Tuesday, January 23, 2007

Happy Birthday, Tessa!

Today my tiny baby girl is four years old. I can hardly believe it! I thought I'd walk down memory lane by posting the story of her birth here...and of course I have to include pictures.

Tessa Katherine, I adore you. The best thing in my life is being your mommy. Happy birthday, sweetheart!
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Tessa Katherine Surface’s Birth Story

The week leading up to the birth….
On Wednesday, January 15th, I went to the hospital for my standard weekly prenatal checkup, expecting to hear the usual things about my pregnancy – usual, in this case, being “everything’s fine!” However, instead I received the distressing news that my blood pressure was too high at 140/90, and that because I’d gained four pounds in the previous week and was retaining water, AND because I was now showing trace amounts of protein in my urine, I was diagnosed with PIH (Pregnancy Induced Hypertension, a.k.a. toxemia or pre-eclampsia). With this unfortunate diagnosis, I was sent home to immediate bed rest until the baby was to be delivered. What a shock! As always, but more than ever, I was extremely grateful that Ryan was with me to hold my hand and to take care of me. The good news was that I was 2 centimeters dilated, with 70% effacement, and that TessaBenjamin was in the –1 position, and those things meant that my Bishop score was over 10, and so the doctor thought that we were likely to deliver “soon,” so it was my hope that I’d go into labor on my own and not need to be on bed rest for long.

Doctor Hutchison made us an appointment for Triage at Swedish for that Saturday, just to make sure that things were okay, and we were told to have our bags packed “just in case.” We rescheduled our Wednesday appointment the next week to Tuesday, and Dr. H told us as well that if we hadn’t had the baby already, we would be induced on Thursday the 23rd. All of this was quite a shock – the pregnancy had progressed so wonderfully normally until then – but of course we were willing to go along with our doctor’s advice, since we understood the seriousness of PIH.

That Friday, I started seeing spots, and so when I called the doctor’s office they told me to come in right away. I asked if Ryan could come home to get me, and they told me that he should just meet me at the office (which, of course, he did). Fortunately, the appointment was relatively uneventful….although they told me that it looked like I was in early labor! The non-stress test showed that our baby’s heartbeat was looking good, and it also showed that I was having mild contractions every 2.5 to 3 minutes. I had felt contractions like these for a couple of weeks, though, so I didn’t believe for a minute that I was actually in labor. It turns out I was right!

On Saturday, we went to triage as scheduled, and the contractions had stopped, my blood pressure was relatively stable (still high but not at a dangerous level), and so they sent us home – without our baby, still pregnant, and still on bed rest.

On Tuesday, we went to the doctor again, and found that we were 3cm dilated and 75-80% effaced. Finally, we asked the nitty-gritty about delivery with PIH. The news was scarier than we’d expected. We were told that I would probably have to receive magnesium sulfate in an IV to prevent seizures and stroke during labor – and the words “seizure” and “stroke” were terrifying. We were also told that it was very likely that I would need to have an epidural, as one of the side effects of an epidural is lowered blood pressure, and also because Pitocen induced labors are often more painful than naturally progressing labors. This was scary to me, because my reading told me that the epidural does make it into the baby’s system, and that babies can often be slower as a result of it in the first few weeks, and this often causes problems with breast feeding. Less scary, but also disappointing, was the fact that I would still be officially on bed rest, so I wouldn’t be allowed to walk around, to labor in a squatting position, or to have the mobility that I’d hoped for. Since those were some of the primary ways I’d intended to manage my pain, I was nervous that they were being taken away from me. However, we were determined to do whatever it took to have a happy, healthy baby, and the excitement that we felt over our baby’s arrival was greater even than our fears.

On Wednesday night, Ryan and I watched “our” movie, which is When Harry Met Sally. (It’s our movie because our relationship parallels theirs in many ways – friends for a long time, then “more than friends,” then struggling to even remain friends….and then true love!) We snuggled on the couch downstairs and talked with each other….it was a great way to spend our last night as a couple before becoming a family.

At about 2am, I was still wide awake and thinking about the events that were sure to follow. I whispered “Are you awake?” and Ryan replied that he was, too. It was impossible to sleep with such an exciting and scary event right around the corner.

Birth Day: January 23, 2003
The hospital called us at 7:30am promptly to let us know that we should come in at 8:30am. This was it – for real! We made a few phone calls to let people (Mom & Dad S., Mom & Dad D., Susan, and Libby) know that the show was on, and then we went to the hospital. When we got to the hospital, we were assigned to a room, and to our nurse, Merllie (who was fabulous!). Merllie hooked us up to monitors and got us settled, and she began a Pitocen drip at about 9:20am. The contractions were present already when she started the drip, and they got stronger with the Pitocen, but I knew that they must have to get a lot stronger to really have an impact, because they didn’t hurt much at all and I was still able to talk through them. When Susan and Libby showed up a while later, Ryan and I were reading from a book (“Notes from an Italian Garden,” which was a gift from Keith & Noel) and feeling relaxed, although excited. My blood pressure looked good, and they decided that they didn’t need to start any magnesium sulfate – what a relief! I was still stuck in bed for the most part, but I was allowed to use the birth ball and the tub, so that was nice.

At about 1:10, the doctor came and performed AROM (Artificial Rupture of Membranes – she broke my bag of waters). It’s at that point that the contractions REALLY started. I found that if I closed my eyes and just blocked out everything else, it was much easier for me to deal with the contractions. I tried several other methods of dealing with them, too – including imagery (I imagined that I was a dolphin, riding up the crest of a wave) and breathing techniques (at first, slow, deep breaths were good, but after a while I used a combination of short breaths followed by a long breath in a he he he he ho pattern). The best thing of all, though, was Ryan – he kept me focused and held my hand, and he did the breathing with me. Susan and Libby hung out in the back, offering Ryan support (which he was extremely grateful for). At first, in between contractions I was able to chat and visit with them – the contractions were intense, but when they were over, they were OVER! I have to admit, I’m proud of the way that I handled the pain. I think that by giving myself positive messages, and by employing the breathing techniques and visualization techniques, I was very successful at managing my pain and my fear. By about 3pm, though, the contractions were so intense that in between I needed to just rest and couldn’t talk much, and sometimes I didn’t even open my eyes between them. I also used the birth ball, with Ryan standing behind me to support me and to keep me breathing. (We have a picture of us in this position.)

At about 3pm, I asked to get into the tub. For reasons I still don’t understand, they filled the tub, drained it, then filled it again! Since the tub was marked “sanitized” I didn’t understand that at all…and it was highly irritating because at that point I felt that I needed a new method of pain management and waiting was incredibly difficult. Anyway, I didn’t get into the tub until about 3:30pm. Just prior to getting into the tub, I was examined and found to be between 5-6cm, and so I thought I probably had a long time to wait before TessaBenjamin would make an appearance.

The tub was bliss! The warm water felt so incredibly good, and I felt that the pressure of the contractions was cut in half by the weightlessness that the deep water offered. Ryan sat behind me, in his swim trunks, hands on my shoulders, and I thought that I could hang out like that for a few hours without complaint. How quickly things change, though! I had about two contractions, and on the third contraction I felt an unbelievable urge to push. I held back because I knew that I wasn’t ready and I didn’t want to bruise my cervix by pushing too soon, but I yelped to the nurse to tell me what to do. They got me out of the tub (and at this point, I should add, modesty had flown OUT the window! I was stark naked, and I didn’t care – all I cared about were the contractions), Ryan dried me off, and I staggered into bed. I was scared at that point – the contractions had been building steadily all afternoon but suddenly at this point they went off the charts for pain, and I hadn’t had time to catch up to that feeling, and I wasn’t managing my pain well.

The contractions seemed to me like they were coming one right on top of the next, and to top it all off I got cold, and then I started shaking (particularly in my legs). The nurse tried to examine me, and the intensity of the contraction made the examination feel absolutely horrid. However, it was worth the exam – she informed me that the reason I felt a need to push was that I had already gone through transition, I was 9-10 cm, and fully ready to push! This was exciting news, but also a bit shocking. Mostly, I felt relieved to hear it because I knew that I couldn’t handle hours more of the pain at that level, and knowing that I was fully dilated made me understand that the reason it had gotten so much more intense was because I was making incredible progress.

At this point, lying on my back started to be painful beyond words. My body BEGGED to be in a standing position, or squatting, and I cried out to the staff to let me get off my back, but they wouldn’t allow it. They had me go on my side, or on my back, and I remember whimpering and moaning because the pain was so intense. At that point I remember asking the nurse Mary (who was also in the room) how long the pushing phase was likely to last, and she said, “Oh, up to three hours.” At this, I wanted to cry, because I genuinely felt that I simply could not last three more hours at that level of intensity – it wasn’t just that I was tired (I actually felt like I had energy still) it was that my body seemed to have a mind of its own and the pain was absolutely unmanageable and made it so that I felt like I couldn’t control my body. She told me that pushing would probably feel like a relief, though, and less painful, which was good news.

Unfortunately, pushing was NOT less painful for me. I felt like I was being scraped with a cheese grater all down the birth canal, and it was very difficult for me to push because my natural instinct in response to the pain was to hold back and fight pushing. I remember holding on to the bedrails and panting and moving my head from side to side, desperate to find some relief and anxious to feel the relief that pushing was supposed to bring. At one point, I heard myself making a lot of noise and I actually had enough presence of mind to open my eyes and say, “Oh my God, I’m a moaner!” which cracked the room up. Soon after that, Ryan said, “If you want to call me bad names and yell at me that’s okay…” and I remember looking at him and saying, “What? I’m not mad at you – I love you!” I think he was relieved but still not sure I wasn’t ready to kill him for putting me in that situation….but I have to say that I never, not for one second, lost focus that this was something I wanted, and I never felt anything but closeness toward Ryan during the labor.

I had written into my birth plan that I did not want an episiotomy, and Dr. Hutchison was marvelous about working with me on that point. She took mineral oil and massaged me, working my body to help ease the baby out. Libby saw this and commented afterwards what an incredible professional Dr. H is – and I have to agree. Interestingly, though, I did get one cut – my hymen! Dr. H said that mine was particularly tough and stubborn, and so it was impeding the baby’s progress. How incredibly odd – I thought that the hymen was usually broken when a girl lost her virginity….and I assure you that this was NOT a virgin birth!

Despite these small moments of levity, pushing was horrific work, and at one point I panted “I can’t!” I didn’t mean “I won’t….” I really meant that I just didn’t know how to summon the strength to keep going. At that point, Dr. Hutchison told me to reach down and touch my baby. I will never forget the silky soft feeling of her hair as she crowned – it was like I believed, for the first time, that it was REAL and that I was really going to have a baby! Her head felt so soft, and I could feel the silken hair, and suddenly everything became much more tangible, and I was able to give a couple of good pushes.

Despite my concentration on my own body, at one point I could feel the atmosphere in the room change, and I heard someone say that the baby’s heartbeat was at or below 80 beats per minute. I knew that a healthy heartbeat would be over 120, and so this was quite frightening. Suddenly, everything started happening at once, and Dr. H order forceps and vacuum extractors. I wasn’t keen on the idea of having my baby forcibly removed from me (and I knew that these tools are tough on babies and often really tear moms, as well) but my fear of the tools was doubled by the fact that I knew that Dr. H’s request for them stemmed from an immediate, severe problem. Dr. H spoke to me very clearly, saying, “Kristina, look me in the eye. Look at me! We need to get this baby out now. Do you understand me?” I did understand, all too well – I knew that my baby (and possibly me, because of the blood pressure issues) was in trouble and that thought was terrifying. However, it gave me strength to do what was needed – and I pushed like I’d never pushed before. The pain was hideous, and when I tore I felt it happen. I felt something protruding inside me, and I remember asking “Is that its nose?!” because I couldn’t figure out why I felt so scraped from the roundness of a head. Well, almost as soon as I could ask, the head popped out – and following it, almost in the same motion, the hand popped out, too, like it was waving! I didn’t see this, but I certainly felt it (and I must say, I think it was the most painful part of the whole thing – I’m informed that it was incredibly cool to witness, but it’s the part of the birth I would change!). I heard Ryan exclaiming about the head and hand, and before I knew it the body came out all at once, at 4:08pm

I really wanted Ryan to be the one to tell me if it was a boy or a girl, and everyone in the room knew that they were to keep mum on the gender until Ryan could tell me. Soooo, no one said anything, and I looked right at Ryan immediately after I felt the baby exit my body, and I saw him choke out “Tessa!” in a barely audible voice. At that point, he burst into tears of relief and joy – seeing his daughter being born was pretty emotional, and fearing for both of our lives at the end only compounded that. The funny thing was, nobody else heard Ryan say it but me, and so they all said, “Tell her! Tell her!” and he had to repeat himself, but I’d already heard.

Tessa was quickly suctioned and placed on my chest. She was so incredibly perfect – her wide eyes looked startled at her introduction to the world, and she gave a beautiful, strong cry to let us know that she was okay. We held her tiny, perfect hands and snuggled her close, so grateful that she had arrived. And….now I can confess it. I would have been happy with a boy, and I certainly would have loved Benjamin – but in my heart of hearts, I always wanted a girl. I was so incredibly delighted that my precious child was a girl that it was like a present – and I was just stunned with complete delight. This joy was heightened by the fact that Ryan had always known that we would have a Tessa – and that made me feel like he had a special connection to his daughter right from the beginning.

After a moment of snuggling and adoration, the nurses took Tessa to clean her up and make sure that she was okay, and Dr. Hutchison started to stitch me up. (I’m no martyr, and I had written into my birth plan that I DID want drugs if I had to be stitched – thank goodness! Dr. H told me that I had about 20 stitches, and even with the drugs I felt quite a bit. After childbirth, I could handle most things, but even so it wasn’t particularly pleasant and I just kept waiting for it to end.) As I was being stitched, proud daddy Ryan snuggled with his newly swaddled baby girl, and then Libby and Susan got to hold her. It wasn’t until then that I realized that Ryan was still in his swim trunks – everything happened so quickly after I got out of the tub that there was absolutely no time for him to do more than to put on a t-shirt! Ryan loves to tell the story that when Tessa was born, he was wearing damp swim trunks and had bare feet….but he didn’t mind.

When I was stitched, Tessa was handed back to me, and she began nursing like a champ. Looking down at my breast, seeing that little face intently focused on her dinner, was – and still is – pretty amazing. Her latch was strong, and she was so alert – it was really love at first sight, but the love grows exponentially.

All in all, my labor and birthing experience was incredibly positive. Ryan was the most incredible labor coach, and I absolutely felt the love and support of not only him but also of the two dear friends who were there to support us (Susan and Libby). I feel grateful that I was able to have the birth without the use of magnesium sulfate, and that my body was cooperative. Most of all, I'm grateful that Tessa was born healthy (Apgars of 9 and 9), and that our family feels so beautifully complete. Really, I may be the luckiest woman alive!

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