Oona's Universe

We drove to Marin to meet our friend Paulo and his twin boys Tristan and Elliot for a hike at Tennessee Valley. A gorgeous day with spring in the air. When we reached the ocean we were met by giant waves rolling into the shore.

Deep thoughts

Valentine's digs

Mama and Oona at Tennessee Valley Beach

Oona at Tennessee Valley Beach

Dad and Oona at Tennessee Valley Beach

Laura woke up early on Sunday morning with cramping pains (they felt a lot like menstrual cramps). Throughout the day Laura was unsure if they were labor pains or not because they were happening at irregular intervals, but they were strong enough to need to rest on the couch with and breathe through. Around 3pm she decided to run some last minute errands, like getting the infant car sear installed, just in case. Laura took a walk through Montclair Park, where she used to play when she was little. Ammon was at work (yeah, working on a Sunday) and trying to finish a big project for a Monday presentation. By 6pm Laura began feeling these were indeed labor pains, but not sure if they were early-labor or false labor or what. She went home to breathe through the contractions and keep up with the timing.

By the time Ammon arrived home at 11pm, Laura’s contractions were strong and becoming somewhat regular at about once every 8 minutes. Laura’s mucus plug came out at midnight – a sure and exciting sign things were happening. We quickly packed a birth bag and got in bed at around 2am to try to relax – sleep was not an option. At 3am Laura’s water broke during a contraction with an exciting pop and a whole lot of liquid- at which point we knew it was for real. Since Laura was tested positive for Group B streptococcus (GBS), a very common (about 25% of all pregnant women) condition, we were instructed to go to the hospital as soon as the water broke in order to start receiving antibiotics every 4 hours through an IV.

We arrived at the Alta Bates Hospital at 3:2oam on Monday morning. The contractions were getting very intense at this point and getting from the parking lot to the birthing floor was challenging – stopping along the way during surges. Laura was examined by our midwife, Hsiu-Li Cheng (pronounced “Show-Li”), who happened to be at the hospital because a couple from one of our birthing class had just had their baby and were using her as well. We were told Laura’s cervix was fully effaced and dilated at 1cm – a diameter that would have most likely sent us home if Laura didn’t have the GBS diagnosis. We were given our room, a generous sized private birthing room with a jacuzzi tub. Our doula, Amy Jones, arrived shortly after. We met Amy in our birthing class – she was assisting as a doula in training and ours would be her first birth.

Ammon, Amy and the nurse (name?) began supporting Laura in her increasingly frequent and intense contractions. We labored all over – walking the halls, on the walls, on the bed, on the ball, hand and knees, and in the jacuzzi tub – continuously seeking more comfortable positions. Laura vomited once at around 5am. (It’s worth mentioning that Laura was not watching the clock and had lost all sense of time and its significance – these times are from Ammon’s expert mental note taking).

Hsiu-Li checked in at 7am as our nurse support was changing. Hsiu-Li examined Laura and determined she was at 3cm and that the baby was still posterior (also known as “back labor”). Our new nurse, Patty, immediately began helping and recommending positions for both comfort and for turning the baby. Both Patty and Amy were tremendous help as the labor become more painful. At around 12pm Laura was diagnosed with having birth-related sciatica, which added an additional layer of intense pain to an already long active labor. The pain was too much to deal with since the pressure that relieved labor pains aggravated the sciatica. And the pain did not let up between contractions because of the back labor. We decided to use Nubain, a painkiller to help with pain management and relaxation.

The Nubain helped a little by relaxing Laura, but the pain level was still through the roof and it seemed the contractions were slowing down because her body and muscles were fatigued, and because the baby was not only posterior, but was presenting her head at a slight angle. Laura labored on her knees leaning over the birth ball for hours, creating space for the baby to turn. At 4pm Hsiu-Li returned and re-examined Laura. The good news was that the baby had successfully turned and was now anterior! Laura was between 4-5cm dilated and having contractions between 6 – 10 minutes apart – somewhat disappointing after 14 hours of intense laboring. For a number of reasons, Hsiu-Li made the suggestion to administer Pitocin. We knew that Pitocin could make the contractions very intense and the thought of that with Laura’s sciatica and back labor was difficult to imagine. So with the blessing of Hsiu-Li and our nurse Patty, we made the decision to have an epidural as well.

As soon as the epidural was administered, at around 5pm, the mood of the room completely changed. Patty dimmed the lights and suggested we all rest while the contractions did their job. Hsiu-Li frequently came in to check the progress and ramp up the Pitocin – apparently Laura was less responsive than most because her muscles were exhausted. Resting with the epidural helped her gain strength for pushing and relieved the hip pain completely. As we got closer to the complete 10cm dilation, the feeling of the room began to shift – new carts full of baby catching tools arrived. We also got a new nurse – we were sad to say goodbye to Patty after 12 hours of amazing and continuous support.

When the pushing began Hsiu-Li employed Amy, Ammon and the new nurse to add acupressure and physical support. Ammon pressed on Laura’s neck and held the bottom of her right foot. The nurse mirrored Ammon while Amy held a pressure point on the thigh. The bed was tilted back to employ gravity in helping help change the angle of the baby’s head, while Laura pulled back on her legs and curled forward, a reclined squat to open up the pelvis. We waited to push during contractions, which were not coming fast enough for Hsiu-Li at about 6 minutes (although some were clustered), and we all worked as Laura pushed. Pushing progressed slowly in part because our baby had her hand on the side of her face and part because her head was cocked a little sideways. Laura pushed in total for about 1.5 hours before the head came through – the last pushes without any contractions. We asked for a mirror to be positioned so Laura could see the birth and witnessed the head as it came out, which was unbelievably awesome. After that it was one final push and the rest was out. Laura and Ammon reached down to catch the baby together and pulled her on to Laura’s chest at 9:06pm. Ammon cut the cord. Good news – Laura did not tear.

Since there was some meconium in the fluids, the baby was taken to an exam table next to Laura and checked to make sure she had not ingested any of it. After about 2 minutes, she was returned to Laura’s chest where they continued to bond. Baby Oona was alert and curious with eyes wide open looking directly at Ammon and Laura. She quickly found her way to Laura’s breast and began her first meal. We waited an hour and a half before allowing the hospital staff to clean and weigh Oona – 7 pounds, 15 ounces & 22 inches long.

After the placenta was birthed, blood continued to flow from inside Laura – some sort of excessive bleeding from the uterus. A doctor was called in to help stop the bleeding, which seemed to be non-threatening and easily remedied, except Laura lost a liter of blood and was became somewhat anemic (looking a little yellow for a few days). We stayed at the hospital for two nights to rest, recuperate and bond with Oona.

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Ending Thoughts

We went into the birth hoping for a natural birth with no drugs or interventions. One of the things we learned in a birthing class was that we should try not to have expectations and that the most important thing is a healthy baby and healthy mom. Our fear was that interventions could cascade into addition interventions and complications – ultimately leading to the cesarean section and issues with the baby. We realized from this experience that some of these interventions were perfect tools for moving us toward our ultimate goal, used thoughtfully and at the right time for our needs. We also realized that without our hard work in the 13 hours of laboring at Alta Bates, we would not have been able to turn the baby which would have led to complications.

In the end, being well informed helped us understand the risks and benefits of certain decisions, but being open to using these interventions when they were needed, with the help of an extremely supportive and experienced support staff, led to a successful and healthy birth – both for the baby and mama. We are very grateful for all of the support we received and continue to receive and we are very in love with this little being, Oona.