i finally had an epidural {nash's birth story}

Hubs and I decided on an epidural. Do not take offense that I included my husband in the decision-making. It was my decision. I was the final decision-maker but he was a key player in all of my deliveries. Allow me to explain.

I was exhausted and anxious. He was exhausted with only an hour of sleep. He was my labor partner for five unmedicated deliveries. He has done his fair share of supporting a laboring mother.

This decision was not an easy one. I knew what to expect with unmedicated births. I was entertaining the unknown by asking for an epidural and that made more anxious. I also felt like a failure (which I quickly shoved that lie away!) I asked myself: why do I need an epidural when women around the world go through deliveries without one? How come praying and meditating was not enough?

I did not have answers.  I knew I needed support and I could not go through another unmedicated delivery without 100% support. I kept praying and I offered up the intentions left on my instagram post. I prayed and prayed. But when  I arrived at triage and found out I was only 6 cm dilated, I made up my mind that I can have the epidural.  I knew right then. I had time to get it... 

The hospital OB checked on me (like a 2 minute stop) just to make sure my OB was on her way. There's always an OB at the hospital who is on-call and ready to help with deliveries just in case the primary OBs could not make it.

The nurse started an IV on my left forearm. I needed a bag of saline (at least a liter) because one of the side effects of an epidural is hypotension (low blood pressure). We certainly did not want that so pushing fluids was recommended.

I emptied my bladder one more time and took the IV pole with me. The bolus of saline fluid went in fast.

The anesthesiologist came while I was in the restroom. This was my first time  getting an epidural. I was a newbie. He took a focused, brief history and made sure I did not have allergies to meds and other significant past medical history.

The anesthesiologist instructed me to sit and lean forward on a table. Hubs faced me and held my hands. The only uncomfortable part was the numbing medicine (topical anesthesia). I was worried about crunching my stomach but that ended up not bothering me at all.  The rest of the procedure was uneventful (thank you, dear God). The anesthesiologist gave me a test dose and asked me if I have numbness on my tongue/mouth. I did not have any numbness on my face or upper body (correct answer). It was a weird feeling when he injected the test dose of the epidural. Did I truly feel a cold liquid? I had some sensory changes (not pain) but not full numbness on my left leg.

Once the test dose confirmed that the catheter was not intrathecally (meaning not inside the dura or sheath) and the catheter was truly epidural (epi = outside) (dura = sheath), the anesthesiologist secured the catheter with lots and lots and lots of tape (just ask Derrick). Every time I got a dose, I felt the cold liquid on the catheter which was taped on my back. I got a dose every 20 minutes.

I had to be on my back fully supine so the pain meds efficiently deliver numbness to both lower extremities. The nurse propped a pillow on my side so I was 20 degrees tilted to make me a little comfortable. I felt the numbness on my left leg first then both legs became numb. I did not feel the contractions at all. I was pain-free. I felt my face softening. I was smiling and making jokes.

Derrick took a quick nap. I tried to rest and closed my eyes. But the BP cuff kept going every 5 minutes. It was apparently protocol to check BP every 5 minutes when an epidural is in place.

I still had the laboring shivers and shakes. Derrick thought it was more than what I experienced in the past deliveries. I told him it was about the same as before. He probably did not notice the shakes as much bec he was focused on my pain and the contractions and helping me get through them.  I was not feeling the contractions but my body was still going through labor.  I had labor shakes (shaking of my legs) in all my deliveries.

For babies 1 through 5, I asked the nurses to check my cervical dilation progress after every contraction specially when I was on the most intense phase - the transition phase - when the cervix dilates from 7 cm to 10 cm and contractions occur every 2 minutes.

This time with the epidural, I was calm. I did not hysterically ask to be checked so often. In fact, I do not think I even asked them to do it. They just checked me on their own.

I did not feel my contractions. I had to rely on the monitor to look at the peaks (aka contractions) when they were happening.

By 530am, almost 2 hours after getting the epidural, my OB checked and I was fully dilated. It was pushing time. My water did not break yet so my OB broke the bag of fluids. My amniotic fluid was meconium-stained. Nash had a bowel movement inside already. Per protocol, the NICU team was present for all meconium deliveries... Just in case there was meconium in the baby's trachea and further medical resuscitation needed. (I will jump forward a bit... Nash did not need any NICU intervention. He had a vigorous cry!)

Pushing with an epidural was something new for me (understatement here). I did not feel anything. I had to be coached on the pushing. I was getting out of breath. I flexed and crunched and held the back of my thighs. I was getting disheartened. My nurse was encouraging. She reminded me that this was a different experience but that I had done this before. I have given birth before.  I was offered the birthing mirror.  I did not see anything. I was losing my determination.There was no progress. I looked at Derrick and asked him what was happening. He shook his head. Nothing. No baby.

I pushed and pushed with the contractions.  It took about 8-10 contractions so 20-30 minutes of pushing which I thought took forever! I was getting worried that I would be that mom who pushed for an hour bec I could not feel where I was pushing. I was getting tired and was breathless. I told myself to push down there although there was no sensory feedback to my brain.

Once I saw Nash's hair, I kept pushing and pushing. The contraction already finished (I think) but I kept going. Finally he was out!

Baby Nash was born at 05:53a. He was 8 lbs 8 oz and 21 inches long. He is my biggest newborn.

He was placed  on my chest right away and he cried. He cried and I gave thanks to the Lord. Derrick cut the umbilical cord.

Nash's birth weight was right at the 90th percentile for his gestational age (38 +3) so they gave him the diagnosis of LGA (large for gestational age). LGA is one of the “complications” for gestational diabetes. The infant of a diabetic mother can grow so big (macrosomia). 

I had a small tear but it stopped bleeding. My OB held pressure on the tear and let the bleeding stop on its own. I did not need any stitches.

Two hours after delivering Nash, the sensation came back to my legs. I was able to walk with assistance to go to the bathroom. I was not able to urinate on my own. So that did take awhile - That feeling or urge to urinate. My nurse had to drain my bladder using a foley catheter. I had about 500 mL of urine. I did not feel the need to urinate that much fluid. Again some functions come back slowly after pain meds.

So what do I think of my epidural experience?

Some noted side effects of having an epidural:
- Slightly prolonged pushing time. Because the meds worked well, thankfully, there was no sensory feedback.
- Sore biceps. I thought  my arms were wore because of the BP cuff measuring my Blood pressure every 5 minutes. But my arms were sore bec of holding my legs and I was contracting my upper body where I could feel something.
- Itching after delivery.  Not sure if it's hormonal-related or med-related but my legs were so itchy. I had to put lotion to relieve the itching. I was already at the postpartum ward when this happened.

Some great things about recovery:
I did not have a sore bottom! I only required the perineal ice pack once. I still required pain meds bec of the uterine contractions post delivery and while nursing. But I did not ask for numbing spray to use down there.
I did not need any stitches. There were no tears. I did not push like what I did before when I was in so much pain. On one of my previous unmedicated births, the OB actually told me to slow down because I was tearing.

All in all, I give my epidural experience an A.

We stayed at the hospital for 36 hours. We could have left after 24 hours because I had a normal vaginal delivery.

Nash needed heel sticks for sugar checks before every feed. That was annoying and sad. My poor baby. But they had to make sure he did not need supplementation because of low sugars. This is another complication of my gestational diabetes. He was used to lots of sugar crossing the placenta since my insulin production was not quite enough and I essentially had glucose intolerance (oversimplification here of gestational diabetes). So once he's not getting sugars in utero, he had to take in sugar by mouth. He needed to nurse and take in all that liquid gold called colostrum. His lowest reading was a point above the needed intervention. Rest of his blood sugars were within normal range. He did not need supplementation. I was not opposed to him getting extra formula if he needed it.

Nash may be my 6th baby but we had a lot of "firsts" experiences with him.
He is now 4 weeks old. His siblings are crazy about him. They all want to hold him and give him kisses. If they see me alone because I am not carrying him, they ask: "where's the baby?"

His Ate Lucy calls him Nashy. Kuya Lucas calls him Mash.
Ignatius John Paul, we are so happy God gave you to us. 

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1 comment:

  1. Sweet boy!! And the checking blood sugar before every feeding is the worst- I had to do that with Cora.:( So glad he's doing well and that your recovery went smoothly!


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