Ian's Birth Story (Warning: Graphic)

After Natalie and Rachel's births, I didn't quite know what to expect for Ian's birth. I thought he might arrive a little earlier than Rachel did (2 days before her due date), and labor might turn the corner quickly as it did with her (~1 hour active labor before she was out).

Starting at around 37 weeks, I had several rounds of very real-feeling contractions. The first time this happened and it seemed to feel stronger than Braxton-Hicks and not go away quickly, I took it seriously. We called my mom out from Dripping Springs to watch the girls, and I notified a couple of neighbors and friends to be on stand-by in case the girls needed supervision before my mom could arrive. Five hours later, labor fizzled out.

Over the next few weeks, I had several more rounds of labor-like contractions, whose only distinction from the real thing was that they didn't get organized in terms of length and spacing, and didn't gradually get stronger. It made for a really exhausting last month of pregnancy.

Then my due date, July 5th, came and went. I tried lots of walking, a round of acupuncture, various foods, sex, massage, yoga to try to get things going. The contractions often came at night, often at around 11PM, which made for terrible insomnia. I was feeling very depleted. During that 40th week, I made a concerted effort to back off and rest while I could.

On Saturday, July 12, I had strong contractions for a couple of hours during the early morning, then things slowed down to contractions every 10 to 15 minutes... ALL day. I was so tired and cranky. At the end of the day, I texted the on-call midwife at the birthing center to ask her what I could do to get to sleep in spite of the contractions. She told me to have a glass of wine (that it would not hurt the baby at this point), and a warm bath, and go to bed. I took her advice, and fell asleep by about 10PM.

At 1AM I woke up with a strong contraction. 10 minutes passed, another contraction. 8 minutes, another. I was so tired of timing contractions, and so hoping this was the real thing, I went ahead and texted the on-call midwife to ask if I should come in. 4 more minutes, another contraction. I texted that info to her, and she replied, "I'll meet you there." Called my mom and a neighbor to come stay with the girls until my mom could get there. I went to get Rob out of bed.

"What the fuck?!" he stammered as he sprung out of bed, confused and on high alert. He hadn't been asleep long, and I'd caught him in a moment in which his natural reaction was fight-or-flight. We laughed about this later. His mind must have been worlds away from my waking him because I was in labor and ready to go to the birthing center.

My neighbor graciously drove me in our Pilot to the birthing center--the little suitcase was already packed and waiting in the hatch. I had a contraction before we left and another right when we arrived. We settled into the Barcelona Room, which was formerly the Santa Fe Room, where I delivered Rachel. Cool! I was excited and really hoping this was the real thing.

Then the contractions slowed down to 10 minutes apart, then limped along at 8 minutes for a while, not seeming to go anywhere. I was dilated 4cm. Roswitha, the midwife, said we'd wait a bit longer and see, but that at 8 minutes apart, she might have to send me back home. I pretty much told my body, inwardly, that I wasn't going to stand for that. I got out of the bed to try to encourage the contractions by walking around. It worked. Things picked up to 5 minutes apart. Then in maybe another hour, they ramped up to 2-3 minutes apart, long and hard. I could feel myself going inward, unable to communicate much with the people in the room (Rob, Cat and occasionally Roswitha. Cat is a midwife in training/birthing assistant.) Things were getting really painful now, and I knew I was progressing. They reminded me to "breathe down" the contractions. I went into the low, gutteral moaning mode. It's weird how you forget these phases until you're in them again. I labored against a chair for what felt like I long time. I tried hands and knees, but it felt like too much work. I started dry-heaving at the end of every contraction, so I was often hovering over the trash can by the end of one. Somehow, I never vomited.

The next time Cat checked me, I was 6cm dilated. I had been asking to get in the tub, which she had advised waiting to do until labor was further along, lest I accidentally slowed things down. The tub seemed like my only possible relief as the recovery period between contractions was starting to feel non-existent. At 6cm, I got in the tub.

I labored on my back, sitting in the water, bracing my hands and feet against bars on the tub, for what felt like a long time. My back was killing me, but I didn't feel like I had the energy to labor in a more active position. I was shaking, making lots of gutteral noises, and starting to grunt--signs of moving into the transition phase, I think, because Roswitha was called in at this point. She checked me--9cm, and just a cervical lip and the bag of amniotic fluid was holding the baby back. I thought surely this was the light at the end of the tunnel. I tried to push through the next several contractions. I would reach the peak of a contraction, start to feel it taper off and immediately start heaving and shaking. I was really exhausted, and getting scared that I wasn't pushing out a baby yet. Ros tried to break my water, and remarked that I have very thick membranes. (A good thing, since I was Group B Strep positive--broken water early in labor would have meant a higher exposure risk for the baby.) Then she noticed something.

"He's turned, OP." She stated. "Move to your hands and knees and we'll try to turn him." My heart sank. OP means face-up. Natalie had been OP, and that had made labor longer and harder. I knew it was possible to deliver a baby OP, but not nearly as easy as a baby turned face-down. With lots of help, I turned over to my hands and knees for the next contraction. The next 10 or so contractions were probably the worst pain I have ever felt in my life, with next to no recovery in between. I was shaking, begging God to help me, all the while feeling the intense muscular effort that I knew I could do nothing to slow or stop. There was no way out except to keep going, even when I felt like I had already exhausted my last energy stores. I prayed for something to change.

"Can I get out of the tub?" I asked. "Of course," Cat and Ros answered, "changing positions might help" (or something like that--the exact words escape me.) I had another awful contraction when I climbed out of the tub, then they raced me to the bed for the next one, on my hands and knees. My water finally broke, like a dam gushing all over the bed. I'm sure I soaked all the pads and such they had put down. They helped me to my side, and checked me again. I was fully dilated. At this point I was still shaking, and grateful to stop trying to get the baby to turn and just focus all my last fumes of energy on pushing. I felt like I might just die mid-push, I was so exhausted. All 3 of them helped--2 grabbing each leg, 1 grabbing the other end of the ski rope that I was clutching, and coached me into the right head-tucked position to push the baby out. I tried one on side, maybe 5 sets of pushes (4-5 pushes per contraction, I think). They helped me flip to the other side, and repeated the pushes. If they weren't such enthusiastic coaches, I don't know how I would have kept going. Finally they had me push on my back, and he started crowning. Roswitha had me reach down to touch baby's head--squishy and covered in hair. Finally, I was truly at the end! Several more pushes, long then short, and he was finally out, warm and slippery on my belly. I collapsed back onto the bed, just clutching him in my arms, waiting to deliver the placenta. They waited until the cord stopped pulsing--which seemed to take a while--then had Rob cut it.

It took a while for the placenta to come out, and for the bleeding to taper off. Looking back on it now, I think my body was so exhausted, it was resting before making my uterus contract again. Once Cat gave me a shot of Pitocin, the bleeding slowed down to an acceptable level.

As had been the case with Rachel, Ian took a long time to calm down enough to latch on and nurse. I guess he had a lot to say about his labor, too. Once he latched on, he decided that was the thing to do for the rest of the day. He did finally go to sleep at one point. I tried to sleep, too, and I did manage to rest. Rob brought Tacodeli breakfast tacos. My mom came up and met Ian, then came back with the girls so that they could meet him later. I was running on fumes, but it was a special and heartwarming day. Ros and Cat stayed probably 2 hours after their shifts ended, making sure everything was going well with Ian and me before they left. Kim (midwife) and Carol (nurse) took over, and took good care of me as they got us through the paperwork and prepared us to go home. Rob came back, we packed up, and took Ian home at around 2PM.

Physically, this was my hardest labor out of the three I've experienced. Emotionally, I'd say Natalie's was the hardest, since it was my first and I was out of control of the process (unwanted induction). Ian has been the sleepiest of my three babies, which has been a godsend, because I don't know how Rob and I would have the energy to help all three kids if Ian wasn't a good sleeper. We'd have to hire someone, probably for overnight help. Thankfully, I've slept better since he was born than I did in the entire month leading up to his birth.

When I look back, I'm amazed that I delivered a 9-lb baby, who was facing the wrong way in the birth canal, with no drugs or interventions. Had someone offered me a C-section near the end, had it really been an option, I would have taken it gratefully. As it is, I'm grateful that Roswitha and Cat had the wisdom and patience to know that as long as everything was fine with the baby, I could find the strength to push him out. I didn't even tear, which is an improvement on the previous two labors. I'm immensely grateful for another healthy, vigorous baby, and excited to get to know him as he grows up.

Why breastfeeding sucks right now, but will be completely worth it later.

I'm now breastfeeding my third child, which might make you think I'm some sort of instant pro at it. You might be thinking, "how hard could it be?" Unless of course, you've tried it. Then you might be thinking, "well she must be good at it, " or "she must have babies who nurse well."

I'm here to tell you that whenever the experts (doctors, lactation consultants, La Leche League literature) say "it shouldn't hurt," that's really a half-truth at best. What they should tell you is that it will very likely involve some soreness, possibly some real pain in the beginning, but that the soreness won't last forever and there are remedies to get you through it. And it's worth it to get through it.

Because for me, the first week ALWAYS hurts. It always involves soreness, no matter how fantastically baby latches on for the first time or the first ten times. Yes, it's important to pay attention to positioning and make sure your baby latches on as well as possible. But that's NOT going to prevent you from having any pain whatsoever. Here's how I know this: even pumping hurts for me in the first week. A pump really can't have a bad latch unless you've fallen asleep and let the thing slide off your nipple and onto bare skin (this happened to a friend--ouch!) But a pump will suck on you, and if your hormones make you engorged and extra sensitive in the nipple region, this sucking is going to hurt, at least mildly and temporarily.

Pumping aside, my babies have ferociously strong sucking instincts, especially in those early colostrum-only days. You know, approximately days 1-3, when your easy-flowing milk isn't there yet. Rob was complaining that his pinky hurt after newborn Rachel and Ian sucked on it. Think about the nerve endings in your pinky, and multiply that by about 20, then again by the 12-16x a day they want to nurse. Ouch.

Then add engorgement to the mix. Day 2 or 3 for me. Those soft breasts turn hot, hard and angry. In my case, they don't seem to want to give up all that milk right away, either. The bumpy, hard nipple/areola is harder for baby to get and keep a good latch on. Fortunately there are some remedies for this, too.

By Day 5 or so, things can soften and calm down to the point where it feels like the worst damage is over, the healing is beginning, and I don't need to marshal so many remedies and preventive measures to get through each feeding. By next month, Ian might be able to latch himself on properly in the dark, as Rachel did by that age. Until then, if I diligently position him well and do just a few things to make for a better latch, we'll keep on trucking and I can be reasonably confident that the worst is well over.

The good news is that after the first month or so, you and baby will have learned each other and the process so well, that you hit payoff mode, where things get good and start to get better and better.

Payoff:

• Baby's digestive system will be happier with breastmilk than formula, resulting in fewer blowouts, less gas and stomach/GI pain. (We switched to formula at 8 months with Natalie and holy moly, the blowouts!) Less need to burp.
• Breastmilk is a natural sedative for baby at night, and the hormones are a natural sedative for you. Result: You both get back to sleep faster than you would otherwise.
• Breastmilk is free (after the initial month's investment, getting over the pain), and always available at the right temperature. No storage/contamination concerns.
• You will lose weight effortlessly, or be able to eat whatever you want without gaining weight.
• Nursing is the best tantrum tamer, if you make it into the toddler years. This is the single biggest reason why I nursed Rachel until age 2-1/2.
• Those cluster feedings that drive you crazy and keep you and baby tethered to each other during the first month? They go away shortly after that, unless baby is sick or something. The feedings gradually space themselves further and further apart. 
• Baby gets more efficient at nursing. What used to take 20 minutes will soon take 5. Yeah!
• Nursing babies rarely, if ever, get constipated. Having gone through constipation with Natalie--believe me, it's best avoided if possible.
• Built-in bonding.
• Possibly fewer ear infections and illnesses. Knocking on wood here, but so far none of my kids has had an ear infection. Ever.

Here's an overview of what I've learned or remembered this time:

Engorgement:

• Dry heat really is your friend. Heat up a rice sock or heating pad and hold it against the engorged flesh of your breast. Not your nipple--I bet that would hurt. Do this for a minute or two prior to starting the feeding, and massage the breast tissue (gently) to help open up those milk ducts.
• Pumping is your enemy when you're engorged. Use it only as a last resort to relieve engorgement, because it tends to backfire--you'll be just as engorged or worse in an hour or two.
• This came from a lactation consultant, and I wish I knew about it earlier! Prior to latching the baby on, surround your nipple with your fingertips, push back against the areola toward the chest wall, then gently pull the nipple out to extend it. This momentarily softens the areola and lengthens the nipple, which makes it easier for the baby to correctly latch on (and stay on).
• Don't be afraid to nurse frequently, but do feel free to cut your baby off it's just dragging on too long and you're hurting. Switch sides, if nothing else. This will give you and your baby and chance to practice that pinky-unlock thing you have to do to get them unlatched if they're not letting go.
• Ibuprofen might be your friend, too. It's anti-inflammatory, which might help somewhat with the engorgement. It helped me.

Nipple soreness:

• Have your baby nurse on the less sore side first, because he/she is going to suck harder at the beginning of the feeding. When you switch sides, the suck should be less intense, giving your more damaged nipple more of a chance to heal.
• Use lanolin--apply after each feeding and before covering up your nipples, so that they don't scab and get stuck to the inside of your bra.
• Those soothing gel pads are only helpful for maybe 24 hours. I used mine too long, found that they started adding to the pain, then promptly threw them in the trash, and have felt better ever since.

Getting a good latch:

• Feed in a quiet, reasonably well-lit room in the beginning. Kids barging in or a too-dark room can make for accidental bad latches.
• Don't re-latch your baby 5-10 times trying to get the perfect latch. It will hurt worst in the first 15-30 seconds of the feed, then ease up (to hurting less or not at all) after that. If it's really a bad latch, it will hurt too much for you to continue beyond 15-30 seconds.
• Those little baby arms and hands are going to get in the way at first. Experiment with swaddling to wrap the arms down, but if that results in more frustration for your baby (and ultimately, you), unwrap the arms and do your best to patiently work with your baby until he/she understands that the hands have to be out of the way in order to nurse. I find myself saying, "arms down" to remind Ian of this, though that's probably more for my memory than his.
• The asymmetrical latch works well--just don't forget to line up baby's belly against yours and cradle the base of his/her neck with your hand properly before attempting to latch on. This positioning really helps.
• Cross-cradle hold is the easiest one to get right at first. It puts you more in control of your baby. It's not so friendly on your back, in my experience, but you can work on easing things up on our back after your nipples are okay. Take your time working up to side-lying or cradle hold. Football hold works best in armless chairs (or in the middle of a couch.) But it's not my forte, so I'll just list it as another option.