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Tess Nicole's Birth!

Tess Nichole Truax was born on Sunday Morning May 4th, 2003, at 4:48 am PDT in Room 3C11 at Cottage Hospital in Santa Barbara California.  She was in good health with no signs of abnormality.

Pam past her due date Tuesday, so she elected to jump start the delivery process on Saturday May 3rd, partially because her OGBYN (Dr. Royce) was on call for the weekend.  Got up about 6:30, and took our time getting to Cottage Hospital in Santa Barbara.  We left Sam at the Echt's in Carpinteria.  He seemed sad to see us go.  We were in the south flow of a late season cold front.  It had rained fairly steady through the previous afternoon, and was now more intermittent heavy showers.  The color was nice between showers and Danny was able to take our picture in his front yard.

Got up to Labor & Delivery about a quarter past 10, and burned a couple hours on the administrative process.  Pam received the first of 3 doses of induction medication (Cytotec, a vaginal suppository tablet to ripen her cervix) at 1 pm.  It took a few hours for her to start responding.  Tom went home about 4 to feed the cat.  Pam took her second dose of Cytotec about 5:20.  By 6:30 Pam was into frequent contractions of moderate intensity.  Tom was back about 7:30.

The contractions seemed to subside somewhat, and the nurse checked Pam about 9:30, no change (about 2 cm and 60 to 70% effaced). She had been a couple centimeters dilated and 50% effaced for a few weeks.  Somewhat concerned that we weren't making progress, we were considering our options including going home.  We had elected to induce without a realistic expectation of the process time, and longed for something more natural than waiting in a weathered room for Pam's hormones to get properly aligned.  We now understood the process typically takes 12 to 48 hours.  After a call to Dr. Lauren for personal support, and discussion with Dr. Royce, we decided to have patience and continue with the induction.  We adjusted our expectations and were hopeful we would have our baby girl by daylight, but were mentally prepared to go the course.

The Cytotec can be administered every 4 hours, and 3 doses is typically the maximum.  There was varied opinion as to weather Pam should receive the 3rd dose.  A nurse did another exam at midnight and inserted the final dose of Cytotec.  Pam's Cervix starting to open toward 3 cm.

Tess ruptured Pam's water with a kick at 1 am.  A nurse brought in a Birthing Ball and Pam worked on it for awhile.

Cervix Check at 1:45; 3 to 4 cm.  Pam was increasingly in more pain

Vomiting at 2 am followed by a shot of Fentanyl to take the edge off Pam's pain.  Fentanyl is administered generally through injection into the bloodstream, and helps for about an hour (maximum allowed is 3 doses).  More vomiting at 3 am.

Cervix Check at 3:20; 5 to 6 cm.  Pam was in a lot of pain and requested another shot of Fentanyl.  Tom persuaded Pam to request an Epidural because it would be more effective for pain, and wouldn't affect the baby as much as Fentanyl because it's administered into the spinal fluid rather than the bloodstream.  We were told the anesthesiologist would be there inside 15 minutes, but 20 minutes later we found out he was participating in an appendectomy, and won't be available for awhile, so they gave Pam another dose of  Fentanyl at 3:40.

4:30 am.  Pam is going through transition without any pain medication, so she is in extreme pain.  The Fentanyl has worn off (it didn't do much anyway), and still no anesthesiologist (he showed up about 20 minutes after delivery).  Pam communicates that she needs to Push.  Tom summons Flora (our birthing nurse).  Flora does another Cervix Check and estimates 9 cm.  She coaches Pam to resist pushing because her cervix still needs to open a little more.

Nurse Flora was coaching Pam to hold back on the pushing.  Dr Royce had her hands full with another delivery.  Dr. Royce got to us about 3:40 and quickly donned fresh scrubs.  Once they started encouraging Pam to push, the head showed in a few contractions, and once the head showed, Pam pushed Tess out on the 2nd or 3rd push.  About 5 minutes of hard deliberate pushing.  No time for an episiotomy...

Delivery at 4:48.  Tess was placed on Pam's chest and her lungs started working a few seconds later.  Tom cut the cord.  Pam bonded for about 10 minutes before Flora took Tess to the exam table and cleaned her up a bit.  She brought her back and Pam & Tess bonded for another 45 minutes.  Somewhere in there Dr Royce delivered the placenta, and did some repair work.

Tom & Flora took Sam to the nursery for measurements and her sponge bath.  Our Pediatrician, Dr. Victoria, examined Tess later in the morning and indicated she was in excellent health.

Sunday morning was a clear colorful postfrontal day with crisp blue skies, some clouds on the mountain range and caps on the ocean.

Tom went home to feed the cat and take a short rest.  Returned about 1 pm with Sam.  Sam did well with his sister and bonded right away.

Tess latched on to Pam's breast about 2:15 and started taking colostrum.

Pam spent the night, but didn't get much sleep.  Too much noise and continual interruptions.  Tess went to the nursery at midnight, but returned at 3:45 to feed, and stayed with Pam till discharge.  Tom & Sam spent the night at home and returned the next morning.

Had lunch at the hospital, and spent a couple hours getting paper work lined up to leave.  Mobile for Carpinteria at 3 pm.  Home at 3:30, about 32½ hours after Tess's birth.

Over the next couple of days, Tess turned into an feeding and pooping machine.  Pam's milk started coming in on Tuesday, and Tess saw Dr. Victoria on Wednesday.

:) Tom
plan to add some video if and when I get through the learning curve.

Pam will add her comments in a few days.