Friday, October 30, 2015

Allison's birth story: C section and hospital stay

When I was about 30 weeks along, I started getting myself mentally prepared for Allison's birth. I was glad I'd already been through it once and expected it to be a breeze this time around. I reviewed everything I knew about contractions, the cervix, and what all goes on during pre, early, and active labor. I'd spent nearly two hours pushing during Tyler's birth, but it was all worth it for the euphoria I felt once I could hold him in my arms. I imagined what that moment would be like with Allison, and I couldn't wait for it. If I'm being perfectly honest, I'd been much less attached to Allison during her pregnancy than I was to Tyler during his. Tyler was the baby I'd spent 7 infertile years longing for, and I had no other children to distract me from connecting with him in utero. But during Allison's pregnancy, I was so focused on parenting the child in my home that I didn't put as much effort into bonding with the child in my womb. I felt tremendously guilty about it, though, and I looked forward to that moment when I'd hold her in my arms and fall instantly in love with her after giving my all to bring her into this world.

That all changed at my 37 week OB appointment. I'd been told she was head down during previous visits, and even at that appointment he believed she was head down but decided to do an ultrasound just to make sure. I was stunned when he told me she was breech. I was now faced with the reality of having a cesarian section if she remained that way. This wasn't in the plan at all! How could this happen? I needed to push her out! I worried I wouldn't feel the same bond with her without the post-pushing euphoria I'd had with Tyler. When my doctor explained the possibility of an external cephallic version (ECV) to attempt to turn her, I immediately said yes. I absolutely had to avoid having a C section! While I was partially concerned about the recovery, particularly how hard it would be to parent Tyler during it, I mostly wanted to deliver her naturally so we could have that moment I'd pictured would bond us forever. My doctor said an ECV worked about 60% of the time and told me that I was a good candidate for it. There were no worries about the cost since my insurance covered it, many friends told me they'd had successful ECV's (and the ones who hadn't were 1st time moms), and several youtube videos of successful ECV's made the procedure seem quick and painless to me. I was fairly confident that Allison was going to turn and would still have the birth I'd pictured.

Unfortunately I couldn't tell the slightest difference between Allison's breech position and Tyler's head down position. Their movements in utero felt very similar to me. If anything she seemed quite a bit more active than Tyler was. I also have no memory of Tyler turning whenever he did, so I didn't know what it was supposed to feel like. The evening after that appointment we did a spinning babies technique called sifting. She'd been very responsive to it, so I was pretty sure she'd already managed to turn on her own. I started feeling hiccups in my gut, something I hadn't felt the entire pregnancy, and even woke Oscar up in the middle of the night to feel the hiccups and confirm that they were down low in my belly. With all the crazy movements she made over the next few days, some particularly painful ones the night before the ECV, I figured we'd go into the hospital the next morning, do an ultrasound, see she'd turned, and walk right out.

After being admitted and prepped for the ECV, and telling everyone I met I was pretty sure she'd already turned, they did the ultrasound and found she was still breech. I was bummed, but they would get her turned, right? I was a good candidate, and the doctor said my water level was fine. She'd be turned soon enough. They gave me some fentanyl, which made me relaxed and happy, and then the ECV began. There was a lot of uncomfortable pressure, but thanks to the drugs I didn't tighten against it at all. The doctor worked at it for a long time, but her head would not budge and her butt was lodged in my pelvis. He'd get one out only to have the other fall back into place. He called in another doctor to help him. One tried turning her head and while the other tried turning her butt, but even that didn't take. They told me she was on her side, so they had to first turn her flat before they could even attempt to turn her head down (apparantly that painful movement I'd felt the night before had just been her turning on her side and making things worse for them). The other doctor asked if this was my first pregnancy. He was surprised to find out it wasn't since it's usually much looser for them if mom's been pregnant before.

After about 7 total attempts, they gave it up, and we scheduled my C section. I couldn't schedule it until September 6th when Allison would be 39 weeks, but I didn't want to wait until her due date or later since I didn't want to go into labor first and have painful, pointless contraction before having an emergency C section. I went into labor with Tyler at 39 weeks 4 days, so I tried to schedule it before then, but the 6th, 7th, 8th, 9th, and 10th were all taken. It was a popular week for scheduled C sections! We scheduled it for the 11th, two days before her due date, and prayed I wouldn't go into labor and/or she would turn on her own before then.

I was super sore over the next few days, which was extra painful when Tyler would climb on me or push on my belly when he wanted to get on/off my lap. If it was that bad from the version, what would it be like after the C section? I began dreading it and even resenting Allison a little bit for putting me in that position. I remember saying to her "why can't you be more like your brother and turn?" While it was very uncomfortable, it was nothing compared to being in active labor before I had any medicine, so I said I'd be willing to try it again just before the C section. I also looked up breech delivery, but it wasn't something I was willing to try. My first uncomplicated labor was excruciating before I got the epidural, and that was with a supportive husband, sister, birthing coach, and a couple rounds of fentanyl. From everything I'd read, a breech delivery is even harder and you have to accept the possibility that you'll need to labor without any drugs. This is because most women progress less once they're on drugs, but I was the exact opposite with Tyler. During my first labor my own tightening against the pain was actually harming the process. I could not get dialated beyond a 4 after 8 hours of early labor and 7 hours of active labor. Then I got the epidural and practically slept through the remaining 6 centimeters in 4 hours. Most hospitals these days won't even perform a breech delivery, so I'd have to go to a birthing center and an epidural would be out of the question. Even if I could handle the pain, I'd be terrified of the baby's head getting stuck in my pelvis because I couldn't relax enough for my cervix to fully dilate. The C section was clearly the less risky choice. I asked my doctor what my chances were of being able to have a vaginal birth after C section (VBAC), and fortunately they're very high because I've already had an uncomplicated vaginal birth.

Over the next couple weeks I saw a chiropractor regularly, continued the sifting once a day, and did handstands on the pool and water aerobics to help her get moving. I really looked forward to my final 39 week appointment with my doctor. For some reason I was convinced she would have turned on her own by then. When she hadn't, I felt agitated and knew I'd be a complete mess if I didn't come to a place of peace with it. I went home, prayed, and had a good cry. I realized I'd been thinking more of myself than of her during the entire process. Even when I thought I was thinking about Tyler, I was actually thinking about how much harder parenting him would be on me after a C section. I asked Oscar if he would give me a blessing to help calm my mind. He did, and he assured me that Allison would come into the world safely and without complications. After it was over he told me he'd wanted to say that she would turn, but he didn't get that impression. For the next week I kept up my efforts to turn her, but I finally began accepting that she wasn't going to turn. I stopped resenting her for it and began enjoying her movements more. She responded in kind by no longer confusing me with her hiccups. From then on I started feeling them in my ribs right where her head was.

My OB was going to be out of town the week of my scheduled C section, so he referred me to one of his partners, Dr Steven Sharmaud. While Ty and I were on a playdate with our friends Carolyn and Eli, I learned that Dr Sharmaud would be performing her upcoming procedure too. She also told me he was the former bishop of the Harbour Pointe Ward, the congregation we share a church building with. She said he was retiring in two weeks and would be moving to Utah for a year before serving a medical mission in Brazil. I thought that was an interesting coincidence and was glad to hear I'd have something to talk about with this doctor I'd never met before I let him cut me open and sew me back together. When I went in for my consultation with him, he looked at me and said "I feel like I know you. Do I?" I explained that he would have seen me in the halls at church and that I knew Carolyn. While we talked I learned he is actually a fertility specialist and is well aquainted with my fertility doctor. SRM used to have a branch up at Providence, but they cancelled the program a few years back when there was a new requirement to build a $100,000 lab for sperm analysis. Since the Providence branch only made about $30,000 a year, they opted out of it.

The two final days before the C section were torture. In addition to late breech pregnancy discomfort, Tyler was particularly demanding and throwing random temper tantrums for no explicable reason. I kept watching the clock waiting for those days to pass. Fortunately, though, I found something that really helped me come to a place of peace. I found a lovely little article that I really identified with called "When Life Gives You a Breech Baby." These paragraphs in particular could have been written by me.

"Every child is different. The way they choose to come to you is different. You are hilarious for thinking you have any control over this. I have spent a great deal of time trying to change these circumstances. Part of me feels responsible for her not turning, that I have been too busy, that I haven't been there for her the way I was with my first baby. It's really hard to not beat myself up about that but I am finally coming around to the fact that maybe she just likes where she is, with her head up under my ribs close to my heart and voice.

The idea of a scheduled c-section has been uncomfortable for me, and I've spent the last few weeks worrying so much about it. Last week I decided enough was enough, that I was creating so much more resistance during these final, beautiful weeks than was necessary. I have reached out to many friends and acquaintances to hear their c-section experiences and have to say that I'm finally getting to a place of peace if this is the route for me. I am so thankful for all of the women who have come forth to share advice and tell me their stories. I am so thankful to be a woman going through this amazing experience called birth. I am so thankful that I have this option. I am so thankful that I am having a little girl who has already started teaching me much needed lessons."

I was in tears when I finished reading. I knew exactly what she meant about feeling guilty and having a hard time letting go of your original, romanticized birth plans, but I was also grateful for the experience. It had forced me to become more connected with the baby in my belly, and the love I'd struggled to feel for her poured out of me once I finally accepted that she might not do what I thought was best. I felt grateful to live in a time when breech presentation doesn't have to be life threatening to mother and child. I marveled at the fact that Cesarian birth is routine and generally successful rather than an emergency attempt to save a child from a dying mother. The fact that doctors can cut a child out of my womb and that both of us can come out of it in one piece is truly amazing! Rather than resenting her for making me go through it, I thanked her for showing me that it would all turn out to be a beautiful learning experience. We still intended to attempt another ECV just before the C section, but I no longer cared if it worked or not. I was ready to accept my baby no matter how she came into the world. I was just excited to meet this sweet little girl who'd already taught me so much.

That night Tyler slept peacefully, little knowing his life would forever change the next day. I took this picture from the camera monitor in his room to commemorate his final night as an only child. The next morning he was thrilled to see Granny and Grampa Hunt. They'd come up for Allison's birth and had kindly offered to take Tyler back down to Utah with them for a week (more about that in a future post). They also took him up to Canada with them for a little excursion before coming back to meet Allison. We were told to check in at 10 for a 12:00pm C section and that visitors would not be allowed until about 4, once I'd been monitored long enough to ensure there were no complications. Since that was a long time before they'd be able to see us, they thought it'd be fun to take a quick trip across the border before meeting their newest granddaughter. We sent Tyler off with his Elmo and Cookie Monster then headed up to the hospital.

It was so weird to show up at the hospital not writhing in pain. I was, however, starting to get pretty uncomfortable. I wasn't having contractions, but everything I did felt extra difficult, even things like sitting and laying down. As miserable as taking care of Tyler was during that final week, it was at least doable. If the C section had been scheduled after the 11th, I would have definitely needed help. There's no way I could have been a parent that day! I can't know for sure, but based on how I felt the 2 days before labor started with Tyler, I'm pretty sure I would have gone into labor naturally within the next 24 hours.

We checked into Triage at 10, ready to have a baby. I was uncomfortable but not miserable since I wasn't having contractions. Compare these smiling pics to the ones in the middle of a contraction from Tyler's birth. They hooked me and Allison up to the monitors, saw our heartrates were normal, and were happy to see her moving. She was actually extra active that day. She somehow knew it was time to make her appearance.

My sister wanted to be at the hospital the entire time we were there, even knowing she wouldn't be able to see us for 6+ hours. Thankfully the people in Triage were really cool that day and actually let her come hang out in Triage with us, which they hadn't allowed during Tyler's birth. My surgery ended up getting delayed over an hour because the doctor was called away for an emergency C section, so there was a lot of laying down waiting uncomfortably on the bed. Malia saw Alli kicking around and was able to feel her moving for quite some time. It was really nice to have her there. I don't even remember what we talked about, but she kept me us smiling and happily distracted during the long wait.

Eventually the nurse anesthetist and Dr Sharmaud came in to tell us it was time and to describe the spinal to me before I was escorted up to the operating room. Neither Lia or Oscar was allowed in while they put the spinal in, but Oscar was brought back in for the surgery. You only get one support person for that. They'd told me I'd be able to use the bathroom before the procedure but the nurse said "no" when I asked her if I could go. The catheter made things better just before the surgery, but I would have really preferred not to have a full bladder while they were putting in the spinal. I didn't dry heave from it like I had during my epidural with Tyler, but they did hit a nerve, which was incredibly jarring. It was the most painful thing I have ever felt in my entire life. It went down the left side of my body through to my toes. I screamed out, and it was over immediately. They told me that's why they don't do this while you're knocked out. If they hit a nerve and unknowingly left it that way, you could suffer permanent nerve damage. After that the left side of my body felt like it weighed 300 pounds and was trying to drag on the ground. They kept asking how I was feeling, and all I could say was "heavy." Eventually I couldn't feel anything below the waist at all. The spinal went through my whole body, but I remained awake. I couldn't move the top half of my body either but they put something cold on my arm and asked if I could sense the coldness. Once I couldn't tell it was cold anymore, but could still tell it was touching me, we were good to go. They attempted another ECV, but they didn't put nearly as much effort into it this time. Dr Sharmaud could tell there was no chance of her budging after only about a minute.

There was a shield put up in front of me, so I couldn't see what was happening, but Oscar was right by my side and could look over the shield. He had to be dressed up in surgical garb in order to be in the operating room (this pic was actually taken in our recovery room. No photography was allowed in the OR). The surgery itself was incredibly quick! It took less than 5 minutes and there were no complications. The doctor clearly had plenty of experience behind him. At one point I said to Oscar "I can tell they're touching me, but have they actually cut me open yet." His eyes got big and he said "they've already cut through your skin, and muscles, and organs! She's almost out!" I was surprised! I really couldn't feel a thing, and I'd thought it would take at least 30 minutes. I wished I could have seen it all since I have a pretty strong stomach for medical procedures (I always watch my own shots), but after watching a C section youtube video, I'm glad they blocked me from it. The speed at which they cut through my many layers would have been a lot to deal with, but now that I know what to expect, I could probably watch my own happening without a problem.

Shortly later I heard Allison make her first cry (hers was louder and quicker than Tyler's) and someone said "she's here!' They took her to a bassinet where she was suctioned, patted, and cleaned up. That had been placed a few feet to my right, so I was able to see her little feet while they worked. That's when the waterworks came. I had a baby girl! It didn't matter that I hadn't pushed her out with every ounce of strength in my body. I felt that overwhelming love for her anyway. I didn't know she was beautiful yet. All I could see were her wrinkled little feet. But I loved her, loved her every bit as much as I'd loved Tyler in that euphoric moment after his birth. Without the exhaustion or the first time mother fears to distract me, I was able to completely bask in that beautiful moment. Once she was ready they gave her to Oscar who had a minute to hold her before they instructed him to hold her next to my head. I still couldn't see her, but I laid my head on hers and wept happily. None of the worries of the past few weeks mattered anymore. I had my baby girl, and soon I would hold her in my arms and never want to let her go.

Once they were satisfied that my body wasn't responding negatively to the surgery, I was wheeled into the recovery room where I was monitored for a couple hours before being giving a permanent room. Being moved was actually one of the coolest parts. They put this little inflatable under you, one person stands at each corner, and it's instantly inflatted while you're quickly moved over to another bed. It reminded me a bit of being bounced up and down on a big parachute as a child. In the recovery room I was able to have Allison on me as the spinal started wearing off the top half of my body. She didn't want to nurse at first but later we knew she was ready once she'd found her thumb. Nursing the 2nd time around was so much easier than the first time when I was terrified and didn't have the vaguest idea what I was doing. Alli's suck reflex wasn't the strongest, but thanks to my previous experience, we got nursing going pretty quickly. At first they'd ask me regularly how often she was nursing and how long she would eat, but we were doing so well that they stopped worrying about us. One nurse (Shirley) even predicted that my milk would come in by the 2nd day, and she was right. It was a day sooner than it came in with Tyler.

The hospital gets terrible cell service but has an okay Wifi connection. Oscar texted the birth announcement to all of our close family, but Lia's phone couldn't get the text. She was hanging out in the waiting room without the vaguest idea that Allison had already been born. She did get WiFi, though, so my brother ended up telling her about it over Facebook. We asked when we could have visitors, and the nurse said "you can have them now as long as there's not too many." Since it was just Lia, they let her in. We were glad Oscar's family and Tyler hadn't arrived back yet or they might not have let anyone in, especially with Tyler running around.

They moved me again and wheeled me into my permanent room. Lia hung out a bit longer while Oscar returned home to get a few things. I was pretty out of it still and not allowed to eat just yet, so for the next couple hours I napped on and off with Alli sleeping on my chest. I absolutely loved holding and nursing her in the hospital! This was a nice contrast from Tyler since I was a new mom and I didn't have a nursing pillow yet, so I was terrified I was going to drop or hurt him. The reclining bed made cosleeping and nursing fabulous. I wish I had a reclining bed at home! I could sit it up relatively straight for nursing then recline it halfway for sleeping, which is much less effort than nursing at night takes these days. With the 45 degree angle on me and the boppy behind her, Allison was perfecty safe, even if my arms went limp while sleeping.
Stacy Jinks Hunt and Allison Eve Hunt are recovering. Allison was evicted forcefully from her mother's womb at 1:34pm via c-section. She weighed in at 7.0 pounds and 18 inches (Allison, not her mother). No complications. 100% cute.
Oscar made Allison's birth announcement with the above photo. My dad says I didn't look like a woman who'd just had major surgery. He says I "looked like a fashion model hired for the photo." I don't know about fashion model, but it was definitely nice to have everything done so quickly and painlessly. The pain gradually came back as the feeling returned to my body, but fortunately I responded well to the pain medication. They took the catheter out later that evening once they thought I'd be able to walk to the bathroom. I did pretty well on the walking. I even asked to walk before they told me I should. The walking itself wasn't too bad, but I always needed help getting in and out of bed, especially putting weight in my legs when I'd first get out and putting my legs back up in the bed afterwards.

Oscar's family showed up with Tyler and got some good cuddles in with Allison. Marcus made sure to retrieve my apple crisp (I'm eating it in the pic above) when the nurse accidentally took it away.

As soon as he walked in, Tyler immediately tried to climb up the bed to get on top of me. He did give me some nice hugs, but I could tell he was going to be the most challenging part of my recovery. In the 7 weeks since he never once grasped the concept that he couldn't climb on me, sit on my lap, or that I couldn't pick him up. Others would have to physically remove him from me, and he'd throw huge temper tantrums, fighting and screaming to get back on me. My little boy gets very used to routine and does not respond well when things don't go the way he expects them to. Thank goodness I had that first week to recover without a toddler in the house! We tried teaching him that mommy was cut by super sharps (what we call knives) and that it hurts her so she puts ice on it to help it, but that only made things considerably worse. He'd slap me on my incision and excitedly say "mommy cut! mommy cut! Hurt! Mommy ice!" He was just so excited to point out what he'd learned, and we couldn't get him to understand that the slapping was hurting mommy more. I got into the habit of wearing my ice pack whenever he was around so he'd slap the ice instead. Seriously, if it weren't for Tyler, my C section recovery would have been a breeze.

I did love this moment though. It was lovely to have my cute little family in front of me and see Tyler taking an interest in his sister. For the most part, though, he was completely indifferent to her, and he absolutely did not want to hold her. He basically saw her as some sort of decoration.

Alli had several tests done and everything looked normal. Her hearing test the next day took a tremendously long time, though, since something electrical kept interfering with the test results. We turned off all our various devices, but it was still having issues. It turned out to be the bed that was causing the problem!

Ty was clearly struggling to stay awake past his bedtime. He made it through but ended up super sick the next day. My boy needs his sleep!

That evening Oscar turned from a happy, proud new father into Mr Grumpy Gus. They had these things around my feet to send circulation into them while I slept. It would regularly make noise that reminded me of a really loud version of the blood pressure cuffs you see in pharmacies. It drove him nuts! He had to get his loud speaker with white noise and stick it right next to his ear.

At some point that night Alli started waking up for a feeding, but I physically could not pull myself up enough to pick her up. I tried to call the nurse, but the remotes had both fallen too far out of my reach. Even though they were attached to cords, I physically could not twist by body in a way to retrieve the one with a call button, and the one I was able to retrieve after a lot of effort required a four digit code to call my nurse. As the nurses changed, the numbers changed, so they were written on the white board, but it was too dark for me to read. I had no choice but to wake Oscar up. With that speaker next to his ear it took awhile! I think I was yelling for at least a full minute before he finally processed what was happening.

Marcus, Martha, and Tyler came back the next morning to say goodbye before starting their long drive to Utah. Ty walked around with me, which is the only time in my life I haven't been able to keep up with a walking toddler. This walk ended up being a bit more challenging than the others because my meds were wearing off. I had to get back to my bed as soon as possible.

Ty started getting pretty restless, so I suggested he go down to the playground I'd seen during my walk. Oscar and Marcus took him down there, but it was closed. Turns out it's a therapy playground for the children admitted to the hospital. He played around on the rocks for a bit instead.

The best full family pics we could get.

Myla and Kienna visited and brought balloons for Allison. They'd never seen a newborn and couldn't believe how small she was. Oscar took them home and bought them Teriyaki when Lia, Chang, and Hana arrived. So far Allison had been sleeping most of the day and really only waking up to eat, but when the Kawaguchis arrive she was super awake and about as interactive as a newborn infant can be. They were all in deep smit!

Such proud parents of our lovely little girl. I had to put her in an outfit that covered her hands because her super sharp nails kept scratching me when she'd nurse.

The hospital provided a little sleepsack with arms to swaddle her. She loved it, and it was so easy. I'm a terrible swaddler, so I knew I was going to need some other blankets like it that make swaddling easier.

She's such a gorgeous girl! One of the benefits of a C section is the baby comes out with a perfectly formed head instead of the coneshaped head from being lodged in the birth canal. Many people saw her soon after birth and said "you must have had a C section!" Tyler, though, is evidence that my cervix can handle baby heads. I pushed him for nearly 2 hours but his head was still fairly round at the end of it. I had people ask if he was a C section too. I think it's because my babies have small heads. Ty was 6th percentile and Allison was 8th. I can't believe I've had two beautiful newborns! Only her hands and feet had that shriveled up look so characteristic of newborns.
This is my favorite picture and memory of the hospital stay. I loved all the snuggles I got with her in there. I actually really enjoyed my time in the hospital. The pain was less than I'd expected, and it was fun to be literally pampered hand and foot while I bonded with my sweet baby all in good company.
After a bit less than 48 hours we got to go home. With Tyler's birth we ended up at the hospital for many hours after we'd been told we'd be released, even though there were no complications. With her birth they got us out earlier than expected and let us have visitors sooner too.

When it was time to go I thought I could make the final walk to our car since I'd had pain meds recently, but I ended up in a wheelchair because I got dizzy after a couple minutes.

She looked so tiny in her carseat! It felt so weird to strap this itty bitty baby into one. I couldn't wait to get her back home where we had a full week to just love on her. It was a wonderful week (more about that in another post), though I have to say I really missed that reclining hospital bed. Man I need one of those when I'm nursing at night!