Birth Story!

Note: Lucas' notes are in italics.

On Thursday, 5/10/12, my water broke in the morning.  Thursday was my first day off of work and I had big plans to get the last few things organized before I went into labor.  Unfortunately, I stood up from the couch that morning, fully dressed and ready to go, only to have my water break.  It was such a weird sensation.  It felt just like I was peeing on myself but without the accompanying sensations of peeing.  Just warm wetness that kept coming.

I was pretty much tied down to the bathroom for a half hour as every time I moved more water came out.  I had a call into our midwives for a plan.  Marsha, the midwife who took care of us all day, called back and suggested going for a walk or doing nipple stimulation to try to start my labor.  I was having light contractions but nothing too serious.  We went for a walk, stocked up on some food for the birth and tried nipple stimulation with my breast pump.  All to no avail.  The contractions remained very light and spaced out.

I called Marsha to update her and she suggested taking castor oil.  Out we went again to find some castor oil.  The CVS pharmacy tech who helped me find the castor oil told me her labor story after taking castor oil - it was fast and furious.  That was encouraging.

Home we went.  Castor oil tastes like nothing and yet it's so thick and slick.  It's almost like a tasteless, oily milk shake.  It's just so dense.  I chased it with some tea.

Two hours later.  No contractions.  Back on the phone with Marsha.  The plan was to drive down to the birth center to start an induction.  If I wasn't delivered or in very active labor by 24 hours after my water broke I would have to be transferred out of the midwives care and into the hospital.

On our ride down to the birth center the castor oil did its job and we stopped at a McDonald's so I could use the bathroom.  After that, the contractions started getting more intense but were still easy enough that I could handle them just by being quiet during them.

At the birth center, my exam showed that the baby's head had still not ever settled into my pelvis.  The head was really high and not putting pressure on my cervix at all.  On an internal exam Marsha found me to be one centimeter dilated and she though she might have felt an ear or a nose on her exam.  This was not ideal, as the back of the baby's head is the best part to dilate the cervix and the easiest to pass through the pelvis. After consulting with her back-up physician, it was decided that it was safe to proceed with an induction even though we weren't entirely sure of the position of the baby.  Basically, the baby's head could change positions and if I became more dilated we would be able to assess the presenting part much more easily. (I think somehow I never really got how big of deal this was at this point. For no reason that I can explain, I assumed that, of course, the baby's head would turn once we got a little more dilated. Of all the things that I had ever heard of about birth, and being married to Colleen means that I probably hear more things than most people, babies coming face-first was not one of them. In my head, it just didn't happen, so it must turn around at some point, right?.) 

Marsha placed a foley bulb - this is a tube that goes through my cervix and two bulbs are inflated, one on the inside of my cervix by the baby and one on the outside of my cervix in the vagina.  She then also placed cervadil - a cervical ripening medication - in my vagina.  Part of getting cervadil meant that the baby's heart rate would be monitored for two hours.  I had to lay in bed and stay on the monitor.  The contractions got a lot more intense with the foley bulb and cervadil and it was all I could do to lay in bed and make it through the contractions.  There was a lot of moaning.

Three hours after the induction was started the foley bulb came out and my cervix was three centimeters dilated.   Another internal exam revealed that it was the baby's nose Marsha felt.  His face was coming first instead of the back of his head like the picture below.  This presentation is really rare, happening only 1 out of every 600-800 births.

Depending on which way the chin is facing, I could have still had a vaginal delivery.  When she first checked, the chin was in the position that would have been okay for vaginal delivery.  Marsha asked if I wanted to stay at the birth center and continue laboring.  I said that I wanted to go back to Hopkins in Baltimore now that it was confirmed that everything wasn't going normally.

I had contacted the doctor in my practice who was my back-up doctor when we were on our way to the birth center so he was aware that the process of having a baby was underway.  On our trip back to Baltimore, I called him again to tell him we were going to the hospital for a face presentation.  I also told him I wanted to forgo a vaginal delivery attempt and go straight to a c-section.  He agreed with this plan and told me he would meet me at the hospital when I got there.

The contractions had spaced out during the hour long trip to Baltimore but each contraction had grown in intensity.  I was having a lot more difficulty dealing with the contractions during our trip.  The contractions were easier to deal with when I was standing.  Of course that's not possible in a car so I was laying down across the back bench of the van.  The trip was manageable but the labor felt very intense.

When we got to the hospital, I was put in the triage room very quickly.  My doctor came soon after I got there and checked my cervix again.  He confirmed the face presentation but the baby had rotated to a position where a vaginal delivery was no longer an option.  This was a relief to me because I had feared that I would feel guilty later about not wanting to attempt a vaginal delivery if it was an option.

I got an epidural for the surgery and we were waiting for a lab to come back before going to the OR when the baby's heart rate started to fall.  I was rushed back to the OR in case the baby's heart rate didn't come back up but when we got back there, the baby's heart rate was fine.  I asked someone to go tell Lucas everything was fine. (A lot of scary stuff happened, but this was probably the scariest. I had my scrub pants half-on when, all of a sudden, everybody was gone. I didn't really know what had happened, just that something non-urgent had become VERY urgent, so urgent that there was no time to tell me what happened or let me finish getting scrubs on. I paced around in the room for the longest five minutes imaginable before someone came back to tell me that everything was fine and the baby's heart rate was back up, and that I'd be allowed to go back in in a few minutes)

Eventually they brought Lucas in to the OR and the surgery started.  Pretty soon the baby was out.  "It's a boy!"  It was our boy, Miles.  Both Lucas and I started crying with joy.  Miles was crying right away.  He was seen by the pediatric team because he was born by c-section and because he was face presentation.  I didn't get to see him for about 15 minutes.  I was the last one in the room to get to see him.  That seems so unfair!  Everyone was talking about how swollen his face was.  Lucas saw Miles at the warmer and came to tell me that after the swelling went down he was going to be a pretty cute baby.

Finally Lucas was able to hold Miles and brought him to me for me to see him.  He was in rough shape.  His top lip was about four times the size of his bottom lip.  His eyes and forehead were really swollen. (You know that one Twilight Zone episode where you never see anyone's face and there's this person in bandages who had some sort of facial reconstruction surgery, and then at the end the bandages are unwrapped and it's a pretty lady and everyone acts horrified and its revealed they are crazy huge lipped aliens and shame on you for thinking beauty meant just one thing! That's kind of what his mouth looked like.)

Luckily, his swelling went down pretty quickly, within 24 hours.  And my recovery went quickly.  We were able to go home in two days.  Aside from some postpartum hormone surges that left me a weeping mess for no reason, things have been going really well at home.  He eats a ton, pees and poops like a champ and even stays asleep at times for 4 hours or so.  We're pretty much in love with him.



Miles Kennedy Carscadden
Born 5/11/12
12:48 AM
6 pounds 8 ounces
20.5 inches in length