Wednesday, November 21, 2018

Welcome to the World, Layla Eleanor Grace

This is long and it's probably slightly hazy on the very minute details (remember that I'm not getting nearly as much sleep as I used to, haha) but there are moments here that I remember so clearly that they must have just happened and more than anything else I have ever experienced in my life, I needed to write it all down.  It's perhaps the most important story I've ever told.





I woke up on the morning on Friday, November 9th (the day after my due date) with pinkish discharge and irregular contractions. I’d been having early labor symptoms for over a week and a half, but no change in dilation for nearly a month. After a half hour, I started tracking them. They never reached the golden 5-1-1 ratio, but they were relatively close. Around 12:45pm, a little over 4 hours after I started keeping track, I decided to call my OB anyway to let them know about the discharge and the contractions. The emergency line nurse told me she would call me back, and when she did, she told me that I should head to the hospital. I asked her if I could wait for my husband to come home, and she said no, that I should get going. So I did, and I was at the hospital and getting settled into a room in labor and delivery within the hour.

Tom met me at the hospital and got there as I was getting ready to be monitored. The nurse was fantastic; she got all of my info and my vitals, and got me hooked up to the monitor. Tom got there, and it wasn’t long before a resident came in. She checked me (I was still dilated to 1cm, just like I had been for the last few weeks) and then performed a short ultrasound to check and make sure there was amniotic fluid in there. There was, and it was great to get a short glance at our girl (even though we couldn’t see her face).

After the ultrasound, the on-call OB came to the room. My OB was out of the country, otherwise she would have been the one to deliver. Still, she spoke very highly of all the doctors in her practice and though I wished it was her, I knew I was still in very good hands. Dr. P. asked me how I felt about having a baby today, and I said “yes please!” She explained that while I was having contractions, they still weren’t doing much of anything to move labor along...yet they were strong enough that they were affecting Layla. Her heart rate was good, but not great, and if I was to be sent home to wait out the start of labor, they would want it to be great. Better to get things started! She explained what lie ahead for me in an induction, and said that she figured that our girl would be born sometime after midnight, hopefully early morning. We told her that sounded good and when she left the room, I cried a little bit. It was actually happening!

The nurse came back and got an IV started. Around 3:30pm, a foley bulb was placed and pitocin was started. If all went according to plan, the foley bulb would be checked around 9:30pm and hopefully would result in dilation to almost 4cm. The pitocin would help as well. Once the foley bulb came out, my bag of waters would be broken, and then hopefully it wouldn’t take long for Layla to be born. Only time would tell.

I was in good spirits. I tried to relax, watched WGN news, started to ride the waves of early consistent contractions. Tom left to run home and take a shower. I spoke with family, who were all on the way. Tom came back with his mom in tow; they ate dinner while I breathed through contractions. Things were intensifying, and at one point I quickly became nauseated and threw up in a garbage can (thanks to Tom and his quick reflexes). We were visited by my mom (who I wanted to be in the room with us when Layla was born) and dad, as well as Tom’s mom, throughout the evening. My sister also came by, and I was grateful for her presence as my sister but also as a fellow mom.

The foley bulb was noticeable but not unbearable. I was feeling pressure, and then there were the waves of the contractions themselves adding to it. I was able to keep up with them, but I could tell things were getting more intense. Around 8:30pm, I was feeling nauseous again. And I was in more pain. Tom asked me if I wanted to try and walk around the room a little bit, and as soon as I stood up I sat back down and threw up. Walking around probably wasn’t going to be good for me, but I figured while I was up, I would try and go to the bathroom.

And it was then that the foley bulb straight up fell out. I called out for Tom and asked him to call the nurse, then sat there on the toilet kind of laughing in disbelief. The hope was that I would be dilated to 4cm when they checked at 9:30, but here it was, 8:30, and it had done its job. The nurse came in and got me cleaned up. After I got back in bed, a resident came in to check my progress. I had made it to 5cm! The next steps would be to break my bag of waters and amp up the pitocin.

During this time, the resident observed that there was meconium in the amniotic fluid and that because of this, the Peds team would have to come in when she was born to check her over. They told me she may not cry right when she came out and that would be okay--they wanted to be sure that she didn’t breathe in any of the fluid. One of the key parts of my birth plan was to have skin-to-skin with Layla right when she was born. I wouldn’t be able to do that now, but keeping her healthy and safe was my top priority. (Induction was also not in my original birth plan, either, but keeping an open mind during the labor and delivery process was very important to me.)

Within an hour of my water being broken, the contractions were almost on top of each other, and they were getting much more painful. I was able to breathe through them, but it was hard for me to focus on anything other than them. Tom and my mom did a good job of keeping me distracted from them, but at a certain point, I realized that I wouldn’t be able to do this forever. I had no idea how long it would take me to get to the point where I was fully dilated. I decided, at this point, that I would ask for an epidural. 

One of my biggest pregnancy related fears was getting an epidural.  I knew that they had a high success rate but I still had an incredible amount of anxiety about it. I would rather have had a natural birth than get an epidural. During our childbirth prep class, I had to employ relaxation techniques during the part about epidurals because I was so worked up about it. However, in that moment… where I had been in labor for nearly 6 hours already (and longer if you count the contractions I had all morning) and the contractions were constant and endless and getting more painful… I needed relief if I was going to make it to the end of this.

I knew it could take up to an hour to get an epidural, but it was just my luck that the anesthesiologist was right next door. She was in my room within 15-20 minutes and we were getting things started. I was terrified, but both she and the nurse did an awesome job of keeping me relax. The procedure itself didn’t hurt all that much (at one point she had inserted the catheter too far right, but we were able to quickly correct the problem) and before I knew it, they were helping me lay down in bed again. I was still able to move my legs a bit, though they kind of felt like they were deeply asleep; from the bottom of my ribcage to the middle of my thighs, I was totally numb and impervious to the contractions coming in wave after wave after wave. I could place my hands on my belly and feel my uterus contracting, but the pain I’d had before was gone, replaced only with pressure. My demeanor changed almost instantly and I immediately felt so much better. Okay, now I can get through this.

Shortly thereafter, Tom and I went dark and tried to settle in for sleep--we were both exhausted and we had a potentially long night ahead of us. I was checked around midnight, and then again around 3am; I was still dilated to 5cm, not making much progress. The nurse explained that I was having contractions so consistently that she wasn’t able to turn up the pitocin. Layla was still doing fine in there, and we were still well within the 24-hour time clock after they broke my water for her to need to be born. I was still doing fine in the pain department, though I did have to switch sides because I felt like the epidural wasn’t working as well. It took me a little while to fall back asleep, and I chatted with my dad over Messenger to fill him in on the latest.

My mom came back into the room and sat with us for a little while. Eventually, though, with no continued progress, she and my dad decided to go to the hotel and see if they could get a few hours of sleep there before it was time to deliver. I was fine with this and told her I would let them know as soon as anything changed. I tried to go back to sleep and succeeded for a little while; I wasn’t in pain, but I was experiencing quite a bit of pressure. I tried to ignore it and get a little more rest.

Tom woke up between 5-5:30am feeling restless (though we were both happy that he had gotten any rest at all, sleeping in a recliner next to my bedside. We knew it would benefit us both). After making sure I was okay and comfortable, he decided to go for a walk. I hung out and rested my eyes, rubbing my hands over my belly. It had been so comforting and reassuring to listen to her heartbeat on the monitor all night, the perfect soundtrack as we dozed in and out of sleep. I couldn’t believe that she would be there soon and felt very emotional. It wouldn’t be long before we would meet her.

Between 5:30 and 5:45am, a resident came in to check my progress. I really hoped that there had been any at all; I did not want to have a c-section if I could avoid it. She was happy to report that I had dilated to 9cm, and I was so excited about this news that I set off the alarm on the monitor (which we both had a laugh about). The pressure was much greater than it had been earlier in the night and I knew I was getting closer and closer to pushing. I called Tom to let him know that we were getting closer, and then called my parents. They had just gotten settled at the hotel and into bed when I called, of course; they said they’d be there as soon as they could.

Shortly after 7am, there was a shift change and I met both the nurse who would be taking over for the morning, as well as the OB who would deliver Layla, Dr. H. I liked her instantly; from the moment she walked into the room she made me feel calm and capable. She told me that she wanted to give me another hour, and then we would do some practice pushes. I did my best to try and stay calm and collected, and I still wasn’t in any real pain, but I felt like the pressure was building every moment. My mom and dad got back to the hospital, and then eventually Tom’s mom came back and brought him something to eat from Hoosier Mama. I started feeling nauseated again. I knew it was not only because of how I felt physically, but emotionally and mentally as well. I felt like I was buckled in on a roller coaster lift hill, inching closer and closer to the top. It wouldn’t be long now.

Except… it would be three hours of pushing (four if you count the practice pushes, which my discharge paperwork did). The OB came back (with the nurse, and a resident, and a med student--the four of them, along with Tom and Mom, were the best support team/cheering squad a girl could ask for) and around 8:15, we did a few practice pushes so I could get the hang of what I was supposed to be doing. I was still on the epidural, but I had enough pressure building to know when the contractions were coming, to know when I should be pushing. It was uncomfortable but it wasn’t nearly as bad as I had been imagining. They suggested to focus on breathing through it--it was a lot more productive than yelling--and to work with my body through the contractions.

I didn’t think the practice pushes were really that bad. Layla was reacting well and she had moved down enough by 9:15am that I started pushing for real. I was kind of amazed by the whole thing; pushing, at least so far, didn’t really resemble how TV makes it look. In between contractions, I would rest, or chat with everyone in the room. I realized that based on the pressure, I could anticipate when my body was gearing up for another contraction, and I would let everyone know another one was coming. Then everyone turned all their attention to me, encouraging me to keep pushing and keep going. Tom held one of my legs up, while the med student held the other one, and the nurse counted from 1-10. Three 10 second pushes later, I would rest again and wait for another one.

For three hours, I pushed. It was such a surreal experience. As time progressed, I found myself having to dig deeper and deeper; this was the hardest thing I had ever done, but I would keep doing it because it was going to bring our daughter into the world. It hurt, but more from the incredible pressure I was feeling. Eventually I ended up having to keep holding my legs up; Layla was getting closer but having a hard time getting past my pubic bone and this helped to get her into a better position.

It wasn’t until the last hour, 45 minutes, that it started to hurt. I still had the epidural going, but at a certain point, it wasn’t going to do too much for me. The amount of encouragement I got from the members of the delivery team, as well as Tom and my mom, was incredibly motivating and so crucial in getting me to the end. It was also an incredible experience to be the one doing the work, to be bringing life into the world. What an empowering and important and completely life-altering experience. I remember the look on Tom’s face, tears in his eyes, as his daughter neared her entrance into the world. Near the very end, the Peds Team came in so that they would be ready once she was here. The last three or four pushes were the hardest by far. But I gave it everything I had, mustered all of my strength and energy, and at 12:10pm on November 10, Layla Eleanor Grace was born and let out a strong and hearty cry.

I was immediately bowled over with a wave of relief and happiness. “Open your eyes and look at her, Mom,” someone said, and I glanced up to see the most beautiful thing I’d ever seen. Her hair was the first thing I noticed--she had a lot of it!--then her long arms and legs. I cried and cried as they went to work on her. She was still crying, and she looked good from what I could tell, but I made Tom go over to be with her (I hated the idea that she went from the safety of my belly, right into this big bright world all alone). He did what I asked and my mom joined him to check her out.

Meanwhile, Dr. H. and the resident were still at work on me. I delivered the placenta, and they set to work massaging my uterus to get it back down to normal size. As it turned out, this was complicated by a postpartum hemorrhage. I felt like I was in another world at the time; I didn’t really know what was going on with me, only that I was in a lot of pain from the intensive massage and that the energy in the room had changed and become more emergent. Tom later remarked to me that it was kind of a tense moment, that Dr. H. and the nurse were working both quickly and seriously to get the bleeding to stop. Eventually, the bleeding subsided and they set to stitching me up as I had torn pushing her out.

After the Peds Team determined that she was in good shape, and Dr. H. and the labor and delivery team got me to a better spot, they brought Layla over and placed her on my chest. It had probably only been 10-15 minutes since she was born, but it felt like a lifetime, and that moment where I looked at her and she looked up at me with those big eyes of hers like she knew exactly who I was… I still get choked up thinking about it, meeting her for the very first time. She was beautiful and perfect; she cried but settled down as soon as she heard my voice. 21 hours after labor had been induced, and after 3 hours of pushing, our dear sweet firstborn daughter had finally arrived. She weighed in at 8 lbs. and 13 oz, and was 19.75 inches long. Giving birth to her was, it is, the most incredible and powerful and meaningful experience of my life.

The room seemed to clear out just as quickly as it had filled up initially; the team hurried off to assist in another delivery. Our parents stopped in to see her and say hello, and then it was just me, Tom, and Layla sitting in the quiet delivery room as the nurse got us ready to go upstairs--Layla would head to the nursery to get further checked out, and I would be taken to my room. It still seemed unbelievable, but we were now a family of three and it felt more incredible than I could put into words.

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