magdalyn's birth

So here is the post about Maggie's birth 4 months after the fact. Better late than never though !

Magdalyn came into our lives Monday, Sept. 20 at 6:03 am (my mom has been going around telling everyone that this is her birthday i.e. June 3rd, so I probably won't ever forget the exact time). She weighed 7 lbs 4 ozs, measured 19 inches long, and was absolutely perfect and beautiful in every way.

Up until just a few days before the birth, I had been having a completely normal, or as my midwife Faith liked to say, boring, pregnancy. My energy was good, I had no issues with being at work or working out, and I felt pretty much normal other than having a watermelon-sized belly. We had been planning for a home birth, because everything was so normal and boring, and I was seeing an OB only about once every 2 months or so.

When I was around 38.5 weeks I went for a checkup with the OB and they decided to scan me because they wanted to try out this demo ultrasound machine that they happened to have there at the time. He made a comment about the fluid looking low but didn't say much else; after they took the machine out he came back in with a fetal monitor instead and hooked me up to that. Another fifteen minutes later he came back in and said that we needed to "talk". He explained to me that my fluid levels were too low and I had a condition called oligohydramnios, which is defined as having an amniotic fluid index of less than 5 (mine was 3.3).

He said fluid levels that low are pretty uncommon (around 4% of pregnancies according to some stats I found) and when it happens they recommend induction right away if you are near term, since it could mean that the placenta was deteriorating. There was also a risk of compression of the umbilical cord. However, the results of the fetal monitoring showed that the baby was doing well and wasn't in any distress at the time, so we decided to go home and think it over first.

When we talked to our midwife Faith, however, she was strongly against induction because of its risks and because my body wasn't yet ready to go into labor (I had 0 dilation). She didn't think the low AFI was as dire as the doctor made it seem because everything else was fine other than that one number, which has some degree of inaccuracy because of the way it is measured in an ultrasound. She had seen cases where there was a low reading using ultrasound, but once the baby was actually being born and the water broke, there was actually enough fluid in there. She had also seen cases where the fluid levels improved a lot with maternal hydration. So because the baby appeared to be doing well, and was the right size (indicating that the placenta was functioning well up until then), she advised us to go back the next day to test again and in the meantime drink lots of water. She also came over and loaned us her portable fetal monitor so that we could continue to see how the baby was doing whenever we wanted. However, the home birth was now out of the question because I would need continuous monitoring during labor and delivery.

On Friday I went in to the doctor again, and this time, the AFI was up to 5, which was the borderline for oligohydramnios. Again, the fetal nonstress test showed that the baby was doing well. My doctor wasn't there however, and instead we talked to another doctor at his office, who still wanted to induce me and was very insistent about it. He couldn't really tell me the exact risk of anything happening to the baby was, but made it clear that he was of the opinion that even if the risk were 1 in a million, I wouldn't want to be that 1. After some thought we decided again to go back home and continue hydrating and monitoring over the weekend.

After being on edge all Friday and Saturday and monitoring about three times each day, I started to feel what I thought were contractions Saturday night during dinner. I went to bed but kept waking up throughout the night as the contractions got stronger. They were painful but not intolerable, and were coming about 2-3 times an hour by Sunday early afternoon.

Around 3pm, I decided to watch Lost to take my mind off the contractions, but all of a sudden they started speeding up A LOT. In about 30 minutes they were coming every 5-6 minutes and I had to turn the TV off. We called Faith who said she'd be by in a couple hours. In the meantime they got progressively more painful and closer together.

By the time she arrived at 5:30pm, the contractions were getting pretty intolerable. She said I was about 3cm dilated and we would go to the hospital once I got to around 5cm. I tried getting in the bath which initially gave me some relief, but the bathtub was really too small for it to do very much. We had rented a birthing tub but hadn't bothered setting it up since we were planning on going to the hospital. I had learned all these pain coping techniques in our birthing class (Birthing from Within) but was completely unable to apply any of it! I would just involuntarily tense up my body and grip whatever I could tightly every time a contraction came on. To make matters worse, the contractions started clustering together - I would have 2 or 3 in a row before getting a break.

At about 6:30pm we left for the hospital. The drive seemed SO LONG even though the hospital was only a mile away. I had my eyes squeezed shut all the way until I got into the room there. I agreed to the epidural as soon as they asked since I didn't think I would be able to make it through another 5-6 hours of the pain (if dilation was happening at 1cm/hour). Unfortunately the one and only anesthesiologist around was busy and would be at least another hour, so they gave me some fentanyl in the meantime to take the edge off the pain. I think it only made a slight difference though.

The anesthesiologist finally came by and put in the epidural when I was around 7cm dilated. It was pretty unnerving because they told me that I could not move no matter what or bad things would happen. The thought of possible paralysis scared me enough that I was able to keep completely still when needed. Finally it was in and almost immediately the pain completely went away. Just like that. Scary stuff. They told me to take a nap to have energy for pushing later on, but I couldn't really fall asleep.

Four hours later, a nurse came in to check on me and I was STILL 7cm dilated. My contractions were only coming every 6 minutes, so instead of labor progressing it seemed to be going in reverse. They started giving me pitocin, which is the same drug given for inducing labor, to make the contractions stronger. Four more long hours later, I was finally fully dilated. They called my doctor and he said to go ahead and start pushing and he would be by later.

The pushing wasn't painful because of the epidural and wasn't too hard since I had managed to doze off in the last few hours so I wasn't tired. The doctor showed up around 5am and by then they said I was pretty close. About 10 minutes later however, by some weird coincidence, another one of his patients walked into the hospital and was about to deliver so he had to leave to go attend to her first! In the meantime, I was supposed to take a 10-minute break from pushing - since he had to be present to "catch the baby"?!

It was really hard to stop pushing though, because I could actually feel the contractions getting stronger at this point and start to become painful again. Along with being able to feel them came the urge to push and it was almost impossible to not push - in fact, it was more painful when I didn't push. So we tried to do fewer pushes per contraction for a while so the baby would just stay in there until the doctor came back.

The doctor finally came back after about 40 minutes! I could really feel the contractions strongly now as well as the skin stretching (sorry, this part is probably tmi) so I was really trying as hard as I could to get her out of there as soon as possible. Finally, in the last contraction, I pushed 5 or 6 times in a row and she popped out! I got to hold her on my chest as the apgar score lady fiddled around with her trying to make her cry. I was exhausted and exuberant and amazed and a myriad of other emotions all rolled up into one...the rest of the morning was just a giant blur as a parade of nurses, doctors, lactation consultants, etc. came in and out of my room.