From: grun@intellistor.com (Paul Grun)
Subject: Our newborn, and birth experience
Organization: Intellistor, Inc.
Date: Fri, 21 Aug 92 00:46:46 GMT


Okay, for anybody who's interested, I'd like
to present our labor story and maybe offer my perspective
on drugs and intervention during labor.
First, the important news:

	   Casey Nathaniel Grun
	   July 17, '92
	   8 lbs, 8 oz.
	   22 inches long (does anybody really care about that?)
	   normal, happy and healthy. ditto for mom.

Our experience began with a (semi) scheduled induction.  Being 11 days
overdue, Liz, the doctor and I agreed to induction for a variety of reasons.
The plan was three doses of
prostaglandin Thursday night followed by Pitocin Friday morning.
In our case, though, the prostaglandin stimulated normal labor,
which began in ernest about 9:00 pm, just as Bill Clinton took the stage to
accept the Democratic nomination.

Liz and I had discussed Stadol and epidurals at length both together
and with our doctor (Peter), and had agreed that we would try
to avoid medication if possible.  Nonetheless, I viewed it ultimately
as her decision.  Having discussed it, the final decision was hers, and
she knew it.

During the night, Liz began to feel that she might really need some pain relief.With much support from the nurse, we tried many approaches before finally
deciding to try Stadol.  It was a good decision.
It did its work beautifully and smoothed the pain right out.  So for
us, Stadol was the right approach.  The effects were evident for several
hours according to Liz.

By dawn, we had only progressed to 4 cm.  We had been having barn-
burning contractions all night long, but they never came any closer than 5
minutes apart. 
Clearly, the labor was not progressing as it should.  We'd need contractions
coming closer together if we were to deliver this baby before mom wore out.
The doctor suggested an epidural and Pitocin; the theory was
that the epidural would help Liz to relax and also help her to handle the
more intense contractions we expected from the Pitocin.  So we discussed it,
and Liz decided to go ahead with it.  I felt that it was a good decision,  
since she was clearly beginning to tire, and the odds of a caesarean were
increasing. 
The epidural went in just fine, although the anesthesiologist made me
leave the room, which I resented very much.  And a Pitocin drip was begun.
With the epidural and the Pitocin, the doctor felt that an internal 
uterine monitor and internal fetal monitoring would be appropriate.  Since
Lizzy now had jelly where once she had legs, this was not objectionable. 
And it was very re-assuring to be able to watch the baby's progress as well
as the strength and timing of the contractions, which gradually began
to do their work. 

The Pitocin drip went on for several hours until by noon Liz had become
fully dilated.  Unfortunately, the baby had still not dropped into her
pelvis, meaning that Liz would have to push the ornery little guy the
whole way out.
At this point, the epidural was disconnected to allow her to fully
participate in the pushing.  Although she could in fact push through the
epidural, it was pretty clear that she'd be much more efficient without it.

Pushing lasted for nearly 3 hours.  Two hours and 57 minutes, to be exact,
and was the most excruciating thing I have ever witnessed.  Between Liz'
exhaustion and the pain, it took absolutely everything she had to present
the baby's head, but finally there it was!  Peter, recognizing
Liz' exhaustion, suggested that we Hoover the kid out.
We had discussed episiotomies at some
length with Peter, who doesn't do them as a matter of course; he understood 
and agreed with our feelings that an episiotomy was to be avoided if at
all possible.  Unfortunately, the vacuum extraction pretty much requires
one.  

Eventually, though, Casey was born and delivered into his mother's
waiting arms.  No attempt was made to hustle him off to the nursery; 
rather, the nursery nurse appeared in the Labor and Delivery room to help
take care of the newborn.  Casey had Apgar scores of 9.5 after 1 minute,
and 10 after 5 minutes and was perfectly healthy.  Within 15 minutes he
was nursing at his mother's breast.

At our request the nurses prepared a LeBoyer bath, which Casey (and his
dad!) seemed to enjoy very much.  In the excitement of the moment we had
completely forgotten about it, but the doctor remembered our wishes and 
reminded us.

So, we wound up doing almost everything that we had hoped to avoid.  We
used Stadol and an epidural to very great effect and required an episiotomy
and Hoover extraction.  I am quite certain that the judicious use of these
interventions, combined with a great deal of patience from our doctor,
allowed us to avoid a C-section.  Looking back, there were at least
3 occasions where I am certain most doctors would have ordered a
caesarean.  I'm glad Peter didn't.

The kind and loving care that we received, both from the labor and delivery
nurses and from our doctor was simply beyond compare.  I honestly believe
that they provided the environment and support to make it the wonderful
experience that it was, interventions not withstanding.  For this, Liz
and I are grateful.
-- 

goes to show, you don't ever know...
grun@intellistor.com