Saturday, June 04, 2011

New Baby, An Account of Augmenting Labor

Our second son was born yesterday.  My wife and he are both doing very, very well.

We do not have an internet nickname for him yet.  In length he resembles Smiley as a newborn (Smiley was 19 inches, little brother is 19.5 inches) and when looking at the back of the head.  But new baby is much plumper in face and form: Smiley was about 6 pounds, little brother is about 8 pounds.  We have put online photographs and seven videos.

A dear friend and her husband are watching Smiley while we are at the hospital.  Today seems like a vacation.  We get to rest and enjoy a quiet break from Smiley's near-constant questions about "Why?" and his requests for Magalene stories.  It is a joy to have a baby that latches and nurses well, and sleeps soundly with a full belly.

Smiley visited us at noon, and enjoyed playing with his little brother.  Smiley offered to take the baby with him so we could rest more.  We politely declined.

Time to write about the labor, which was quite an adventure.  Perhaps this account will some day be of comfort and assurance to another mother.

My wife eats very healthy foods.  She is not "in shape" but takes a walk almost daily.  She has both faith and fortitude.  There was no reason she could not deliver a baby naturally.

Yet my wife knew she had five risk factors.  Her age is in the latter 30s.  She is over average weight.  The baby had a two-vessel cord (one artery instead of the usual two).  Smiley was footling breech and delivered by Cesarean Section.  Wy wife had not yet begun having regular Braxton Hicks contractions a week before her due date, and two days past her due date she had not yet entered Early Labor.  A sixth risk factor appeared during delivery: During each push the baby's heart rate declined from the 140s down to the 60s because the umbilical cord was wrapped around his neck and leg.

During the past week my wife visited an acupuncturist four times.  After the first treatment the baby dropped.  During the second and for a short time after she had regular small contractions seven minutes apart.  The third and fourth treatments did not prompt any noticeable changes.  Although these efforts did not induce labor we were happy we tried.  Acupuncture does not always work to induce labor.  But it is safe and our insurance covers most of the cost.

Although we know people for whom Black Cohosh has quickly induced labor, my wife did not want to try that.  She preferred options for which both effectiveness and risks have been more thoroughly studied.

Then it was time to try what the hospital had to offer: a Foley Bulb.  Although the device is simple, this technology has been improved greatly in recent years.  It sometimes induces labor, which is why we tried it.  Its use has some risks, but considering my wife's many risk factors it was a good option compared to waiting.  She used it Thursday and it did cause several hours of laboring during which the baby probably turned from "sunny side up" to face down.  But then when my wife went to bed, very tired, the labor stopped.  Those hours of contractions were clearly only induced and not really natural labor because sleep would not stop natural labor.  In the morning an exam measured only 3 cm dilation.

(Note that we used the Foley Bulb only "halfway".  The device primarily serves as a cervix ripener before pitocin is used to induce labor.  But we did not want to use pitocin to induce labor.  That can be a good choice for mothers without my wife's risk factors.  It could have been a good choice for my wife if she had been one of those cases where the Foley Bulb causes dilation of more than 6 cm.  But on Friday morning it was clear that pitocin induction had a high chance of causing some laboring but still a C-section as the final outcome.  That is a bad combination for several reasons, including how taking in more than one IV bag of liquid before a C-section can cause breast tissue swelling that interferes with early breast feeding.)

We prayed a lot and were resigned to a C-section on Friday afternoon.  The other option would be waiting.  That would normally be clearly the best choice, but my wife's risk factors made it unclear that waiting would be risk-free and be helpful.

Neither of us were hearing anything clearly from God.  Yet it seemed as if we had laid out a very large fleece.  We had done all we could to help my wife have natural labor.  It seemed her body was simply not agreeable to that plan.

Then, half an hour before that scheduled C-section, she finally started laboring naturally.  The operation was quickly canceled.  The labor began very slowly.  My wife requested some pitocin to augment labor (even with her risk factors that was quite safe now that we were past the point of inducing labor).  The pace of labor increased but was still slow.

It was a pleasant afternoon together.  Early labor was not difficult.  The main problem was that my wife could not eat or drink, and was on an IV, because there was still some risk of complications and needing to operate.

After eight hours the Active phase of labor began.  An exam measured 5 cm dilation.  We expected a long, hard night made extra frustrating and tiring by her lack of food that day.

Twenty minutes later the pain was at its peak.  An exam measured 9 cm dilation.  My wife had already gone from Active labor to Transitional Labor.  Her plan was to try laboring without pain medication, and she was now eager to change that plan.  But there was no time.  She could not keep still long enough to receive the shot, and we would switch from Transitional Labor to Delivery any moment anyway.

Delivery was slightly exciting because of the cord wrap.  During each of the longer, farther-apart contractions of Delivery my wife could push three or four times, separated by a huge, quick, deep breath in.  It soon became clear that she would get five contractions on her own before some vacuum or an episiotomy would be needed.  With each contraction the baby came farther, but the cord also pulled tighter and the baby's heart rate declined more drastically.  On the final push of that fifth Delivery contraction the baby emerged.

My wife was able to have the natural labor and delivery for which she had hoped and prayed.  That during the process she had times of being at peace with an operation or with using pain medication made it all the sweeter to receive her desire.  Clearly God had given us what we prayed about for his sake, just because he loves for my wife.  (Had our prayers been answered more promptly or smoothly, without time for us to come to peace with the alternatives, we would have assumed God was being nice to us for our sake.  That is a nice kind of answered prayer, but not as sweet.)

UPDATE: Final paragraph edited for clarity.


Heather said...

That is so exciting, and praise the Lord for His grace and provision! Congratulations!

Nathen said...

Hooray! And I also became an uncle yesterday. A good day all around.

cayswann said...

So thankful to hear everyone is well. My love to the entire family!