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Thursday, December 1, 2011

a birth story - Libby Butler

Beautiful, amazing, super funny Libby, my husband's cousin's wife (so technically MY very own cousin now, too!) wrote a lovely birth story about her daughter, Robyn, born this past September. She wrote it in a letter form to her daughter as a keepsake for the baby book. LOVE this idea! I'm totally going to re-write my birth story of my son for his baby book now! THANKS, Libby for the great idea!


"I wrote this as a story for my daughter to put in her baby book. Here is a still lengthy but modified version – can you believe I actually deleted details :)

1.What happened the day your baby was born? Did your water break, and if so, where were you, how did that feel? Who took you to the hospital? What helped you during labor (ice chips? music? etc.)? Any funny or scary stories about the labor itself or the birth? How long was your labor, start to finish?

Mom's story for Robyn

Sunday, September 11, 2011
The day started out like most of my late pregnancy days. I was feeling lazy and uncomfortable waiting for you to come. Dad probably had prompted me multiple times to get my act together so we could get out of the house for awhile. We decided to go for a drive toward Freeport. Somewhere along the way I starting having some stronger than normal braxton hicks contractions, not uncomfortable, just different than normal, and coming frequently but not regularly. We decided to stop in town so I could get out and walk and go to the bathroom in hopes of easing some of the contractions. I remember telling your dad that I was uncomfortable and wanted to head home to get some lunch. Looking back, I realize that your dad didn't know I was questioning what was going on because he continued to take the scenic routes home and I was thinking: “What is he doing? I might be in labor!”

I clued him in that I was confused as to what my body was doing and we started timing contractions. The “contractions” were not regular, coming 2-5+ mins apart. We got home and ate lunch around 2:00 p.m. and I started feeling better. The rest of the afternoon progressed with some mild contractions, pretty typical for me.

I met Leah for ice cream at Cold Stone. We talked a lot about my upcoming induction and my hope that you would still decide to come on your own. I wanted to experience the excitement of going into labor. Although, with only about 28 hours to go and already 9 days late, I did not expect it would happen. I knew it was important to get you born since the doctors were estimating you to be a big girl (9 ½ pounds) and they were worried you might have a difficult time going through the birth canal if we didn't act soon. As it was, I already bought a few extra days since the doctors encouraged us to get you born starting on Friday (9/9) and gave us until Monday (9/12) as a last possible day. I was uncomfortable with being SO pregnant, but tolerating the discomfort better since I'd stopped working on 9/2 (your due date). I'd spent much of the previous weeks reading the Twilight series and keeping myself as distracted as possible waiting impatiently for your arrival.

I got home from ice cream around 4:00 and hung out on the couch. I made mental notes that I needed to finish packing, to try to finish reading the last Twilight book, and discuss with dad where we were going to go for our last dinner on Monday night as a twosome before getting admitted to Maine Medical Center to start the induction process. Dad and I were even going to get pedicures so I'd have cute toes for the delivery :) At about 6:30 pm I was in the middle of reading the MeOTA minute (a newsletter for the state of Maine occupational therapy organization) when I felt a pop and heard a tiny popping/scratching noise. I had a heads up from co-workers that they had known their water had broken because they could HEAR it! I was pretty sure I knew my water had broken but was somewhat in shock and denial...until I felt the gush of fluid. I ran past dad to the bathroom with what must have been an odd look because he followed me questioning what was going on.

***This is where the story becomes somewhat fuzzy for me because everything that happened in the next 19 hours was such a combination of emotions tied with intense fatigue that my memory is foggy on the details. I will try to recall the events as accurately as I can.***

I sat down on the toilet with full awareness but total shock of what was happening. I had so much wanted you to come on your own. I couldn't believe that the night before our scheduled admission for the induction that it was going to happen.

I hadn't even finished packing yet...although that was my own fault as you were already 9 days overdue at this point. My first phone call was to Grammie. My line was "this is not a false alarm, my water broke!". I had called her earlier in the day when I was having contractions and she was disappointed when it turned out I wasn't in labor. I then texted Aunt Alison, Aunt Connie, Grandma and Grandpa, Aunt Kathy and Uncle Calvin, and Leah to tell them my water broke. Finally, I made the call to the doctor (all while still sitting on the toilet). You'd think I would have called the doctor first but I was so excited to tell people you were coming. Dr. Wilberg asked me about the type of gush and the color of the fluid and then told me to head to Maine Medical Center.

Dad and I scrambled around the house, picking up, shutting windows, feeding the cats, and finalizing packing. I was kicking myself because I hadn't bothered to wash my hair that day (not normally a problem but I hadn't washed it the day before either). We were a scattered mess of emotions...but mostly excited to get the process rolling and get you out so we could meet you! The car ride to the hospital was a blur. We took note of the full moon as we crossed over the Casco Bay bridge from South Portland to Portland. I sputtered about the length of labor and wondered if you'd be born on Monday, your great grandfather's birthday. I thought that would be neat.

We arrived at the MMC parking garage and as soon as I stepped out of the car my water gushed again...soaking through my pants. I was embarrassed to walk the LONG corridor to the birth unit. We checked in at security...they were expecting us and let us go straight to the 2nd floor to triage. We got set up in a room and I was hooked up to monitors to check out your heart rate and my contractions. I had been able to feel the contractions but was in no way in pain...more slight discomfort. We gave them the details of the water breaking and discussed the contractions I'd had earlier in the day, apparently it is pretty common and those contractions were a sign my labor was starting.

Your grammie showed up to join the fun and help keep dad and myself company as it was bound to be a long night. Many people had checked my fluid, and based on the color they were able to determine that you had already had your first bowel movement (called meconium), which can be a potential complication and something that needed to be monitored. It was confirmed that my water had actually broken and a typical exam would not be was pretty obvious since each time I moved more water gushed out of me. I was also checked for dilation and effacing, pretty much the same as I'd been for 4 weeks, 1 cm dilated and 75% effaced. I had an IV line put in as I would later be required to have antibiotics every 4 hours to prevent an infection as you passed through the birth canal. I hadn't eaten dinner so one of the nurses brought me a salad. When my room was ready, and it was officially confirmed I was in labor, we were transferred to the labor and delivery unit.

I was hooked up to the IV and checked periodically for progress. I took a shower, as I was concerned that my hair wasn't going to see shampoo for a number of hours. And I wanted to put on regular clothes because after working in the nursing home for 3+ years I was determined NOT to wear a johnnie (although I had been given one initially because the gushing amniotic fluid made my clothes pretty wet). Plus, I'd spent some effort considering what I would actually wear for labor.

Monday, September 12, 2011
Eventually it was determined that I wasn't making much progress; my contractions continued to be relatively insignificant. They were showing up on the monitor but were by no means painful. It was recommended to start an IV of pitocen, a drug designed to simulate the body's ocytoncin, the hormone responsible for progression of labor. I was not too upset by the IV, I figured I was going to be induced and would have required the drug anyway the next day. It was important to get my labor moving since my water had broken and they knew you had already had a bowel movement. Pitocen was added very slowly, then increased as needed depending on my progress in labor. It seemed as if labor continued to progress slowly, having barely dilated to 2 cm and 80% effaced after hours of being in labor. I questioned the medical staff multiple times if I was going to have the baby that day (Monday now) and all were convinced I would.

I decided to get in bed to try to get some rest. As the pitocen worked its *magic* I started counting and breathing. As the contractions started getting longer and longer I was getting more anxious by the counting. I decided to get up and do some laps. We joked with the nurses as we walked around and it seemed my contractions were timed perfectly with passing one particular nurses' station. The pain started amping up and I was having more difficulty with the strolling, plus I couldn't tell if I was nauseous or having heartburn. I was generally feeling uncomfortable. I went back to the room and threw up...awesome, I'd hoped after 31 weeks of nausea, with relief only at 38 weeks, I'd finally be rid of it. You'd think I'd had some major accomplishment though as the nurses were very excited. Apparently vomiting is a good sign that labor is progressing. I was given an IV of zofran to control the nausea (now on 3 IV meds, plus fluids). Our nurse suggested I try the birthing ball. I hung out on the ball while dad rubbed my shoulders and hair as I breathed through the contractions. I finally got to the point where I was having difficulty focusing and asked for nubain (a pain reliving narcotic) - the contractions were getting more and more painful, I was having consistent back pain, and pain that continued even after the contractions were over. I don't really remember the pain but it felt a lot like intense lower pelvic cramping. I changed positions frequently, from the ball to the floor, to standing up with my head resting on the bed. The first shift medical resident, Jen, came in to introduce herself and discuss my birth plan...around 6:00 am (at least it was light outside). I turned my head and looked at her in mid contraction and said "you have a cute haircut". Within minutes the nubain had kicked in and I was able to stand up, relax, and discuss my birth plan again. The medication made an obvious impact...the contractions were still painful but I was able to relax between each one. I explained to Jen that I wanted to try to avoid an epidural but was thinking that I probably wouldn't be able to. She explained that pitocen labors tend to be more painful (great!) as they bring on stronger contractions. I was checked again and was 5 cm dilated, it was nice to finally show some progress.

I decided to try the whirlpool tub which was a great plan, I was in there off and on for a couple of hours. I was so warm, and dad helped by massaging my legs during each contraction as a way to distract me. I was able to breath through each contraction for most of the time, but as the nubain wore off I was having continued difficulty with back pain and unrelenting contraction pain. I decided it was time for another nubain shot...which did nothing! Apparently it typically acts only as a placebo on the second dose...the nurse told my husband but sugested not to tell me.

I totally lost focus and could not manage my pain. I did not want to continue enduring the pain and asked for an epidural. I had read somewhere that in no other situation would a human be made to ensure that kind of pain without medical totally made sense in that moment.

I was upset about my decision and made sure your dad was okay with it too because he also wanted me to try natural labor, but he was totally supportive of my plan. My fears about getting an epidural and not being able to use my legs were gone. My OBGYN had told me that if I got to a point in my labor where I wanted an epidural I would not be's amazing how right she was.

The resident Jen came in and knelt next to the tub to calmly explain that getting the epidural would mean no more tub and a requirement to return bed, through my tears I whispered that I was totally okay with that. I was helped out of the tub by dad and the nurse, which was pretty challenging since the pain was so high. I got back into bed to get ready for the anesthesiologist. My contractions were painful and at one point I was gripping the bed rail, Jen calmly removed my hand and held it for me through the contraction. If it isn't obvious by now I really liked her, she was so nurturing and helpful through the final stages of labor.

I was very lucky, the anesthesiologist was in the building and came to my room in less than 15 minutes. I had to sit at the edge of bed very still while the needle was inserted. I could feel my legs starting to go numb, like super intense falling asleep feeling. It was weird because my left leg was more numb than the right. I was helped back to bed and finally had the ability to rest and relax. I was feeling pretty woozy, which I was told was from the last shot of nubain. I again was checked for progress and was told I was 8 cm dilated, very exciting...and I was happy to know that I made it so far into labor without the epidural.

The rest of the morning into early afternoon was a waiting game, waiting for more dilation and waiting for you to come down into the birth canal. I was able to get some rest with the pain gone...and grammie and dad were able to rest too. It was somewhat uncomfortable lying down even with the epidural, I could still feel some cramping in the upper part of my uterus and felt the muscles pressing up into my chest. I also felt like my butt was falling asleep...even though it technically already was. I kept trying to roll myself over from side to side which was NOT easy to do when the muscles in my lower part of my body were not available...and my trunk muscles had long disappeared. It was also weird because I could tell my body to move, see my body move, but could not feel it move.

After a couple of hours the doctors checked me and I was finally 10 centimeters, I remember looking at your dad and giving him 2 thumbs up :)

You still had to get down further into the birth canal so we waited about another hour for you to get into position. At 1:00 pm I was checked again and we could see your long dark hair! The birthing staff got a real kick out of seeing that, your dad took a picture for me so I could see it too. I was very excited because I had hoped you would have hair and we knew you were going to have plenty since it arrived way before you did. And the old wives' tale was true for me regarding heartburn during pregnancy.

You still weren't all the way down in the birth canal but since you were so close it was suggested that I get ready to start pushing. I was concerned about how I would possibly push when I couldn't feel what I was doing (and I was thankful for that!). There was some conversation about the possibility of trying to push with the epidural, turning down the epidural, or turning it off all together. In my mind I was thinking, oh goodness, do NOT turn off the epidural! We waited about 20 minutes for Dr. Wilburg to arrive (we had met him previously during labor when he explained about meconium and the process that might happen if you needed to be taken to have your lungs cleared out). Dr. Wilberg agreed that even though you weren't totally in place, we were ready to push. I was told that when I had a contraction to take a deep breath then push 3 times each to the count of 10. It sounds pretty easy but I had no idea how exhausting pushing would be and how hard it would be to count. I ended up losing count around 5 then winging it. I wanted to do a good job since I didn't want them to turn off the epidural. According to the people around me I did a great job, your head would appear then go away (typical for delivery). The doctor had to snip a little bit of tissue but he assured me it was barely anything...I wouldn't need stitches and wouldn't even notice it after the birth...I mention this because after what actually happened during the birth this little snip was insignificant and somewhat comical.

I was told that the doctor might shout to stop pushing because he was worried if you were really big your shoulders might get stuck and he would need to slow down the arrival to deliver your shoulders gently. During the delivery the doctor noticed "thick meconium", so the nurse called the NICU to have staff on hand when you came out. It was very odd to be in the middle of delivery and have all kinds of people pile in the room, but since I had time to rest between pushing, sometimes up to 5 mins between contractions, I was filled in on why they were there and their role to assist you when you were born.

Finally your head crowned. After only 10 minutes of pushing it took 10 seconds from when your head crowned to your entrance into the world according to the timestamp on our camera. You dad was firmly told to put the camera down and cut the cord...we weren't sure at the time why the doctor was so firm but we found out later it was a combination of making sure you were healthy but mostly because I had some complications inside the birth canal (I'll get to that).

As soon as you were born I got a quick glimpse of you, everything happened so fast I barely remember seeing you before you were whisked away. You were taken to a warming cart where the NICU staff cleaned you up, assessed you, and put a tube into your lungs to clear out the meconium (you didn't like it). Your dad was with you taking pictures and he got to trim the cord again since the first time was so rushed. I could hear you crying from the delivery table. Your dad was talking to you and trying to calm you down. I was REALLY anxious to hear about your stats (height and weight) were 21.5 inches long and 8 pounds 4 ounces...not the giant they estimated you to be.

At one point your dad tried to come over to see me because he had no idea what was going on at the delivery table, I told him to get back to you and keep you company. I had to deliver the placenta. I was really curious about the placenta and asked to see what it looked like. It was much smaller than I had imagined, probably the size of an eggplant. The doctors also commented on how beautifully coiled your umbilical cord was...I had no idea that people even took note of those things :) I remember thinking that I'd heard the delivery of the placenta can be painful and I was thankful it wasn' was only later I realized I'd had an epidural, so of course it wasn't painful! I pretty much felt nothing during both the delivery and the afterbirth.

Here is the part that is NOT included in the story to my daughter. I've included it here because it was a reality for me during labor and definitely something I will never forget. And I figure if I had to endure this, dammit I get to tell people about it! :)

During the delivery the doctor was very concerned because apparently there was a lot of bright red blood. He thought that I might have ruptured an artery. It turned out that as my daughter's head barreled down through my vagina like a tractor trailer truck at top speed it pushed into the bony notches in my pelvic causing tearing inside. She ripped her way through on both sides then down the back...both through the tissue and the muscle. I laugh at the little snip the doctor had done initially because it was NOTHING compared to this.

I had to have multiple lengthy repairs done to each of the layers. Her head, which I'd assumed would be cone-shaped was perfectly had made NO accomodations to mold to fit through. The doctor told me I could have easily delivered a 9 1/2 pound baby because my body would have just ripped open to allow it through. I spent about an hour on the table getting was odd to be naked and spread eagle on the delivery table with 3 people working intently in my vagina while 5 NICU nurses were in the room working on my daughter. The doctor told me I had the convinience of a vaginal delivery with the recovery of a C-section...hmmm. From what I've been told, of those people who tear, only about 4% tear like I for those of you who are pregnant don't be too worried, this is pretty uncommon. Plus, it is more common in a fast delivery...a little extra time pushing is a good thing!

Back to the story for my daughter: I was allowed to hold you after about 15 minutes. I couldn't believe how cute you were! I just stared at you and stroked your arms, back, and had SO MUCH hair! Really beautiful long dark hair on your head, and fuzzy dark hair on your ears, shoulders, arm, back, and was so cute. Everyone commented on your beautiful hair and long eyelashes. I kept thinking to myself, wow, we made this beautiful girl. I think I was in somewhat of a state of shock, I couldn't believe you were FINALLY here and that I was holding you in my arms. You made the most adorable little noises, they melted my heart. If I could have paused that moment in time I would have, it was such a special time for me.

2. What did you pack in your hospital bag? What did you forget to pack that you recommend pregnant moms to be pack in theirs?
I packed pretty much everything I needed for a weekend vacation. Only in hindsight I realize I could have used a couple different things. It took me FOREVER to get breast cream from the pharmacy...if you are breast feeding, bring it! I also would have brought black pants or shorts (the aftermath of labor is messy). I also found that nursing cami's are great for both nursing and for "skin to skin" because you can just peal the top down. I found myself topless a lot...and it's weird when housekeeping, the pediatrician, sister's boyfriend, etc walk in :) For the baby, I brought items that I might have wanted to use in her photo shoot (handmade blankets, hat, outift).

3. What was the best part about your hospital stay (besides meeting your little one of course)?
The staff at Maine Medical Center was awesome. I felt very well cared for in both the labor and delivery floor and the mother care floor. I would never have known there was anyone else in the building it was so quiet.

4. What was the worst part about your hospital stay (besides the labor of course)?
I think the hardest part about the hospital stay was waking up in the middle of the night to my baby choking on mucous. She was born so quickly and the mucous wasn't fully squeezed out of her system. I had to grab her and turn her over on my arm and bang on her back until the mucous came out. I was thankful for taking pediatric CPR a few weeks before and felt I could act on instinct. Of course the nurses were there too but it didn't dawn on me to push the call button until she was breathing again. We decided after that to keep her in the nursery because I was a panicked wreck and couldn't sleep for fear she would choke again.

5. What is your advice for new parents for surviving the hospital stay and making it more comfortable?
If you are planning on breastfeeding ask for a lactation consultant. They have the best, most accurate advice.

6. How soon after you got home after the hospital stay did you feel back to *slightly normal*?
My daughter is 10 weeks old...I am still healing from my tears and on modified not quite yet back to normal. The good thing about recovery is that I have plenty of time to enjoy my daughter without the stress of exercising. Amazingly, even though I make jokes about my body, I really don't care that I'm still carrying extra weight and my belly is kinda jiggly. It did something pretty amazing.

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