For those just want to know about the eventual happy outcome, we were thrilled to invite a healthy 7lb 4.5 oz baby girl into the world on October 16, 2008! [Pictures below]. For those interested in more labor and delivery details...read on for Kiera's birth story:
A week prior to "labor day," Karma was told at a midwifery appointment that she was easily 3 centimeters dilated and her cervix fully effaced. Kiera's head was at Station Zero, seated nicely within the pelvis. We were optimistic that her labor would go relatively quickly and efficiently.
Wednesday, October 15, was business as usual. I went to work Downtown and came home after work at the regular time, and Karma continued to stay active running errands and keeping busy. In the afternoon, she went on a "long and bouncy" three-mile walk with her mom, then came home to take a two-hour nap. Taking the rest was fortunate since she didn't know at the time that sleep would be in such short supply. We wound down the evening watching TV and reading our books.
Karma felt some cramps when we went to bed Wednesday night, but figured she'd sleep through them as she had the past several days. After a few hours of fitful sleep, she woke me around 12:30am and we mentally went through our playbook to try to determine whether the cramps were ordinary "pre-labor" or actual early-stage labor pains. Karma took a shower and then we went for a middle-of-the-night 1.5 mile walk around the neighborhood. Since her cramps continued to intensify and recurred at a consistent 3 minutes, we knew this was probably the real thing. Paula came over to the house around 4:00am to help me provide support to Karma. By 6:00am, Karma could barely stand and her sole focus was on getting through each increasingly intense contraction. We decided to make our way to the birth center.
Up until getting to the birth center, things went smoothly and according to plan. Unfortunately, it didn't take long for the unexpected to throw us for a loop.
Approx. 8 Hours into Labor
The initial check at the birth center revealed that she was only 2 centimeters dilated. This would suggest that her cervix actually closed up slightly instead of opening (as it should during labor contractions). After hours of intense labor at home, this information was highly disconcerting and frustrating. It also didn't bode well for our goal of progressive relaxation through the remainder of labor.
Staff at the birth center gave Karma the option of returning home to resume early-stage labor, or spend some time in the whirlpool bath in the birthing suite and be re-checked prior to being sent home. Karma opted for the bath, and after about an hour and a half of intense contractions, was re-examined and found to be about 6-7 centimeters dilated. The labor was back on track!
Approx. 12 Hours into Labor
Karma continued laboring in the bath with intense contractions. At some point, it was decided that it would be optimal for her to exit the tub since she would have the flexibility of more laboring positions in the suite and that she could be better supported by the birth team. During the move, one of the midwives quickly attempted to check her dilation while Karma transitioned to a laboring position near the bed. She wasn't able to absolutely confirm complete dilation (10 cm) without another invasive and disruptive examination, but the cursory check - together with the fact that Karma thought she might be feeling the urge to push - suggested that Stage 2 labor had begun.
Karma assumed a birthing position and for the next hour and a half we encouraged her to push with all her energy since we eagerly expected to see Kiera at any moment. The pushes didn't appear outwardly productive, but there was no indication that anything was amiss.
Approx. 14 Hours into Labor
Later into this exhaustive pushing stage, one of the midwives re-examined Karma between contractions since the baby hadn't presented and Karma was showing signs of fatigue. Our ballooning enthusiasm for the imminent birth suddenly burst when it was announced that Karma was only 8 centimeters dilated. It was crushing to realize that all of the work spent pushing was wasted energy. In fact, we soon learned that it also created a real problem since it appeared to contribute to the inflammation of her cervix, preventing further necessary dilation and increasing the pain of labor.
After this setback, Karma's labor slowed dramatically for a short period of time, and we convinced her to return to the whirlpool bath to re-group.
Approx. 16 Hours into Labor
After about two more hours in the bath, Karma's contractions became extremely intense and nearly overlapping. The birth team was optimistic that she had entered Transition. She returned to the hospital bed, where another examination revealed that she had still not dilated beyond 8 centimeters. Her bag of waters, which appeared to block the opening to the cervix, was manually broken in an attempt to stimulate the final dilation necessary for delivery. Unfortunately, this action seemed to also dramatically increase pressure against her inflamed cervix. The pain skyrocketed to a point far beyond an acceptable level, and if there was any chance of delivering Kiera without emergency surgery, an epidural had to be performed.
The birth team rushed to locate the only anesthesiologist available in the entire hospital, and after an agonizingly slow 45 minutes, he was able to provide assistance to Karma.
Approx. 18 Hours into Labor
After the pain medication set in, Karma was able to relax somewhat and attempt to gather whatever energy she had left in her. Her Stage One labor contractions continued for about an hour, and the spirits of the birth team rose again when the midwife announced that she was fully dilated. By 3:45pm, she was pushing once again.
Approx. 21 Hours into Labor
With assistance from the midwife, we were able to see the brunette locks on a portion of Kiera's head within the first hour of pushing. Unfortunately, continuing progress was slow, and Karma struggled with every ounce of her nearly depleted energy to push Kiera farther along. The baby's head was just positioned so that passage through the birth canal was obstructed.
At 7:30pm, the resident obstetrician who came in to observe Karma's deteriorating condition and position of the baby gave three options:
1) She would give Karma 15 more minutes to attempt to push the baby out naturally;
2) The OB could attempt to deliver Kiera using risky vacuum extraction; or
3) Caesarean section.
Considering the tremendous effort vested in the past 21 hours of labor and her desire for minimal obstetrical intervention, it was clear from the determined look on Karma's face that she would pour everything she had left into Option #1. The birth team continued to provide as much encouragement as possible, and the resulting final pushes were extraordinarily productive. Almost immediately after the OB returned to the birthing suite to decide on Options #2 or 3, Kiera's head crowned and the room exploded with cheers and tears. Seconds later, her shoulders and arms presented at 7:46pm and I enjoyed the once-in-a-lifetime honor of catching Kiera and placing her on exuberant and exhausted Mom's chest. Later in the evening we learned that our cheers of happiness at the moment of birth could be heard beyond the room and across the building in the Family Waiting Area.
As mentioned earlier, our precious little conehead weighed in at 7 lb 4.5 oz and 19 inches in length.
Today marks her one week birthday, and we enjoy spending every moment with this sweet baby girl. She's growing so fast - she even lost her conehead!
.JPG)

1 comment:
Karma & Trevor!! Fabulous blog and pics! Truly. I hope it's all going well. Those first few weeks are so wonderful, but a little overwhelming, too. You are so smart to be home with family for support. Nobody takes care of that baby like Granny, eh?
I hope you are getting lots of rest. I will give you a call this weekend!
Gemma
Post a Comment