Archive for September, 2011

Birth, Boxing and Plan B

All of you that saw me during my pregnancy knew I wanted just a few things: to have a healthy baby; to stay active and reasonably fit while pregnant; and to have a natural, unassisted childbirth.  I got the first two. 

When I’d tell people I wanted to have a birth without an epidural, they’d say “You don’t need to be a hero.” Women around the world give birth every day, some with pain relief and many without.  I didn’t think it made me a hero or special or unusual – an unassisted birth was just an experience I wanted to try to have.

The pain of childbirth didn’t scare me too much, I was more in awe of the nothing-short-of-science fiction, physical changes the body goes through to let that little one out into the world.  I mean a hard, firm tissue (the cervix) actually thins down to the thickness of a piece of paper and then gets out of the way so the uterus has an opening to push the baby out of – that’s wild! And don’t get me started on the placenta, what a miraculous piece of engineering that is.

Pain, I’m used to – especially in 60 second or so increments – because of how I workout.  I love a hard workout and I love the satisfaction of pushing through to the other side (unfortunately, at times I’ve done this at a disservice to myself). So the pain part didn’t really worry me – it was fear of the unknown that did.

Post workout belly pic the week before my due date.

Being unsure of  what exactly would happen to me, to my body and to my baby when this all gets under way was what got to me.  Fear is one of those things that messes me up, so I knew if I could stay calm and not get scared I’d be ok.  So that’s what my childbirth readying was all about – managing stress and not being fearful.  I figured at worst this would be helpful to me in my everyday life! So I skipped Lamaze and opted for Hypnobirthing – very naturopathic of me, I know.

Hypnobirthing was about staying calm, not giving into the popular notion that my body can’t handle this without a lot of medical intervention, and keeping the focus on the baby.  The language they use in Hypnobirthing was great: let the baby out vs. push the baby out; surges vs. contractions; and birth vs. labor.  I wasn’t actually hypnotizing myself (never got into it that deep) but I was able to learn to keep myself relaxed  for 9 months as my body changed, my practice exploded and my life as I knew it took a 180 degree turn.  I really loved what my pregnancy taught me. Despite the birth not going according to plan, I’ll always have those lessons I learned:  to slow down, stay calm, know “it can get done tomorrow” and I can be busy but the stress is optional (something I wish I learned YEARS ago!).

So now what happened when it came time to give birth?

When I hit 8 months, almost to the day, I started having Braxton Hicks (or false) contractions. They didn’t really hurt, but they were new.  Most women who have these have them off and on throughout the second and third trimester. Prior to this I’d had just one or two, but all of a sudden I was having them every day, all day.  It wasn’t alarming and I’d always expected that I’d deliver early. These contractions told me I was probably right – my body was getting ready.

The second week of August was incredibly busy as I tried to squeeze in a few more new patients and of course get everyone set on a protocol or plan to work on while I was on leave – I didn’t want anyone to feel left behind or to be not making progress during my time off.  And true to form a certain family member of mine had some big drama that threw my already crazy week into overdrive.  Armed with my “keep calm” outlook, I held up pretty well.  Contractions kept steady at a couple per hour most hours of the day and my doctor said I was dilated 1 cm – all normal for 37 weeks.

The week ended with me feeling more than contractions. I felt very crampy, tired, uncomfortable, and not able to exercise or even walk more than a few blocks – figured we were getting close! During the next week everything stayed about the same and I wrapped up loose ends at my office – until Wednesday when things felt weirder still….and I was exhausted!

Auntie Jessica

I’d planned on having my sister in law, Jessica, as my birth coach – however, she lives in Colorado and she wasn’t scheduled to be here for over a week. Thinking we were “oh so close”, I changed her ticket. By the time she got here, all the “weirdness” had stopped and I was back to being able to walk a ton, good energy and just those little contractions.  Oh well! We had fun working out and shopping for a few last minute baby things. Amidst our running around, pedicures and massages, we had an earthquake here in NYC – and mommy was getting a little uncomfortable being this big.

My dad came out for a quick visit and to see his first born full term pregnant. We a great few days and then we had a hurricane! Thinking my baby must be the third in these phenomena of Mother Nature’s – and hoping the barometric pressure change would break my water and we’d be off to the races…but no such luck.

Next up was the arrival of my brother (Jessica’s husband) and my niece – again, more fun but why wasn’t I getting any baby action??? Now just one week from my due date I saw my doctor and she said, “You’re due next Tuesday and you’re obviously getting uncomfortable, so how about we just induce you next Wednesday when I’m on call?” My OB is perfectly nice and clearly capable as a physician, but here we are week 39.5 and still not at all on the same page.  I reminded her the last thing I wanted was to be induced. She said shewas fine waiting until 41 weeks, but then I’d have to be induced. She stripped my membranes hoping it would speed things along (By the way, this was not comfortable! And she didn’t even tell me she was going to do it – she just did it while checking to see how dilated I was.  A little heads up would’ve been nice. Grrr…. we just were not in synch which was increasingly stressful as I approached my delivery.)

We left the doctor’s office to meet Jessica and family in Central Park and I realized that things not going the according to my birth plan is already a very real possibility. Not even in labor yet and we are talking induction, which means Pitocin.  Pitocin is not inherently evil but it was not part of my plan. It is synthetic oxytocin, the hormone associated with emotional bonding and I wanted my own flooding through my veins,  when I had my baby, not the fake version.  Pitocin also produces very strong contractions, so an epidural is also part of deal here as well.

Pitocin was the one thing I really didn’t want , but so far I’d been doing everything to move things along with no luck: lots of walking, weight lifting including full squats (butt to heels) to get plenty of pressure from her little head on my cervix, sitting frog-legged (for the same reason), drinking red raspberry leaf tea, homeopathic remedies and acupuncture.  I even tried castor oil…yuck.

My three year old niece wanted to see the Statue of “Libery”, so we set off for a boat cruise on the Hudson. We figured a little rocking around on the river couldn’t hurt my situation either.  After the membrane stripping, I was having stronger contractions and was very uncomfortable at dinner that night. No appetite and again, totally exhausted.

The five of us spent another night, laughing and having fun. I’m so grateful for these few days with my brother and his family I simply can’t even express it, it was just so special for me.  Getting ready for bed I had the first of what under any other circumstances would be just plain gross “events” of birth: passing of the mucous plug. This did mean though that things were finally happening. Yeah! Contractions were strong all night, but woke up the next day to nothing.  The contractions, even the little ones, had totally stopped.

Super frustrated, we went for another walk, I gave myself more acupuncture and we headed off to dinner around 6pm where all of a sudden, my contractions picked up again. They were 2-3 minutes apart – finally! And held stead there for 3 hours so Jessica, Joe and I packed up the gear, called the car service and crossed the Brooklyn Bridge into Manhattan. Finally, here we go…

First stop: triage (where they will decide if I’m ready to be admitted or not).  I was put in a “room” (aka behind a curtain) and my history was taken by a nurse.  I told her about my uncomplicated pregnancy and of course was asked what I’m allergic to: penicillin and latex.  Now hooked up to the monitor with contractions measuring above 100 (150-170 is when the pushing happens) she said, “You are in labor, so sit tight and I’ll send in the doctor to check you.” Great, now hopefully I’m dilated over 3cm or they will send me home.

They let Joe in to sit with me and we watched my contractions continue at 100-120. They hurt but it I felt pretty good – which is more than I can say for the lady across the way from me. She was screaming hysterically – she sounded completely and utterly terrified. Joe asked, “What the hell are they doing to her??!!  It sounds like she’s getting a C-section without anesthesia!” I didn’t know what they were doing but it sounded horrifying.  She was screaming about how much blood, was the baby ok, and apologizing over and over again.  Her husband and the doctor were telling her it was going to be OK…..turns out they were doing a blood draw and she hates needles.  Wow.

The chief resident finally came in and took my entire history – again. Seemed weird – shouldn’t that piece of paper the nurse wrote on be following me somehow? She checked my cervix and said, “You’re at 2-3 cm is all. Do you want your epidural now?”  I replied, “Um, no thanks.”  “So you want to wait?” she asked. I replied, “No, I don’t actually want one at all..”  She looked at me surprised, “Really? Not at all?” I told her I’m not planning on it, at least at this point.  “Huh, OK”, she said, “Then I’d say leave and go walk around for 2 hours and come back. If you stay here we’re gonna want to intervene and mess with you”. Thanks for the honesty. I’ll see y’all in 2 hours.

We left the hospital at 11:30 pm and I wish I could’ve just gone to bed, I was so tired already – but we walked around for 2 hours and then went back to triage. My damn history was taken by yet another nurse.  Do I not have a chart around here? This is ridiculous.  Next they send in another doctor to see if I’ve made the 3cm cut.  She does the exam and says I’m at 3cm and they will admit me – but before admitting me, she takes my history….AGAIN! Of course, she asks one more time what I’m allergic to.  When I say latex, she replies “Oops, sorry.” I asked, “Did you use a latex glove for my exam?” “Yeah, sorry about that,” she replied. Well that explains why I’m starting to itch like crazy – luckily there is so much else going on down there that the allergic reaction I was having was the least of my worries.

In labor and delivery finally and of course, the nurse in my room took my history again. Afterwards, she did put a sign on my door and an allergy bracelet on me – whew, no more accidental latex exam gloves! Another nurse came in to put a hep lock (a plastic tube that goes in the vein in the back of your hand for an easy IV hookup later).  I said I didn’t want it as I wasn’t planning on an epidural.  She left to grab any doctor from the hallway to get me to cooperate.  Some random doctor came in and said, “I see you have a birth plan (not that she’d read it) but you have to have the hep lock, it’s protocol”.  I asked, “Is it protocol or is it mandatory?”  She rolled her eyes, already stepping backwards trying to leave the room and not deal with me, “I’d recommend it.   “But is it mandatory?” I asked.  She repeated, “It’s protocol.”  I said, “Just tell me if it’s mandatory and we can stop having this discussion. If it’s not, then let me decline it.“ She just sorta stared at me blankly repeating yet again, “Its protocol.”  Choosing my battles, I told them to just go ahead and put the damn thing in….this was not the hill I was going to die on.

Now admitted, settled and with Jessica snoozing for a minute in the chair, Joe talked me through the contractions. I was hitting 120-150 now and they were still 2-3 minutes apart.

My wiggling toes...

I’ve never felt more tired yet more relaxed – I was even able to doze off between contractions, giving me much needed rest but hardly a good night’s sleep. They say women in labor just do “something” to get through it, something they didn’t plan on.  For me, it was wiggling my toes. No idea where this came from but as the pain picked up I’d wiggle my toes and breath, listening to Joe’s calming voice and knowing it was only a few more seconds (much like how I get through a tough metabolic circuit!)

At 10am the next morning, Dr Wong came in to check me. I figured I’ve got to be close to 10 by now since I’ve been at this for 14 hours. 4cm is all…bummer. Dr Wong is in my doctor’s practice, but was not my OB going into this whole thing – however, I couldn’t have lucked out more.  She was incredibly supportive of me trying to have a natural birth and made every suggestion to me starting with “The baby is doing fine so you let me know what you’d like to do. Here are your options…” I couldn’t have asked for anything more. (Baby’s heart rate was steady as could be – 130-136 the entire time. Everyone was impressed with how even it was and I credit it to those 9 months of workouts she’d already had!)

My options at this point were to get up and walk around to try and speed things up or have her break my water.  I opted for walking.  As we walked up and down the hall, the staff looked at me like I was planning on delivering my baby out my nose.  “What’s she doing?” I’d hear them whisper. “She’s not getting an epidural,” I heard my nurse reply.  I was the only laboring woman up and walking around, which was honestly truly surprising – I really didn’t think what I was doing was this far out of the norm.

Passing the nurse’s station, Dr Wong stopped me and asked if had a copy of my prenatal bloodwork on me.  What the heck? No, I didn’t have that tucked in my hospital gown. She said they couldn’t find my screening tests and if they didn’t get their hands on them and verify that I was negative for hepatitis and HIV, the hospital wouldn’t let me breastfeed.  If another contraction didn’t hit me, I may have hit someone on this disorganized hospital staff! I was really ticked off and would’ve have happily bought my labs with me had I known they needed me to. Turns out their computers were down, hence some of the repeat history taking and now this lab fiasco. Dr Wong said she’d figure it out. I was grateful since I had a few other things to focus on.

Getting through another contraction.

As we paced the hall, when I’d have a contraction I’d lean on Joe and he’d talk me through it – I couldn’t have asked for better support.  Jessica walked with us and we all talked and laughed whenever I wasn’t breathing through the pain. After 20minutes or so I had to lie down, I was simply so, so, so, tired. I rested a bit and got back up on my feet.  Jessica was giving me a homeopathic remedy (Kali phosphoricum) every 30 minutes to help with the exhaustion.  It really helped – no telling how soon I would’ve hit the wall without it.

My contractions still holding steady at 2-3 minutes apart, but on my next exam guess who was still at 4com? Ok, let’s break my water.  Contractions continued hitting 150 or more and I was tolerating the pain – but exhaustion was really setting in as we approached the 18 hour mark.

Now, somewhere in the next hour, my body met its breaking point.  I felt like those triathaletes that cross the finish line and lose control of their legs and fall down like they are made of Jello. I started to get really nauseous and really hot with each contraction and then afterwards my legs and jaw would tremble uncontrollably. I needed to eat and drink but I was so nauseous now that it was really hard to get water in, let alone food. Having physically hit a wall, I kept mental focus on the baby as long as I could. I’d just say in my head to my body and to her, “Just do what you need to do”.  This is how I got this far, but all of a sudden I just couldn’t sustain it – now I’d hit a mental wall.  This was new for me, I’m not sure I’ve ever felt like I couldn’t keep going.

Physically I’d reached my edge before, but mentally I’ve always been able to keep going. Years ago when I herniated a disc in my low back, I finished my workout for crying out loud! (Granted when I got home I nearly had to sleep in my car because I was in so much pain I didn’t think i could get out.) I worked out on a torn hamstring for 3 months before giving in and admitting I had a major injury I’d better deal with.  Mentally feeling tapped out was new for me, and it was new for Joe to see me like this.

He was nervous, apparently there was no color in my face – even my lips were white.  Now that my mind had also waved the white flag, my contractions slowed way, way, way down.  Now coming only every 10-12 minutes and registering around 50.  I asked Joe how intense they were because they were hurting so much more.  “They are like a third of what you’ve been having since last night. That last one only hit 30,” he said. I had no idea how I’d keep going like this. I was done. And with everything slowing down my body had obviously decided it was done too.

No matter via Plan A, B or C - this was the end goal.

I felt my reserves were tapped out and If I wanted to even hope to avoid a C Section, I was ready for some medical intervention.  Dr Wong examined me and there I was, still sitting at 4cm.  We discussed Pitocin to get things moving.  At this point, I’d all but stopped laboring on my own with weak contractions now about 15 minutes apart….welcome to Plan B.

Joe said, “I’m sorry honey, I know this isn’t what you wanted.” I said that I was sad that it wasn’t going the way I wanted, but I felt OK about it and I felt I got here on my own time and for my own reasons and I never felt pressured to do anything against my plan. “It was a great birth plan we had, just wasn’t in the cards for us to do it that way this time,” I said.  He replied, “Well, like Mike Tyson once said, ‘Everyone’s got a plan – until they get punched in the face.’” Yeah, that’s about how I felt right now.

Before I could get the epidural, it took 3 bags of saline to get me hydrated and put some color back in my face.  I needed that fluid! Which explains the immense puff I had in all the pictures after the birth. Check out my hand when I held Lola for the first time, it’s looks twice its normal size. Leaving the hospital 2 days later I could barely get my flip flops on I was still so swollen!

When I was getting the epidural put in place I was leaning over Joe (still incredibly nauseous and hoping I didn’t throw up on him) and having to hold perfectly still as to protect my, um, spinal cord…..and of course, I start having a contraction.  The anesthesiologist said, “Well don’t move, even if you feel an electric like sensation in your legs, don’t move”.  As if the pain of the epidural and pain of the contraction wasn’t enough – the stupid blood pressure cuff goes off to take my BP.  It was almost comical. But finally, well hydrated and the pain of the contractions gone, I was able to rest and let things progress…with the aid of modern medicine.

In another 2 hours (seemed everything operated on a 2 hour schedule here), and after 2 doses of Pitocin, I was dilated to about 6-7.  Well at least that’s something, but we’re not yet at the big 10. With the pain, nausea and hot flashes relieved, I was able to eat a few bites and drink some water…this is all fine and good but it’s now nearly 24 hours since this whole business started back and I am ready to get this show on the road.  My body, however, was not.

It took 6 doses of Pitocin to get me all the way dilated – a far cry from the zero I had originally wanted! Around 7pm my nurse looked at the pads that were lying under me and squealed with joy upon seeing the next, would-be-gross-in-any-other-situation-but-all-too-exciting-in-this-one, “event” of birth: bloody show.  I was lying in this little mess, but thanks to the anesthesia I had from the waist down I didn’t even know it. I wasn’t as giddy as my nurse, but I was happy that we had a lot of progress finally – and it meant I would probably have my baby within a couple hours.

Dr Wong checked me again and we were at 9.5 – whoo hoo! I had by now given up the sadness of not having my own hormones doing the work for me and was very thankful to have had the assistance I needed when I just couldn’t go on any more. And best of all, I changed my plan when I was ready and not before. I couldn’t have asked for more than this if a natural birth wasn’t possible for me this time.  It felt good to embrace Plan B, but not before one more little hurdle: baby was face up, a harder position to push her out in. They positioned me on my left side and being somewhat mentally back in the game, I talked to my baby and rubbed my belly. Almost instantly I felt her move.

Doc told me she’d be back soon and we’d start to push. Thankfully by now I was rested and felt I could actually push – just a few hours ago I feared C section would be the only option for my completely exhausted body (and mind).

At hour 27, with Jessica holding one knee, Joe holding the other and Dr Wong casually sitting on the side of my bed, I was able to push my little one out (and she had turned face down just like I’d asked her to).  It took 5 contractions (3-4 pushes with each) to get her out.  During the third contraction I spiked a fever and had to start IV antibiotics.  “Give her Amp and Gent,” Dr Wong said.  I was so focused on pushing – and honestly a bit out of it still – that I was trying to say “No Ampicillin!”, but no words came out. Luckily, my nurse remembered my allergy to penicillin and all is cousins, and they made the switch. One more allergic reaction avoided.

Sadly, because of the epidural I didn’t feel her being born at all – but I also didn’t feel the second degree tear I got either. I had literally zero feedback for how hard I was pushing.  All three of them kept saying “Just a bit harder, she’s almost here” – but I had no idea how to do it harder, I couldn’t feel anything! It was like picking up a stack of heavy textbooks and getting no input that you should perhaps use two hands, maybe bend your legs and that you might have to recruit an additional muscle or two to get the job done.  I am not sure how, but apparently I was able to push a bit harder.

Because of my fever, the final step in my birth plan went by the wayside as well.  I wanted the baby to be immediately placed on my chest. I wanted to hold and nurse her right away – saving all other housekeeping like cleaning, eye drops, heel sticks, footprinting, etc until we’d had time to make eye contact, breastfeed and bond…at least a little. Not knowing what caused my fever, she needed to be examined right away. So the little creature that was familiar yet totally new to me was now here, but all the way across the room.

She was crying and I was still being tended to – delivering the placenta and getting stitched up.  Jessica told Joe to go to her and talk to her, and that she’d stay with me.  Joe quietly said to our little baby, “Its ok baby girl”. She obviously recognized his voice and her crying ceased – it was kinda incredible.

It is surreal to spend every moment with this little being for 9 months and then to all of a sudden have her in the room.  I almost felt like, “Is this really the baby that’s been in me? Or is she someone else?”  It was so hard to believe after all that time, all that pregnancy brings, all the labor and birth are, that she’s finally here….and she’s healthy and perfect. All in all, Plan B worked out just fine. 

Being a determined, stubborn, control freak, I’ve never been much for Plan Bs in general, but as all big experiences do – especially those that stretch us both mentally and physically – this one taught me a whole lot:

Being prepared is where it’s at. Have a plan…then be willing to adjust that plan.  Don’t give up what you want most because it isn’t going your way. In this case, I immediately wanted a natural birth, but I ultimately wanted a healthy baby and a safe delivery. With my body not cooperating, I had to either give up (potentially) what I wanted most or give up what I wanted right now and adopt Plan B.

So when you are planning to hit the gym and your day gets crazy busy and you’re out of time – it’s not what you planned, but get in a Plan B workout.  Sure it’s not your favorite spin class but a set of 10-15 sprints up your stairs is a fat burning workout. It’s not the perfectly calibrated strength training workout on the best equipment at your gym, but a quick set of say full squats (maybe with arms on your head to up the intensity), pushups, reverse lunges, tricep dips on a chair and full sit ups for 4 sets, 10 reps each is still a good workout. And one that will take you all of 10 minutes in the comfort of your own home without any equipment – and best of all, you get to avoid skipping a workout and get closer to your ultimate goal.

Or when you get up the gusto to have an “on plan” lunch with the friend that you always indulge with and you see they don’t have organic salads on the menu or their chicken breast comes with some kind of oil or sauce you don’t think is 100% Dr Brooke approved – don’t throw in the towel based on these tiny details and have the fried fish and chips. Instead, opt for Plan B – the conventional produce and the chicken that’s not quite perfect.

So whether in birth or as you craft your better body, look for Plan Bs and see more and more opportunities to get what you ultimately want. For me, the birth drove home what my pregnancy had been teaching me all along: go with the flow and let go of the need to control it all.  So thank you to my little Lola Jean for teaching mommy a very important lesson – and please be patient with me as I continue to need a reminder on this one.

Thank you to my family, friends and patients for all your support, advice and patience during my pregnancy and now, during my maternity leave.  You are all very appreciated!

And now, just a few final pics:

Cousins: Miluse and Lola

Grateful doesn't even describe how I felt having my family with me for this.

Just moments before we got to go home.

First day at home in baby's new room.

Lola's tiny little head in Daddy's hands.

Plan B panned out just fine for this little family.

My beautiful little creature.

September 30, 2011 at 12:24 am 7 comments


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