River and Saffron

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On Friday, November 11th, I decided I should get one bit of exercise in that week since I hadn't exercised that week with Dad Fister in town. So I went swimming at around 8am or so, and Dad Fister rode the bus with me all the way to Western Addition, and he walked up and down Fillmore Street, touring while I swam. I did my usual half hour of very pregnant breaststroke. Then we went and got bagel sandwiches afterwards.

 

The ride home I felt fine, but from 37-40 weeks, I was experiencing a mix of nausea, diarrhea and digestive distress off and on, which can be signs labor is about to start so of course it was driving me crazy these past few weeks.

 

A few hours after we arrived home, we decided to take a trip to the SFMoMA to show Dad Fister, since it's free with our membership and had been reopened earlier this year after years of renovation. We arrived at around 1:30pm. On the walk from the bus stop to the museum, I was really not feeling well. Nauseous and generally uncomfortable and fatigued. Well, since it was the day before my due date, it probably wasn't anything special from what I had been experiencing the past several weeks, I told myself.

 

 

As soon as we arrived, I went to use the restroom, and when I wiped I found some very slight pink and very very faint greenish mucus. I thought hmmmm, curious, I wonder if this is something. But it was so faint, I didn't think it was a strong enough sign of anything. So I joined Andrew and Dad Fister at SightGlass, a cafe in the museum because I said I needed water, so they got coffee and pastries, haa.

 

 

After about 10 minutes, I felt an extreme pressure on my bladder and general pelvic area, so I said "Whoa, I need to use the bathroom!" And when I got up, I walked to the elevator as I didn't see any bathroom on that floor. Then all of a sudden, GUSH! I feel a small amount of warm liquid coating my underwear....Uhhhhh, OMG...stay calm! I'm not sure what just happened but I need a bathroom NOW!

 

 

So when I reach the bathroom, there's more pinkish fluid, and slight green. I call our doula, Vincenza and am talking on the phone with her in the stall of the public restroom of the freaking SFMoMA! But I had to focus. Vincenza told me to stay calm, which was good advice, because I was starting to get a bit hyper and jittery.

 

 

So when I composed myself, I met back up with Andrew and Dad Fister, we got a Lyft home, and went to the Birth Center to meet with Sara our midwife at around 4:30pm. She said that since I am positive for Group B Strep, and my water broke with slight traces of meconium (baby poop) it's actually important that I start labor soon, within 18 hours. The Group B Strep and presence of meconium introduce an increased risk for a bacterial infection.

 

 

I was worried that already I'm having risk factors presented to me before I've even started labor. But I just had to stay focused and accept this information. So the plan was to go home, rest, and hope that contractions start before 10am the next day. We bought some castor oil to try to induce labor naturally. So we go home, and right as we arrive at home, I start having contractions that are quite strong for my expectations, and very quickly become regular. This was around 6pm..and I very quickly was on my hands and knees with towels, very disoriented, moaning through what felt like active labor from the start...so that really took me off guard, as I was expecting a longer more gentler phase of early labor, where I could, you know, set the mood, light some candles, change into my waterbirth bra and support bead necklace..., maybe put on some music, turn on the infuser and give my doula my birth affirmation cards....you know, make some preparations, make some food, and get grounded and focused.

 

 

NOPE! Contractions came FULL force, starting at around 6 minutes apart, and within a few hours, were 3-4 minutes apart. At this point I was moving back and forth between the bathroom and the bedroom, just unable to fully recover from each contraction, increasing in strength and frequency. I already was feeling drained from swimming early that day, then going straight to the MoMA...and going straight home and then the Birth Center....how was I going to endure this labor if it went into the night? I just told myself to take it one contraction at a time, and put each one FULLY behind me as it past. Andrew and Vincenza worked together to make me as "comfortable" as possible, while timing contractions.

 

So by about 9-10pm, Andrew and Vincenza were making arrangements to head to the Birth Center, and I was unknowingly, starting transition, the hardest and shortest part of labor. All I noticed was the contractions became stronger, lower and deeper, and my high songy feminine moans turned into FIERCE grunty, low and loud GROANS...as I tried to handle each one...I just let my body react, and while I was wondering softly...where am I in this labor?? I thought for sure I was starting active labor at least! I was staying in the moment, knowing I just had to respond to my body and let it guide me.

 

Around 10:30pm I had to get dressed to leave. Getting dressed was hard, I was thankful San Francisco was having a warm spell that week of November, because I couldn't conceive of putting on pants, so I put on a maternity skirt. I got in the car and we were slowly making our way through the heart of the Castro on a Friday night....neon lights, rowdy music and sounds of drunkeness swim through my ears and past. It was apparently really backed up on the roads, and Andrew now wishes he took an alternate route.

 

I'm sitting on as little pelvic bone as possible, and having contractions about every 2-3 minutes apart. After the birth, Vincenza said she thinks I went through transition in the car, which is known to often be the hardest part of labor. Okay, awesome. We got to the Birth Center at around 11pm, and I waddled in the low lights to the back room, and Sara quickly checked my dilation...to all of our surprise, I was fully dilated and it was time to push! What?!!

 

I couldn't believe it...but I felt a burst of confidence and was eager since I know pushing is considered "easier" than contractions, because the pushing sensation can be a bit of a relief and it's also more exciting and generally the average amount of time pushing for first time moms is around 2-3 hours. I thought wow, am I almost there? Well, the first two hours I was making progress and baby was descending down the birth canal. After about another 2 hours though, baby was not making any progress. Sara the midwife had me try a ton of different positions. I was on the bed on all fours, I was side lined with the peanut ball, I was in the tub for a while, tried pulling on a rebozo wrap, I tried the birth stool, I tried the toilet, I tried the floor. They tried a mirror so I could see baby's head and "be motivated", HA!

 

Hours went by, and around 4am, Sara proposed a non-emergency transfer to the hospital. She said baby's heart rate was strong the whole time, and my body was fine too, aside from a small increase in temperature for a bit, it dipped down and stayed down. So it wasn't an emergency, but I had been pushing for 6 hours, and 3-4 hours of no progress. Baby was apparently at +2 in the birth canal, which is about half way. So the longer I kept at it, the more fatigued I would get, and the more of a risk of bacterial infection there would be, as the meconium was getting worse, which can indicate the baby is under stress, even though the heart rate was fine.

 

 

 

What a difficult call for me to make in such a context. My dream was to have a waterbirth, but I had to factor in the context of how everything was going. I did not feel pressured at all to decide one way or the other, but I agreed that it was time to move things along and that would be safest for everyone, as much as I didn't want to go to the hospital.

 

 

I knew this decision could threaten my spirits, so I decided to just stay focused and strong. I chose to look at this as just another transition in my labor. I slowly, reluctantly got dressed, and waddled my way out of the center, into the elevator and into the car...with 5 of us squished in. I cannot tell you how weird it is to feel a baby at +2 down the canal...this big mass has transformed my pelvis and I'm just doing my best to walk.

 

I had push surges all the way on the drive there, and as I walked into the hospital. I remember having to stop at least twice, hang on to the railings in the hallway and push.

Things moved very quickly after I got situated on the bed with the doctors. They did a quick ultrasound to assess baby's position, which was ROA, right occiput anterior. Not usually a troublesome position, as OA, occiput anterior is the ideal position, but baby's head was just turned in such a way that it was stuck in my pelvis. The plan was to use a vacuum to help rotate and pull the baby as I pushed. If this didn't work, I would have to have a c-section. Unfortunately, only two people could accompany me to the operating room, so Dawn, the photographer, and Vincenza had to wait outside, and Andrew and Sara joined.

 

I did NOT want a c-section, so I became REALLY focused, despite the sea of staff covered in gowns and masks, the bright lights, the blur of urgent and efficient conversation. But first, they offered pitocin. As I was already at the hospital, I knew the spiral of intervention was probably inevitable, so I agreed to a dose in hopes that it would strengthen my contractions. IT DID NOTHING. I felt no change in my surges. Okay...so now they suggested a spinal injection, which would numb me from the waist down, like an epidural, but not as extreme, and it wears off more quickly. The main reason for this, was if the vacuum didn't work, they could go quickly into a c-section, as at that time, it would be more of an emergency with the baby's head so far down. I agreed to the spinal.

 

 

So, since I was numb, I wouldn't feel the surges coming, so the nurses had to feel my abdomen for the uterus contracting, and TELL me when to push! Oh boy, how could I do it without feeling it?! But I just relied on muscle memory, and pushed 3 times on the first surge as they inserted the vacuum. No luck. Again, second surge, 3 pushes, each time, the staff was cheering me on, telling me to push harder harder harder!! Baby moved farther down. Third surge was coming...doctors told me to try "once more" as if I didn't feel the pressure enough already. 1 PUSH. 2 PUSH. 3 PUSHHHHH, and out came the head! a few seconds later, the doctors removed the baby and it came rolling up my body with multiple hands guiding it to my chest. All of a sudden, our baby was born! I didn't feel anything physically down there so it was a different experience...but a REALLY intense, emotional, and high pressured one.

 

 

 

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I looked at my baby, who was chubby and PINK, and the umbilical cord was THICK, pale and rubbery. Baby started crying immediately, and man, I couldn't believe the resilience of everyone, including myself. I looked up at Andrew, and he was crying! I've never seen him cry in our 9 years of marriage!! I was so happy to see him cry. Seeing Andrew cry was what made me most emotional, not seeing my baby....though that WAS wonderful and relieving, maybe because it just happened so fast at the end, and I really was worried about my own health...my brain was trying to catch up to my body. I actually forgot to check the sex when baby was brought to my chest. (I chose to be surprised, Andrew chose to know the sex ahead of time, yes, he kept it a secret from me!) When they brought baby to the warming table to be checked and weighed, one of the doctors asked "Oh, did you want to know the sex?" Why yes, in fact, I do. They showed me from across the room, it's a boy.

 

Andrew did not get to cut the initial cord, as it was originally in our birth plan, but he got to trim the rest of the cord at the warming table. The doctors chose to cut the cord quickly as they were worried about the stress the baby had gone through with being in the canal so long and having the vacuum and meconium.

 

I asked them to please save the placenta as they were preparing to retrieve it, and they were cool about that. I also asked if I tore, and Sara said I suffered a 4th degree tear. "Oh shit!" I said....that was disappointing to hear, but I also had so much euphoria and adrenaline, that I was more accepting than I ever thought I would be to hearing something like that. I had actively exercised for months and months to have a strong pelvic floor so I wouldn't tear, but alas. We do not have control. We think I tore when the doctors maneuvered the baby's shoulders to get the body out.

 

Healing from the 4th degree has been the biggest challenge in my post partum experience. Not taking care of a newborn, but taking care of a newborn, while being disabled for weeks. Andrew basically took care of both Saffron and I the first 3-4 weeks. I had to lay on my side for several weeks. I couldn't sit, I couldn't lift the baby easily at first. The first 3-4 days I was extremely sore everywhere, like I was in a car accident. Because you're using all these muscles, my neck especially was sore because I had to keep lifting it when pushing when on my back or side. My legs were also sore and my shoulders from holding myself up during contractions.

 

One of the hardest adjustments to healing post partum was my lack of bladder and bowel control. The spinal initially contributed to this too, where I couldn't feel the urge to pee, so my bladder was very sore and very full, and I had to have it emptied twice by a catheter after birth. I was soon able to regain feeling and control down there though within two days. The bowels have been more challenging. I struggled with incontinence for about 5-6 weeks. I was on a rigorous medication schedule that included two pain relievers, and three stool softeners. At home, I was doing Sitz baths once a day, and taking a calcium magnesium supplement and prenatals. So just the medication schedule and healing routine was a production!

 

The nurses and general care during my post partum experience were great. Really excellent, I was very impressed and grateful. It was really nice to be cared for so well, have the nurses be friendly instead of bitter in the middle of a night shift. All of our food was delivered to our room, and we had lots of nice options to choose from. They were very good at foreseeing what I needed before asking. They also had lots of helpful advice on breastfeeding. I could only do the side-lying position since I couldn't sit up, and little Saffron caught on so well to it, as I hear it can be a more challenging feeding position.

 

We left the hospital Monday at around noon. I wasn't honestly thrilled about going home so soon, not because I didn't feel prepared to have a baby, but because I was still so immobile and in pain. But I managed to get out of bed, change clothes, actually put on makeup and finger comb my hair...and do a bit of packing while Andrew was getting the car. The ride home was actually fine, Saffron was asleep the whole time! I just had to sit all crooked on one cheek.When we got home, there was a sigh of relief for sure. I was actually feeling light headed on the drive home, I just over exerted myself when packing perhaps. I was fine after some peanut butter banana toast and rest. The midwives did 3 home visits, and my doula did 1, so we had lots of check-ins and feedback  the first two weeks to get us on the right track. Looking back, the consensus was that I fooled both the doula and the midwife, I apparently "didn't look like I was a mother in transition" when I arrived at the Birth Center. So it was surprising to everyone that I was fully dilated so quickly. So, I'll take that as a compliment. 

Reflecting back, I'm very thankful for all the support of everyone involved. I'm not sure how it would have ended up if we didn't go to the hospital. It's scary to think of how often childbirth has complications, even when you do everything in your power to educate yourself and prepare physically.  It's too bad I tore so badly, and it gives me anxiety to think about having a second child vaginally, but the body heals miraculously, and I'll cross that bridge when I come to it. Andrew was such a strong support the whole time, I was so impressed at his nurturing, calming presence. I know I did an awesome job to handle basically no early labor, and an active and transition labor of 5 hours, and 8 hours of pushing. What an unconventional timeline! But that's always been Saffron's style. He accepted our invitation to join the family, and very timely let us know after 3.5 years of inviting, the day before our IVF treatment was scheduled to begin.

 

 

Saffron Severin Drum Fister

Born 11/12/2016 (Due date baby)

9 lbs 3 oz, 20.5 inches