THE HATCHING OF SILAS (Long Version)

Background

Babies are neat. Kids are neat. In particular, based on a sample size of one (Russell Loren Parsons, born 12/21/99), David and I concluded OUR kids are neat, and now that we had already managed to have the cutest baby in the whole wide world, why not do it again?

So we were very pleased to realize (just in time for David's birthday) that another baby was on the way, due April 12, 2002. We were less pleased to contemplate what lay in between that time and baby arrival time, namely, swell-up-like-a-toad-and-cry-and-puke-frequently time, a.k.a. pregnancy, but we didn't have any better ideas... and really, first and second trimesters turned out to be not as bad as I was expecting (much better than with Russell). Somehow then we experienced a time warp for January through March, which took approximately four years to get through (with a different cold virus for the family every week), but finally it was April... baby month!

By April, the baby was (we presumed) pretty much cooked; we felt reasonably good about how we'd prepared Russell for the birth; our bags were packed; I was thoroughly sick of being pregnant; and we kind of looked forward to the birth experience, so we felt ready to go ahead and have this baby. Also, my blood pressure started to rise (as it had with Russell in the last trimester), which put me at risk of needing various medications and/or interventions I didn't want if it got any worse. Russell started saying, "Tiny baby, get out!", and I thought that summed up my point of view pretty well too.

Aside from some worries about the blood pressure problems, I felt really good about our odds of having a great birth experience with this baby. Our plan for this birth was very similar to the one we had for Russell's birth, which we were very happy with. We were excited to be able to hire the same doula (labor assistant), Ginny Potter, who was invaluable during Russell's birth, for physical and mental support and practical advice on position changes and labor coping techniques that helped us manage to have the unmedicated birth we wanted for the baby and me. We were also glad to have the same doctor, Dr. Callahan of Portland Family Practice, who has been the doctor to the whole family since 1996 and who delivered Russell. We knew from our previous experiences with him that he is a good listener who respects his patients' points of view and is realistic and open about the advantages and disadvantages of various medical options. The hospital, Providence Portland Medical Center, was the same place we had Russell, too; the nurses and facilities there were great and we had felt supported and even pampered (so to speak) as new parents.

We were also incredibly lucky (and relieved) to have David's parents, Metta and Roger, in town (they moved here from Wisconsin in 1999) and willing to take care of Russell while we were in the hospital having his little brother or sister (we had chosen not to know which). He had never actually spent the night away from David and me, so we were all a little nervous about that, but he adores Grandma and Grandpa, so we knew it would work out somehow.

The Big Day Arrives

On Saturday, April 6, six days before my due date, I woke up at 8 a.m. and realized I was having contractions. I wasn't all that shocked, since I had had some "bloody show" the night before. (If you don't know what that is, you probably don't want to know, but I'm including details for birth story junkies.) I was pleasantly surprised, though, to find out I could function more or less normally through the contractions: with Russell, even my first contractions had been painful enough that I couldn't get anything done while they were going on. Having an early labor stage was really cool, because it gave me a chance to organize last-minute things and be excited without yet being too overwhelmed by labor. I also could not believe how lucky I was to go into labor at 8 a.m., after everyone involved had had a decent night's sleep but before much of the day had passed.

I woke up David and told him happily that things were progressing and I thought it was likely this would be the day, showered, brushed my teeth, got David to download a Palm Pilot program to time contractions (no, I'm not joking!), and started packing some last-minute things. David called his parents to say that we might be calling them soon for the Real Deal, but that we weren't sure yet; fifteen minutes later, we realized the poor people were going to be on tenterhooks all morning regardless, so they may as well come over, and they arrived six minutes after he called to tell them that! Luckily for us, Russell slept late, so we woke him about 9.

I made a bunch of phone calls as the contractions gradually got more intense. They had been 3-5 minutes apart the whole time, but only 30 seconds long, and now they were 45-60 seconds long and stronger. By the usual labor standards, this pattern didn't yet qualify for heading off to the hospital, but one of my few worries about labor and birth was that this birth might go very fast, and I was delighted to get the chance to go in before things had advanced too far. So I spoke with Ginny (our doula) and her backup doula a few times, because Ginny was teaching a class that day and we needed to figure out if and how and when she could make it, and I also called the doctor's office and the hospital. Both Ginny and the hospital nurse suggested that perhaps I should still labor at home a while longer, but I just told them that we were going in and if they thought it wasn't real labor when I got there, we'd burn that bridge when we came to it (to use David's expression). We found out later that Ginny concluded that "the mom always knows" (at least, the second time!) and, rather than waiting to find out what happened next, she scrambled to get her replacement teacher set up so she could take off for the hospital.

At 10 a.m., Russell, David, and I piled into Metta and Roger's car and we set off for the hospital. I had a few contractions on the way, but they were manageable with some concentration and deep breathing, so mostly I had time and energy to be happy things had started off so well and that we were all together. I was so glad to get a last chance to talk to Russell about how David and I were going to the hospital to have the tiny baby (probably!) and how he was going to go have fun with Grandma and Grandpa. He seemed pretty cheerful, which was a big relief. Everything outside looked bright and fresh and colorful in the beautiful spring weather. April is a good time to have a baby.

Monitors and Needles

As soon as David and I got out of the car and started walking through the hospital, my contractions started getting more intense, although in between them, I felt fine. I would just stop and sway and breathe through them when they hit, then keep trudging along, feeling pretty calm and happy now that we were safely there. We got on the elevator and a guy on there asked me, "Are you in labor?" I nodded, and he added, "Good thing you came in before they were five minutes apart!" I suppose I didn't really look like I was in REAL labor or something. I stopped about 20 feet short of the nurses' station at the maternity ward to handle the next contraction, so David scooted up and told them who I was, and we headed off to our room, where we would spend the next day or two if they didn't send me home. It was amusing to be able to answer the question, "What's been going on with your contractions?" by handing over the Palm-Pilot-entered history. Ginny arrived around this time, and was enchanted with the contraction timer, which she downloaded to her Palm Pilot sometime within the next few hours. To cement our status as technogeeks, the next thing we did in the room was to check the CD player (it didn't work; the nurse nicely rushed off for another one, which did).

The next hour and a half was not agonizing, but it sure was tedious. I wanted to focus on handling labor, but a bunch of paperwork and preventative medical work (none of which ended up making a damn bit of difference, fortunately) kept getting in the way. First, Karla, the nurse, wanted to get some baseline readings of the baby's heartbeat and my blood pressure, which is pretty standard. They use an external fetal monitor to do this, and it's not that bad: the mom gets a sort of belt put around her middle and must lie fairly still for the monitoring period, which is about 20-30 minutes for the initial reading. I think they usually try to monitor for another 15 minutes every hour or so during labor. Anyway, the baby's heartbeat was fine, and my blood pressure was 135/97, which was kind of lousy but expected, and not bad enough to require immediate drugs.

Karla also checked my cervix and found it to be 3-4 cm dilated and 90% effaced; the baby was at -2 station. A brief birthing tutorial for those who want it: A cervix must dilate to 10 cm before it is open enough to allow that big head to get pushed through; a very, very rough (and fairly optimistic) rule of thumb is that it might dilate about 1 cm per hour during active labor (fairly hard contractions). Before that, some people begin dilating on the day they give birth, while others could walk around at 3-4 cm for weeks. I don't know which category I was in, because my doctor very sensibly avoids doing an unnecessary measurement that doesn't help predict much of anything.

In any case, my cervix and contractions were judged to be in sufficiently active labor that Karla reassured us we wouldn't be tossed out into the lobby, but would instead get to stay and have a baby. She also told us we had checked in to the last empty labor/delivery/recovery room at the hospital! Yikes. (Kind of surprising for a Saturday, really, since the huge number of induced births tend to be during the week.)

I had expected the 20-30 minutes of holding still for monitoring, but then I got some slightly bad news. Karla had not spoken to my doctor, Dr. Callahan, but with another doctor from the same practice who was on call that day to do the OB work, Dr. Susie Bobenreith (I think). We had never met her, but the doctors from that group have all been great so we weren't too worried she'd be awful. However, possibly since she was not my doctor, she wanted to have more things in place to deal with my blood pressure issues than Dr. Callahan had required in a similar situation with Russell. Karla told us she wanted me to have blood drawn for lab work and to have a heparin lock put in, which is basically a needle into an arm vein with a plastic thingy attached so that in an emergency they can hook an IV up immediately to the plastic thingy, rather than having to find the vein at that time.

I knew I was getting off light compared to what some doctors would do, and I don't mind needles, so my only hesitation was that I'd have to stay in the hospital bed while they did this stuff, but I agreed without much protest because it did seem reasonable. It was a frustrating experience, though, with a lot of waiting for various people to do their thing, and people having me get in certain positions or do certain things or answer health insurance or medical questions. The contractions were getting harder to handle, and I had to moan through them; at one point, fortunately not with a needle going in, I had to vomit for a few minutes. As each contraction came, I would ask them if they could wait till it was over, and they always did, very politely, for which I am grateful!

The contractions seemed much lower and more painful than they were at a corresponding stage with Russell. I told David that, and added that I didn't know if I could keep managing to go without drugs, and he said the right thing, that they'd been very hard with Russell too and I could handle it. I chose to believe him at the time, but afterwards, given how the labor ended up going, we figured they really were more painful! I also realized the idea of an epidural was more appealing in some ways this time: I'd already proven I could do an unmedicated birth and had experienced all the physical sensations, and would numbness be such a bad thing?? But knowing I could do it worked for me, too, because I really believed I wasn't going to need the drugs: I just needed to prompt David and Ginny for their verbal reassurance over and over to make myself feel better.

I had imagined that at this stage of labor I would be trying various physical positions, and picturing the same mental images and using the same focal object (a small sculpture by Sheba Grossman) that helped me so much when I was in labor having Russell. Instead, I had to lie (for the fetal monitor) or sit (for the blood work) still on the bed, and there were way too many conversations and distractions to focus mentally. I wasn't angry at anyone in particular, but I did find the situation maddening, and I have to hand it to anyone who can manage an entire unmedicated birth while being restricted like that. The main thing that helped me was looking forward to being released to go to the Jacuzzi down the hall. The other things that helped were David and Ginny's encouragement and massages; our wonderful labor CDs that David and I had made together; the way David would tell me the contraction was easing off (for some reason he could tell this before I could); and letting my frustration out during contractions by growling and beating upon the big rubber birthing ball Ginny had brought and put on the bed for me to lean on as I sat. Poor Karla... I thought at the time that I was fairly verbally restrained and polite about the waiting, especially when she couldn't get the hep lock in, but between the growls and the emphatic repeated statement, "I want to go in the Jacuzzi!", I think she felt kind of guilty.

Finally, about an hour and a half after we'd arrived at the hospital, I was done with being needled and monitored and was cleared for heading off down the hall to the Jacuzzi. Phew!

The Really Exciting Part

So at 11:45 a.m., I staggered out into the hall with David, Ginny, and Karla, barely able to stand when the contractions hit. The Jacuzzi room had a toilet, too, which I sat on while they filled the tub. Karla checked my cervix again at 11:57 to see how I was progressing, and told us I was 5-6 cm. Ginny emphasized how great that was, but I wasn't sure how I felt about it. I was relieved to hear my cervix was indeed dilating, but labor had felt so intense I had thought perhaps it would have dilated more. On the other hand, I was pretty sure Karla wouldn't have let me enter the promised land of hot water if I'd been at 8 cm or something: at that hospital, with those medical personnel, water births are not considered an option.

I would have thought (if I had been capable of it at that point) that Karla, having determined I had 4-5 cm to go, would have relaxed and sauntered off for a much-deserved coffee break, but she must have had some kind of nurse's instinct that this baby was impatient to get on out of there. I could hear her whispering urgently to Ginny to get her RIGHT AWAY if I showed any signs of needing to push; then she charged out to go call Dr. Bobenreith (the on-call doctor from my doctor's practice), I think. She also got a wheelchair (!) to leave outside the Jacuzzi room just in case.

Meanwhile, as I sat on the toilet waiting for the water to fill the tub high enough for me to get in, I had a really massive contraction. I had been trying to keep my voice low (deep, that is, not especially quiet) when I moaned through the contractions, because I remembered that helps in staying as relaxed as possible, while a high shriek helps encourage a panicky, painful reaction from one's body. With this contraction, though, I felt my voice rising in tone uncontrollably. As it faded, I started apologizing to David and Ginny for handling it badly, but they did their labor support thing of assuring me everything I was doing was perfect. (Delivering that line must get monotonous, but it really does help.)

After that big contraction, I more or less fell into the tub. It felt unbelievably good; for the first time in at least an hour, I was actually able to truly relax between the contractions. I had a sudden surge of confidence and energy, and felt that now I was going to be able to really focus on working with my body to give birth. I exclaimed to David and Ginny on how good it felt as I sunk deep into the tub... so deep that David leaned over me and asked gently if I wanted to raise my face out of the water. "No!" I snapped, before realizing inhaling was about to be a problem if I didn't. (He was smart enough to let me draw this conclusion on my own.)

Along came another contraction, but I wasn't scared of it this time; with my labor CD and Jacuzzi I could handle anything! I sang (well, sort of) with the music and could hear Ginny suggesting David sing with me, which struck us both as unthinkable and funny even in labor.

The next contraction, though, felt different... really intense and low in my abdomen. REALLY REALLY low. "Julie, do you feel an urge to push?" asked Ginny. I didn't want to answer, because I was thinking (roughly), "Oh HELL! If I say yes, they're going to make me get out of the Jacuzzi!" But it was so obviously true that I had to admit it.

There followed a huge blur of activity. For the next few minutes, I was too caught up in labor to be aware of who was where doing what, but we pieced it together later. Ginny went dashing down the hall to get Karla, who came rushing back with her, saying she would check my dilation. When Karla came in and saw me going through the next contraction, complete with pushing and moaning, she said, "Forget it! We have to get her out of there!" and started shouting at me, "Julie, you need to get out of the tub! You have to get out of the tub NOW!" as I yelled back, "I CAN'T!" I was considering adding, "MAKE ME!" (hey, I was in labor) when she added, "IT'S NOT SAFE FOR THE BABY!" That sunk in as the contraction was fading off a little, and with their help I staggered out of the tub and into the wheelchair. Somebody tossed a towel or something over me, and somehow as we whisked off down the hall they collected another nurse and the only doctor on the floor at that time.

Back in the hospital room, they cranked the bed down in record time and somehow got me onto it. It's amusing in retrospect to think that I had all these plans to try different pushing positions for this delivery. With Russell, after an hour and change of very controlled pushing in various positions, the most comfortable position for me and for the doctor as I actually delivered the baby was the one the doctor advised, sitting semi-reclined on the bed, but I got a second-degree tear that had me in a lot of pain as it healed, and wondered afterwards if I could have avoided that with a different position. (Probably not; Russell had his hand up by his head as he came out.) Anyway, for this second birth, it felt like a miracle I wasn't having him in the hallway, and none of us were about to suggest a position change as I went through what felt like continuous contractions that cycled from painful to alien-taking-over-my-body.

Right after they bundled me onto the bed, my water broke (exploded was more like it). Labor was overwhelming at this point, and I felt like things were completely running away from me and that I couldn't possibly go through this much longer. I was terrified that perhaps I wasn't really at the pushing stage and would have hours more of this kind of pain. But I also grasped that all these professionals really expected that this baby was about to be BORN, and part of me believed it too and felt exhilarated. My friend Shirley later described this kind of labor experience perfectly: she remarked it was like "being stuck on a roller coaster ride you didn't ask to be on."

Through the blur I heard someone say "complete!" and I knew that at least I had reached the magic 10 cm point. Karla quickly introduced the O.B. (Dr. Alice Weaver) as the doctor who would be delivering the baby; she looked kind and amazingly unruffled. (We found out later that she was also the beloved O.B. of my friend Wendy, and was the doctor who delivered her daughter (and Russell's friend) Sophie a week after Russell was born.)

I could feel the next big push coming and cried out something about being scared of tearing. Ginny tried to help me push slowly and release energy with puffs of breath so I'd be less likely to tear, but I felt like I couldn't stand to have the baby where it was and had to get it out NOW. Dr. Weaver must have perceived what I wanted to hear, and said in a calm, almost conversational tone, "Go ahead and push if you want to." So I did, twice, and felt the baby's head come out, and on the next push, he was born into David's waiting hands!

It was 12:13 p.m., only 16 minutes after the nurse had checked me and found me to be at 5-6 centimeters. Everything had happened so fast it had almost felt like a movie, not our real lives. But there he was, born at last, indisputably a real, honest-to-god BABY... Silas Loren Wright.

When they put Silas in my arms, I was amazed at how tiny he was, much much smaller than Russell had been, I was sure... but in fact he was 8 lb 6.5 oz, 21 inches, with a 14 inch head, compared to Russell's 8 lb 13 oz, 21.25 in, 13.5 in. His Apgar scores were 9 and 9 (meaning he was healthy and vigorous). He was covered with vernix (that waxy white stuff) and had lots of brown hair on his head, and wrinkly little hands and feet with long nails. He cried some before dozing off to recover from his big experience.

Delivering the placenta hurt some and took half an hour, but I felt a lot better once that was done. I did tear some during delivery and needed stitches, but it was only a first-degree tear (not through muscle), and hurt much less than the second-degree one I had last time. (It was Dr. Bobenreith who got to do the delivery of the placenta and the stitches; the poor woman missed the fun part and came charging in ten minutes later. Dr. Callahan called a few hours later, too, sounding really disappointed that he had missed the page earlier that day, but we told him he wouldn't have made it in time anyway.)

Family Together

My favorite memory from the whole day was when Russell came to visit with Metta and Roger. His face was lit up with the most beautiful smile I've ever seen; he was just so thrilled to see the "tiny baby". He has been so, so sweet to Silas and to us; he loves helping and taking care of the baby. I know there will be sibling issues ahead, but for now it has been wonderful.

We got to bring Silas home late the next afternoon, after they'd checked and cleared us both (especially my blood pressure). My physical recovery has been a lot easier than it was after Russell's birth, and I've been able to leave the house to do things since that first day home. Of course, it helps enormously that David is doing so much of the work and that our friends and family have been terrific about cooking for us and playing with Russell.

THANK YOU to everyone who's helped welcome this new baby into the world, by helping us all during and after the pregnancy and birth, being happy with us, and/or reading this story!

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