The Delivery

Or, the agony and the ecstasy

I debated whether to even do a post about the delivery or to just end the blog at the end of my bed rest, since this story mainly has revolved around the pregnancy. Plus I know other women who have had even worse birthing experiences than I did, so I don't want to leave the impression that I think mine somehow was more unique than the rest. But it just didn't seem right to bring you up to the end of the pregnancy and then just say, "And then he was born and everything was hunky dory." Because besides being anti-climactic, that wouldn't really be telling the whole truth. So here it is, in all its gory glory--Caleb's birth story.

I ended the previous post at the point when I woke up to my water breaking in the wee hours of Saturday, August 25. After I shouted at John, telling him my water broke, he responded, barely conscious, "Are you sure?" (The guy was understandably gun shy after so many trips to the ER). Growing more agitated by the second, I said, "Yes, I'm SURE. Come take a look for yourself." It took him what seemed like years to get out of bed, and as I told him to grab our bags and put Bauer outside, I sent out a group text to my friends and family and called my mom. We were planning on using our miles to book her a last minute flight out once I went into labor, rather than having her come out before, since we had no idea when Caleb was going to be coming.

So John shoved our bags in the car while he talked to an airline agent to get the flight arranged. After he got off the phone he took one look at my soaked pajamas and said, "Let me get a towel to put down on the seat." Barely keeping it together, I said, "Okay, but HURRY!!"

I know they tell you that you usually have quite a bit of time even after your water breaks before the baby arrives, but I was still feeling panicky because with how far progressed I was, I had no idea how close we might be to Caleb's grand entrance.

We arrived at the hospital and an attendant wheeled me up to L&D, where a nurse got me settled into a room and told me the doctor would be in shortly. It was weird to be back in the maternity wing, where I had been so many times before, because while in the past we had always been trying to stop him from entering the world too soon, this time we were focused on ushering him into it.

The contractions were starting to get stronger than I had ever experienced before. The nurse checked my cervix and said that it was still dilated about 3 cm, then another nurse started inputting information into the computer next to the bed. (I don't know why they had to re-enter all that stuff every time I visited...you'd think they'd still have my address and birth date in their system). As she asked me questions about insurance and medical history, my contractions were gaining steam and making it hard to talk. So it was then that I had my first "momzilla" moment and said, "Shouldn't...you guys...already have...all this...info...BY NOW?!" John could tell I was about to go postal on the poor woman so he took over and answered all the questions as best he could.

Sideways

At this point I asked if they could call my doctor and see if he could come in, but they told me that unfortunately he was still on vacation and wouldn't be back until Monday. The doctor on call was the one who had done the cervical ultrasound so many weeks before and had told me I was doing everything I could to save Caleb. When he walked in and saw me at a much bigger 38 weeks, he recognized me and said how surprised and happy he was that we had made it that far. His soothing voice and gentle demeanor instantly helped calm me down a little bit.

As he checked my cervix and Caleb's positioning, I could tell by his face that something wasn't quite right. He said that Caleb was sideways (which explained why my belly had been so lopsided for the past several weeks) and that we would have to try to turn him in order for him to get through the birth canal. I immediately said okay, not realizing how painful the turning process was going to be. The doctor reached his hand up there and started twisting, breaking my water even further. My guts felt like they were being wrung out like a wet rag as blood and fluid gushed out onto the bed and floor (sorry, didn't know you were in for a Stephen King novel, did you?). He said he was able to turn Caleb's head to the correct position, but he wasn't sure how long it would stay that way.

The contractions intensified after that and within a couple of hours I was dilated 5 cm and eligible for an epidural. I decided to get one. I had gone into the delivery with the philosophy that if I could do it naturally that would be awesome, but if I felt I needed the epidural I was going to get it. (I now have a slightly different philosophy, given what ended up happening).

The anesthesiologist came in and got the epidural going. He had to redo it once because the first time it gave me a burning sensation that apparently wasn't normal. But after everything got worked out, the drug started setting in and I became a lot more comfortable, enough so that John and I were even able to take a nap for a couple hours. The doctor came in and said his shift was ending and that he had been hoping he'd be there for the delivery but that it looked like it would be the next doctor on call who would do the honors.

Post-epidural. Drugged and delirious.

The new doctor (who is one of the doctors in my doctor's practice) came in and introduced himself and asked if I had any questions. I wanted to know his stance on episiotomies, and he said he only does them if they're absolutely necessary and that he would ask my permission first if that became the case. That sounded all right to me.

Around this time my mom's flight arrived so my friend picked her up at the airport and brought her to the hospital. I felt a huge sense of relief when I saw her, because it was important to me that she be there for Caleb's birth. Shortly after that, at around 10 a.m., I asked a nurse to check my cervix again because I was pretty sure that I was fully dilated. She said I probably wasn't but that she would check. Sure enough, I was at a 10 and probably had been for a while.

When push comes to shove

Since I was dilated 10 cm, they told me I could start pushing. So I put my knees up and tried to push, and that's when I discovered a problem. I couldn't feel anything. I had no idea if I was pushing or not. And then they discovered another problem. Caleb's head had gone back to being sideways.

The doctor came in and was able to reposition Caleb again, but he said he wasn't sure if it would hold. He also said that we were going to have to wait for the epidural to wear off some since I couldn't feel enough to push. By this point I was ready for the whole experience to be over and asked exasperatedly, "Can't you just reach in there and pull him out?!" Apparently that's not an option if the baby hasn't even crowned yet, but at the time it seemed pretty feasible to me.

As the medicine wore off and the contractions grew stronger, I started trying to push again. We fell into a rhythm where I would do three pushes and then rest. The first push was always my best one and Caleb would move down a little further, but then during the second push I started losing steam, and by the third, rather than moving down he would instead retract upward to his previous position.

Part of the problem during this whole thing, I think, was that I hadn't been able to take any birthing classes, since I had been on bed rest the entire third trimester. John had rented a couple DVD's at the library and we had watched them on the laptop while I was in bed, but it's not the same as being able to practice it. On top of that, I had zero energy as a result of being bed ridden for so long, and I had no muscle strength to draw upon to get through the pushing and the delivery.

On top of being physically unprepared for labor and delivery, I was completely unprepared psychologically. For so long, I had been doing everything I could to avoid delivering Caleb that I just wasn't ready for this experience. It was like I was stuck in a completely different head space than the one I needed to be in at that moment.

The nurse could tell I was in emotional distress and asked what I was afraid of. I told her I was worried I wouldn't be able to give birth vaginally and that they'd have to do a C-section. I told her this partly to explain why I was scared and partly to make my feelings known on the matter in case they were going to start pressuring me in that direction.

I didn't want a C-section for the normal reasons---it's better, if at all possible, for the mother and for the baby to do a vaginal birth (obviously there are situations in which this isn't possible and a C-section becomes the safest option for all parties). But additionally, for me it was really important to avoid doing a C-section because when a woman with an irritable uterus like mine has a C-section she can have serious complications in subsequent pregnancies...as in, her uterus ruptures. Obviously, I wanted to avoid the potential for that complication at all costs.

My doctor and I had already discussed this, but I wasn't sure where the doctor on call stood on the issue. Fortunately he completely agreed, which is why I think they ended up letting me labor and push longer than they usually allow women to do these days.

So I kept pushing. And pushing. At one point, after another round of three pushes where they could see Caleb's head start to emerge and then retreat back again after the third push, the nurse said to me, "Are you sure you're pushing as hard as you can?" I've never wanted to deck anyone more than I did in that moment. John later said that if looks could kill, mine would have.

But I would like to point out that even though John and I both expected that I would be cursing like a sailor during this whole experience, I didn't swear once. I think I was too traumatized to even get a four-letter word out. Instead I just kept gazing at the crucifix hanging on the wall and thinking, "God help me. God help me. God HELP ME!" While I didn't end up flying off the handle with anyone, at one point I did turn to John and say, with complete conviction, "Not a single person in this hospital knows what they're doing!" He still laughs about that one.

You've got to be kidding me

I wish the doctor had come in more frequently, because the next time he finally did, he explained why the pushing wasn't working. Caleb's head had returned to being sideways. And since his head was sideways, I was basically trying to push out a head circumference twice the size of what I would normally be pushing out. So Caleb's poor little dome was getting stuck under my pubic bone, and my poor pelvic muscles and joints, which were already completely shot from how low I carried him during the pregnancy, were struggling to accommodate this unusual delivery.

The doctor said he wasn't going to be able to get Caleb's head turned again and he and the nurse asked if I wanted a little bit of an epidural to take the edge off. Looking back, I shouldn't have done it. But I didn't know what would be best and I wanted to do everything I could to help myself get through this ordeal without having to resort to a C-section. (I now understand why it's beneficial to have a doula or someone present, because I could have used an objective third party to help me weigh my options. It's really easy for a woman to lose her voice during this whole process when so many medical people are telling you what you should be doing).

So they gave me the epidural bolus and guess what happened? It killed my contractions. The labor completely stopped. So there we were, Caleb partway through the birth canal, and my body was no longer trying to push him out. After some debate, they ended up giving me Pitocin to induce contractions again and the doctor told me I'd have to go epidural free from then on out and deliver naturally.

The Pitocin kicked the contractions into hyper drive. I started the whole pushing process over again and eventually, we got to a point where the nurse said they should bring the doctor in because we were finally getting close.

The final countdown

When the doctor came in and assessed the situation, he said we were closer but that I was going to have to push really hard to get Caleb out. My first thought was, "What do you think I've been doing this whole time?!" But all I could manage to gasp in response was, "This. Sucks." Everyone in the room laughed, except for me.
 
After some gut-wrenching pushing sessions, I saw the doctor reach for the scissors. John later told me the doc was about to ask if I was okay with him doing an episiotomy, because he could tell what was about to happen. But I didn't hear him because I was busy expending the very last ounce of strength I had to give one final big push. As I pushed I heard a loud scream and felt Caleb's head finally break free (turns out the person screaming was me). I felt my muscles tearing and skin ripping and then watched as the doctor quickly dropped the scissors and reached in his hand to help guide Caleb's head the rest of the way out as blood poured over his little face. I gave a couple more pushes to get his shoulders through, and then...he was out!

And so, after so many anxious months followed by 13 hours of labor, Caleb Brenler Proffitt arrived at 3:54 p.m. on August 25, 2012. He was safe. He was healthy. He was beautiful.

As they cleaned Caleb up I saw a big hemotoma on the side of his head where all the trauma occurred. It looked like he had a little horn. I asked if it would be permanent and the nurses laughed and assured me it would go away. And then they placed him on my chest. I wish I could say that in that moment I felt overwhelming love and peace, but all I felt was pain and I wanted it to stop. The delivery had given me a third degree perineal tear, which I won't go into detail to describe, but let's just say little Caleb blew the church doors wide open during his grand entrance. And because the epidural had worn off and the local anesthetic wasn't working for whatever reason, I could feel the entire stitching process. So I was annoyed and tired of being in pain and all I wanted to do was enjoy holding my baby.

The doctor finally finished sewing me up and people started clearing out of the room. And then there were three. Our little family. I stared at my boy's face, memorizing every feature, and couldn't believe he was actually there. Safe, in my arms.

Finally, safe in my arms.

With Caleb's birth at 38 weeks and a healthy 7 lb. 7 oz. and 21 inches, I thought we were finally out of the woods. And in the glow of that late summer afternoon, it was easy to believe the darkness was finally behind us. But as one trial ended, another loomed just ahead. Because for me, a new darkness was descending.

~~~~~~~~~~~~~~~

So after really wrestling over whether I would share what happened after Caleb was born, I think I've decided, for a few different reasons, to go ahead and write a post about it. But for now, I'm going to end this post with the most incredible moment of my life, after God enabled my broken body to safely deliver our precious son and John and I stared at him in wonder as he nestled against my chest, breathing steadily on his own with fully functioning lungs, our hearts beating together in time.

Three's company

I created a Labor & Delivery playlist in my Spotify account to have playing in the room to help me focus and keep calm. These two songs are from that list. The first, "Show Me," by Audrey Assad, is kind of morbid in one sense, but in another it's kind of the perfect song for someone in labor, because in a way, a woman really does go through a process that feels like death in order to bring forth new life. The second song, "In My Arms," by Plumb, is one of my favorites because it perfectly encapsulates how I feel when I'm holding Caleb.