31 January 2014

The Terrifying, Surprising and Miraculous Birth Story of Grayson Knight Duganz, Part 3

*Note: This is a Birth Story - as such there are details and photos (though nothing too graphic) of birth. If you don't want to read about things like dilation and cervix effacement, please skip this post. ALSO this may trigger some traumatic birth issues, so please don't read if you are vulnerable to reading about a close call with mom and baby. *

So when I left off, I had just gotten the sleepy pain medicine to get a break. I remember that although I dozed off, I wasn't actually fully asleep. I could still feel the contractions, they were just waaaay less intense.
Ahhhh sweet sleep (ish).
When the medication started to wear off after about a half hour of relief, I realized how done I was. I was so exhausted and really did not feel like I had the strength to continue for another six hours or more plus pushing. I talked over the options with Lori. I wanted another dose of the pain medication, but that wasn't recommended as it might cause me to be too sleepy to push. The only other options were to continue on without anything or get an epidural.

Talking over options with Lori & my family.
 If you follow my blog at all, you know I was a HUGE advocate of natural birth. I really, really wanted one and everything Patrick and I had done to prepare for the birth was in anticipation of it being epidural-free. So when it came to this point, I really struggled with the decision. I had been in labor for around 18 hours and without any sleep for almost two days. I was around 7.5 cm. I could handle the smaller contractions but when the bigger ones came, I really struggled. I know I stared to scream through the harder ones. My body/mind were just so, so tired.

So I talked about it with Patrick and my family. I knew I needed help but I felt like an utter failure to even consider getting an epidural. I felt like I was betraying the beautiful vision that we had created for the birth of our son. Luckily, I have an amazing husband who didn't blink an eye in supporting me. I think at that point everyone was so tired that the thought of having an easier labor via epidural was a good idea for everyone. So I decided to get the drugs.

The anesthesiologist had literally just left the building, because it was around 6 pm. They paged him and luckily caught him before he had gotten too far from the hospital. He arrived and got the epidural placed quickly. It wasn't that bad of a process and the anesthesiologist was a really nice guy. After that, I felt haaaappy.

After the epidural. Yes, I look terrible. Happy, but terrible. But I guess that just goes to show how awfully exhausted I was.
After the epidural took effect, things totally changed. I was able to speak again and I became actually aware of my surroundings. I was able to visit with my in-laws and Grayson's uncle John, who had been waiting for hours in the waiting area since they had told us that he would be born by noon (ha!).

It was at that point that Lori informed us that she hadn't wanted to say anything before the epidural because she was afraid I would punch her in the face BUT that my contractions were not doing enough. Like I said in Pt. 1, it's not recommended to be in labor longer than 24 hours after the water breaks and the way I was progressing it looked like I would reach the 30 hour mark before I even could start pushing. So she recommended a small dose of pitocin to get things going faster. This was also something that I was very against before the birth. I figured labor would take however long it would take and that was that. But it really did seem like my uterus was struggling to perform the way it was meant to and needed some help (the reason why would become all to evident soon).

My coach giving me words of encouragement.
 So we started the pitocin drip. I don't really have much memory of what happened in the next five hours. I know I started to progress faster and I guess maybe I slept for some/a lot of it? Finally around 10 pm, I was 10 cm, fully effaced and ready to push.

Pushing was actually really great in the beginning. I felt like I was doing a good job and Lori, Patrick & my family kept telling me how well I was doing. I felt so successful.

In between pushes. See? Pretty happy camper.
I had been warned that getting the epidural would increase pushing time. Plus I was a first time mom, which also increases the average length of pushing. However, after only about 45 minutes Grayson was crowning. I was in the zone! Now here's where the "terrifying" part of the story comes in.

Grayson had crowned and at the same time, Lori realized that we were dealing with a MUCH bigger baby than anticipated. I don't remember this but Patrick recalls hearing her say "oh no no no no" when she realized how big his head was in its entirety. I was able to push his head out but the bigger problem then became apparent - his shoulder was stuck on my pelvis. This is called shoulder dystocia and it's one of the major emergencies that labor & delivery people run practice drills to prepare for because there's no way of knowing if it's going to happen. And once it is happening, there is a finite time (four minutes) before the baby can be in serious trouble (lack of oxygen to the brain, among other issues).
Shoulder dystocia - you can see the top shoulder of the baby is stuck.
I remember hearing Lori start shouting and suddenly the room was filled with people. I found out later that she had called a code, so every on-duty nurse that wasn't with another patient ran to my room. She also yelled for the on-call OB, who didn't end up arriving until after Grayson was born. Lori, the nurses and my family all tried to help get me in to a yoga-esque pretzel position to increase the room in the pelvis and help Grayson get un-stuck. That didn't work. As a last resort before drastic emergency measures needed to be taken, Lori said I needed to flip onto my hands and knees (called the Gaskin maneuver). Now despite the fact that I had the epidural and was supposedly unable to move my lower limbs, I flipped myself almost the entire way. Lori kept yelling that I had to push, push, push. At this point apparently I let out a primal scream that scared my poor family to the point where Patrick thought I was actually dying. I reassured him later that I was just trying SO hard to get Grayson born that the scream must have been my survival instinct, mama bear, primitive self kicking in.

I remember being more scared than I ever have been in my whole life. I thought that I was going to lose my baby boy. Thankfully the Gaskin maneuver and the primal scream pushing were enough that I was able to push him out completely. But even after he was born, I didn't know if he had survived the birth. He wasn't breathing when he came out and apparently had started to turn blue. They rushed him over to the newborn table and gave him oxygen, which he didn't need because he started to cry right when they got him over there. I was so scared and so out-of-it that I didn't hear his first cry. Patrick leaned in and told me to stay with him and just breathe. That he was okay and I did it. I remember saying that I couldn't hear him cry, was he crying, was he okay? Patrick told me yes and to listen and I could hear him, which I did.

Reassuring me that everything was okay.

Grayson testing out his lungs.

Hearing him crying and knowing that he was okay was one of the best moments of my life.
So his first apgar score was really low (the benchmark they use to determine a newborn's health). But his five minute score was 9 (out of 10) so he was a real champ. I just can't believe that through the whole 26 hour labor, the pushing and the severe shoulder dystocia that his heart rate never faltered. He is such a strong, feisty and beautiful little man.

Doing the Apgar tests (I think).
The nurse put him on the scale and I remember hearing her tell my dad "oh that's probably not right, sometimes we have to reset this..." because the scale initially said 10 pounds, 5 ounces. So she re-set it and viola, 10 pounds, 6 ounces. That's when everything started to make sense. How slow the labor was progressing, why my contractions weren't very effective but the pain was really high, the shoulder dystocia.... He was a very, very big baby. And not just on weight. His length was 22.5 inches and he had a head circumference of 14".

Patrick asked several nurses and as far as anyone can remember, he was not only the biggest baby born in December, but the biggest baby born vaginally in recent memory. After the birth, Lori reviewed my chart to see if she had missed any indicator of his size. Normally very big babies are born to either women with gestational diabetes or Hispanic women (apparently). I did not have either of those factors. What I did have was an extremely healthy, large placenta and a very thick umbilical cord. Grayson was just a very well nourished little fetus. Add that to the fact that he was a week late, and that I'm tall and can "hide" his size in my long torso and you get a very unexpected large baby.


Getting his big old noggin measured.

Heavyweight champ! The baby that held the title before Grayson was a measly 8 pounds 8 ounces.
 In the end, pretty much everything in our birth plan was thrown out the window (did I mention that during the whole shoulder dystocia thing Lori had to do an episiotomy?...ya that pretty much completed the list of things I did NOT want to happen during the birth that ended up happening). But everything that happened was for the best. If I hadn't gotten the epidural, I most likely would have passed out from the pain of the shoulder dystocia and would have ended up with an emergency c-section.

I had pictured this beautiful event and it turned out to be the most terrifying day of my life, and I think I can safely say, the lives of pretty much everyone else in that room. Even Lori, our battle-tested, uber-experienced midwife said it was one of the worst shoulder dystocias she'd ever seen and that what she really wanted to do was go home and drink three bottles of wine. Later she would describe him as "the baby who took ten years off my life."

Lori meets Grayson and tells him she's got some words for him haha.
Thankfully everyone turned out okay, healthy and happy. In the end, that's what is really important. I'm still mourning  my "beautiful" birth I had created in my mind, but whenever I feel sad about it, I just look at his little face and know it doesn't matter. He's here and that's everything.

This post is long enough now and even though there's a lot more to talk about that we've been through in the past month (Grayson's high blood sugar at birth, jaundice, and weight gain issues, my mastitis, intense healing process, etc...) but for now I'll just say that we are all doing well and so, so happy to have such a miraculous baby boy in our lives. I can't imagine life without him and I would do it all again a thousand times just to see his sweet little face. And with that, I'll leave you with some more lovely images by my sis Maleea (who I'd just like to give mad props for continuing to photograph despite the intensely stressful conditions). Thanks for reading, it's been cathartic to write this out. Now I'm off to kiss my baby's sweet little cheeks.

Holding daddy's hand minutes after birth.

Everything in the world.

My little boy.

Daddy-son bonding time.

I have no caption for this image because it makes me cry.

The rest of the fam gets to meet the little fighter. 
After two days in the hospital, we got to head home.

30 January 2014

The Terrifying, Surprising and Miraculous Birth Story of Grayson Knight Duganz, Part 2

*Note: This is a Birth Story - as such there are details and photos (though nothing too graphic) of birth. If you don't want to read about things like dilation and cervix effacement, please skip this post

So our midwife Cassie had just arrived at the hospital. My family - mom, sister and dad - were there as well. Cassie was one of the two certified nurse midwives we'd seen throughout our pregnancy via the Bozeman OB/GYN Clinic. (As a side note, we love them and would HIGHLY recommend them to anyone in the area.) So Cassie was a labor and delivery nurse for years at Bozeman Deaconess before pursuing her advanced midwife training. We loved her bedside manner and easy-going nature. Lori, the other midwife, was a military nurse for years and years. She had a more non-nonsense approach and tons of experience - she estimates she's delivered around 1,500(!) babies.

Captain Picard is my good luck charm so of course he accompanied us to the hospital.

So when we got to the hospital Cassie was technically on-call, although she had really just finished her shift. She came in to check on me anyway. At this point I was in the jacuzzi tub that was in my hospital room. I didn't much care for the jacuzzi part but the tub part was wonderful. The nurse even came in with some drops of essential oil (lavender) to enhance the relaxation. After Cassie sat with me for a while, she let me know that it was actually her day off and she was going skiing with her family. Lori would be taking over from there. We had mainly seen Cassie for our pre-natal appointments so I was bummed she had to go. But I was confident that Lori would do a great job.

The next few hours are kind of a blur to me (I'm pretty sure women have hormones that make them forget what giving birth is like so as to continue to propagate the species). I know that the contractions were hard. I wasn't getting a "rest period" in between each one, like I was supposed to. Instead I would go from like a 5 on the pain scale to a 10 and then back to a 5. Patrick and I had planned on taking walks, listening to the awesome birth playlist he made me, doing all of our contraction "positions" that we learned in our birth class (like slow dancing to said playlist). Unfortunately I just wasn't able to do any of that. Most of the time during these hours of contractions I was either 1. In the bath 2. Rocking on a birthing ball 3. In the bath tub with the shower running. I rarely laid down in bed, even though I was exhausted and really wanted to sleep, because it seemed to make the pain worse.

Laboring on the ball under a shroud of warm blankets (best part of the hospital) while Patrick rubs my back.
So I would labor for two or three hours and then Lori would check my progress. I was mostly just quiet I guess and I even remember Lori telling me at one point she couldn't even tell when I was having contractions because my facial expression didn't change at all. Lori, Patrick & the rest of my family were great throughout this period. They would just sit with me and help me through the contractions. Patrick would rub my back and try to help me get into the peaceful place we'd practiced so many times before. My family would take turns with Patrick holding my hand and sitting with me so he could get a break every once in a while.

My sis holds my hand while I'm in the tub.
The discouraging part was that despite how hard I was working and how hard my contractions were coming, I was not progress very fast. After two or three hours of intense laboring, I would get maybe 1 or 1.5 more centimeters. Lori said that sometimes it happens that way and usually at some point we would experience a "jump" and gain 3 or more very quickly. That never really happened.

One of the few times I labored in bed. Poor Patrick didn't sleep at all either through the whole labor.
I have no earthly idea what time it was, but at some point during that day Lori thought it would be a good idea to finish breaking my water. Because although my water had technically broken, the sac itself hadn't fully ruptured. Lori's thought was that if we broke the water, it would help encourage Grayson to move down and put more pressure on my cervix to get things going faster. Unfortunately this didn't work either.

 However I did get a second wind at some point after the waters broke and really felt like I could do it. I worked really hard through the contractions and spent another probably two or three hours alternating between the shower and the ball. I thought for sure when Lori checked me again, I would be at least at 8 cm. I was hoping for 9 cm. So when she said I was maybe at 7, it was really discouraging. The way I was progressing, that meant another 6-9 hours before I was even close to being ready to push.

My amazing coach, keeping me going.
At that point I had been laboring for probably around 18 hours or so. Another possible 10 hours before I could even begin the pushing process seemed unbearable. I hadn't slept in over 30 hours. I was exhausted, frustrated and discouraged. That was the point that my birth plan went out the window.

Part of me wishes that I hadn't had any cervix checks performed. Maybe I would have had the strength to keep going if I didn't know how slowly I was progressing. But at that point I just really, really needed a break and to sleep for even five minutes. Lori suggested I have a small dose of some pain reliever that now I can't remember the name of. It would be administered into my IV port and would last around 45 minutes. Just long enough for me to get some sleep and maybe build up more strength for when I needed to push. So my resolve and pride out the window, I accepted the medical intervention.

To Be Continued In Part 3....

*All photos credited to my amazing sister, Maleea Muhlestein*

29 January 2014

The Terrifying, Surprising and Miraculous Birth Story of Grayson Knight Duganz, Part 1

*Note: This is a Birth Story - as such there are details about birth. If you don't want to read about things like dilation and cervix effacement, please skip this post*

There are so many preconceptions and expectations surrounding pregnancy and birth. Patrick and I spent months and months planning for, dreaming about and picturing Grayson's birth. We wanted a natural birth. We expected it to take between 12-15 hours (average for first-time mom). We expected Grayson to weigh around 8 pounds when he was born. We expected that it would be challenging but neither of us anticipated just how difficult/exhausting/terrifying it would be.

To start with, Patrick was sick. The sickest I've seen him in years. We took him to the doctor the day he started feeling badly - not the flu (thanks to the flu shot) - but some nasty bug going around. Because of this, I had stopped actively trying to go into labor (stomping around outside in the snow, eating spicy food, etc.) as I didn't want it to happen when Patrick was still feeling lousy.

But the morning of the 29th, four days after Grayson's estimated due date, Patrick started feeling better. My dad suggested that we go for a short hike to help labor get started.  So we drove up Hyalite Canyon and hiked the half mile trail to Palisades Falls. The drive itself was stressful enough - we even got stuck briefly in the powdery snow when the tires of Rhino (my sister's Exterra) got off the tire tracks a little. Luckily a group of about 15 snowshoers just happened by and helped push the vehicle out of the deep snow and back onto the road. 
Ready for the hike at 40 weeks plus 5 days.
The hike was pretty exhausting, despite it's "easy" rating. At the top of the hike, I sat down on a tree stump and watched the crazy people attempt to climb the waterfall.
Ice climbers at the Falls. 
As I sat there, I felt something a little different. I had suspicion that my water had broken, but I wasn't sure. We headed back down the trail and I brushed off the feeling that maybe I had started labor. We got back home and the evening progressed normally. After the long day, I went to bed early.

Around 10 pm,  I started feeling contractions. Or what I thought could be contractions. I wasn't sure since I'd been having braxton hicks for weeks. I told Patrick I thought this could be it, and we started timing the contractions. Eventually it became apparent that these weren't going away, that they were getting longer and stronger, and that I was in true labor. Patrick woke my family and let them know that this was it. He also called our midwife, who advised us to wait until the contractions were longer and a shorter time apart before heading in to the hospital.

Patrick made me a bubble bath and we rode out the early contractions. Around 4:30 am, they got to the point that my midwife had indicated would be a good time to head in. I figured after laboring at home for around 6 hours, that I was approximately half way, or a little less through the labor.

We arrived at the hospital and got set up in a room. I had already pre-registered and my midwife had called to let them know I was coming in so that part was easy. The nurse on call wanted to check me so she could let my midwife know how things were progressing. Like I said, I figured I was around a 5 or 6 cm dilation, or about half way there. She checked me and declared I was at 2 cm. I'm pretty sure I would have punched her in the face if I'd been able to.

She seemed ready to send me home as she figured this was false labor. Just to make sure, she did a test to check if, in fact, my water had broken. Sure enough, it had. This started the clock. Standard medical practice doesn't like the water to be broken for more than 24 hours before the baby is born. It can cause infection and possibly lead the baby into distress. So my midwife Cassie arrived, ready to get this baby born.

To Be Continued in Part 2....