Our little Zoe is one week old today, so I thought it would be fitting to post her birth story today. I was planning on writing it, but Chris wrote about it on his webpage, so I thought I'd steal it. It's a really good perspective, and as you'll find out I was a bit out of it at times, so I think he's got the best view of it. I did want to include my thoughts from time to time, so those (will be in parenthesis and italics). Here she blows...
all along we wanted to do things as naturally as possible. i think most people would prefer to not use drugs, not get induced, not get labor delaying drugs, not get a c-section, etc. well, 41 weeks in and the doctor wanted to induce. we all talked about it, though, and agreed that we'd induce at 42 weeks. meryl's mom delivered both her kids two weeks late and needed some pitocin along the way so it wasn't a huge surprise when 42 weeks came and labor hadn't started naturally. we were scheduled for induction on the day of her 42nd week. we called in at 4p as scheduled for a 5p induction, but they were full. recommended we go to kaiser in walnut creek. meryl started to panic, i went into diversion mode. so, we went to jamba juice for a snack and home depot for an errand. called again at 5p and they let us come in at 6p. the induction process is a slow one and that's something we didn't know beforehand. this is actually probably a good thing because they don't want to just start an iv and pump you full of a bunch of pitocin right away. they do the paperwork, you get to know the nurses, you get family visitors, etc. it wasn't until late that night that meryl actually started getting any meds (misoprostol, i think) to move things along. getting the iv in was a bit of an issue, though. they tried 5 times before they could successfully get an iv into meryl. apparently she has a lot of valves in her veins so it was quite difficult. it was also difficult to watch and caused meryl to become annoyed and her hands to be swollen. the misoprostol is supposed to ripen the cervix so pitocin can be used. we tried it and 8 hours later there was little to no additional effacement/ripening so the pitocin was next.
this started the contractions and zoe seemed to be responding okay to the medication. she had a little bit of a deceleration in her heart rate during the contractions, but that's not unusual. (because of this I was more at risk of having a possible c-section down the line, so I wasn't allowed to have breakfast - just lots of jello - and I was selfishly very annoyed. You don't get between Meryl and her food.) after some time with the pitocin and increasing the dosage of that meryl's water broke naturally. or, at least it wasn't artificially punctured which is sometimes done by the doctor to move things along. at this point the real stuff began. contractions became much more difficult for meryl and i had to concentrate much more on helping her through each one. it became clear pretty quickly, though, that the pain was going to be too much. so, meryl decided she wanted a pain medication (some kind of narcotic, the name of which i've forgotten) that would last about an hour and take away some of the pain. unfortunately this medication didn't do much so meryl opted for an epidural and they hooked this up about 45 minutes after the initial pain medication. (I was pretty disappointed in myself because I really wanted to give birth naturally, but I caved and felt bad). depending upon who you go to for the information, anywhere from 60-90% of u.s. births are done with an epidural.
about 10 minutes after having the epidural catheter hooked up to her, meryl and i were alone in the room and she mentioned that she felt a bit nauseous. her eyes started to sag and she didn't look like she was fully aware. i talked to her and she looked like she was falling asleep. i told her to stay awake and her head kept nodding down. i hit the nurse's call button. after a few seconds of that i rubbed her chest to wake her up, but she was only marginally present. i went to the door and yelled for some help. our nurse was at the end of the hallway and started jogging towards the room. she said that it wasn't unusual, but i wasn't so sure. in retrospect, i think she may have been saying that it wasn't unusual for patients to get tired after getting taking the narcotic, but this was clearly different. (I don't remember much of this. I remember telling Chris I was out of it, but I have no recollection of him trying to keep me awake and I vaguely remember hearing him yell for the nurse). she took meryl's blood pressure and i believe it was 65/38 which is ridiculously low and was very frightening to see. the nurse went outside and asked for help. the next few minutes were kind of frantic. they got her some meds to help with her blood pressure, the nurse tried to reposition the baby monitor to get a better read on zoe's heart rate (which was now half of what it was when she was active), and more and more people were coming into the small room to help out. meryl was staring at me and i was trying to look at the monitor to see her blood pressure and zoe's heart rate. i was also looking at the nurse for some sign of where things were going. i was also trying to look at meryl with as much confidence as i could so she felt like things were going to be okay. it was clear to me that things were no longer on the best case scenario path, but i couldn't impart that to meryl in any way. (Chris was the strongest and most supportive partner I could have asked for. I was looking between our nurse and Chris the whole time asking over and over again if the baby was okay and both of them were so strong, and reassuring, despite Chris having no idea if things really were okay. But he completely kept things together for me and Zoe. I am so lucky that he is so strong and supportive because having him there holding my hand telling me things were okay was just about the only thing making me not go into complete shock and have a breakdown).
after a few minutes of monitoring meryl's BP and zoe's heart rate, someone said "i'm going to call it" and everyone started wrapping up the monitors and moving things around to get the bed out of the room as quickly as possible. now we were going to the operating room which was just a couple doors down the hallway. i followed and saw a look of concern on a woman in the hallway. this didn't look very good. as i got to the door a nurse stopped me and said i needed to get some scrubs on. i got back to the room and was in the scrubs in about 20 seconds, but then wasn't allowed in the OR because there were so many people in there already. (Meanwhile I was trying not to have a mental breakdown being wheeled to an operating room without my partner, afraid something would happen to our baby and having 20 people run all around you saying things you don't understand and getting you ready for possible surgery).
i waited in our labor room for a few minutes wondering if i should text the family (which was waiting downstairs) about the development or leave it be. i decided that an open ended panic text wouldn't be a good idea so i just waited. a doctor came in and told me i had to wait and that meryl was being prepped for a c-section. of course i knew this already and it didn't help. all i cared about was being able to be with meryl so she had someone there. i asked if i could go to the door so she could see me and they said no. finally, they let me go in. (Bless the doctor's heart who stood next to the table I was on the whole time holding and squeezing my hand the entire time I cried and asked if Zoe was okay and when Chris could come in. I asked both of those things over and over and over again. I just wanted Chris in there so bad and I was so scared.) zoe's heart rate had settled down. meryl was more stable. the doctor, though, was talking to her about the risks associated with a c-section. chance of infection, possibly needing a blood transfusion, blood may contain HIV in about 1 in 300k cases, etc. etc. etc. things were moving very quickly, but we had the option now of not going through with the c-section. they said that meryl and zoe were both stable right now so we could wait if we wanted. i asked how dilated she was (they try not to check once the water has broken because of possible infection) - only 4.5cm (pushing starts at around 10cm). i knew we were still at least a few hours away from being dilated enough to start pushing. (in the nearly 24 hours of induced labor I had only progressed 1.5cm) in that time meryl's BP could dip again, zoe's HR could dip again, we'd be worried about these things the entire time. i knew the recovery was going to be worse. i knew it wasn't what we had wanted. i knew we could try to wait it out and face another panic later. we decided to get zoe out as quickly as possible so everyone would be healthy.
meryl signed a form in the OR on the operating table. it's one of those situations where you don't exactly call your lawyer to review the document. they started the prep and within another 10 minutes (there wasn't a rush anymore now that mom and daughter were stable) she was prepped and ready to go. they put the drape up so meryl and i (i was sitting next to her head) couldn't see any of the surgery. the first cut was at 7:04p and at 7:12p someone said "dad stand up" so i did and i saw zoe. she was long and thin and then she started to cry. the moment she started crying a switch went off in my head. i was a father now and i was so happy. i told meryl how beautiful she was and how happy i was. we were both teary eyed and relieved at this point. (it was so surreal hearing her cries because I was so scared that things were going to go wrong. I was so happy to hear her cry) a minute or so later i was able to go over and see zoe as they cleaned her up and were taking her apgar scores (i found out a few minutes later she scored an 8 at 1 minute and a 9 at 5 minutes). we had wanted zoe to come straight to meryl's chest after birth and have me cut the umbilical cord. unfortunately neither of those happened. i looked back and saw meryl cut open on the operating table. i went back over to her and told her how beautiful our daughter was and how proud i was of her. i joked with her that i'd let her wait a week or so before working on the trim in the closet. (seriously, thank god for Chris. His strong support and ability to make me laugh in that moment are beautiful. He knows just what I need and I am so thankful for him). within a few minutes of birth i had zoe in my arms and by meryl's side. it took another 30 minutes or so to get the placenta out and meryl stitched up and bandaged.
so that's the story of the birth.
i found out later that 32.8% of u.s. births are by c-section (our nurse said it was about 25% and is the most common surgery in the u.s. now). at kaiser in oakland that number is about 19%. both are pretty high numbers relative to what they were 40 years ago. then again, they used to drug mothers up a lot more back then. vacuums were used more, etc. in our case it was a matter of running out of options. after you pass 41 weeks the risk of a stillbirth (about a million times worse an outcome than a c-section) almost doubles, even for healthy, white women with babies in the ideal range of 3,000-4,000 grams. i had looked up this data before we reached 42 weeks to try to determine how much of an overreaction the induction at 41 weeks was. we both determined it was a bit of an overreaction by kaiser to have a policy of pushing for induction at 41 weeks, but we also understood it considering the increased possibility of a stillbirth (still only about 2 in 1,000 for our situation - white, age of mother, baby between 3,000 and 4,000 grams). also, it turned out that zoe was a bit bigger than 4,000 grams and therefore slightly more prone to complications like stillbirth.
as much as we would have liked to just let nature run its course, options start running out as time wears on. we tried many of the old wives' tales to naturally induce labor, too - sex, spicy foods, raspberry leaf tea, squats, walking, etc. nothing made it come naturally. and once you induce you have fewer options as well. and once your water breaks you have a ticking clock because of the possibility of infection. nature just didn't cooperate. in retrospect, i think we mostly did the right thing. it probably would have been better to avoid the narcotics or, barring that, wait for the epidural until after the narcotics had worn off more. it's our guess that the combination of pain medications and meryl's historical intolerance for pain meds led to the drop in BP.
another thing we learned is that labor times are basically guesses. we learned in the birthing class a while back that only about 8-12% of the time does the water break before labor starts. so, there's no real "start" of labor. contractions are happening before "labor" and the water hasn't broken. i'm not sure how people come up with numbers like "our labor was 60 hours" or "our labor was 2 hours." meryl was having contractions for a week before the induction. sometimes contractions aren't very regular so you can't even really rely on a set length of contraction or time interval.
having a child was an illuminating experience (and will continue to be, i'm sure). intellectually i knew pretty much everything i've experienced and felt since that moment. however, you don't really know it until it happens. i understand why my mom dotes on me so (too) much at times. i understand now why some parents shake their crying baby to death. i understand wanting the death penalty now that i've cared for a baby. the same babies that some people throw in the dumpster. the same babies that kermit gosnell snipped in the spine. i disagree with the death penalty, but i wouldn't mind someone snuffing these abhorrent people out for doing what they do to infants.
that said, it hasn't been all about illumination. i understand even less how my dad could leave me at 9 months and not come back for years. i'd rather die than leave zoe or harm her in any way.
that first day was the most frightening and most happy day of my life. i was so worried for meryl and zoe one moment and then so happy and proud just 30 minutes later. that first night was bliss. zoe slept well and meryl and i were in heaven thinking about the family we had started.
since then it's been more rocky. zoe is having some trouble nursing and her cries are maddening and depressing. intellectually, we know there's nothing we can do to avoid these outbursts. she's basically an animal and she only has one mode of expression. we just have to guess what's wrong and try everything we can to soothe her. i think we're both more equipped to deal with toddlers and children than infants. but damned if we both don't also wish those happy times would never end. a sleeping infant on her mother's chest is just about the most adorable thing i've ever seen.