Lillian Moana Goff
February 24, 2011 10:22PM
10lbs 2oz. 21 1/4 inches
Our Birth Story
***WARNING*** THIS MAY BE GRAPHIC
In New Zealand Midwifery is the dominant practice for normal births. When we arrived in October I rang the midwife office and was assigned Angela- nobody I knew here had ever heard of her, which made me a little nervous. My nerves were calmed at my first appointment when we talked for over an hour. She is very thorough- crossing the t’s and dotting the i’s- without being pushy or disrespectful.
My pregnancy was progressing smoothly, I never got high blood pressure and severe swelling like I had done with John. I did end up having 3 glucose screenings because my numbers were borderline, eventually passing the 2-hour screen. Unlike in the US, unless there is a medical reason they won’t do an internal exam to check progress or do a sweep of the membranes until 40 weeks. Given my history of Group B Strep and my illness during John’s birth Ange did order a GBS test (again, not normally done) but I did the test myself!! It took me awhile to get my mind around all of the defferences, no matter how natural it all was.
Lily was really taking her sweet time joining our family. Our due date was February 17, and John was born 2 weeks early so everyone thought Lily would follow suit, she had other plans!
Gramma Queen and PopPop had arrived from Michigan to meet the newest grandchild, they got to spend a lot of quality time with John!! The dates of their visit were Feb 10-22, but when Lily showed no signs of arrival they extended their stay until the 25th.
At my 40 week appointment Jeff was working so PopPop went with me to Blenheim (the hospital is in the next town, about a 30 minute drive from our house) just in case anything happened. We had all been living on edge since about 38 weeks- after all, it could be any day! Ange did a sweep and said I was dialated about 2cm but my cervix was still long and hard (typical for a second child, the baby doesn’t engage until show time and therefore the cervix stays hard). After a trip to the supermarket for wine and beer and a visit to the ‘StillBooks’ a used book/homebrew supply store (yes, it really does exist!) we headed back to Picton. I hadn’t changed my activity level at all, if anything I was doing more while Mom and Dad were here (less cooking, more moving). I took John to school and waited.
4 days before birth...defying gravity.
Waiting and waiting and waiting. I think that is really the hardest part, especially after the due date has come and gone. John was having sleepovers with TQ and PopPop every night so I was able to sleep a little more- though I was up every hour or so to go to the bathroom! Every morning I would go have breakfast with John and Mom would ask ‘how are you feeling?’ I answered ‘fine’ and her response was ‘too bad...’ no pressure! What could I do? I was still lifting John, pushing him on the swings, walking a lot. I was drinking rasberry leaf tea (meant to strengthen your uterine muscles) taking evening primrose capsules (in both ends, its supposed to help soften the cervix) eating spicy foods and trying to relax. I got really tired of the comments around town and didn’t want to go out much. The ladies at the library and the supermarket all knew me and would make comments daily ‘still in one piece?’ isn’t it obvious?? I know they meant well, but really? The worst were the comments from people about how huge I was, how big Lily was going to be (8-9 lbs was the common prediction) I shed many tears when people said truly awful things- it was shocking to me that most of the comments came from mothers themselves, people who had been there! Oh well, I know I will be kind the next time I see a heavily pregnant, obviously miserable, mother-to-be!
Wednesday February 23 Jeff and I went to Blenheim to the maternity ward for my 41 week appointment. We couldn’t have the casual office appointment this week because after 40 weeks they require a heart rate monitor on the baby just to meaure that the baby is happy and not in distress. I sat, hooked up to the machines for 20 minutes watching Lily’s perfect little heart beat and watching the fairly regular Braxton Hicks contractions on the ticker tape. Ange was in a birth down the hall so another midwife did the monitor, however Ange was able to join me a few minutes later- the birth she was attending was over- one push and the baby was out- first time mom too, thats what I want!!! Ange did another sweep, and told me she was really agressive about this one (yay) and we scheduled and induction for Monday morning. Jeff and I walked around town and had a nice morning just the 2 of us. We drove back to Picton and had dinner at the Irish Bar down the street from Mom and Dad’s apartment. All night i was waiting in anticipation, but to no avail.
Mom and Dad had scheduled a vineyard tour in Blenheim the next morning, you can’t come all the way to theMarlborough Valley, New Zealand and not see the vineyards! Jeff and John and I were getting ready to go to story time at the library and I was on the floor playing with John when I felt a small pop. Immediately my mind started racing- is this it? I had read that spontanious membrane rupture only happens in about 10-15% of the population, its not like in the movies where the water comes pouring out followed closely by the baby! I was actually unsure if thats what it was. I went to the bathroom and still couldn’t tell, so I put a pad on and said “lets go to the library” Jeff was unsure and wanted to at least drive there but I insisted everything was fine and that we could walk. It is only 2 blocks to the library from where we were so driving seemed silly. We were almost there when I felt a huge gush. It was a bit like feeling like I was wetting my pants, but I had absolutely no control (kegels wouldn’t stop it!) Suddenly my pants were soaked through and I sat on a low wall and held our library book bag on my lap. I sent Jeff to get the car and some towels from Mom and Dad’s place while I texted a friend to see if they could still take John to the story time. Jeff took me back to Mom and Dad’s (they had cable TV, what else could I do, I couldn’t walk!) Jeff went back to the library to check on John while I sat, and sat, and sat. We decided to go back to our house before Mom and Dad got back from the tour but they got home just as we were packing up the car. John was at school at that point so we didn’t have him to worry about. I went home and had a long shower and waited some more. I was having some contractions but nothing real regular. Around 3 or 4 we decided to go for a walk to try to get things into motion. We only went about a block and I had 3 contractions which were getting more intense as time progressed. By around 5 they were every 5-7 minutes apart so we called Ange and let her know we’d be heading to Blenheim. We still had a 30 minute drive and my worst fear was having to give birth in the car alone! We agreed to meet at the Marernity Ward at 6, this gave us time to get our stuff together, stop and see John and get Jeff something to eat.
We stopped at McDonald's on our way into town. I stayed in the car while Jeff ran in to get food. While he was inside I had 3 contractions, they were definately speeding up. The smell of the food was so vile to me that I wouldn’t let poor Jeff eat in the car, he’d have to wolf it down later when he went back out to get our hospital bag. I sipped some Sprite and ate a few almonds, I knew I’d need the energy! Its apparently a myth that you can’t eat while in labor- you may end up vomiting but many women do that regardless when they transition.
We met Ange and got settled into my birthing room. I had wanted to be able to labor in the tub but because I had ruptured membranes and GBS (strep) I wasn’t allowed to- oh well. I had an IV dock put in and some antibiotics administered for the GBS. Although I had the dock in my hand, I didn’t have to be hooked up to the antibiotics continuously, they just do it every 4 hours via syringe- I was free to move around as much as I wanted to! Ange got me a birth ball to sit on, but that caused me more pain during contractions, I think Lily was sitting on some nerves and so I couldn’t ‘sit’ that bent over, it felt so much better to stand and lean on the bed. Ange had to check me at one point so I got up on the bed and laid on my back. While there I had 2 contractions, one coming right on top of the first. Those 2 were by FAR the most uncomfortable ones I had- laying on your back really is not a natural position for birth!
For awhile Jeff and I were reading magazines, watching the clock every time I felt a contraction. I was drinking water and Ange made me some toast with peanut butter for energy. I managed to eat half of it but couldn’t stomach much more. By this time contractions were coming closer and closer and really getting more painful. In New Zealand there are a few forms of pain management. One is Pethidine which is a form of morphine, I had decided against that because it can cross the placenta and cause the baby to be lethargic and possibly need more help to breathe after birth- boy am I glad I refused that one! The other is Nitrous Oxide (Laughing Gas)- which I did choose to have. I had a mouth piece and a long flexible tube attached to a big tank. You have to take long, deep breaths starting just as a contraction starts and it supposedly takes the edge off. Looking back on it, I’m not sure how much it did for the pain, but it did give me something to really focus on and it slowed my breathing and made me think.
The contractions started coming closer and closer together. Jeff and I were basically left to our own devices to labor naturally. Ange was there, but she didn’t intervene unless we asked her to. I remember one point when the pain was getting more intense I looked at Jeff and said ‘Part of me really wants an epidural, but another part of me really doesn’t- I mean, if Mandy can do it so can I!’ (Sorry Mandy). I was laboring standing and leaning against the bed. I tried sitting on a Swiss Ball, but that made me bend too far and caused a lot of pain. I stood back up and just continued leaning over on the bed. Lily had been laying head down but with her back along one side, so leaning forward helped position her like a hammock in the correct position, she could have easily gone posterior had I been on my back.
After leaning over the bed for awhile (my concept of time is gone at this point) my hips began to get very tired. I felt I couldn’t stand anymore and kneeled on the floor with my knees on a towel. Ange and another midwife managed to find me a mattress to kneel on and that is how I continued to labor. I remember being really hot but shivering at the same time. I was having a lot of lower back pain so Jeff got me a cool washcloth and put it on my back while rubbing gently. During one contraction I couldn’t handle the washcloth anymore, but I also couldn’t talk. Ange thought maybe I was trying to tell Jeff to stop rubbing, I remember saying NO! and I reached back and grabbed the cloth and threw it across the room! Another thing I remember was getting a text on the phone and saying to the phone “OH, SHUT THE F**K UP!” I seriously only cared about one thing, and was pissed off at anything that took my focus.
I began feeling the urge to push and was really trying not to. Ange hadn’t checked my progress since the first time and I was unsure what to do. I remember her asking me if I was pushing and I tried to lie thinking I’d be in trouble for pushing too early. Ange quietly told me to listen to my body and go ahead and push if thats what I needed to do. YES! It was like sweet relief to begin pushing. At this point I was done with the gas and all on my own. This is where everything gets extremely fuzzy. I remember Ange using a doppler to check Lily’s heart rate, and I remember being extremely angry because the gel felt awful. Ange had to get nearly under me with a mirror to try to see how Lily was progressing, remember I was on the floor on my knees! After pushing for a while it was decided that there was no way I could continue on the floor, I simply couldn’t get my knees far enough apart. There was a count of three and then I tried to stand, Jeff and Ange and probably other people helped me onto the bed. I laid on my left side and Jeff was given instructions to hold my top leg up (I think this was a little more than he bargained for, but he did a great job!)
The one thing I remember distinctly at this point it one of the ward midwives dimmed the lights. Everything in the room was quiet (except possibly me, I can’t really remember), I could see people moving around but I don’t remember much sound. I was pushing harder than I’ve ever pushed in my life. I could see Ange and one of the ward midwives talking quietly and it was decided that I would have to have an episiotomy. They gave me some local anesthetic and began cutting, OW! (When talking with Ange after everything I found out this was her first ever episiotomy in her midwife career- Thanks Lily! Also this was a point in delivery that she was most worried about me- apparently they were in such a hurry to keep me from tearing too much that they couldn’t wait for the local to completely kick in, and I felt everything! YIKES.) After a few good pushes Lily’s head was out and her body followed quickly. One of the ward midwives told me that they all saw the size of Lily’s head and were instantly worried about her shoulders, but since she was born with her elbow by her hear (hand first) this streamlined things and she just slid right out.
Lily was put on my chest and into my arms immediately and one of the midwives was rubbing her back. She seemed to be having a hard time breathing so they got the bulb syringe and tried clearing out her airway. The next thing I knew Lily was on the warmed incubator and a pediatric team was running into the room. I don’t have any sound in my memory of this time, what I remember is almost like a slow motion panic. Ange said to me that this was the other time she was worried about me. It looked to her as though I was in a transe and had checked out of my body for awhile. She said it only lasted a few moments, but that she was watching me closely. Jeff was holding my hand tightly and he had to sit on the floor to keep from fainting (though never let go of my hand). This is by far the worst part of my memory of Lily’s birth. Seeing my precious baby turning blue and not crying was quite possibly one of the worst experiences in my life. I am so glad we were in a hospital (homebirth is very common in NZ, but never an option for me) and that there was a skilled team just a button push away. Ange kept calm and reassured me many times that she was going to be okay. I’m not sure what all they did across the room, but I do remember seeing someone pumping the balloon to breathe for her. After they got Lily stable they took her to a room in the Pediatric ward to observe her. I hated being separated from her, it was not part of the ‘plan’! I was told that if everything was stable they’d be able to bring her back to me to try nursing soon. While all of this was going on I still had to deliver the placenta (this is the part that most books don’t tell you about!) Ange was massaging my belly and helping things move along. It was also decided that they’d have to call the OB in to stitch me up, none of the midwives were comfortable with doing it (thanks again, Lily). Jeff was able to go to the Peds ward and check on Lily, one of the nurses took pictures of him holding her tiny hand. Its difficult to look at those pictures because she has a tube in her nose and an IV in her arm, but those cheeks were SO chubby! After I was all cleaned up and stitched up they brought Lily back to me and Ange helped me get her latched on. Lily had no problems attaching herself to me, in fact she sucked hungrily for 50 minutes! My hope was to be able to breastfeed Lily. John and I couldn’t quite figure it out, and frankly we did not have a supportive team in the hospital to figure it out. In New Zealand they are quite happy to have a mother and baby stay in the hospital until they have breastfeeding figured out- what a difference!
Ange, my amazing midwife.
My mind is a bit of a blur. We spent 5 days in the hospital with an amazing team of both the maternity ward midwives and the pediatric nurses. Lily had to be on antibiotics for 5 full days so they wouldn’t let us go home until they completed the round. I was to thankful that I was allowed to stay with her and really be able to spend those first days getting to know my little girl. Jeff was amazing during these days, taking full care of John and driving the 45 minutes daily to see Lily and I.
Day 3 postpartum (the day they usually send you packing in the US) is usually the most emotional day. All the midwives watch a new mother carefully on day 3 and spend extra time just talking. Day 3 for us was awful. In the morning we saw a pediatrician and he noticed that Lily was showing the early signs of dehydration. Although she was nursing well, my milk had not yet come in and she was beginning to suffer. The first few days she had a nasal-gastric tube (a small tube in her nose that led to her stomach). This was for getting out residual mucus, but had the added benefit of helping her ‘wind’ yep, they could suck the burps right out!! Anyways, it had come out early on day 2 but due to the dehydration it was decided that they would replace it and feed Lily formula while I nursed her. This was good for 2 reasons, Lily would recieve the calories needed to help her fight off the infection as well as hydrate her without using a bottle, and because she was still nursing she would continue to stimulate milk production. By day 4 my milk was coming in and she was getting less and less formula and my last night in the hospital the 2 (great) night nurses schemed and took out the tube (oops, the little poppet pulled it out herself!) It was so wonderful to see my baby girls face without a tube taped to her cheek!
Before discharge I met with a lactation consultant and it was decided that I would continue formula ‘top ups’ of about 50ml as needed. If Lily seemed hungry I could do more, just read her cues. Since the tube was out (and I couldn’t use it at home anyways) I was loaned a Medela Suplimental Nursing System (SNS) which is basically a bottle that you hang on your neck that has 2 tiny tubes running from it. The traditional method is to tape it to your breast and then latch the baby on with the tube in her mouth as well. She receives the formula while nursing naturally. However, I had started using silicone nipple shields in the hospital for bloody nipples (although her latch was strong, it was slightly off center, leaving me a mess!) and you can’t use both. Lily was happy to use the SNS on while sucking on my finger, at least for the first few days! I would nurse her all through the day and then at around 10PM I would ‘top up’ with the SNS, it seemed like the perfect plan! We should have known, as soon as we settle into a routine she changed it up- figures. One night she absolutely refused the SNS. The next night I tried again to no avail. My Lily was now 100% breastfed!
Ange continued to visit me at home for the first 6 weeks, weighing her every week and talking about my state of mind/recovery. What a relief to have her come to me rather then having to schedule a drive into Blenheim with 2 kids! After the 6 weeks we were handed off to the Plunket nurses which follow the growth and development until age 5. The Plunket nurse visited us at home for a few weeks, again weighing Lily and charting her growth. We talked about my continued health, diet, and wellbeing. What an amazing system! I only had one hiccup with Plunket. Lily had and continues to be a slow weight gainer. She started off so large, but has not stayed in that percentile. However, she is still growing at a continuous rate, hovering between the 25th and 50th percentile (just like John did). My Plunket nurse suggested that I might reintroduce formula to Lily, and stated that I ‘just learn to be okay with that’. Well, I wasn’t. I made a commitment and I was willing to put in the work to increase my milk supply or whatever else was necessary for the health of my baby. Luckily for me I have a strong group of friends who immediately hugged me and told me that sometimes you have to follow your instincts and just look at your baby instead of listening to the ‘experts’. My pediatrician was happy with Lily’s gaining at her medical checkup we had the week previous and she was doing everything she was supposed to be doing.
A year later, Lily is a great eater. She is a wee little thing, and if she really has a big breakfast she *might* double her birth weight at her 1 year appointment. She took her first few steps a few weeks ago but still prefers to crawl (much faster and efficient!) Lily has a few words starting to come in, and even does a couple signs that we have been consistent with (all done, for example, when she is finally done eating dinner). Her napping is amazing, usually right on schedule 2 times per day and then to bed at 7pm. These past few weeks she has even been sleeping through the night (7-6!!!). Our sweet flower. Such a joy to be around. Her smile is contagious and her personality shines. I can't wait to see what the future holds for this little soul.
We love you, Lillian Moana!
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