Friday, August 25, 2017

Laia Isabela's birth story

Our beautiful daughter Laia was born on June 30 at 10:50, weighing  3900 gr. and measuring 52 cm. when I was exactly 41 weeks pregnant. We had been waiting for so long. Every week after week 34 (when her sister was born) felt like a relief... until the point where I started to worry she would never come by herself.  My mom arrived when I was almost 37 weeks. We really did not think I would make it past 38 weeks (my due date was June 23) and everybody joked that I would spend my birthday giving birth to this girl. But both dates came and went. We've had a lovely summer (for Dutch standards) and those last days were hard. I remember I could not sleep from the warmth, the back pain and the difficulty finding a comfortable position in bed, my feet were swollen and I felt enormous even when I kept walking and walking up until the very end. I did gain about 15 kg (I stopped weighing myself when I reached that point... I didn't want to know about any further weight, at around 38 weeks) eventhough I ate healthy food and kept active. I guess your body will do what it has to do.

On May 31st, timely coinciding with our 7th civil wedding anniversary, we went for what we expected to be a routine checkup only to realize that the baby was way up high touching my ribs (from being almost engaged in previous appointments) and since I was 36 weeks and 5 days and had tons of amniotic fluid (polyhydroamnios) the gynecologist recommended an External Cephalic Version (in other words, they turned the baby). It luckily went well and the girl stayed down for the rest of the pregnancy. At that point they started doing prenatal checkups very often. One week after that, just before I reached 38 weeks there was a day where I did not feel the baby move a lot and that raised all kinds of red flags. Since our girl seemed to be measuring "too big" and I had all that fluid they talked about starting an induction -right then and there- it was June 9. I was alone at the hospital, but I felt the baby was fine (I had been hearing her heartbeat all along) and still wanted a chance at labor starting spontaneously, when the time came. They had me checked for gestational diabetes, verified that the baby's blood and mine had not mixed during the EVC and monitored both of us. They ruled out all the known causes for polyhydroamnios, so that remained a mystery, but it was a relief as well.  I had to go for fetal monitoring everyday from then on but was told I would most probably be induced during the week that followed.  After 3 days of daily checkups a different gynecologist looked at us and decided to let us wait, since the measurements late in pregnancy are not that accurate and the 32 week scan (when measurements are more reliable) showed she was within the normal size range. I did not have diabetes, our blood hadn't mixed, my blood pressure was fine (regardless of my swollen ankles), I was feeling well and she was active, moving a lot, with a strong and steady heartbeat. So we waited, and waited and waited. I went on long walks with my mom, I ate eggplant parmigiana, I talked to the baby, I went to Monkey town and jumped around with the toddler. But she was way too comfy inside. There were some days where I had intense Braxton Hicks or a night where I had a couple of  regular contractions; but that lasted 1 hour or 2 and then... nothing.  When I reached 39 weeks and days I started asking how far they would let me go (I did not want to wait so long anymore) and they said by week 40 we could start discussing an induction. I was afraid she would be too big and I would tear myself badly or that the placenta would stop working.  Then week 40 came and I was told if there was no medical reason / fetal distress they would not induce labor until week 41. I was relieved by learning that latest research shows that inductions do not necessarily lead to more interventions or c-sections. And so we scheduled an induction for the day I was 40 weeks and 6 days. The baby was engaged, but I was only 1 cm. dilated and so they could not break the membranes.

Last belly picture at the hospital while waiting
On June 29, at 15:00  a Foley catheter (a little balloon) was introduced in my cervix. After this, they connected the CTG to monitor the fetal heartbeat and possible contractions. I was supposed to have the catheter on until 6:00 am of the next day, when they would check if I had dilated any further and if I was around 2-3 cm. by then they would proceed to break my membranes and start oxytocin (pitocin) if needed. The procedure did not hurt, it was only a bit uncomfortable, like getting a PAP smear, as they have to use a speculum to push the catheter in. After they introduced it I started feeling mild menstrual-like cramps, every now and then but I could handle them and I was told this was normal. The husband stayed with me until about 18:00 pm, when he went back home to have dinner and get rest, as we expected everything to start happening early in the morning the next day.  He left me with a Fanta and some chocolate chip cookies. I was mostly entertained, chatting to my family  and losing time on the internet. I video-called Yu and my mom who were home, showed them my hospital dinner and waited. At first I had the room at the maternity guard for myself, but later another woman (who presumably was also there for an induction) came, together with her husband. It was weird and sad because as soon as she came they closed the curtains in the middle of the room without saying hello or acknowledging me (though I tried) and she kept moaning and sobbing to herself. I would have liked to talk to her, offer comfort, but she mostly seemed annoyed that she had to share the room. It was so different from my first experience at that same maternity guard, when I stayed for a week on bed rest at the hospital before Yu's birth and other women would come and go but we'd  talk to each other and bond over why it was that we were there.

At around 22:00 pm I tried to get some sleep but as I was dozing off, around 23:00 regular cramps, that were starting to get more painful in intensity woke me up. I walked to the nurses in the guard, but they told me to take a couple of paracetamol and ride it out. However, 10 or 20  minutes after I asked to be connected to the CTG for monitoring because it was becoming too painful and I really felt something was happening.

Finally, at 24:10 they connected me to the monitor and at 24:29 I had contractions every 4-5 minutes with the maximum intensity (100-120 on whatever scale they use to determine uterine activity). At 24:43 the doctor finally came to check me and it turned out I was already 4 cm. dilated. This was the official (spontaneous) start of labor, they took the Foley catheter out and told me I could call my husband in. Mark arrived soon after and we moved to the labor and delivery section.

By 1:22 we were in the room I would deliver, I was still 4 cm, but I could barely stand the pain and most of all I felt it was starting to progress very fast.  I requested an epidural, as this time I was determined to get pain relief. Funnily enough, the nurse in charge suggested I take a warm shower instead as "hot water is the best analgesic" and "we didn't know if labor was going to go so  fast that maybe the anesthesiologist would not have time to come from home".  I already knew the risks of an epidural (I might get a fever and antibiotics as a consequence, contractions could get slower, I had to get an IV drip in case my blood pressure dropped and I would not be able to stand up until after delivery) and had thought long and hard about it. My previous birth had been extremely fast (I went from 4 cm to 10 cm. in less than 3 hrs) and intense, with a tiny baby, and I did not want to try that level of painful intensity with a larger baby.

 I think they sensed my determination and called the gynecologist, who have me the talk about the risks (again). She was confident I would do well with it, as I had been through birth before and was going to be able to feel the sensations / contractions / urge to push and finally got the anesthesiologist. I really do not know why they try so strong to dissuade you from pain relief, as if there was value or medals for going through it.

The blessed epidural came at 1:59. I was a bit scared of that part where they tell you to sit very still while they put it in, but it did not hurt at all. I still felt the contractions, and they were still very mildly painful, but they were manageable, like menstrual cramps. At some point I started to feel very numb and the pain totally disappeared, though I did still feel my uterus contract.

At 3:08 they came to check me again, I was 6 cm. dilated, which was a good progress, right out from textbooks,  and contractions were regular and efficient. Two hours passed and by 5:00 am I was still 6 cm. and my contractions had become irregular, so they broke the membranes to generate efficient contractions and we were told to wait.

Around 6:30 we started playing music to call Laia, we listened to some of the music we always played her and her sister while in the womb: 
 Origin of Love, ( Mika),
Cuando Llegaré (Natalia Lafourcade and Emmanuel del Real),
Amor de mis Amores ( Natalia Lafourcade),
Around the World  (Daft Punk),
Gypsy (Suzanne Vega).

I think it kind of worked because I started feeling contractions. But at 7:08 the obgyn came again and I had not progressed from 6 cm. So they started me on oxytocin. They told me to rest because the active part of labor was yet to start and we had been awake all night (I have an obsession with the CTG and loved to see how often the contractions came and how high they'd go on the scale). I was able to sleep a bit. The contractions became strong almost right away. I felt weak, tired, dizzy, thirsty. The breakfast trolley came and I had some milk, orange juice and bread with raisins. I was so happy to eat. And then I started shaking and vomiting, but I felt no pain. I thought it was an effect of the anaesthesia, but they told me it was my bodies' reaction to the intense contractions, that the pain would be unbearable without the pain relief. I felt like that girl in the Exorcist.

Finally, at 9:29 I was 10 cm. dilated. But Laia was a bit "high" still, so they told us to wait to start pushing, so that she would go down by herself and my cervix could become softer. At 10:00 am they checked my vitals and I had a fever, so I had to get antibiotics and wait until they were all in to start pushing. (They said this was a consequence of the epidural, but I think it is just what my body does with labor, as with Yu I did not have an epidural but I also got a fever just before starting active labor).

At 10:40 I was finally able to start pushing. I think I pushed through 4 contractions. The gynaecologist in training that was assisting the obgyn was the best... he kept encouraging me and made me feel so confident and powerful. Him  and Mark . At those moments, being told you are "doing great" and that they see the baby coming is what keeps you through it. Only 10 minutes after, at 10:50, Laia was born. They put her in my arms right away (after totally failing at getting a photo of Mark cutting the umbilical cord, pro tip: hand the nurses a phone or some other simple device that they will be able to use). It was the happiest moment, having her in my arms after so long, talking to her, holding, feeling, smelling her.

Then at 11:00 I was told I had to go to the operating room... my placenta had detached from the umbilical cord when they were trying to pull it out and they had to extract it manually. I think this was the hardest part for Mark, as he stayed alone with our girl and was told I had to get general anesthesia. It turned out, since I had an epidural, they just had to up the dose and I was conscious during the whole procedure. It was very entertaining and I did not feel anything. They were finished quite fast, but I had to wait about an hour in observation at the intensive care unit to make sure I was not losing blood and everything was fine. I was so thirsty. They must have known because the nurse came with an ice-pop that tasted like heaven. I could not wait to go back up to our family. It seemed like such a long time, but around 13:00 they finally pushed me up to our room. It was pure joy to find Mark,  Yulia, my mom, my mother in law, and Laia sleeping peacefully in her cot.

I have such complicated feelings about birth. Both my birth experiences were very positive,  I remember them fondly and happily and yet I also can't stop thinking of the process as violent, even when this time I was under anesthesia. People describe giving birth as a mystical experience. I think it is mystical, in ways: like going to the deepest pits of hell, of horror and pain and then coming back to the most undescribable joy and love. Like experiencing eternity. Having my body take the lead was like being possessed, without having any power against it. Fear is inevitable, being able to let it happen, to embrace it, to lose all control and flow were the hardest parts but also the what let me make it through to the other side.


  1. Congratulations on little Laia!

    It seems like we women can't win for losing with the whole epidural decision. I am personally not interested in them and when I ended up being induced (without pitocin) the nurses were far too pushy about it for my liking. Once you are aware of the risks either way they should just let you have your decision. I'm glad you got your epidural this time!

    I hope everyone is well and that Yu is adjusting well to being a big sister. :)

    1. Thank you Sheryl. And yeah, I do not get it, one way or another women seem to be pushed around. I think doulas are a great help (though I did not get one this time either).
      We are doing well, Yu is very happy and proud, though of course there are some difficult moments, specially at ·the end of the day (it is rush hour and everyone is tired).
      I hope you are doing well too.

  2. felicidades amanda!!!!! todo este tiempo te habia pensado mucho, queria escribirte pero como vez no es que este muy presente en el cibermundo por cuestiones varias..........tu bebe esta preciosa! me alegra de corazón que todo este bien.

    1. Muchas gracias ! Yo también he estado pensando mucho en tí. Utilizas el facebook? Espero que ustedes se encuentren muy bien en Italia, Edo seguro está enorme y guapísimo!

  3. Thanks for sharing the birth story of your daughter! Sounds like you were aware of your options and spoke up for yourself to get the birth you wanted.

    1. `Thanks, it really is difficult with birth, so unpredictable and you end up thinking what would have happened if I had done this or that. We are so happy that it all went well. I hope you are doing well too!


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