Judah’s complete Birth Story is below, its a bit long but there were lots of things to tell. The short version is this:
Judah Michael was born Tuesday, December 28, 2010 at University of Washington Medical Center via C-Section after about 36 hours of labor. He was 9 lbs 2 oz, 21.5 inches long, and had a 14.5 inch head. He and Mom were healthy and happy and went calmly right into Daddy’s arms after birth.
Marginal Previa
Back in early August when I was at 20 weeks we had our first ultrasound and found out we were having a healthy baby boy. We also discovered that his placenta was “low lying”, or a little too close to the cervix. In most (99%) of these cases the placenta will pull away and give enough space but they still need to check it again at 32 weeks. So November 4th we headed back in. We were actually pretty excited for this appointment because we were hoping to get a 3D or 4D picture of our boy. Sure enough they turned on the 3D and 4D at the start of the appointment and we got a great picture of little guy. We even got a little video of him moving his fist and squishing his lips. It was absolutely amazing to see him as a little person inside of my belly. Unfortunately, at the end of the appointment we learned that my placenta was still a little too close to the cervix for comfort, about 2.1 cm. After consulting with our midwives and the maternal fetal doctor, we learned that we needed to get to 3 cm to have a birth center birth and to 2.5 cm to attempt a normal vaginal birth at the hospital. Less than 2.5 cm meant a scheduled C-section. We scheduled another ultrasound for 35 weeks and started to resign ourselves to a C-section which was definitely not what we’d hoped for.
Interestingly enough, this fall we participated in Redemption Groups at our church where we’ve really explored what it means to be redeemed. One thing that really stuck out was that most of the time the way in which we expect God to redeem us is not really what He has planned for us at all. Our expectations are much too short-sighted and His way is always better. This situation we were finding ourselves in was a remarkable opportunity to really apply what we had learned and trust that whatever God had planned for our birth He would be there with us. So we prayed ourselves and asked for prayer from our community that:
1. That baby and I would remain healthy and get to full term safely.
2. That this distance will lengthen to 3 cm.
3. If we only get to 2.5 cm that we would have a smooth transition to a good OB and can proceed with a natural birth at the hospital.
4. If nothing moves, that we would have a smooth transition to a good OB to do a C-Section.
5. That we’d submit to God’s will for baby’s birth and be at peace with maybe not getting our ideal plan.
At week 35 we went back in for our third ultrasound. Baby was still looking good and very firmly in the down position. It took quite a bit of “shoving” on my belly to get him to pull his head away from the cervix to take a measurement. And the measurement was…4 cm!!! We were completely cleared to go for a birth center birth! We were both a little in shock with the news. I think we were both expecting a scheduled C-section, or at least a hospital birth attempt. Granted, it still could go that way but whatever happens, God’s got it under control.
Preeclampsia
At my Tuesday, 38 week appointment my blood pressure showed a slight increase from an average around 110/70 for most of my pregnancy to around 120/80. This was concerning to my midwives as it can be an indicator of preeclampsia so they took a blood draw. The results of the blood draw showed some markers that my liver and kidneys might be working harder than they should so we were called in for more tests the next day. My blood pressure remained around 120/80, the next batch of blood work was stable with the previous batch, and the baby seemed non-stressed. However, the next day we received the results from my urine analysis that showed protein at a concerning level for the midwives. So we were ordered to the University of Washington Hospital for further checking on Friday afternoon.
At this point, given the concern of our midwives, we were pretty much thinking that we would be being induced that evening, since the only cure for preeclampsia is to get the baby out. That was a bit of a shock to the system, particularly since we found out right before we were supposed to go into Jamie’s work Christmas potluck. So we had bit of food, opened our white elephant gifts and headed home to finish packing our birth bag...oh and write our birth plan (nothing like last minute). Plus there were tons of calls to make to alert family, cancel dinner plans, and arrange puppy care before heading to the hospital. Once at the hospital they stared monitoring baby, took my blood pressure, more urine and blood. Then we chatted with the resident doctor about what had been going on and brought us here. He reviewed my records with the other doctors and they determined that based on all they saw there, in their opinion I didn’t have sufficient levels to diagnose preeclampsia at that point. So they canceled the blood and urine testing, and sent us home to wait things out and monitor how I felt. They faxed over their results and we were transferred back to the care of the birth center. We even made it over to our friends for our scheduled dinner that evening.
The next Tuesday was my 39 week appointment and while my blood pressure was pretty good some additional blood work showed that my kidney’s were possibly beginning to work too hard (creatine elevation). Given the previous indicators that made the midwives uncomfortable about preeclampsia, they felt I was no longer within the low risk group that midwives feel comfortable allowing to be delivered at the birth center. So on Wednesday (12/22) we again transferred care over to the University of Washington. We met with a great doctor (Dr. Cheng) who was reassuring that UW will make every effort to give us as natural a birth as they can. As she said, there's sort of 2 routes we can go down from here. The natural route if all indicators stay steady and we don't develop into preeclampsia (she classified me as having maternal hypertension at this point). Or the route where interventions might be needed to get labor going if we move into preeclampsia symptoms, the key on this path being finding the right balance between when to intervene and when to wait a bit more. So we’re back doing what we were doing, monitoring how I’m doing and waiting for labor to start. Since we seemed ok with checking blood pressure and were very aware of the signs of preeclampsia thanks to our awesome birth class (BirthZone), she was ok with not seeing us again until after Christmas (Monday, 12/27). So we went home saddened that our birth center birth was no longer possible, but pleased and surprised at how open the UW was to our wants for a natural birth.
The Birth
On Sunday night at 12:45 am, we were lying in bed talking as the baby was kicking and moving, when suddenly I felt a tightening on my lower right hand side. I remember thinking, “this could be a contraction”, when all of a sudden my water broke and gushed all over the bed. I jumped up and ran to the bathroom while Jamie quickly stripped the bed. Jamie called the hospital and they directed us to come right in. We arrived around 2:00 am and they checked me out to see that I had indeed had a complete rupture of membranes, once that was determined we were admitted (around 3 am) and were able to try to catch a bit of sleep as we waited for labor to really start. We woke up and continued waiting through the next day, knowing that at a certain point we’d be started on pitocin due to the fact that the risk of infection greatly increases the longer it takes for labor to progress after your water breaks. At 3:00 pm we started on a slowly increasing pitocin drip and labor started moving along. Our doula, Deb, arrived around 7:00 pm when I was having contractions 4-5 minutes apart (around 6 milliunits/hour). We did some walking, stretching, and watched some Bones for distraction.
At 10:00 pm (up to 8 milliunits/hour now) the Doctor measured me and I was at 3 cm dilation. About this time I started developing back labor, severe pain in the lower back that is most intense during contractions and often lasts between contractions. I emptied my stomach laboring in bed, so got in the tub for about an hour (where I finished emptying my stomach) to try to help the back labor. After I got out we tried a few other comfort measures, including the hip squeeze, but I was definitely tiring and coming to the end of myself in coping with the never ending pain. About 2:00 am we called the Doctor to see how much progress I’d made and assess our next steps. Sadly, in the 4 hours of intense back labor, I’d only managed to get to 4 cm dilation. Having made so little progress and being exhausted from the back labor on top of no sleep in two nights, we decided it was time to get an epidural. At 2:45 I got my epidural, holding completely still in the fetal position through 3 contractions (that’s about all I remember about it), and by 3:30 I was myself again. (Jamie notes that I even smiled and was able to laugh as I was settling in for a nap)
Jamie and I were able to sleep for about 4 hours and awoke at 8:30 am on 12/28 (my due date) fully dilated, with baby at 0 station, and ready to push. After attempting to let my body “labor down”, move the baby further down naturally, we started the pushing process about 9:30. I pushed in all sorts of positions for about 3 hours all without making any progress moving baby down the birth canal, he stayed at 0 station the whole time. Thankfully throughout this whole labor baby's heart rate was solid and steady, with no dips or periods of distress. However, with 4 hours at full dilation, and 3 hours of pushing with zero station change, the Doctors recommended a C-Section since it was clear baby wouldn’t be able to come out vaginally. Jamie and I took a moment by ourselves to consider this and mourn the absolute mess of our intended birth plan, but we knew it was what needed to happen to meet our little guy and have him healthy so we gave the go ahead.
Jamie quickly pointed out that since we had signed the consent forms for a C section, perhaps we could shut off the now 12 milliunits/hour of pitocin dripping into my veins and avoid forcing the baby against my pelvic floor (and get rid of the remanants of back labor I was still feeling through the epidural). The nurse said, “Good point”, and quickly shut the machine off. My contractions began to lighten and become further apart over the next 90 minutes. Since baby and I weren’t in any distress there wasn’t a hurry to get us into the OR, and they finally wheeled me in about 2:00 pm and Jamie followed soon after. At 2:46 pm they pulled out a beautiful healthy baby boy. Jamie was able to be right by his side as they cleaned him off and did the initial assessments (an 8-9 on the APGARs, 9 lbs 2 oz, 21.5 inches long, and a 14.5 inch head). Jamie was then able to hold him against his bare chest, where he immediately quieted down, and he sat at my head to show him to me while they finished closing me up. The closing took a bit longer than expected due to some spots they found behind my uterus. They called in a consult and determined they were probably the remanants of some previous endometrosis. Sadly, during the whole procedure I badly had the shakes from the epidural drugs, including bits of nausea and tingles. After they initially pulled him out and I knew he was alright and healthy I was unable to concentrate very much on him and instead had to focus on getting through the shaking. I was so thankful Jamie was there to comfort him and bond with him in his first moments of life. At 3:55 pm we got back to our room, my shaking had gone down, and I was able to hold him for the first time. He is gorgeous and wonderful and I’m so proud to be his Mom.
Jamie’s Thoughts
This having a baby business is MUCH longer than I was prepared for. I was dead on my feet, and even though I tried to stay hydrated and fed, the lack of sleep was incredibly difficult to deal with and really messed with my emotions.
The beginning was so full of excitement about what was happening, it was hard to sleep at all. As the pitosin started working, and she began having back pain, it was incredibly difficult to watch. When I left the room to get ice water I was very aware that unlike me, my wife couldn’t leave labor and take a quick break, so the guilt was noticable. However, the occasional water run was the only way I was able to keep it together and stay upbeat as our birth plan fell to pieces around us. The worst, by far, was in the middle of the back labor, when she emptied her stomach again and again during the worst contractions and back pain imaginable. It broke my heart to be unable to do so little to make the pain go away. (except for the hip squeeze, which did help).
When they came to give Michelle her epidural, knowing what was going on during the procedure, and hearing the resident trying her best and the attending providing corrections was difficult. That worrying, coupled with hunching over to hold Michelle’s hand to help her through the 3 contractions where she couldn’t move AT ALL, was too much for me and I felt the blood drain from my face and nausea set in. I quickly asked the doula to take over and left the room and the nurse took one look at my face and followed me out the door to make sure I didn’t faint. After sticking my head under a ice cold water stream at the closest faucet for 5 minutes, I managed to keep my dinner down and go back to Michelle.
Then I had the best 5 hours sleep of my life, never waking, even when they came in to flip Michelle over. The pushing was no where near as bad as the back labor. We tried side-lying with someone supporting her leg, the squat bar, hands and knees over the back of the neat electric transformer bed, and more side lying. We changed about every 20 minutes or so. I knew what would happen if our son didn’t rotate and move his head, but I was totally unprepared when the doctor came in and said, “It’s time to make the decision for a C Section”. I broke down and they gave us (mostly me) a couple minutes to collect ourselves. In the end, I simply focused on what I wanted most, which was a healthy baby boy and a healthy mom, and I remembered the birth plan cards during our birth class, that of the 3 things we wanted MOST, we could have 2 of them with a C Section (Healthy Mom and Baby, and Skin to Skin Contact immediately after birth (with Dad if need be)).
Going into delivery, we still hadn’t decided on a name (although we had a short list). When they delivered my son, and I saw his full head of dark hair, and felt the strength in his arms and hands and heard the sound of his cry, I knew he needed a strong name. We had just been through a marathon 38 hours of labor, with all sorts of interventions, and he had kept his heart rate perfectly throughout even the strongest contractions. The strongest name on our final list kept running through my head as I looked at my son - Judah. I was able to tuck him against my bare chest and go sit by Michelle’s head while they fiddled with her uterus. Judah calmed down, didn’t cry at all, and had his eyes open as he looked around his new world. Looking down and seeing my 15 minute old son grasp the strings of my gown and play with my chest hair was amazing to behold! That evening, as we sat in our postpartum room, and I read in our name book about the name Judah, I wept when I read “There’s nothing fragile about this antique [name], though. Judah sounds like a warrior...” He truly was our little warrior! The meaning of Judah is “Praise; Thanks to God”, and after our journey through his birth it also perfectly expressed our heart. We knew then that we had chosen the right name for him. We gave him Michelle’s father’s name Michael for a middle name. Judah Michael Zaehring is a precious addition to our family, and the pain and journey to get him in our arms was nothing compared to the joy we feel today. We can’t wait to get to know him better!
