Monday, April 16, 2012

Our Daughter: Gates Hensley Silverstein

What follows is our labor story. For us, our labor - and the path it took - worked. We combined techniques learned in both the McMoyler Method and Mindfulness Childbirth and Parenting classes. For background noise, we chose Sounds of a Puerto Rican Rainforest complete with coqui frogs. We also played music by Ill Gates (for whom our daughter is named), Ganucheau, and Beats Antique.

Our birth "plan" was simply to make decisions as they came and to choose a path that led to a healthy baby. Three preferences that we had were 1) to prevent tearing of the perineum, 2) to be as mobile as possible to allow gravity to help the baby descend, and 3) to avoid needles where possible.

Our first big decision that we made (and reevaluated) was to start labor by inducing. (In my family, on both my mother and my father's sides, first babies are late. My aunt had three 10-month pregnancies. In none of my labor fantasies did I imagine delivering early or on time.) Originally we'd been up for waiting up to 42 weeks. At our visit to the OBGYN 4 days after our due date, we chose not to wait any longer. Our reasons were: I was extremely uncomfortable; I was getting very little sleep; and construction on our street complicated getting to the hospital - a fear if I went into active labor during the week between 7:30 AM and 5:00 PM. Note that had we wanted to wait to see if labor started on its own we could have; the placenta and both the baby's heart beat and activity level were good. Another benefit of inducing was that one of our close friends, Bri, was able to be with us for labor and delivery.

We chose to deliver at CPMC California Campus, and from start to finish - not including the softening of the cervix - labor took approximately 17 hours. (I may have slept through about 7 hours of labor - a good portion of active labor and all of transition labor).

Our daughter, Gates Hensley Silverstein, was born 8 lbs, 20 inches at 7:46 AM on April 2nd via C-section. The nurses, doctors (OBGYNs, pediatricians, and anesthesiologists), and lactation consultants were all amazing. Over our 6-day stay, many people helped us; unfortunately, I can't remember everyone's names. A few members of the staff who especially stood out were: Colleen (Labor & Delivery), Mary (Recovery), Martie (Postpartum), Bella (Postpartum), Jasmin (Postpartum), and Kim (Postpartum).

In addition to the professionals at CPMC, we've been blessed with an incredibly supportive community. cubes and I would like to thank Bri for assisting us during labor, Heather and Ed for taking care of SpriteKat while we were in the hospital, Annie and Simon for getting us settled when we came home from the hospital, and those who have run errands for us or delivered food: my parents; Heather; Annie and Simon; Juicy, Steve23, and Poppy; Mella and Andy; Alice and Tom; Nina; Aislynn and Whelpley; Ames and Steve; Vanessa; Helen and Bri; and Josh.

For those that are interested, here is a more in-depth timeline.
  • 4:30 PM on Saturday - cubes delivers take out from Chow. I enjoy a meal of Spaghetti and Meatballs.

  • 5:00 PM on Saturday - We call the OB Reception for an arrival time.

  • 6:30 PM on Saturday - We arrive at the OB Reception and check in. We get assigned Room 201, which is one of the seven rooms available that have a bath tub. The nurse draws an IV with a heparin lock. I'm hooked up to a fetal monitor.

  • 8:45 PM on Saturday - First dose of Misoprostol is administered.

  • 12:45 AM on Sunday - My cervix is checked; first dose of Misoprostol has had no effect. Second dose of Misoprostol is administered.

  • 4:45 AM on Sunday - My cervix is checked; second dose of Misoprostol has had no effect. Third dose of Misoprostol is administered.

  • 9:45 AM on Sunday - My cervix is checked; 80% effacement with 1 cm dilation. I'm given the go ahead to have a light breakfast. I order a plain bagel with a small plate of fruit. (This is the last food that I'll have until lunch on Tuesday.)

  • 10 AM on Sunday - My bag of waters is broken to encourage labor. Bri is called; he heads to the hospital to join us.

  • Early-afternoon on Sunday - The nurse lets us know that I don't have to be continuously monitored and can walk around. cubes and I try walking slowly up and down the hallway; my legs feel too weak for me to comfortably do more than one lap. We talked with the partner of the other woman who came in at the same time as me to be induced. (Her cervix is not effaced and she hasn't dilated yet. She has started taking Fentanyl to cope with labor pains.) We try a variety of positions. For me, sitting on the birthing ball relieved the most pressure on my lower back. Intoning, which in class hadn't worked for me, allows me to cope with contractions. Focusing on sound and visualization techniques, which in class worked for me, didn't work during actual labor.

  • Noon on Sunday - 3 cm dilation; early labor begins. I'm disappointed that labor is not further along. I receive 1st shot of Fentanyl. I suspect Gates is sunny side up as there is no real break between contractions. Doctor shows us another technique for coping with pain - applying inwards pressure to the hips.

  • Early afternoon on Sunday - Labor is progressing slowly. The decision is made to begin Pitocin to increase effectiveness of contractions.

  • Mid-afternoon on Sunday - 6 cm dilation. Active labor begins. I receive 2nd shot of Fentanyl (Later in recovery, I discovered that I'd been laboring without pain medications for a period of time. I hadn't noticed that the first shot had worn off.)

  • Late afternoon on Sunday - Contractions are now pretty intense. Intoning and applying counter pressure to my lower back are no longer sufficient for me to cope. cubes, Bri, and Colleen (our nurse) are in my face reassuring me that I can do it and getting me to focus on the breath.

  • Mid-to-Late-evening on Sunday - I'm given an epidural. My blood pressure drops; I'm given Ephedrine. Gates' heart beat drops. Both my blood pressure and Gates' heart beat return to acceptable levels. Gates' vitals are monitored; we're advised that we may need to go with a C-Section. We take a wait-and -see approach; active labor continues.

  • Midnight on Monday - Gates' vital signs look good. The decision is made to continue towards a vaginal delivery.

  • 4:30 AM on Monday - I begin pushing.

  • 6:30 AM on Monday - cubes, Bri, and Colleen are in my face, reassuring me that I can do this and getting me to focus on the current contraction. After 2 hrs of pushing, Gates is at halfway point. (I'd thought I'd been pushing for only 30-40 minutes.) Starving and exhausted, I don't think I can continue. Tears have been streaming down my face with the last few sets of pushes. (I have forgotten that I can increase the epidural.) cubes, Bri, and I make the decision to go with a C-Section. For the first time in hours, I feel that I can do this and we're going to have a baby. Pitocin is stopped. I'm prepped for surgery. cubes and Bri don their bunny suits.

  • 7:00 AM on Monday - I go to OR for C-Section.

  • 7:46 AM on Monday - Gates is born.

Ciao Bella!
Credits: All images taken by Eden Hensley Silverstein for The Road to the Good Life.