i have wanted to sit down and write ms tessa mae's birth story since before it even happened. i had these ideas about how it would go. "i found myself in labor and took a walk around our yard. it was a beautiful day. i labored at home for x hours and loved on my husband. i finished getting everything prepared. finally i realized it was time to go to the hospital. we went in and were greeted by a sweet nurse and my favorite doctor. though labor was hard, i did it without much medical intervention. i hooked up to the monitors the manditory 15 mins an hour and though i had a catheter, didn't need it for fluids. after a few hours and some pushing, i had a beautiful baby girl of 7lbs 10oz - she was perfect and we got to bond immediately. i saw andrew cut the cord and then she and i snuggled and learned to breastfeed. it was wonderful and now we're home and doing great."
unfortunately, our labor went nothing like i had hoped. and writing about it has become nearly impossible because 1. it's been so long now i have forgotten many of the details 2. the baby won't be content unless she's sleeping on my chest and 3. it makes me somewhat sad to relive how horrendous it was. yes, everyone ended up ok, and i am thankful for many things, especially the fact that i didn't cave to a c-section despite the CONTINUOUS prodding from doctors, but nothing else went to plan. i have tried to be positive and tried to be flexible, and if you ask my husband, he'd probably say i've been both, but inwardly i'm sort of crushed at how everything went.
i went in to the ob for a check on friday 3/19, because they wanted to continue monitoring the baby (though she had no problems) and my bp. it was actually much lower than it had been because i made them take it AFTER i'd been listening to the heartbeat for 20 mins instead of right as i walked in the door. though i had passed the 24-hour urine test, i had 260 on the protein (260 what's, i have no idea), and you have to be at 300 to be considered pre-eclampsia, so i was still considered borderline. they wanted to do an ultrasound to check the level of amniotic fluid (because that can get low with p-e), and on our way to the ultrasound room, the doctor asked "when's the last time you guys had a growth check?" uh... never? i guess that's one more thing capital area obgyn screwed the pooch on. so she said we'd just do one of those today as well. as we watched the ultrasound, the technician (the one who was very uninformative the first time) said very little except that she couldn't get a good angle to measure the head of the baby. after waiting what felt like forever, i started worrying there was something wrong. andrew said everything was fine and not to worry. finally we went to the doctor's personal office where she told us "i didn't even think about this as an option, but your little girl is a squirt" uhh ok... i thought. "she's measuring in at around 5lbs 4oz, which puts her in the 4th percentile. even if that's a little off, we get concerned if they're under the 10th percentile, and since you're past 37 weeks, i've alerted dr. tosky, who is the doctor on call, and we're going to go ahead and admit you to labor and delivery." matter of factly, like i was just going to say ok, sounds good!
what do you mean?? she's small, so you want to take her early?! what kind of sense does that make? apparently, her size could have indicated that she had intra uterine growth restriction (iugr), which means she's not getting what she needs from the placenta. and even though she isn't having any problems, we don't want her to go into distress. i cried. "can't we even wait until tomorrow??" no "but you didn't even know about it before 5 mins ago, and everything was fine, what's the rush??" they didn't want something to happen in the one night i would have gone home. they just expected us to walk over to the hospital and have a baby. BUT i don't have a bag packed. we're not ready. the house isn't clean. her room isn't ready! the bassinet sheets aren't washed! i haven't eaten lunch. they're not going to let me eat. I'M NOT READY! i tear up just thinking about how horrible it was. we convinced the doctor to let us come home and pack a bag, and eventually we convinced her to let me eat a small lunch (i had whole wheat pasta with alfredo sauce and a few bites of chicken in hopes it would help me with what we were going to attempt). i tried to sit outside and be zen. i tried to focus. i tried to relax. but all i really did was panic and cry. i prayed some but it was frantic and frazzled.
we got to l&d around 2:30, and i got the most painful iv catheter ever, placed into my wrist joint and taped to my hand... everyone agreed this was ridiculous, but they left it, nonetheless, for the entire process. i got hooked up to monitors, which also stayed on the entire time. my nemesis, the blood pressure cuff, was permanently affixed to my arm, and dr tosky came in to consult. he checked my cervix and proceeded to tell me it was "uninducible" -- WHAT DOES THAT MEAN??? i asked, and he began explaining effacement and dilation, etc. i told him i knew what that meant, and i understood that i was not dilated or effaced (i mean, i'm here for an early induction, what did you expect?), but what does it mean that i'm uninducible?? apparently it meant he'd really like to do a quick little c-section, which i understood as he explained dilation and effacement again twice, and then told me my options were to begin pitocin induction or have a c-section. i told him i was NOT having a c-section, and he looked at me skeptically and somewhat condescendingly said i had a less than 50% chance of a vaginal delivery with the odds i was up against and, did i know that this was going to take probably 18-24 hours? yes. i did. so we were moved to a room and began pitocin.
when you're induced you have to be monitored constantly, and you receive fluids constantly, and you are on your pitocin drip, which is increased every few minutes to move your contractions along, with the hope that the contractions are enough to soften and open your cervix. pitocin contractions are unlike real contractions in that rather than looking like a rolling hill on the monitor, beginning slowly, peaking over 60-90 seconds, and then coming down, they are what you call "square" contractions, in that you get maybe 3 seconds of "i'm about to have a contraction warning pain" and then you get to WHAM-O full peak of contraction, and after a while it tapers off.
so we began with the pitocin and the mild contractions, and over the next few hours, upped it until i was having pretty steady contractions about 5 mins apart. dr tosky came and checked me and was optimistic that i was 1cm and 50% effaced. pretty good considering all we were up against. dr. tosky decided that it would be a good time to break my water and "really get this labor going" - so he did. and MAN that was the most disgusting thing ever! people do not tell you how gross it is, but i will. it is GROSS. it feels like you peed on yourself and then sat in diarrhea. AND you continue to drip constantly until you deliver. NASTY. but anyway,we continued to up the pitocin through the evening and night hours, and tosky came in again to check me around 2am (i think... times are shady now). he was even more optimistic that i was now at 2 cm and 80% effaced. we decided to continue with the course and add in a little stadol. i say a little because i only took the half-dose, which was .5mL/hr, but it totally knocked me for a loop. it is a narcotic that doesn't do anything for pain but what it does is put you to sleep between contractions, and i took it so that i could get some sleep during the night, knowing that we were going to have a full day of labor ahead of us still. i felt totally drunk and couldn't really communicate well. apparently though, through all of the labor so far i looked, as andrew said, very zen. i was just trying to breathe through contractions and think about relaxing everything so that we could continue on with our progress. the stadol did put me to sleep for the two minutes between contractions, but it also meant that i woke up in pain every two minutes when the contraction came again. during this time, andrew and the doula were each sleeping, and sometimes i woke up and panicked a bit in my head when i couldn't seem to get their attention. other than a few instances of back labor, which laboring with my arms on the top of the bed helped with, we proceeded this way until about 7am.
at that time, dr. tosky was no longer on call, and he brought in the doctor to relieve him. she was from the centre obgyn (because they share weekend call), so i'd never met her before. her name was dr. clark, and she was wonderful. she checked me, and we were all happy to find i was now at 4cm! tosky even smiled and said that we'd be having a baby that day (now 3/20). he left, and we continued for i think about 3 more hours. during that time, the pitocin continued to get cranked, and at one point we had a real problem, because instead of "piggy back contractions" which happen around transition, and mean you have one contraction that doesn't completely end before you have second one, i was having 4 contractions in a row without them stopping. this whole process was taking about 10 minutes. after a few of these, i told andrew and betty jo (the doula) that i could not take 10 minute contractions (as i do not feel most people could without being numb). they called in the nurse (i think we were on #3 by now), and she said that sometimes pitocin can do that, but that it should work itself out. if it didn't she'd be glad to turn it down a notch. well, we went again, and it didn't, and after looking at the monitor, she proceeded to turn it down a few times until it normalized back into regular contractions. i was a little worried that they'd backed off, but i knew if i continued with 4 in a row, i wouldn't make it through the pushing part because i'd be so exhausted.
a few hours later, dr. clark came in and checked me again. bad news. i hadn't moved in all that time. still at 4 cm and 80%. once again, i was given two options, and one was a c-section. "well at this point, we can either do an epidural and crank the pitocin way up, and hope that with you being numb and unable to tense up, and with the pitocin on full blast, you will dilate completely, or we can do a c-section." i immediately said "i want the epidural." and apparently i surprised everyone, andrew included, and dr clark said i could think about it for a few minutes, but i knew i didn't want a c-section, and i cut her off and said again, "i want the epidural." while i was waiting for it, i threw up (which is apparently a good sign).
by this time, i was on nurse #5, and none of us were a fan of hers. she had been frustrating me for a long time, but she got to the end of my rope when we were preparing for the epidural placement and she kept pushing my head to my chest. "please don't do that" i warned once. she persisted. "PLEASE don't do that." i said more emphatically. i had been very nice to every person at this point, and i hated to change that, but daggonit lady, stop pushing on my head! she did it one more time, and i looked her dead in the face and in my stern, firm, more-than-teacher voice said "STOP TOUCHING ME." at which point, i believe she became afraid, as andrew said she just stood there with her hands on the bed for the rest of the placement. while a small part of me felt mildly bad, the rest of me thought, it's about time! the epidural took 3 sticks to place (way to go anesthesiologist!) - the first one went in, and when he tested it, pulled back blood. what a winner. the second one, he attempted to place in a non-numbed nerve location, as my back involuntarily spasmed, and the third finally went in and worked... at least for a little. having an epidural is interesting because half of your belly is numb, but you can still feel the top half contracting, and then your legs feel like they're on pins and needles, like when you sleep on your arm and wake up to that tingly this-is-not-my-arm feeling. the rather alarming thing for me anyway, was that with the epidural i began shaking uncontrollably. this is not, apparently unusual, but it was freaky.
once i was numb, dr clark told us our job was to sleep for a few hours in preparation of pushing. i believe it was about noon at this time. nurse 5 came in and proceeded to bang around and make noise and prevent sleep from occurring for the next 30 mins or more, until, with andrew at the point of breakdown and wanting sleep, i once again made the cranky-laboring-lady demand that she hurry up and get out because the doctor told us our job was to sleep and she was preventing that. she left, and andrew slept for about 30 more mins. at this point i couldn't sleep because i had begun to feel some unpleasant things. i knew i should feel pressure, but i knew i shouldn't feel pain. i laid there, trying to figure out what i was feeling, and by the time my mom and betty jo returned to the room from lunch, and andrew woke up, i was somewhat panicked in pain. the pitocin was way up so that the contractions were literally non-stop, and the numbness was quickly wearing off completely. by the time nurse 5 bothered to come into the room, i felt like i was literally writhing in pain, and none of my coping techniques were working.
she turned the epidural up to the highest rate i was allowed, and it did nothing. she told me i had to wait up to 15 mins for effect, and i told her again, it was NOT working. then, after screwing around some more, she gave me the induction dose again, which also did nothing, and told me again to wait for another 15 minutes. i don't know where in my body those drugs were going, but they were not going into the right place. at this point, we had a few options, 1. let me writhe in pain and wait for the baby to "labor down" into the birth canal, or 2. start pushing and potentially push for a while knowing that the baby was not yet fixed in my pelvic bones. the nurse had checked me and deduced that i was basically 10cm and fully effaced, and i had a slight feeling to push, so i decided that's what i would do.
well, true to form, nurse 5 disappeared and left me to be in pain for some unknown reason. at this point betty jo recommended i do some non-productive pushing by using my yoga breathing to focus on inhaling and then exhaling by pushing my belly button to my spine. this wouldn't move the baby much but would help me alleviate the need to push. i did this for what felt like a few seconds, but andrew says was like 20 mins, before it was no longer helpful. at this point, my mom and betty jo had both gone in search of someone to help and were being ignored. betty jo then told me to grunt loudly with each breath (basically sounding like i was constipated) and "at least if it doesn't do anything, you'll get someone's attention and they'll come in to see what the noise is all about." so i grunted and groaned as loudly as i could with each breath, and shockingly, in comes nurse-unhelpful. again she asks if i would like to push now. YES! i answer, and she disappears again. so i decide to just start pushing, and magically, she re-appears!
from that point it moved really fast. i was basically purple-pushing, and pushing so hard that i thought i might have an aneurism, but it was working, so i continued. very soon, i got to the point where the doctor was between my legs and told me to breathe through a contraction. i did. then she told me to use very controlled pushes - no problem! that was WAY easier than the opposite. she started raving about how controlled the pushing was and what a great job i was doing. heck, that part was fine, i don't know how other people can push full-blast for hours, because after 20 mins of pushing, i was exhausted and... tess was born!
i wanted to hold her, but they had the special care nursery in there, and after andrew cut the cord and they put her on my stomach for a few seconds, they took her to the warmer to check her all over. though i didn't find out till later, her apgars were 8 and 9 - woohoo! too bad i didn't know that and was freaking out the whole time wondering if she was ok, if she had the right number of fingers and toes, and all i kept hearing was "she has dimples!" i was like seriously people, just tell me if my baby is ok! in retrospect, i know they wouldn't have been talking about dimples if she wasn't, but at the time i'd been in labor for 24 hours and was not exactly thinking clearly.
i have never felt so overwhelmed and proud and happy as when they finally handed her to me. this isn't a good picture, but it does show how i felt, especially for those of you who know that i don't cry. andrew's the crier, but oh did i cry.
i'm sure there's lots more to the story and lots more to tell about what happened after she made her great appearance to the world, but that all took a very long time to get out, and though andrew and betty jo both insist that i made the whole labor look easy (which i find hard to believe), reliving it is definitely stressful. it was NOT the labor we'd planned for, hoped for, or even imagined, but we got our little girl, and i did manage to do it all without a c-section.
tessa mae korhonen
born on march 20, 2010 at 2:42pm
5lbs 15oz and 19.25 inches long
