Delivering Sheperd

Warning: This post contains TMI.

photo by Jeannine Pound Photography

False labor. I'd heard of it. I didn't really expect to have it. I thought maybe false labor was just feeling so uncomfortable you wish that the baby would come. Or maybe you'd start to have some contractions but it wouldn't be anything like what real labor started out like. I was wrong.

I was due on Saturday, May 23rd with our second son. Nothing happened that day but I didn't expect it to. I expected it to happen the following Tuesday, which was the day after Memorial Day. Nothing happened that day either. That being said, I couldn't have expected it too much because I set my contract at work to end at the end of the week on May 29.

On Wednesday, May 27, I started having contractions. It was just like when I had Foster. Really light, menstrual cramp like feelings in my lower back and abdomen.  With Foster I had these cramps for the duration of a walk home from dinner and then things kicked into high gear and I was headed to the hospital 2 hours later. This time things started out much slower. Instead of starting out at 3 min long and 5 min apart, they were about a minute long and 5-20 min apart. So I went along with my day. 10 hours later things were at every 5 minutes and getting a little more intense. We thought it was time. Ryan sent out a text to our friends and family that things appear to have started and that we'd keep everyone posted. I put Foster to bed and things slowed back down. Then they were gone. Nothing. All night I wondered if I'd suddenly wake up in full blown labor but it just didn't come back.

The next day I called my doctor and asked to have my membranes swept. I figured maybe it just needed a little push and he had said the day before that he thought I'd be a prime candidate for it to work really well. I wouldn't have likely rushed things except for a few key drivers:

1. Ryan had two weeks of paternity leave and we were already nearing the end of week one.
2. I worried that another late baby would mean another trip to the NICU because of meconium.
3. With a sunny-side up baby I was worried that the bigger he got the harder it would be to deliver him.

A membrane sweep is essentially a cervical exam (I was at 2cm dilation at the time) and then the doctor goes past the cervix with a finger and 'sweeps' the membrane to separate it a little from the cervical opening. The process usually dislodges the mucus plug and releases prostaglandins which help to trigger labor. It's also pretty uncomfortable. The whole thing takes about 20 seconds. Afterwards we went home and continued on with our day. I started having contractions again about an hour later and we had a repeat of Wednesday. About 10 hours of contractions and then nothing. Gone. No signs of baby coming.

The following morning, Friday, I lost my mucus plug (gross) and again started having contractions. This time I had about 4-6 hours and a few were getting strong, but nothing that was like the contractions that told me things were real with Foster. Again, the contractions stopped late in the evening and didn't pick back up again.

Over the weekend I really didn't have any signs. I was starting to worry. When would things get going? How would I know it was real after all of the false labor? How the heck was I going to get a sunny-side up baby out? What was my recovery going to look like when Ryan only had one week left off from work and we still didn't have the baby? I was particularly concerned that I would need to be induced using pitocin. It just didn't seem like my body was responding to normal triggers like a lot of walking, membrane sweeps, sex, spicy food, etc. If I was induced with pitocin I worried it was more likely I'd want an epidural. If I had an epidural I'd have to labor on my back which is the worst position for a sunny-side up kid. If I wasn't able to get the baby to turn during labor I'd either likely have a very long and slow delivery that resulted in tearing or I'd have to go and have a C-section after who knows how many hours of trying to deliver vaginally. I had the whole scenario playing over and over in my head.

So, on Monday I went in for another membrane sweep. Delightful. I was at about 3cm dilated at that point. I also had to do a non-stress test for 20 minutes to monitor the baby to make sure he was doing OK. Essentially they just record his heartbeat and my contractions and make sure that the latter doesn't have an adverse effect on the former. Everything looked good. That was reassuring at least.

A few hours later I started to have some contractions again. Just like all the other times. Super light, about 5-20 minutes apart. Nothing to write home about. At about 10pm I put Foster to bed and the contractions had essentially stopped. Ryan and I turned on 'Last Week Tonight' with John Oliver and settled in for the night. Then the contractions picked back up again. They were still really light but lasting about 2 minutes and were 5 minutes apart. Nothing I hadn't had before, but it was the first time that they had picked back up again after Foster's bed time. Closer to 10:45 they were lasting about 3 minutes and were coming every 3-5 minutes. For those who aren't aware, contraction timing measures the time between the START of each contraction. Meaning if you start having a contraction, it lasts for 3 minutes and you have another contraction 4 minutes later it means you only have a break of a minute....not a break of 4 minutes. This isn't a big deal when things are light and slow but it starts to be a very big deal later on.

This was the first time that my contractions had been moving up in intensity like this. It felt like it may be real again. I walked around the house during each contraction and Ryan and I started to pack things up.  By 11 I knew we were going in. I could still walk and talk but it was getting more and more uncomfortable. I didn't want to wait as long as I had with Foster (which was only about an hour), so I called my doctor and told him I thought I should go in. He asked a few questions and then agreed. Next I texted Bill to give him the latest update and ask if he could come over to stay with Foster until my parents would come down the next morning. He said he'd be over in 7 minutes (he lives 4 minutes away). Finally I texted my parents to tell them to plan on being at our place to relieve Bill by 8am and that we were headed in.

By the time Bill got there at 11:15 it was definitely real. I could still walk (so much better than with Foster), but I didn't know how much longer that was going to last. Ryan and I packed up and headed out. I'm SO grateful that I didn't go into labor during rush hour. That could have turned our 12 minute drive to the hospital into 45 minutes to an hour. Instead, we were parked and in the elevators by 11:30. We got to triage and Ryan was able to answer all of the nurse's questions. This was another nice change from Foster's delivery where Ryan had to park the car after dropping me off at the emergency entrance with some EMTs who wheeled me up to triage.

I was checked into a triage room and was told that they would check my dilation and then determine if I was to be admitted. I told them I had to use the bathroom before they did that. Ryan went with me into the single occupant bathroom to make sure I was OK. Another big change with this labor was that my body had spent the previous week trying to 'clear out' everything bowel related but it just kept coming. With Foster I never had that part of the experience...that was definitely a benefit of Foster's delivery over this one. While I was washing my hands I started to have another contraction so I was working through that when an older woman walked into the bathroom. She wasn't a patient or someone who worked there from what I could tell. She just stood there. Looking from the toilet to Ryan and me, and then back to the toilet. Like she was considering using it even though we were there. It was bizarre. Ryan told her that we would just be a minute and she shuffled back out. So strange.

I went back to the triage room and had contraction after contraction while they checked me out. I was at 6cm dilated and 90% effaced. I had reached the "I'm not moving from this hands and knees position unless you make me" stage of labor. The nurses wheeled me from triage to the delivery room and I rolled from one bed to the other between contractions. Things were getting really intense. I was having feelings like I had when I was in transition with Foster. Super strong contractions that were hitting me in waves, one after the other. I'd feel a contraction winding down and be hoping for a break and the next one would come crashing down. I started using my coping technique I used with Foster which is essentially an 'ahhh ahhh ahhh' loud sound during each contraction (so continuous). At one of the rare real breaks between contractions I told the nurse I thought I was in transition. She agreed that I probably was. It all seemed so fast. I started to worry that my doctor wouldn't make it.

Things felt different this time. The baby was moving a LOT during the downside of each contraction. Like he was thrashing about trying to turn into the right position. There was a lot more pressure during contractions and I really had the urge to push. I could feel that the bag of waters, which still hadn't broken, baring down. I felt like Old Faithful getting ready to blow. All of this intensity made my coping sounds escalate into more screams than I remember having with Foster. More screams escalated into grabbing onto Ryan a lot more than in my first labor. I remember thinking it would be funny to say, "you did this to me", but there was no way I'd be able to say that many words.

My doctor showed up and checked me. I was at 7cm and had a large 'bulging bag of waters'. Yeah, no kidding. Then he left the room. Everyone was talking normally but I couldn't hear what they were saying because of my 'coping'. I didn't know why my doctor left. With Foster they broke my waters for me at 7cm and I shot straight to 9cm and was able to go through transition to get to 10 and then start pushing.  I was already in transition...why the hell weren't they breaking my waters? During another rare break where I could speak I asked why and the nurse offered to get the doctor back in. Ryan made sure there wasn't a reason he was holding off and then the decision was made to go ahead and break them. I love that my doctor isn't the rushed type and allows nature to take its course, but I wanted that thing broken. Now.

As soon as my water broke all hell broke loose too. I instantly NEEDED to push. There was no urge....it was happening. This also meant that I started sh*tting everywhere. Or at least in my mind it was everywhere. Everyone else assured me it wasn't that much and to not worry about it. OK fine. The other things that happened when my waters broke was that I shot from 7cm to past 9cm, just like last time. But unlike last time there was no meconium (hooray!). Unfortunately, another difference was that this time the baby's heart rate plummeted. My super calm and collected doctor's tone changed quickly; it was still collected but there was an urgency. I started to hear things like 'NICU' and 'I want a vacuum up here' and 'we need to get this baby out'. I didn't panic...but I definitely wanted to do my part to make sure the baby got out safely and quickly. I was laboring on my hands and knees still at this point, which is the position that Foster was delivered. The nurses and doctor instructed me to spread my knees wider and really squat down as much as I could. I did this and I could feel the baby progressing with every push. But then my doctor said he needed more room to maneuver. Apparently I was only at 9.5cm and my doctor was helping to 'hold aside' that last .5cm and he didn't have the space to see what he was doing, make sure the baby was turning correctly, and try to speed things along. He told Ryan he needed me on my back. With Foster, every change in position was a discussion. Waiting until I was ready and easing into things. That wasn't a luxury we had this time. We needed to move. I flipped over onto my back without hesitation and continued pushing. It was encouraging that I could feel the baby moving down with each push, but I was still worried that I wasn't doing enough. Ryan was coaching me along, and the nurses were helping him to give my legs something to brace against. Before I knew it Ryan was telling me the head was out and my doctor was telling me not to push for the next contraction. The baby had turned, thankfully, and so his head had eased out quickly. Then he kept on turning and his shoulders got stuck. The doctor used my next contraction to ensure the cord was fine, turn the shoulders and then ask for one last push from me to get the rest of baby out. Just like with Foster it was the weirdest and slow-motion-like feeling to do that final push. Maybe it's because we make especially long kids, or maybe it's the endorphins but with both labors I distinctly remember feeling like the little bodies take the longest, slowest ride out. It was 12:57am.

As soon as baby was out he was fine. I had pushed for 6 minutes after laboring for under 2 hours. The NICU nurse came in with her equipment and stopped. The doctor told her that she was no longer needed. She looked confused....she had just been called. He assured her that they had needed her but that I had pushed the baby out during the time it takes to get from one floor to the other.

Ryan cut the cord (an event he heralds as less than exciting) and baby was placed on my chest. I was elated. It was the moment I had wanted with Foster and never got. It was the moment that I almost didn't get again. There he was. On me, looking like an alien, all puffy and wrinkly and mine.

The team kept working to deliver the placenta. Telling me to give little pushes and doing that horrible thing where they 'massage' the belly to help the uterus contract and close up shop. My doctor was talking about how I lost quite a bit of blood, about 500ccs during delivery. The placenta was delivered intact and the nurse did the practice push where they press down on the belly to make sure that nothing else comes out. But I gushed blood. Probably another 50ccs. That was a lot for a practice push. They explained to me that because the placenta was whole it was likely I had blood clots and that they would need to go in to get them. OK, sure. I'm riding high on hormones. Can't bring me down. Then they pressed on my stomach again....OK screw that. The doctor explained that it was going to be really uncomfortable for him to check for clots and ordered some morphine. I said that opiates tend to make me puke, or at least they did when I had my wisdom teeth out, so they gave me half a dose.

The doctor reached into my uterus (WEIRD!) and at the same time pressed down on my belly which brought his hands together with just my flesh between them. Then he pulled downward to scrape any clots out. It was awful. So they pushed the second half of the morphine and did it again. It was still awful but less so. A LOT of clots came out along with another 500ccs of blood. I made Ryan take a picture and show me, and he made me let him delete it right after he did. They gave another practice push on my belly and no gush. The doctor said I had a level 1 tear that he normally wouldn't stitch but because of the blood he wanted to be safe. He threw in 2 stitches and the doctor's work was done.

The whole time the baby was on my chest doing that little teeny baby cry. He sounded so healthy and strong. I moved him so he could try nursing and he latched on immediately...and with force. The kid knew what to do. It was amazing. He was able to continue nursing while I was cleaned up and the nurses monitored my vitals.

There was talk of a possible blood transfusion if my hematocrit score was bad. The good thing is that a pregnant woman has about 30% more blood than when she isn't pregnant so I had more to lose than I would have had normally. They had to put an IV in just in case there was a need to do something quickly.They had one put in during labor but when I turned from my knees to my back while pushing I had ripped it out. So they tried four times to get an IV into my arm and all four times my veins blew it right back out. Finally they brought in the big gun who had a different technique and she landed it. I was able to move to our postpartum room with Ryan and baby.

My blood scores were OK so no need for a transfusion but they were going to be paying close attention to my blood pressure and any other symptoms.

That first night in the hospital I was able to nurse and cuddle with our new baby boy. We decided to name him Sheperd Alden. We liked that Sheperd, like Foster, was a verb and that it meant to guide or lead. Alden means 'a wise, old friend' and also means 'within Scottish borders' so we thought it was also very fitting for what we were hoping would be traits of our boy.  Ryan had thought of Sheperd while sleeping and we both loved it right away. Then we didn't love it. It would be hard to spell...and while we loved he nickname of Shep we weren't sure if it would be something you could shout out without sounding like you were swearing. But for whatever reason when we saw him we went right back to Sheperd.

The next day was a bit of a daze. Nursing and trying to sleep and also having a few visitors stop by. My parents brought Foster in to meet his brother and it was nothing short of adorable. Foster was so gentle and sweet and seemed to know exactly what had just happened to get 'baby brother' out of his momma to a place where he could see and touch him. That night Bill brought us pizza for dinner and to tell us how easy Foster had been for him the night he stayed over. Foster had woken up once but gone right back to bed when Bill checked on him and patted his back. The next morning he acted like it was completely normal to see Bill there instead of his parents. Ryan stayed at home that night so he could avoid the horrible guest bed in the postpartum room and so that he could be with Foster. He came back the following morning so we could do the final tests on Sheperd and get discharged. It was so crazy to be leaving so quickly after staying 4 or 5 days and dealing with the stress of the NICU with Foster.

We strapped Sheperd into his car seat and off we went. Driving home with a newborn in the back next to his big brother's seat. That's us. The Buchans. Family of four. A car with a backseat full of kids.