The Story

It's been a week. Here it is. 

THE STORY

After a good night’s sleep in anticipation for a long, drawn out induction and labor process, we received a call from the hospital at around 0800 that it was time to come in and get things started.  Of course, Megan wanted to get in one last good walk in prior to her hospital confinement, (and this is even after getting in 17,000 steps the day prior) so we parked in a nearby neighborhood and enjoyed a pleasant walk to the hospital.

We checked in at the 11th floor of women’s pavilion and were directed to our room on the 9th floor (beautiful view by the way), in which we understood we would be staying for a long time to come. After getting situated and having vitals conducted, Megan had the hep-lock inserted into her hand. Of course, Megan being afraid of needles, this was a sour moment to begin with. It was amplified not only by a miss on the first attempt, but the needle seemed to even twist and push the vein, dramatically causing Megan to stop breathing and freak out a little, further causing a significant dip in Autumn’s heart rate. This ultimately resulted in Autumn’s first emergency quick reaction force experience.  Nurses and doctors flooded the room and supplied Megan with oxygen and IV to assist Megan and baby Autumn. Although the quick response is appreciated, initially it was a little intimidating, so we slowed down the team and made them explain to us what was going on and why Megan was being given IV and oxygen, but afterwards it made sense and all worked out well. 

We met with Dr. Ivey at around 1245, at which point he explained our options, and after his recommendation and some discussion we decided to go with the cervidil. Cervidil allowed for us to see if the medication would be effective, but also have the option to remove it if complications were to begin. (Which was great foresight, as you’ll understand later.) Megan’s first preference was to try the foley balloon, but Dr. Ivey suggested using it to open Megan’s cervix after the cervidil began her contractions, since the balloon opens but doesn’t drive contractions.

At around 1330 the cervidil was inserted. Unfortunately, here Megan experienced another unpleasant medical ‘redo’. Inserting the cervidil seemed like such a painful process that it even made me squeamish, but it’s really important to get it placed right behind the cervix. Unfortunately, upon first placement, the string attached to the cervidil got caught on his finger, accidentally pulling it out and resulting in Megan having to endure it a second time. But in the end, it was inserted, and it worked extremely well. Maybe even too well. What’s important to understand, however, is that we expected Dr. Ivey to insert the foley sometime the following morning. What we definitely weren’t expecting is that 7 hours and 15 minutes later Autumn would be joining us in this world.  

At around 1430 contractions began coming pretty regularly. Over the past few weeks Megan was having ‘Braxton Hicks’ contractions, noticed not because she felt them, but because we noticed them on the weekly fetal non-stress tests. Every once in a while she’d feel some tightening, and I could even feel the tightening putting my hand on her stomach, but even these only lasted maybe 15-20 seconds. However, the contractions on the afternoon of 06 September turned out to be quite different. 

So here I think I should explain that Megan wanted to have a natural birth, and therefore spent the last 3 months preparing by studying a method called ‘Hypnobirthing’. Sounds a little, strange, so let me explain. First, let me admit that I was at first ‘skeptical.’ When I hear the word ‘hypno’, it brings me back to a college experience in which a hypnotist hypnotized about 8 college students on stage and made them do extremely weird and embarrassing things on stage. To this day, there’s still skepticism as to whether students were faking or truly hypnotized. To be clear, ‘hypnobirthing’ is NOT that. For those that have heard the phrase ‘mind over body’, that’s what the concept really comes down to. The purpose of hypnobirthing is to educate people that the birthing process does not have to be the excruciating, painful, terrible experience that so many have made it out to be. According to the philosophy, the reason we have that connotation is due to society gradually rescripting the birthing experience over time, which we won’t get into right now. Ultimately, what it did for us is empower Megan to confidently assume control over the birthing process, armed with both mental and physical tools and techniques to control her birthing experience. 

Unfortunately, as those following this blog understand, Megan had to alter her birthing plan due to baby Autumn’s medical circumstances. Which brings us back to 06 September at Children’s Hospital in Houston, Texas, after Megan had been induced with cervidil against her initial desires, but for the good of baby Autumn and her heart condition. Did hypnobirthing work? My answer is both ‘yes’ and ‘no’. No, because the experience was not the calm, relaxed birth that we had seen various hypnobirthing mothers experience. Yes, because Megan had a fast, insanely intense reaction to the induction by cervidil, and was incredible at handling the pain and intensity of the experience. I know and believe in Megan’s mental toughness and resilience more than anyone, but even I absolutely in disbelief by her resolve to get through the extremely challenging and intense experience of the evening. 

So to continue the story, at around 1430 contractions began occurring at a rate of about one contraction every 5 minutes, lasting about 30-45 seconds, with what Megan would describe as medium intensity and would gradually increase in speed and intensity for next 5 1/2 hours. There are pictures and videos of this phase, in which Megan is handling the contractions extremely well and practicing some awesome hypnobirthing techniques. She went back and forth between the bed and the yoga ball. The team (Brian, Mary Anne, Amanda, and Lisa) came in to support Megan during that time, and things were going well. However, come about 1830, things got intense. Really intense.

Now, a key element to this story is the presence of Robin, arriving at about 1800, an exceptional Doula. For those of you wondering what a Doula is and does, I had the same questions. And after this experience, I strongly think that everyone should consider hiring a Doula. We had a very hands on approach to Megan’s natural birth, applying counter pressure and relaxation massage techniques non-stop throughout the birthing process. Let me tell you, on top of being emotionally exhausting, it is definitely physically exhausting as well. Not only did Robin bring various methods for counter pressure to assist Megan, but also assessed and assisted little Autumn down the birth canal throughout the pregnancy, ensured Autumn was awake and working with Megan during contractions, and was an amazing source of information before, during and after the process.  

Now, of course, most labor stories I’ve heard are intense and mention the unimaginable pains of childbirth. However, it’s difficult to come by an experience with contractions that are 60-90 seconds, 6-8 in a row, extremely intense, followed by a 15 second break (at most) before going at it again, all lasting from 1830-1945. Now, if you look at the ‘side effects’ of cervidil online, it reads the following: 

What are the most common side effects of CERVIDIL?

The most common side effects associated with the administration of CERVIDIL are contractions occurring at a rate faster than normal (tachysystole) and signs that the baby is exhausted or in distress (uterine hyperstimulation). In clinical trials, these effects occurred alone or together in less than 1 in 20 women who were given CERVIDIL.

Well, it looks like Megan was in that 5% of women that have the tachysystole effect with cervidil. I make this point not to scare anyone about cervidil, nor complain about Megan being administered the drug. In fact, Dr. Ivey was in the room monitoring Megan when she went into intense contractions, and removed the cervidil after deciding that her contractions were becoming too frequent and too close in such a short time period, and were putting Autumn at risk her heart condition. But I do make this point to hopefully capture the unfathomable intensity of the situation, and to highlight that Megan got through it like a freakin’ champion. In addition, Megan gave up the comfort provided  by the yoga ball due to the stress it put on Autumn’s heart to be in that position (the fetal monitors were good to assess Autumn’s heart stress, but also stimulated a steady flow of concern for Autumn throughout the process), and instead endured labor laying on her left and right sides. Granted, Megan will downplay this whole experience, but that’s just Megan. DO NOT let her fool you. She was and is nothing short of incredible. 

At about 1945 the contractions were just so intense and frequent with about 5-10 second breaks in-between, that we had to do something to slow them back down. (And gentlemen, as I’m sure some of you know from experience, it's the most powerless and helpless I’ve ever felt. I was strongly, strongly tempted to convince Megan to just take the epidural and stop the pain so many times.) Eventually I asked the nurse if there were any non-epidural options for pain relief, and she suggested something called ‘Nubain’. She mentioned that it would work immediately, but it may cause some grogginess, it would only take a slight edge off of the intensity, it would only last 30 minutes at most, and she could only receive it once every hour. Not the most promising sounding pain relief, but we went with it. 

After about two more intense sets of contractions it started working. I could tell because Megan’s breathing improved, and the contractions actually began to space out to about 2-3 minutes in between. She described the contractions as feeling more like waves (the preferred term used for hypnobirthing) of intensity, and that the breaks in between made them much more manageable, but the feeling was still very intense at the top of each wave. However, the breaks in-between made them much more manageable. This lasted for about what the nurse said it would, roughly 30 minutes. However, I don’t think Megan was aware of how long it was supposed to last, so at 2030 didn’t tell her, hoping she could just make it through the next 30 minutes to 2100. What’d we’d very soon find it, is she wouldn’t have to. 

Then we had a strange moment. Though in some serious pain, Megan just suddenly got out of bed and headed for the bathroom, pulling IV machine, cords and all. The nurse and I scrambled to keep up with her and untangle her form her cords on her way to the bathroom, but Megan was fully determined to get to the bathroom. After a short calm between storms in the bathroom, on came two really intense contractions (and two really hard hand squeezes!), followed by Megan calmly stating “I’m pretty sure that was my mucous plug.” Curious, I checked it out, and thought “ahh, yup. So that’s what a mucous plug looks like…” Anyway, she came out of the bathroom, laid back on the bed, and started saying that the pressure extremely intense and wouldn’t let up.

So at about 2040, Our Doula, Robin, pointed out that the mucous plug was definitely gone and that Megan may be crowning. I checked it out, and saw a head! It was incredible! I started yelling at Megan, “Megan! You made it! We’re at the finish line! You’ve got this! You’ve got this! You’ve got this!” I quickly picked up my phone and dialed Mary Anne, yelling into the phone “The baby here! I see her head! The baby here!” Meanwhile, Mary Anne, who was with the rest of the team at Chipotle, made a mad dash out of the restaurant and headed right for the hospital, with team in full stride behind her. Back in the hospital, the Nurse yelled “OMG! I can’t believe it, she’s already dilated!” And hit the button on the wall for the medical quick reaction force to again come into the room and assist Megan through the delivery. 

So to quickly backtrack, part of the irony was that Dr. Ivey had left about an hour earlier, stating “She’s only two cm dilated, about 90% effaced. I should be able to be back by the time she delivers, but Meg, just do me a favor and don’t deliver at 2100.” Well, go figure. And Megan was so controlled about managing her pain, never screamed or yelled, and the nurse couldn’t believe that she was already 10 cm dilated when it happened. And in addition, to really understand the situation, you have to realize that due to the assumptions of the medical professionals, Megan thought she was going to have to endure this insanity for the next 12 hours until morning. Fortunately, that was not that case at all.

Dr. Brandon Lang, the senior resident on call, controlled the situation really well, and Megan used her hypnobirthing breathing techniques to ‘breath’ the baby out as opposed to push her out, and after two breaths I looked down, and Autumn’s little head was out looking right at us! I yelled “Megan! Look! There she is! She’s here!” Megan responded “This. Really. Hurts.” Robin reassured her, “It’s OK Meg, that’s your perineum stretching, you’re really close, you’re almost there.” And then, Autumn was here! For a brief moment she was able to lay on Megan's chest, adn then was quickly rushed over to the crash cart.

She came out a little grayish blue due to her heart condition, and didn’t cry at first. Her initial Apgar score was I believe a 1. Then, after some great work by a team of about 6 doctors around her little table, Megan and I suddenly heard little Autumn’s first scream. Megan put on an exhausted smile of relief, continually asking “Andre, is she ok? Is she ok? I want to hold her before she goes to the NICU.” Thanks be to God, little Autumn was OK, and Megan was even able to hold her for about 20 seconds before she was rushed to the NICU.

Well, I think this story is long enough. In my opinion, the induction via Cervidil had huge effects on Megan’s very intense birthing experience. Then again, Megan also went to a chiropractor, had an induction acupuncture, and had an induction massage prior to her medicinal induction.  Did hypnobirthing work? The birth was not a hypnobirth experience, but I think the techniques were effective in helping Megan maintain her composure and in control throughout such an intense experience. Bottom line, the experience blew my mind. Megan is the toughest, most resilient person I know. Hands down. And Autumn, if you’re reading these words one day, I hope you can gather from this story how awesome your birth story was, and how incredible your mother was in bringing you into his world.