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pruisner.com
Lydia Augusta Pruisner
Tuesday, September 8, 2009
Alice began having contractions at 04:00 on Saturday morning. I awoke shortly before 07:00 to the sound of Alice taking a shower, and I remember thinking “There can only be one reason Alice is up before 7AM to take a shower on a Saturday morning. I should try to go back to sleep because it will be a very long day.” I slept no more than a few minutes, when a still wet and towel-clad Alice stood over me at bedside and gave me the news. Having gone through the exact same exercise 6 days before when Alice had some contractions and we’d gone to the hospital, we didn’t have a sense of urgency and slowly worked to get all of the hospital luggage put together. Alice began timing contractions, and when she became too uncomfortable, I continued the tabulations. At just after 10:00, we departed for the hospital.
The first nurse to attend to Alice at Trinity BirthPlace was Janel, who examined Alice and determined she was 1 or 1.5 centimeters dilated and 95% effaced. The fetal heart rate monitor and contraction monitor indicated baby was still happy and healthy and that the contractions were real, but were still about 5 minutes apart. We stayed for observation through the early afternoon, at which time I went back to the house to attend to Mabel and let one of our friends Johanna in to play with Mabel and keep her occupied. I went back to the hospital, where Alice had been told that she could either labor at home or stay at the hospital and move the birthing process along using pitocin. Alice opted for the former, and we went back home at 15:00.
Alice’s mother Margaret joined shortly after returning home, and later, Alice’s sister Julie arrived just before 18:00. The contractions became more regular and stronger through the afternoon, and by 20:00, Alice, Margaret, and I went back to the hospital. A new nurse, Vicki, examined Alice in the same room we had been in earlier in the day, room 77, and reported that no more progress had been made in dilation or effacement. Shortly thereafter, my parents, Kendall and Peggy, and Alice’s father Tony arrived and joined us in the birthing room. Alice was beginning to get frustrated by the lack of progress in dilation and effacement and began getting emotional between contractions. A long, warm shower helped relax her, and the nurses convinced her to take a muscle relaxing shot in her left hip and an intravenous pain medication to help her sleep through some of the contractions. Having been soothed by the shower and optimistic about labor progress, Alice coined the phrase “Go go gadget cervix!” By 00:30 on Sunday morning, Alice was settling into her hospital bed, Margaret was snuggling into a couch in the waiting area, Kendall, Peggy, Tony, and Julie had gone to sleep at our house, and I was sleeping in the birthing room on a couch.
Sunday morning labor resumed at 03:30 when Alice awoke. For the next 3 hours, Alice was sleeping between contractions, but wasn’t able to rest completely. A 06:30, Alice and I began getting cleaned up and commenced more laboring. Nurse Vicki came to the room and confirmed that despite Alice’s sleep and decreased contraction frequency, Alice was then dilated to 3 centimeters. Dr. Tjarks felt the progress was enough to warrant breaking Alice’s water, which marked the point of no return, as birth should occur no later than 24 hours after the water has broken. Alice tried several positions during the morning laboring process, and she and I worked to maintain consistent breathing to keep her focused during contractions. A shift change in the late morning brought nurse Lisa to our room and an examination early in the afternoon confirmed that no further dilation had been achieved despite the morning labors and water breakage. At 12:45, after 32.75 hours of contractions, Alice made the call to proceed with pitocin to stimulate more contractions and an epidural to mitigate the pain. An anesthesiologist was called, and Dr. Babu came to the birthing room at 13:25 to insert the epidural needle. The epidural provided some welcome relief from the pain, and this allowed Alice to nap a little bit and also to hold some normal conversations which helped the stress level for Alice, Margaret, and me.
The pitocin allowed Alice to dilate to 9 centimeters by 15:30 when Lisa performed another examination. At 16:00, Dr. Tjarks declared that Alice was fully dilated at 10 centimeters and pushing began at 16:30. Shortly before the pushing began, Peggy, Kendall, and Tony came back to the hospital and awaited word of the birth in the waiting room. Margaret was stationed at Alice’s left side and I was at her right while nurse Lisa positioned Alice’s legs in elevated stirrups and stationed herself at the foot of the bed. The foot of the bed dropped down and the overhead spotlights were focused on Alice’s midsection. The pushing process was centered on each contraction, during which, Alice took a deep breath and pushed while I counted from 1 to 10; then breathe, pushing, and counting was repeated two more times during each contraction. While having the father do the contraction counting sounded like a nice idea, the three hours of pushing left me feeling like the jerk who kept counting and also minimized my time with Alice and my ability to encourage her during the pushing. Between contractions, Alice had nearly reached a point of despair as she was exhausted physically, and the epidural was no longer having much effect. After three hours of contractions, nurse Lisa ended her shift and departed the delivery room, only to be replaced by half-dozen other nurses of various descriptions. Dr. Tjarks made the decision to speed the delivery, because though the baby’s head had been visible during pushing for more than an hour, progress had been slow. Fortunately, the baby monitor indicated the baby’s pulse was consistent and strong. Dr. Tjarks decided to give Alice an episiotomy, which is basically a relief cut in the skin which enlarges the delivery opening. Afterward, Dr. Tjarks confirmed the episiotomy was a level two, on a scale of one to four, from minimally invasive to completely through the wall.
After only three contractions, and significant mechanical persuasion of the baby by Dr. Tjarks, the baby was born at 19:41. The doctor clamped the umbilical cord of the crying baby, and allowed me to cut the cord, before the baby was whisked away to an examination table. Once on the examination table, she quieted down quickly due to the heating lamps which compensated for the cold air. Inititally, the baby’s skin color was a strong pink, but then faded a bit and she began to look pale. The attending nurse was nervous that the baby wasn’t intaking oxygen well, and a probe was mounted to the baby’s chest to measure oxygen level, which hovered between 90 and 100, with 100 being perfect. The initial APGAR score was 7, and after 10 minutes, the APGAR score was 9, an indication of a vital and healthy baby. The baby was quickly shifted to a scale, where she weighed 8 pounds 2.3 ounces and was 20.75 inches long. After having the doctor stitch her episiotomy, Alice finally got to hold her newborn baby. Minutes later, all of the nurses were gone and Margaret had joined the other grandparents and Julie in the waiting room, and Alice and I got a few precious minutes to enjoy our daughter alone. It was during this time that Alice and I agreed on the name Lydia Augusta Pruisner. After the name was chosen and we had caught our collective breath, the grandparents flooded into the birthing room and Lydia was passed around to all in the room and many pictures were taken.
A short time later, Alice was transferred to a different hospital room to rest and sleep, and the rest of us went home to rest too. Monday was a bit of a blur as nurses kept checking in and providing input on everything from breastfeeding to bilirubin. Kendall and Peggy visited in the morning, and Margaret and Tony visited in the afternoon and evening, and I was with Alice and Lydia all day. That evening, several of our friends stopped by to see Lydia for the first time. Monday night was difficult for Alice, as Lydia was awake and ready to feed on a very regular basis but was getting little satisfaction from the colostrum Alice was producing. On Tuesday, Alice, Margaret, and I got Lydia prepared to leave the hospital after a short lesson by one of the nurses on bathing, which happens to include lots of squirming and crying. Shortly after 12:00 on Tuesday, Lydia made her trip home in baby UNC basketball shirt. A photo album from the hospital stay through the trip home has been posted, and linked below. The coming week promises more pictures and stories, so check back soon.
Lydia snuggles into Micah