need, or cut me” but she didn’t think we needed that yet. She put her hands inside me (owww… just owwww… the epidural seemed to be doing F all at this stage) and said that FW was a slight transverse – he was facing the wrong way (up, not down – ah back labor also explains the yell for the epidural earlier) and slightly sideways. Again, I am grateful I was with the Women’s Specialists, many OB’s would have gone for an emergency C-section at this stage. Not Dr. D. Mindful of my ‘no C-section if possible’ [and now it does seem silly I was so adamant about that] scrawled all over my birth plan, she just turned him manually while he was inside me.

That. Is. The. Most. Pain. I. Have. Ever. Experienced. I swore violently – then apologized. But Dr. D was doing absolutely the right thing, using each contraction and push to slowly stretch me and rotate FW. I began to worry that FW was in danger as his heart rate was dropping, but Dr. D was wonderfully calm. I even said “if you need to do a C-section, do it!” but she said “I don’t need to see him now. I do need to see him soon, but he is OK now” and quietly called some extra pediatricians in. Once Dr D had figured out he was the wrong way and stuck in my weird pelvis it was all quick quick. Another 30 mins or so of pushing, with her help, and my beautiful boy was born:

He was handed straight to me:

and taken off for some checks as he had been stuck for quite a while. All the checks were done in the room, and Wes got to help, although he mostly took photos:

FW had become Sam! The long pushing didn’t affect him at all. He took a while to cry which freaked me out (I got slightly panicked over that) but his apgar scores were 8 and 9 and his lungs, when he decided to use them, were certainly powerful enough 🙂

Sam was little enough that I only had a minor second degree tear which Dr D and an intern stitched up, while Sam was assessed. Sadly, as I was quite ill, I didn’t get Sam back after that 😦 But, that is not this story. This is the story of how the lovely Samuel Clarke Frazier came into the world at 16.32 on November 4th 2012, weighing 6 lb and 15 oz. A wonderful, wonderful day: