A Little Background on the Story of Max/ Pregnancy: At 33 weeks pregnant I was diagnosed with something called Cholestasis of Pregnancy. This means that my liver and gallbladder were affected by the hormones and not working properly. My liver function tests were a bit high, and my bile acid was 14 when it should have been 10. In the weeks leading up to to delivery, my bile acids climbed to 40 and were tested again the day before I had the baby. I did not receive the results until after Max was born, but when I did they were 144! The risks of cholestasis are not well understood, but it is universally accepted that the rate of stillbirth is significantly higher, especially when you get into the later weeks of pregnancy. So, if I seem more excited than I should to have a baby at 36 weeks, knowing all the risks involved in delivering a preterm baby, that is why :)
Max's Birth Story
It's hard to know where to begin the story of Max's birth, so I'll back up a bit to Thursday January 16, 2014. I left work early for what should have been my last official doctor's appointment before I was induced. I arrived at the office and discovered one of my best friends, who has the same doctor as me, waiting for her appointment too. This was great because it distracted me from how nervous I was about Max being taken over by my crazy liver bile. We had a quick ultrasound, Max scored 8/8 (again) and the appointment went well overall. My doctor agreed to rerun my blood tests to check on my liver, and she casually mentioned that she was working on Sunday so if I wanted to talk to the baby, I should tell him to come then. Ha ha.
I was up on Thursday night a few times itching, but nothing out of the ordinary. On Friday morning my alarm went off and I went to get in the shower. When I went to the bathroom I discovered I was bleeding. I haven't had any bleeding in pregnancy at all, so I completely panicked. I took the fastest shower ever and then insisted Eric drive me directly to the doctor even though it was 6am. We left without taking a single thing or eating breakfast. On the way I texted my friend from work and asked her to just figure out something for my kids to do because I wasn't coming in. She was the first person to mention to me that maybe I was in labor.
When I arrived at Labor and Delivery, they immediately hooked me up to the Non Stress Test machine. It was clear Max was a-ok and what was also clear was how REGULAR my contractions were! The midwife checked my cervix and said I was at 3cm. She said I might be in early labor or I may just walk around like that for the next three weeks. She recommend that we walk around the hospital for a bit and see if I made any progress. Eric and I walked back and forth for the next hour. At this point, I was feeling the contractions, but able to walk and talk through them with no real difficulty. When we headed back at about 10 am, the midwife said I was still at 3cm. She was pretty sure I was in labor, but it is standard not to admit patients at only 3cm. She suggested going home for awhile, but did give me the option to stay and continue walking. We decided to go home since we assumed it would be awhile and we hadn't brought any stuff with us anyways!
Back at home we finished packing up our hospital bags and Eric set up a bath for me. I was standing on the bathroom floor about to get into the bath when my water broke. Obviously it was right back to the hospital for me! By the time I got to the hospital my contractions were getting a lot more painful. Eric dropped me off at the hospital entrance and went to park the car. I made an extremely slow walk up to Labor and Delivery, stopping at every contraction to hold on to the wall. The Labor and Delivery floor at MGH is Floor 14 so I thought I was in a comedy show when the elevator literally stopped on every. single. floor.
They brought me right back to the same room I occupied that morning (well earlier that morning, it was still not even noon) and said I was now at 6cm and would be admitted. It was at this point that I asked for an epidural. A few words about the epidural: I read lots of birth stories on blogs in preparation for my own and I found it SO HARD to find ones where the mom actually had an epidural. Among my own friends, most of us have had them (not all, but several) but in the blog world I feel like natural birth is more popular. I think that is great for some people, but for me there was never any question I would have an epidural. I actually feel like I was much more present and aware of what was going on once I was not so focused on the pain.
Speaking of pain, it takes FOREVER to get an epidural. In my mind I was absolutely cursing EVERYONE during this process because you have to get fluids, meet the doctor, hear all about the risks, blah blah blah :) I also had to move to an actual delivery room during this time because before I was just in the "will we admit you?" room. I was in increasing pain at this point and my patience level for the wait was very low. The funniest thing was when they make you sign a paper saying you understand the risks. I distinctly recall that my signature was a line… it was in no way my name. I was in way too much pain for real writing and I was pretty sure I was going to throw up at any moment. One of the reasons that I think many people avoid the epidural is fear of the giant needle, which I didn't see, or fear of the risks. I did find it very scary when they were putting it in my back during a very painful contraction because I knew I could not move but my entire body wanted to move. I really had to use the last of my mental battle at this point to make sure I was not hurt by the needle. I will also say that I am not some crazy painkiller person… I've never taken anything stronger than Advil for pain and if the nurses who were trying to sell me on painkillers all weekend could see how much I wanted an epidural, they would've thought I was a walking contradiction :) Really I just look at things on a case by case basis. Oh, and one more thing about the epidural. When I was reading about breastfeeding, there is a lot of propaganda out there trying to convince you that if you have an epidural your baby will not want to breastfeed. This was totally not the case for me, and I'm glad I choose not to let this scare me.
Fortunately, it started to work almost instantly and by the time Eric returned from the car (they sent him out of the room), I was happily enjoying a red popsicle and in much better spirits. I had barely dipped into my popsicle when the nurse told me I was already at 10cm. I have NEVER expected it all to go that quick, especially because I thought up until this day that I'd be induced in a marathon-like process. It's actually funny ALL things I expected that I was wrong about. I thought I'd want to do yoga poses in early labor, in reality everything progressed so quickly that I went from not needing them yet to being in too much pain to even think about them. I thought I wouldn't want anyone in the delivery room except Eric, but when it became that day and I realized I was going to have nurses, medical residents and doctors all around, I suddenly did not care anymore. I thought I'd be watching Friends DVDs and in reality I didn't bring a single one. Ha.
Now it was time to push. Pushing is something I didn't know much about, but learned pretty quickly. The epidural is interesting because you can feel when a contraction happens and you need to push, but it doesn't hurt. Pushing was both totally exhausting and also kind of a cool experience (epidural talking). I literally felt like I had a million cheerleaders telling me how AWESOME I was doing the whole time. I was also quite thankful during this process that I had stayed so active during pregnancy. It was probably the hardest workout I'd ever done so it was nice to be in relatively good shape at least! Another thing I thought I would not want was to have a mirror so I could see what's happening, but they kind of pressured me into it and since I was in totally don't care about anything mode, I just went with it. In hindsight I think it was kind of cool. A little after 3 I started to get really close to pushing Max out and the doctors came in. I assume everyone has doctors at the end of the labor, but for me it was very important because Max had meconium, meaning he had pooped while still in my tummy. Believe it or not, we actually knew this because of the cool of my water when it broke. I knew this was a strong possibility anyway because it's fairly common in babies AND basically all cholestasis babies do it. It is also supposed to be a sign of fetal destress and is one theory about something that may contribute to the stillbirth rate among cholestasis babies, so I'm thankful this ended up being no big deal for him.
On one final push, Max came out, Eric cut the cord and Max was immediately taken away by the doctors so they could clear his air passage of the poop :) I did ask if he was okay because the first thing you expect babies to do is cry, but they reminded me that they wanted to clear his air passage before he cried so it was a good thing. My hospital has a strict skin to skin immediately following birth policy so Max was right on my chest about 1 minute later. During this overwhelming time of "meeting" Max for the first time, doctors were telling me that I had a third degree tear. I didn't know much about what that meant but I could tell it was not good. After I delivered the placenta, which was easy, they then spent the next 45 minutes stitching me up which can only be described as pure torture. It was the second time that day when someone kept telling me "we are almost done" and it was so clear they would NEVER. BE. DONE. I felt better when my friend told me after her natural birth she called for the drugs during this after part. Ha.
Eventually, that was finally over and Max was HERE. I knew he had many tests ahead he would need to pass, but once he was out of me and away from my liver bile I felt pretty confident that he would be totally fine. And, just so I don't leave you hanging, he passed all of his tests no problem and most people in the hospital could not really believe he was the 36 week old baby :) It must have been all the ninja fighting of the liver bile...