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Ursula's Birth

I went into pregnancy well educated about reproduction- I had taken my first endocrinology class years before, but immediately prior to becoming pregnant I had studied human medical genetics, an upper level embryology course and human reproductive biology. I had also worked for many years as a researcher in physiology. It was *because* of all that coursework that I decided to get pregnant when I did.

I knew LaMaze wouldn't work for me so I sought out a local alternative, non hospital based childbirth education course that very much encouraged knowledge of interventions and how they affect birth, practical attachment parenting, and breastfeeding basics. It was great! Over the course of pregnancy I read the scientific literature on when to cut the cord, why ob's like labor to be over within 24 hours, what epidurals really do, the function of the placenta, neonatal jaundice as an adaptive mechanism, oxytocin as a bonding hormone, and on and on. Lori (my ob) and I discussed the papers, she would dig through the literature and find more- our appointments were always scheduled for at least twice the normal amount of time. Dirk, my husband, is a computer science professor, but very interested in biology so he joined right in.

I was determined to have a birth with no meds, no induction, no monitoring. My due date was November 10, 1994 and my pregnancy just kept going. I had weekly ob visits scheduled including one for the 25th of November, which was over two weeks past my due date. My ob was very understanding and willing to work with me as we tried herbal methods of starting labor as well as acupressure, lots of walks, tons of sex. Finally on Monday November 21 I awakened at 6:00 am with contractions every five minutes. My friend from Chicago called and I told her to get on the plane and fly out, and I called our doula. All day I labored with contractions five minutes apart that were very manageable. Leigh, (the doula) and I walked the dogs and then I napped. Heather arrived from Chicago and we walked the dogs 3 miles. In the evening after dinner my friend Doloris came over to take my blood pressure and it was elevating- normally I have very low blood pressure- and I was pitting. (Pitting is when the indentation on the skin stays after being pressed with a finger- a sign of pre-eclampsia.) I called Lori, our ob and she thought it should be checked out. Monday night we arrived at the hospital, the fetal monitor showed heart rate decelerations, and an ultrasound showed very little amniotic fluid. (It hadn't broken.) So we stayed.

All night Monday I took Black and Blue Cohosh to encourage contractions as I wasn't dilating very rapidly. The contractions were quite manageable but more intense. I dozed and listened to my baby's heartbeat- steady and then slowing with every contraction. Heather, Leigh and Dirk took turns sleeping throughout the night as I figured I would need more from them later. :-) Lori, her baby and her husband (a neonatalogist) slept in a room next door.

Tuesday morning we strolled around the hospital (after a terrible breakfast), visited the chapel, had contractions. 30 hours after my labor started we discussed pitocin as I wasn't dilating very much. I agreed if I could have pain meds, and the herbal tinctures were causing my mouth to get raw from the alcohol. Lori reminded me that the risk of a c-section goes way up if an epidural is given so she suggested an IV painkiller. So I started on pitocin and fentynal. Once the pitocin started I couldn't leave the room anymore, but I did take a shower. Contractions really picked up when the water ran over my head- it was great!- but finally Annette the wonderful nurse asked me to get back to where it was easier to monitor. Heartrate decelerations were getting worse so out came the oxygen. With every contraction I put the oxygen mask over my face so the baby would get more. It made me feel like I was suffocating.

During the night- who knows when- I ended up having a walking epidural. (An epidural normally has a cocaine like drug in the epidural space, a walking epidural has a sedative in the spinal space.) I could still sit up, hobble with help to sit on my big inflatable ball, move around a little. My anesthesiologist was a great guy, but it was kind of funny because he had everyone put on little caps to cover their hair. I think the needle had to be re-done after 8 hours or so. I remember that all the overhead flourescent lights were turned on to do the epidural and it felt so *good* to have a *change* in something- so I asked that they stay on. Poor Lori came in in the middle of the night to be greeted by bright lights all around, and me still laboring. I had the same nurse, Carol, both nights.

Wednesday morning I was fully dilated- 48 hours after labor began. I started pushing, with propping from Heather, Leigh and Dirk. I was on my third nurse, Donna. By then I couldn't wear my contacts anymore, but had to take my glasses off with every contraction- what an irritant. :-) I pushed and pushed all morning but the baby just wasn't descending. At about noon - 6 or 7 hours after I was fully dilated, the doses of pitocin, fentynal and the walking epidural were no longer adjustable. In order to feel the contractions at all they were too strong to handle, and because of the pitocin they were coming right on top of each other. When Lori came in to check me I said, "Lori, this baby isn't coming out, is she?" She said she didn't think so... *sigh*

So I got ready for a c-section. It was brutal to sign the consent forms- it was brutal to wait for another anesthesiologist to come in and do a surgical spinal. The needle had to be re-done since it was no longer properly located, and the IV had to be re-done. No wonder- I'd been hauling around tubing for 27 hours by then. Lying on the operating table was awful- it was rock hard, and my upper body was shaking from the anesthesia. I had planned to watch the surgery if it came to that, but I just felt dreadful when Lori asked if I wanted the screen lowered and I said no. I wish I would have now.

When Lori got the incisions made (after a discussion with her husband about how big they needed to be- he thought I had a huge baby in there, but she won with the smaller incision) and got to Ursula we finally find out what the problem was. Ursula had a little teeny tiny short cord wrapped around her neck twice. Lori had to unwrap her cord before she could remove her from the uterus. Ursula had been bungee jumping in labor for 2.5 days. Dirk came over and told me that we had a "beautiful blue daughter" and then went back to be with her as she was being suctioned for a long time. Finally I heard her cry, Dirk brought her to me and then Dirk and Heather took her off to the nursery. Immediately I wanted to follow, and it seemed forever before I was stitched up and wheeled into a birthing room, although not the same one I had been in for two days.

Forty-five minutes after she was born I was learning to nurse her with the help of the hospital IBCLC, Terry. It's not very comfortable to nurse in a hospital bed, so next time I'm bringing a nursing pillow along. The IV and pitocin had puffed me up with edema so latching on was a little tough for Ursula at first. The nursery nurses were *terrible* because they wanted to prick her heel constantly to check her blood sugar, give her formula and have her lie under the warming lights. Even though I was exhausted I wouldn't let them and Ursula slept with me. Dirk and Heather passed out and I couldn't wake them during the night to help me with her so I had to ring the nurses. Having Ursula sleep on me and nurse constantly was the best thing for her- and me, too.

I got to spend half of Thursday (Thanksgiving) in the birthing room but then had to move to a very hideous post-partum room. I had to collect my urine to measure output, ring for the nurses to put Ursula in and out of bed with me- I really wanted to go home. The nurses in labor and delivery were so wonderful- the post-partum ones were awful. One came in during the night and very critically said "Oh, she's still on that boob, huh?" . I was so offended that she was using a derogatory term to refer to my breasts and that she was offering the standard 'limit the feedings' bad advice that I actually rang her back and told her. :-)

Finally Friday morning Lori said I could go home- but it took all day to get us discharged since it was the day after a holiday and tons of babies were born. I was so happy to get out of there and go home, nurse and nap, and eat good food. Because of the pitocin my milk came in on Tuesday, 6 days after Ursula was born. She was born at 6 lb 3 oz and was down to 5 lb 5 oz or so, but peeing and pooping quite well, and no signs of dehydration. I spent about a month just getting to learn to nurse, getting to know my daughter and letting my mother and then my in-laws do the rest. (Dirk was overwhelmed by teaching so he was letting everything go except that and taking care of us.)

It was a great birth experience- even though it ended with surgery. People sometimes feel sorry for me that I labored so long and then had a c-section anyway, but it was the way I wanted it. No one pressured me into anything, and Lori and I trusted each other enough to do that. I know I did everything to have a vaginal birth. I also know that I won't plan a c-section next time as it's really not the best way to give birth, nor is it a good thing to have to recover from when tending a little tiny wonderful baby.

I'm due with my second in 21 weeks. I have a different ob this time as Lori has changed practices to one too far away from me. Melissa, my new ob, makes jokes about my 'three week labor' but is very supportive of what we did. She's also supportive of my continuing to nurse Ursula throughout this pregnancy, and thinks Ursula is "so cute she should be illegal." :-) I do too.

Kate

Ursula's Little Sister, Olivia Sage's Birth