rms10: (pantheon)
[personal profile] rms10
Leo's birth (and aftermath)!

Executive summary:
11 hours of labor
10 minutes of pushing

Leo's stats:
7 lb, 6 oz.
19.5 inches
Apgar 9 and 9
40w4d gestation
Born Tuesday, November 6, at 3:52 p.m.

I'd been having the odd contraction before then -- fewer than ten per day -- but I woke up at 5 a.m. on the 6th in labor. At first I wasn't sure if they were labor contractions or just stomach cramps, in part because I was feeling the sensation in front. Then I realized that they were labor contractions, and that unlike last time, it wasn't back labor, and hopefully the baby was in a good position. Hooray! At this point the contractions were fairly frequent -- every 5 minutes or so -- but very short, about 15 seconds long. I showered, had a small bowl of cereal, and helped a bit at wrangling my 3-year-old. We called the doula, and waited for her to arrive before my husband took our son to babysitter's.

It was 8 a.m. before she arrived, and then it was 9:30 before my husband was back home. During this time the contractions got stronger, but were more spaced out. At one point I even took a 15-minute nap on the couch between contractions. I think my body knew that my husband wasn't home, and slowed down to wait for him. Once he got back, the contractions became more frequent, but never settled down into a real pattern. I was doing squats during contractions. By noon, I had to work a bit more with them -- swaying my hips and vocalizing.

Around 1:30 my contractions became more intense, and were coming every 2-3 minutes. Suddenly I was in transition, despite earlier contractions not being in a pattern. So we went to the hospital, which meant dealing with three or four contractions in the car, ugh. I still felt mostly fine when we got there, except during contractions, but I guess it was apparent to everyone there that the baby was coming ASAP. They got me into a L&D room, and I tried to answer admission questions between contractions, which was interesting. A midwife did a cervical check, noting that I was at 7 cm with a bulging bag of waters, and that once my water broke I'd be at 10 cm. A few contractions later, my water broke.

I'd been laying on my side to deal with contractions while they did some fetal monitoring, but then I got on my hands and knees (with the upper portion of the bed raised up). I had two contractions that I really felt some bearing down on, and then two contractions where I really pushed. There was definitely some burning during the pushing -- in part because my scar from last time didn't hold, and I tore again -- but Leo came out after only about 8 minutes of pushing! It's amazing what perfect positioning will get you. (I maybe should have gone a bit slower, and then perhaps I wouldn't have torn so badly, but it is so hard to not push with all your might at that point.) The nurses and midwife helped turn me over and handed him to me. Apparently right before he was born they'd guessed his weight to be only 6 or 6-and-a-half pounds, so they were pretty surprised that he was 7 lb 6 oz! Ha! I held him while they stitched me up (a third degree tear -- hey, not as bad as the fourth degree from last time!) and nursed him. He latched on right away, which was awesome.

It was less than an hour and a half from arriving at the hospital to him being born. I do not necessarily recommend this, because there was a lot of chaos when I arrived.

In a nice small world connection, the midwife who delivered him is good friends with the mother of the woman who was our doula for our first child!

About two hours after Leo was born, I had a postpartum hemorrhage, and it was pretty much a textbook presentation of it. (Uterine atony. I also had "a lot" of bleeding after my first child was born, but it wasn't at PPH levels -- I think it was at most 400 mL lost -- so I'm not sure if that was enough to increase my risk for PPH this time.) Treating it required an IV of pitocin, a shot of something in my thigh, and some rectally-administered cytotec. (And one other intervention, listed in the gory detail section). I lost a bit over 1 liter of blood, and they typed my blood in case I needed a transfusion, but my vital signs remained stable and my blood count was juuuust high enough that I was able to get by with fluids in the IV. It was scary for my husband while it was happening -- suddenly there were lots of people in the room dealing with it -- and at the time I was a bit out of it, but in retrospect it was pretty scary. Also, recovering from that much blood loss sucked.

The other thing they had to do when this happened was manually clean the blood clots out of my uterus. OW. They gave me some fentanyl in my IV before they did this, but it was worse than childbirth itself. OMG.

I consider myself very lucky in that I've had two mostly-positive labor and delivery experiences. And I'm kind of delighted that I did manage to give birth entirely intervention-free! However. While my husband and I had long-since decided that we only wanted at most two kids, now I am absolutely certain that I am done. My pregnancies were both easy, and childbirth -- especially the second time round -- is not the most difficult, painful, or strenuous thing I've done in my life. The PPH, however, was pretty awful, and knowing that I'd be at risk for another one is scary. My family has donated to Life for African Mothers, due to my experience.

(For reference, here is the birth story from my older son's birth.)

Date: 2012-12-04 08:11 pm (UTC)
From: [identity profile] eirias.livejournal.com
Gosh, that DOES sound scary. I'm glad you're okay.

Date: 2012-12-04 08:22 pm (UTC)
From: [identity profile] rms10.livejournal.com
Thanks! This recovery has actually been quicker than the recovery from the first one -- probably a combination of more aggressive management of the blood loss (advantage of losing more blood?) and a less severe tear.

Also, Leo latched RIGHT away, and breastfeeding with him has been a breeze. Sam didn't even latch for two days, and that makes a difference in terms of how the uterus contracts after childbirth.

Date: 2012-12-04 08:42 pm (UTC)
From: [identity profile] claddagh.livejournal.com
Postpartum hemmorhage is grounds for a transfer regardless of birth location, as far as I know. If they have access to pitocin, they will use it. If they don't, they try to get the baby to latch to stimulate uterine contractions. (Discussed in my childbirth class) However, they call 911. In the childbirth classes (located at our local birth center), they were clear that limiting blood loss is one thing paramedics are well-trained for and equipped for.

With home birth and birth center, the provider stays to make sure that your uterus is contracting and that you aren't losing too much blood. In the hospital, they check on you annoyingly frequently.

Date: 2012-12-04 09:01 pm (UTC)
starfishchick: (Default)
From: [personal profile] starfishchick
I'm glad that (all in all) it was a good experience. I have a lot of ISSUES about labour and delivery so it's probably healthy for me to read true stories, blood and all!

Date: 2012-12-04 10:25 pm (UTC)
From: [identity profile] rms10.livejournal.com
Oh dear, I should have warned you away from the gory section. But do keep in mind that I went home less than 48 hours after he was born, and felt mostly fine. By three weeks postpartum, I was wrangling both boys by myself in the mornings and getting S to preschool at something approaching a reasonable time. All's well that ends well. :)

Date: 2012-12-05 03:39 pm (UTC)
starfishchick: (Default)
From: [personal profile] starfishchick
No no, it's a good thing. Maybe exposing myself to Real People with Real Stories (both good and bad) will help?

Date: 2012-12-04 10:33 pm (UTC)
From: [identity profile] bugorama.livejournal.com
i had a retained placenta after my recent homebirth, and the midwives gave me shots of pitocin and methergine. when that didn't work and i was bleeding heavily, they called 911 and i was transported to the hospital in an ambulance. my midwife palpated my abdomen the entire time we were transporting, until i was actually being wheeled into the OR, where they gave me a spinal block before manually removed the placenta and clots (so grateful for that spinal! my midwife tried to do the same thing at home, and WOAH the pain! you are so right! having a hand in one's uterus is OUCHIE!).

i lost about 2 liters of blood by the time it was all over. i'm still anemic three months later! these things are scary, eh? it was my second homebirth -- the first was much less eventful! it definitely makes me feel like our family is "complete." : )

Date: 2012-12-04 11:16 pm (UTC)
From: [identity profile] rms10.livejournal.com
2 L, yikes. Retained placentas sound scary.

Date: 2012-12-05 12:20 am (UTC)
From: [identity profile] thekat03.livejournal.com
I've thankfully only been on the physician side of a postpartum hemorrhage, but yeah... that whole cleaning out the clots manually makes me think that obstetric providers with small hands are SO much more appealing than those with big hands. d:

Date: 2012-12-05 06:08 am (UTC)
From: [identity profile] rms10.livejournal.com
Haha, and ow.
(deleted comment)

Date: 2012-12-05 06:11 am (UTC)
From: [identity profile] rms10.livejournal.com
Oh, just low blood pressure, light-headedness, general wooziness, and anemia. In itself, not too bad. Combined with recovering from the rest of childbirth and starting bresstfeeding (which itself requires hydration and lots of food), all while sleep-deprived, and then it starts to get rough.

Date: 2012-12-05 08:00 pm (UTC)
From: [identity profile] duchess-k.livejournal.com
Good for you! Love this story!
I'm sure that a birthing center has emergency pitocin shots to get the ball rolling on stabilizing, and then transfer to hospital facilities would follow. If no pitocin was available, I'm sure ambulance transfer is in order.

I too had a 4th degree with my first. I had a 2nd or 3rd degree with my second. Boy what a difference! The midwives said it was 2nd, but that was after a bit of discussion and brow-furrowing. I think the extent of my scar tissue and reconstructed anatomy made it a little difficult to make the call. But I recovered just fine!

Date: 2012-12-06 12:18 am (UTC)
From: [identity profile] princessselene.livejournal.com
I had postpartum hemorrhage immediately after delivering my first daughter and ended up with two D&Cs and six blood transfusions. I had huge blood clots the size of my fist (my husband said the last one before the gave me a spinal before the second surgery looked like it was the size of a pound of ground hamburger). Turns out that I lost TWO 2 liters of blood and looked grey my first visit to the OR. I'm still anemic over two years later and have to take iron pills twice a day (which is saddening, because I used to donate blood every 2-3 months for years beforehand).

The birth of our second child, Ashley, ended in c-section, but was a MUCH better birth experience overall. The fact that I requested the c-section might have something to do with it though, since it was 3 in the morning at that point and I'd had NO sleep for over 24 hours at that point. I was exhausted and out of energy.

March 2013


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