November 06, 2010

Not exactly as planned

Finally I am writing about my labour and delivery. Yes, it has taken quite some time. Kai has already grown out of some of his clothing, including the tiny knitted cap that he received at the hospital. People tell me that this time will fly past so I am taking lots of pictures and trying to cherish the beautiful moments. The longest-lasting periods of time are not those moments, however; they are the times when Kai is wailing in the wee hours of the morning and I am weepy from frustration and exhaustion. If Mother Nature has her way, I will soon forget all about the bad times and be eager to give Kai a little brother or sister. I'm not there yet.

As I posted last time, I have been wanting to document my labour and delivery. Much of it was a blur right after it happened. The memories get fuzzier the more time passes and the worse the sleep deprivation becomes. Kai is asleep on my lap right now and, while I should be napping, I don't want to lose my recollection of his day of birth altogether. It is time to write, coherently or otherwise.

After threatening to arrive prematurely and precipitously, Kai changed his mind and decided to stay in the womb so long that labour had to be induced. On September 7, following an internal exam by the on-call doctor at the hospital, a gel was applied to my cervix to start dilation. The doctor happened to be male, and because of this Scott was decidedly uncomfortable. Have you ever seen footage of someone reaching into a cow to help her birth a calf? That was what came to mind every time a doctor or nurse had to give me an internal examination toward the end of my pregnancy. They appeared to be up to their elbows trying to reach my cervix. This was odd, seeing as Kai's head had been pressing on my cervix for the past several weeks and had felt as though it was about to emerge at any moment. At any rate, Scott's discomfort was nothing compared to mine. I put late-pregnancy cervical exams at the bottom of my fun-activities-for-a-rainy-day list.

Because my parents live much closer to the hospital than we do, Scott and I spent the night at their place. The next day I had a 10:30 am appointment to be induced. At 8:00 that morning, I awoke with the realization that the gel had done its job; Scott then awoke to the sound of me saying, "Water broke! Water broke!" while I grabbed tissues and tried to avoid wetting the carpet in my parents' spare bedroom. I was remarkably calm, except for worrying about the carpet. I had read up on the stages of childbirth and knew that my water breaking was not necessarily indicative of the baby's imminent arrival. Mild contractions began at about 8:15 am. I called the maternity ward and they instructed me to come in for my appointment as scheduled. Meanwhile, Scott walked through the kitchen, said good morning to my dad and mentioned that my water had broken. My father's feet barely touched the floor as he raced around getting ready to drive us to the hospital. I reassured my parents that there was no rush, and I took the time to shower and have breakfast.

Once at the hospital, Scott and I had a great deal of waiting in store for us. Most of the patients who had been booked for induction were being sent home, as the department was full of unscheduled labours and deliveries. I would have been sent home too if it weren't for my water having broken. I counted myself as lucky. Eventually I was brought to triage, examined, given a pair of hospital gowns and told to take a hike for a couple of hours. We found a quiet hallway where I paced while Scott timed my contractions. They came as close as three to five minutes apart. I found it difficult to determine when they started and ended, perhaps because they were fairly mild. Over the next several hours I split my time between pacing the halls and laying in a triage bed cringing at the wounded-animal sounds of the labouring women around me. At the time I had to wonder about the apparently low pain tolerance of my fellow patients, as my contractions weren't even bad enough to make me gasp.

I don't recall how my dilation was progressing, if at all, but I do remember that it took many hours and a shift change before I was actually admitted and brought to a labour and delivery room. It seemed that everyone was too busy to look at my chart; I was dismayed at having to tell each new staff member who saw me that my water had broken that morning. I had heard that a woman should not go too long between her water breaking and delivery, as every hour that passed meant an increased risk of infection.

Eleven hours elapsed between the onset of contractions and my first dose of Pitocin to induce labour. I was hooked up to monitors and both Scott and I were given blankets and pillows; it was going to be a long night. My contractions continued uneventfully. Scott and I chatted and I remained in good spirits. I was relieved to be out of the triage room full of drama queens who couldn't handle a few cramps. As punishment for thinking such a nasty thought, I was suddenly hit by a contraction that made my head spin. The Pitocin was working. "I need an epidural," I blurted. Scott left the room to find a nurse. He returned with an angel. Emily was to be my labour and delivery nurse for the remainder of her shift.

Emily called in the anesthesiologist. That was reason enough to love Emily, but her bedside manner sealed the deal. She was terrific. I won't go into detail about the epidural except to say that, due to my scoliosis, it was unpleasant and took two attempts. Scott and Emily kept me calm throughout the process. Once the painkillers kicked in, I was in good spirits again. This is also where my memories become confused. I recall that I began dilating rapidly. Parents visited, monitors were hooked up, Scott and I snoozed occasionally... not necessarily in that order. In fact, "not necessarily in that order" applies to this entire post. At some point we moved from a cramped, last-resort delivery room to a large corner room. I was rolled in on my bed, so the move made little difference to me except to confuse my memories further.

Thanks to the epidural I did not feel any pain, but the baby's heart rate plummeted with every contraction. I recall Emily requesting assistance, calling out what sounded like, "I need help with a bratty!" I was lucid enough to realize that she was talking about bradycardia, a low heart rate. My medication was adjusted repeatedly. The on-call doctor came in from time to time. At one point the baby's heart rate dipped to 40 and I asked how much longer he could tolerate the fluctuations. Although the baby was in distress and labour was not progressing as hoped, the doctor said that she wanted to avoid a C-section if possible. That led to many more hours of labour and additional scary episodes of fetal bradycardia.

Finally, after thirty-one hours of labour and a few attempts at pushing, it was determined that the baby was stuck. In medical terms, the doctors decided to perform a C-section due to "failure to progress and non-reassuring fetal tracing." Baby Kai was born on the afternoon of September 9, 2010. He was healthy, weighed 2950 grams (6 lbs 8 oz) and measured 47 cm long. And with that, life changed forever.

Because I was behind a surgical drape it was several minutes before I saw the baby. Or at least it felt like several minutes. My sense of time was skewed due to the medication. Following the surgery we moved to a recovery room. I thought that perhaps 20 minutes had passed before we invited our families in to meet Kai, but I am told that it was actually a couple of hours. What do I know, I was as high as a kite.

Scott, Kai and I spent the next two days in a private hospital room. "Private" refers only to the number of patients in the room and does not describe our first little while as a family. Nurses came and went at all hours, poking, pricking and medicating. Most were nice, but some were gruff and unpleasant. I noticed this in spite of being on an extended adrenaline rush that had me out of bed and fluttering about long before I should have been so active. Our hospital stay included incidents of incompetence, a great deal of contradictory advice, continually interrupted sleep and a startling amount of bloodshed after I accidentally pulled out my IV. I also found myself in tears off and on, which was to be expected. What I hadn't realized was just how long the tears would continue. But my post-partum depression is a topic for another post. For now, the happy side of things: some more photos of Kai.