Introducing Elias Andrew Cox

So Eli is finally here. (By the way, to clear up what is obviously a bit confusing, no - there is not a strange, geographical cluster of children named Elias in my neighborhood. When we decided to name him Elias we figured we'd call him Eli for short. Then I discovered a crapton of kids named Eli, and that's what prompted the earlier posts.) He arrived on January 27th at 7:43 pm weighing a whopping 9lbs, 4 oz and measuring over 22 inches. He's a big guy, but as Andy rightly points out, he kind of needs to be given his brother's temperament. I felt somewhat justified in being as miserable as I was toward the end of the pregnancy when they told me how big he was. At 5'3'' I'm no Amazon. I'm amazed he managed to fit in there for as long as he did.

We arrived home from the hospital today. Unfortunately, I was not successful in bringing Eli into the world in the normal manner, so like his brother before him he was born by C-section. There are several regular readers of this blog who I have not managed to talk to yet, and I'm sure that I'll be asked to explain what happened several times over so I've decided to just put the birth story up here, to avoid the repeated retelling. It's pretty upsetting for me, because I tried really, really hard to avoid a repeat surgical birth. I took a VBAC class, I hired a doula, I dumped my original OB practice and switched to a practice of midwives with a 70-80% success rate with VBAC deliveries, I read every book on the subject I could find....and I still ended up in an OR.

The short version of the story is that I developed a fever after an hour of pushing that kept creeping up, and the midwife and the ob on call began to worry that I had a uterine infection. The fact that my water had been broken for over 12 hours didn't work in my favor. Eli's heartbeat started to react to my elevated temperature, and the OB said that it wouldn't be safe, given that their efforts to bring my fever down had failed, and given that they didn't know for sure if I had an infection or what kind I had and whether or not the baby was currently being exposed to infection, to have him remain undelivered for any more than a half hour. Also, since his heart rate was hitting 190-200during contractions in response to the fever, they were worried that he was becoming distressed. Based on his position - he was in a terrible birth position, face up and with his head cocked to the side - the midwife estimated it would take 2 hours or more of the pushing phase to get him out, and that he was still too high in the birth canal to make a vacuum or forceps delivery possible to comply with the 1/2 hour deadline. The OB told me that in her opinion, there was zero chance of me being able to deliver him within 30 minutes no matter how hard I pushed or what assistance they used, so I agreed to stop trying and I got sent into surgery. The worst part about it was that because this time it was an 'emergency' rather than just a plain old this-labor-isn't-going-anywhere-and-I'm-bored situation, they took Eli immediately up the special care nursery for his antibiotics before I could even hold him. I didn't get him back until almost 8 hours later. With Owen, I got to hold him while they were wheeling me into recovery and start feeding him before they had even taken the spinal out.

Later, after it was over, another one of the midwives in the practice (not the one that was there to deliver me) came to talk about the outcome. I thought that was really nice of them to send her, actually. When they have a failed VBAC, they send someone in to process what happened with you. She went over the whole chart with me, reading the notes entered by the nurses, midwives and doctors. When she got to the note where the doctor wrote that she didn't feel a delivery would be possible, I jokingly asked "and is that the part of the chart where it notes 'patient went psycho?'?" She laughed, but I notice she didn't really say no. I did kind of go a teeny bit psycho when it became obvious that I was not going to be successful. I know there are a lot of people who are mystified by how important it was to me to not have another C-section, and it's hard to really explain why but it just was. Besides my emotional investment in the whole issue, there was the entire problem of caring for a toddler and a newborn after surgery, which is about as bad as I feared it would be. Recovering from a C-section with your first baby sucks, but is ultimately not that bad. Recovering from one when your two year old wants to jump on you, be picked up, run around and play, and needs to be lifted about 50 times a day just to perform essential life functions REALLY sucks.

Ultimately, after 'processing' the whole experience for a few days, I've come to the conclusion that the problem lay in my decision to get the epidural. My research, and input from one of the pediatricians in Owen's doctors' group, indicates that while it's possible that I had a uterine infection (we will never know - both Eli and I were treated immediately with IV antibiotics and they don't bother finding out unless after the 48 hour course of antibiotics there is still presence of infection, at which time they figure out what it is and treat it further) I think it's more likely that the epidural was responsible for raising my body temperature to mimic a fever. And Eli's heartrate was elevated in response to my elevated temperature, not an infection of the amniotic fluid. Had I been able to go without the drugs, I would have a) probably had him much faster and b) probably would have been successful.

I'm dissapointed in myself that I caved and got the drugs (and so quickly, at that. Once my contractions were 2 minutes apart and more than 45 seconds long they said "how do you feel about getting some pain reli..." and I said "NEEDLE. IN MY BACK. DO IT.") I didn't even try to stick it out, really. And to that I have to say that it really was that bad. I'm not sure, that if you put me in that much pain again, right now, and you said that it was a do-over, but that if I accepted pain relief I would end up with a surgery FOR SURE but if I didn't take it I wouldn't have to have one, I'm not sure I would have been able to turn it down, even then. Because in that moment, I couldn't handle it. None of the techniques they went over in any of the two childbirth classes I took, nor the presence of the doula (who was amazing by the way - never go to a birth without one) helped me resist. So am I happy I tried? I don't know. I think I'm too sad about the whole thing to really be happy I tried. Given the outcome, I almost wish I hadn't, because then I maybe wouldn't be so dissapointed.

Ultimately, however, I just need to get over the whole thing. But that's not going to happen today, or frankly probably this year. It's very unlikely that I'll have a third birth experience, and if I do, there's almost a 100% chance it will be a scheduled c-section with no chance of a trial of labor before hand.

Luckily for me, I now have two beautiful and healthy children, so ultimately how they came into the world doesn't matter. And that is the last depressing word I have on the subject. From here forward, nothing but adorable pictures of Owen in his "I'm a big brother' t-shirt holding Eli (who is screaming his head off) for the first time. Stay tuned for those, tomorrow.