I'd had 2 sleepless nights in a row on Sunday and Monday, making me a tired and grumpy woman on Monday and Tuesday, Nov. 19 and 20, which were also A and Ls 3rd and 12th bdays, respectively. I pulled myself together, baked cakes and pulled off the birthday celebrations. Daryl joked with me on Tuesday morning that I only had to get through another 16 hours or so until it was tomorrow because the then baby would come, to get it's own birthday.
Tuesday night we finished birthday cake around 10pm and I headed to my room to lay down. I was watching TV, totally exhausted, when around 10:30pm I had a very strong contraction, stronger than any I'd had on the preceding nights. I had one every 10 minutes for the next half hour, but they weren't all as strong as the first. Daryl came to bed at 11pm and I warned him that this might be it.
During the next half hour, they shortened to about one every 7 minutes. I completed packing my bag during this time. I now told Daryl not to fall deeply asleep, as I wanted his help. He jokingly said, "Don't worry--I'll drive you." I told him I needed his help with dealing with the contractions, so he got out of bed and made an espresso. When he came upstairs again, he witnessed a difficult contraction. After it was over, he said, "Get dressed. We're going." I called labor and delivery triage to tell them we were on our way. Our big kids were still up, as Daryl had told them around 11:30pm that we were leaving soon. It was now midnight. We arrived around 12:30am. The contractions were now about 5-6 minutes apart. Some were very painful, others were not--they varied in intensity.
After running the obligatory monitor strip, asking me the same questions over several times, etc. the head triage nurse came in to check my cervix. She said she couldn't feel any cervix, just a lip and a bulging bag of waters. I was speechless when I realized that she meant that she couldn't feel my cervix because it was TOTALLY DILATED. She went to get a doctor, saying they would probably just break my water and I'd have a baby.
They quickly moved me to a room, and the doctor (Chief Resident) came in. He wanted to know if I'd consider waiting to see if they could give me the antibiotics for Group B Strep. For the antibiotics to be effective, they have to be administered 3 hours before baby arrives, or the baby will have to have a shot. He said it was possible that my water wouldn't break on it's own for 3 hours. I told him I didn't want to wait that long and didn't see the point, since most likely the baby would have to have the shot, and then I"d have taken the antibiotics (and continued laboring really hard) for nothing.
The Chief Resident went and got the Attending, who had the same discussion with Daryl and I. The doctors left the room briefly so we could think about it and dh and I were confused by how hard they were pushing this idea. At that point, the nurse, who was wonderful, told us, "Just tell them what you want to do." When they returned, we said that we wanted to break my water and have the baby. I also declined an IV but agreed to a heplock inserted in my hand in case of emergency, which doctors said was not negotiable due to the risk of heavy bleeding associated with having had so many babies.
Next the pediatrician came in, and we had the SAME discussion about antibiotics with her! I was now contracting every 3-4 minutes, and they were more intense. Finally, after convincing them all that we were SURE we didn't want to start the antibiotics, the Attending, who was a woman with a very warm and friendly midwife-like approach, checked me. She said that while I was fully dilated, the baby was too high to break my water without risking cord prolapse. She said that was an option if we were willing to risk it, but that the other 2 options were: continue laboring and wait for my water to break on it's own or she could poke a tiny hole in the amniotic sac with a needle, wait for some water to drain, and then fully rupture the membranes.
I chose the latter option. What she didn't tell me was that I had to stay laying down while she kept her hand inside, massaging the sac to drain the fluid. I did NOT appreciate this during contractions. After a few contractions, she felt it was safe to rupture the sac, but had some trouble getting it to break. When it did, there was a thick meconium. She had warned me that my cervix might recede to about 8cm after my water broke, as the bag was holding it open. This did happen. I had done some pushing during the draining of the fluid and after, but it wasn't very effective.
At this point she said I could do whatever I wanted, so I stood up. I knew instinctively that I needed gravity to bring the baby down and redilate the rest of the way. Standing up made the monitor lose the baby's signal, so they insisted I either lay back down, or allow a fetal scalp monitor. I allowed them to place the fetal scalp monitor. After another contraction, they checked me again and said I was 8-9cm, but so stretchy I could push any time I wanted. I still didn't feel the urge, so I kept standing. Halfway through the next contraction, I felt the urge to bear down really strong. I jumped back onto the bed and said "I need to push NOW." The staff scurried to break down the bed and call pediatrics (due to the meconium). I pushed through the rest of that contraction, and during the next one his head emerged. They encouraged me to continue pushing and another contraction began, but his shoulders were stuck. This happened so quickly that I was unaware of it, but suddenly the bed was flat (I had been pushing in a semi-upright position) and the nurse was pushing on my belly and there was a commotion around the baby. I said "What's going on?" but everyone just told me to push, so I did, and the Attending reached in and rotated his shoulder, and out he slid. He was only stuck for a matter of seconds.
They whisked him away to suction him. He was fine, and we were relieved. Meanwhile, I had a small gush of blood after he was born. This alarmed the doctors, who ordered pitocin and began attempting to free the placenta. Up to this point, until the baby was out, I had not shed a single drop of blood--no bloody show or other bleeding during labor, which was unusual for me. Although they told me that it normally takes 20-30 minutes for the placenta to emerge, they kept pulling at it and massaging my uterus. After 10-15 minutes, they handed me Mateo and I put him to the breast. He latched right on like a pro. I immediately felt cramping, and said to the nurse that it was either his nursing or the pitocin kicking in. She said it was definitely the nursing, since she was just getting the pitocin started. I did not hemorrhage or even bleed heavily despite the doctors' worries. Soon the placenta emerged, the doctors all left, and Daryl and I were alone with Mateo and the nurse.
He was born at 2:11am. Around 4:30am Daryl headed home. He had called home soon after Mateo arrived and told our oldest daughter the news.
The shoulder dystocia, which seemed like a big at the time, in retrospect does not, although the Attending told us that it was "a true obstetrical emergency". Looking back on other births, I can certainly remember the midwife reaching in and easing the shoulders out, especially with my biggest babies, but just being more low key about it.
If we hadn't spent all that time discussing whether or not to have antibiotics, Mateo probably would have arrived much sooner. I am truly glad that my water didn't break in the car, since there would have been a good chance that we wouldn't make it to the hospital. I would love to know how dilated I was when labor began that evening, since the number of truly hard contractions I had was probably 10-12 at most.
I had to stay 36 hours due to GBS, but the pediatrician released us after only 33 so I went home at 11am in time for Thanksgiving dinner!
And yes, now we have birthdays on Nov. 19, 20 and 21!
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