PC Diary @ 38 Weeks 3 Days – The Final Entry

20 Dec: Preparing to expand our Family to 3.  My Tuesday 20th December started out with uncertainty – uncertainty as to when exactly I would be admitted to hospital to start the induction process.  Chris took the whole day off work and we planned for it to be our last day together as a family of 2.  It started with a visit to my Obstetrician to check the status of my cervix.  I was still only 2cm dilated and 70% effaced.  This meant that my doctor wanted me to be admitted to hospital later that evening to ripen my cervix.  So Chris and I decided to finally do something we always talk about doing but never got round to doing – take a trip to Cracker Barrel for lunch.  Yes, four years in Virginia and we had yet to visit a Cracker Barrel!  We stuffed ourselves as if it was our last meal ever.

It was very surreal knowing that I was going to start labour imminently.  The final hours before I called the hospital to check if I should come in were beautiful.  Chris and I shared a candle lit bath together and relaxed.  Afterwards we sat down together and put together a birthing music playlist.  We went through all my music, reminised over our various wedding playlists and created a 5 hour mix of chilled out tunes.  This proved to be one of the best things we could have done together.

20 Dec 7PM – It was time to call the hospital – but it was shift change so no one knew if I should come in.  Eventually at 9PM the hospital told me to come in….and to make sure I had eaten because as soon as I was admitted I would not be allowed to eat!!!! We grabbed our hospital bags and got in the car, the 15 minute drive to the hospital was quiet, I noticed all the Christmas lights for the first time.  This was not how I had imagined my labour to begin; I had imagined being in the midst of contractions, sat on a towel just in case my waters broke.  Instead, my head was full of questions about what was going to happen, how my birth story would play out, my head was surprisingly clear.

20 Dec 9PM: Cervical Ripening.  I checked into the maternity unit, I had already pre-registered at the hospital so I just needed to show my insurance card, ID and sign one more form.  I was tagged with various bracelets and shown to my room.  The room was a lot bigger than I remembered from our hospital tour we had taken several months ago.  It had a fancy bed that moved into all sorts of positions, various monitors for baby and mother, a crib with a radiant heater, a shower room and a sofa bed for Chris to sleep on.

20 Dec 10PM – The nurses prepared me by hooking me up to the baby monitoring system round my belly, and put an Intravenous lock in ready to administer whatever drugs I would need, if needed. They took some basic medical history information and looked over my Birth plan.  It can be summed up as “please don’t ask me if I want pain meds, I will request them” but in general I was flexible and mentally prepared to go with the flow as my labour progresses. As this is my first time, I couldn’t possibly know what is or isn’t right for me, and every birth is different anyway.  The nurses thought that was very practical and good for my mental health.

The nurse put in the Cervadil ripening agent, it was on a string like a tampon.  She wasn’t able to use lubricant so it was incredibly painful.  She couldn’t find my cervix easily because the baby’s head was so low, she had to get around the head.  Once that hell was over, I was not allowed to get up from bed for an hour.  I needed to pee after ten minutes of the cervadil being inserted, the next 50 minutes I spent watching the clock, more hell.  The nurse came in to check my vitals every hour.  It was a sleepless night. Chris got about 4 or 5 hours broken sleep, however I probably only got about 2 hours sleep in sum total.  This was mostly because every time I rolled over baby’s heart rate monitor fell off baby and the Nurse would come running in!  Every time I needed to pee I had to unplug the monitor. I think I got up to pee about 8 times through the night.  Let’s just say I was not feeling refreshed in the morning.

21 Dec 5 AM: A rude awakening.  I woke up at around 5 AM with strong contractions, they were different to the contractions I have experienced throughout my pregnancy.  Things were moving along, there was a good chance that I was actually starting to shift into active labour just from the cervadil.

21 Dec 7AM: Cervix check. It was shift change, so the obstetrician came into check on me, with my contractions getting stronger she said she could do a cervix check and get the cervadil out sooner if I liked.  I felt like things had probably progressed over night because I was really uncomfortable and had to stinger contractions.  Again, not being able to use lubricant removed the cervadil and the OB checked my cervix.  I had progressed only to 2.5cm 90% effaced, she was looking for better progress than that, so she stuffed the cervadil back in me and said it could come out at 10AM – the whole 12 hours since it was inserted.  It felt like she was literally stuffing me with a dry towel, she made me bleed and I cried in pain.  I wished at that point that I could have had the non-FDA approved drug for cervix ripening misroprostol instead because I have used these before for my previous Dilation and Curettage procedures.  Ah well, I digress….

21 Dec 9AM: Active Labour. I started to experience longer stronger and more frequent contractions, about 4-5 minutes apart.  The contractions were becoming more painful and I couldn’t talk during the contraction and needed to concentrate.  These were the type of contractions that we had learned about in birthing class that were the ones I would feel as I would go into active labour and would need make my way into the hospital.  We ummed and ahhed about when to get our Doula, Sharon, to come in.  My contractions started to really need me to move into new positions and I was feeling like we would benefit from her support sooner rather than later, so we called Sharon at 9.40AM, and she arrived almost 20 minutes later.
21 Dec 10 AM: cervidil removed.  The cervidil was removed, I felt massive relief that it was out, but really sore from it being in me and with another cervix check I was now 3cm dilated. I was offered an hours break from the monitoring before starting the next stage of the labour where contractions would be induced from the drug Pitocin –  it mimics the hormone oxytocin which is what causes the contractions to develop.  We decided to take a 30 minute break to keep the ball rolling.  I was taken off the monitor and my ‘break’ consisted of taking a nice warm shower and feeding me up with a breakfast cereal bar, some haribo gummies and some really big glugs of water.  But I was still getting contractions during my ‘break’!  The shower was lovely and warming, it really helped me to relax and feel refreshed, ready to really focus on my breathing and thinking about my baby moving down the birth canal.

When the time came to end my break, I was put back on the monitor, the nurse surprised me and said I didn’t need to go on the pitocin because my contractions were looking strong and good and that I had entered active labour on my own.  I was thrilled at this because avoiding Pitocin was highly desirable for me and my goal to make this birth without pain medication if possible.

Our Doula: Sharon. So we got on with progressing my labour.  Sharon helped us try different positions to get baby moving. Having Sharon coach both of us through this labour was incredible. It felt so natural and she made me feel calm and comfortable with everything that we tried. Sharon wasn’t solely focused on me, she also made sure Chris was ready and prepared for everything that was going on and how he could help me. Her guidance was like a conductor of a symphony orchestra, there was never any hesitation and always deliberate consideration in her coaching style. At no point did I ever think, what on earth is going on or I don’t like what is happening here.  

Chris remembered to put our music playlist on. This was one of the best distractions and ways to keep me focused and relaxed in between contractions. Sometimes I even sang along to songs, maybe not out loud (or maybe I did I cant remember everything perfectly!), but mostly in my head. It helped me with my breathing as I listened to the rhythm of the music playing.

Active labour progresses. We tried almost all the positions possible that we had seen in our handout from the birthing class, and more that Sharon showed us. I think we used every single birthing prop that the hospital owned throughout my whole labour!! I was so grateful for all the effort the nurses put in to getting the things I needed for me. Their support was relentless.

Standing position – I held onto Chris/Sharon’s shoulders and swayed through the contractions.

Lunging to the side position – I really liked this, it was hard work, but I felt like the deep lunge was helping my baby move with the gravity. I placed one foot on a foot stool and Chris took my weight, with Sharon close by to help as I leaned over him into the lunge.

Sitting on the toilet position – I quickly discovered when I went to go pee that this position was intense on my body. Sharon helped me put both my feet wide apart on two foot steps. 

My contractions here were really painful and deep, but this was a good thing according to Sharon.  I trusted her, but it was one of my least favourite positions. I came to be afraid of the toilet!!! Sharon told me early on that as soon as it gets too comfortable she wants me to change position so we can progress the labour! At this point I really was starting to feel like I needed to poo, but I had pooed earlier in the morning three times already, I couldn’t possibly have any more poo left in me?!

Sitting on the Birthing stool position – With my back to the bed, leaning on Chris in between contractions, Sharon was able to massage my back. Again, another challenging position, but it allowed me to relax in between contractions. Poor Chris was getting a real good work out by this time!!

Birthing stool in shower position – Sharon could tell I was getting tired and wanted me to take a break. She suggested taking a shower using the Wireless monitor. It was logistically challenging to make sure the wireless monitor didnt get wet but we sussed it. This actually didn’t work out as well as first time I showered because I got too cold.

The Nurses all commented on how warm the room was compared to many other women, yet I was cold a lot, I had to frequently snuggle in my fleecey dressing gown.  It was white and amazingly throughout the whole labour didn’t get any blood or other bodily fluids on it, I think because Sharon and Chris were taking good care of me.

Apparently at around 1PM Chris and Sharon had a discussion on when I’d deliver – Sharon hazarded a guess for 2.30 PM….hahaha my baby had other ideas…

Walking – at 2PM with the wireless monitor still on I was able to take a walk down the corridor. But then my contractions really had started to slow down.  I met my OB in the corridor, she told me because contractions were slowing down she suggested I needed to to go on the Pitocin to move the show on the road.  So I agreed and had another Cervix check – I was still only 3cm dilated.  It was Frustrating to hear this, but Sharon explained how not to get disheartened and how to get over that mental state. I was given IV fluids and the Pitocin was administered. I started with a dose of 2, then every 30 minutes my dose went up by 2…I think the maximum dose I got to was 10, but I don’t really remember. This also meant that I was limited where I could go as I had the drip following me – moving into different positions became a logisitcal nightmare! But Chris, Sharon and my nurse worked hard to help me at every stage. Their support was relentless.

Side lying down position – I took ‘rests’ in side position with and without the peanut ball.  I truly hated having a contraction in the side position even though I was getting rest.

Sitting on Birthing ball – I sat on the Birthing ball leaning on the end of bed, Chris sat on the bed coaching me and Sharon sat behind me, massaging my back.This was a good position for me, I felt like I was progressing my baby girl down but was comfortable on my bum and back.

Squatting position – Oh this position was painful and hard work, even though all my weight was on Chris as I squatted.  It was lots of Hard work for Chris!  He was getting a good work out!!!

21 Dec 5PM: Transition Phase: The pain was getting really intense.  My Contractions were 1-3 minutes apart lasting a minute and sometimes longer.  I started to really grunt through the contractions, trying not to wail like a banshee and breathe deeply.  Sometimes it felt like I couldnt breathe.  Sometimes I hyperventilated. But Baby was having decelerations at the right times of my contractions indicating that the next stage of labour might be very soon.  I was spotting brown blood – a good sign for my labour progressing.

Soon the baby started to struggle and her heart rate was dropping. The nurse gave me oxygen and that helped baby.

Sharon told Chris to get dinner before it was too late – he brought back a salad because it was the only thing he knew I wouldn’t be jealous of!

I rested whilst he got dinner, sat up right with feet together and knees out.

On all fours on bed position. I got on all fours leaning over the birthing ball on the bed in between contractions, and sat upright on my knees wide open during contractions.

When I shifted back to the birthing stool I felt a warm dribbley gush; I wasnt sure if it was blood or my waters breaking.  It was my waters breaking.  So I had another Cervix check – this time I was 7cm, and still felt really frustrated because contractions were so intense and I felt like I should be closer.

I really was near the point of no return for pain meds, I wasn’t aware of when that was exactly, but I really appreciated my whole team for respecting my wishes and not asking me.

There came a point when all I could hear on the monitor was my baby’s heart rate decelerating, I was really concerned for baby and I said out loud – please do what ever it takes to keep my baby safe! – everyone said of course we will!!! Ebony was my nurse for most of my labour, she was wonderful and even wore a Christmas necklace that lit up! It was a shame she had to leave as her shift ended because I was only at it for another two hours, but that’s the way it has to be.

They started to bring in all the equipment needed for delivery.  Seeing this happen, I began to feel like I could do this, I had renewed energy!!!  But I found it so hard to breathe through the contractions, every time I started to hyperventilate I thought about my anchor point – somewhere at the top of some beautiful rocky mountains. I remembered from all that I’ve read that the end is near when you feel like you are on the edge of almost dying. Knowing that helped me continue through the pain.

The nurse asked me if I could feel any thing different and that I had to tell them if I could.  But I didn’t know what ‘different’ felt like, I had felt ‘different’ for the past 90 minutes like I wanted to poo and squeeze this baby out!  I was starting to feel frustrated because I couldn’t understand what I should be feeling.  Every other contraction I felt like I was vomiting poo out of my stomach but through my bum.  So it was time to check my cervix again.

Second stage: Pushing – Another cervix check and I was fully dilated.  It was time to push.  Sharon was explaining to me how pushing was going to feel.  I don’t remember how it happened but I was moved to a lying down position and told that when I felt a contraction I could start to push. But that concept was completely Alien to me. I had no idea what ‘pushing’ should be like. Chris and my Doula grabbed a leg each and pulled them almost back with my knees almost up to my head as I held onto my thighs (trying not to squeeze them). I needed to take a deep breathe in and squeeze from my backside, sort of aiming the squeeze downwards, counting down to ten without screaming or making a noise as I pushed, breathing out as I squeezed really, really hard.  I managed this about two or three times per contraction.  It was hard work. After the contraction stopped  my legs were lowered down and I took a breather, using the oxygen because I was feeling dizzy, I needed to keep breathing.

The room was slowly filling up with various people, I couldn’t tell you how many people were in the room at that point, but now I knew why the room was so big.  I was told not to worry, but the Neonatal Intensive Care Unit (NICU) team were there just in case, because we knew that my baby would be small and could have problems.  It didn’t worry me, it made me feel in good hands.

It was hard sometimes to tell when a contraction was coming, they felt less intense than what I had been feeling for the past few hours.  After several pushes my Obstetrician arrived and she started giving directions.  My baby’s heart rate was decelerating, so in between contractions I was shifted and rolled to my left side because the baby didn’t like me being on my back for long.  It was terrifying.  All I could think of was getting this far and having to have an emergency Cesarean to get her out.  I was so determined to push her out and that is all I could think of as I pushed through the pain.

My doctor explained to me that I wasn’t quite fully dilated so she helped pull my cervix down so that the baby could get it’s head through, it was so, so painful.  She was guiding me how to push every time. Everyone in the room was helping me, counting down from ten and encouraged me to keep pushing hard. Eventually she told me I had just two more big pushes, she needed to get baby out ASAP, so she was going to use the vacuum.  We had seen one of these in our birthing class, so I wasn’t afraid of it, just relieved that baby stood a chance of getting out safely, even if it meant help.  My doctor put the vacuum on baby, the tugging that pursued afterwards was incredibly memorable and painful.  One more really big push, I was struggling to feel the timing of the contractions, I felt a big tug from the doctor as she used the vacuum to help baby come out.

The feeling of my baby coming out was amazing, I could feel everything, it didn’t hurt anything close to what I had felt the past 12 hours.  It was an almost euphoric feeling rushing through me.  The pain was now irrelevant. After 37 minutes of pushing, my baby was finally placed on my tummy, she was so warm, wet and gooey.  I looked at my baby, I didn’t cry like I thought I would, I was in complete awe at what had just happened.  The umbilical cord was prepared and Chris cut it, and the baby was taken quickly to the heater to be checked over.

I started shaking uncontrollably, I was so cold.  But my doctor said this was normal, it was my adrenaline gone crazy.  I was trying to watch what was happening to my baby.  Chris went to the baby to watch what was going on.

Meanwhile with another contraction I pushed and delivered my placenta, it came out quite easily. I was then quickly stitched up by my doctor because I had a second degree tear.  All of this was part of the labour far more painful than I had anticipated! Although it was mostly a blur, I was exhausted, but on a complete high.

21 Dec 9.21PM: Welcome baby!!!  And there she was – she was still a girl!  She arrived into the world at 2112 on 12/21 (or 21/12).  She was placed on me for the golden hour of skin to skin.  I cannot explain the feeling of love running through me, the relief that she was finally in my arms.  After everything we had been through over the past few years to get her here, she was now safe in my arms.

Sharon and Chris helped me with getting her latched on to my breast and she started to feed.  I was so incredibly overwhelmed to be able to breastfeed in that moment.

It took us a few hours to name her, but we finally agreed upon Aviana Ruby! 

Thank yous. I would like to say a big thank you to all the staff on duty during my labour and delivery at Sentara Princess Anne Hospital and Virginia Beach OBGYN-this team did everything they could for us to safely bring Aviana to us. And of course Sharon from Hampton Roads Doulas, I doubt I would have been able to do it without her amazing skills and knowledge! Finally, my wonderful husband Chris, my partner in crime and my biggest rock in my life, you were incredibly strong through all of this. Thank you, thank you, thank you XX