Thursday, February 16, 2012

The birthening, part 3: Wednesday, or, Progress? Please?

Ed. Note: I had a self-imposed deadline to finish my birth story: March 22, The Speaker's due date. Then that kid decided to go and get born 6 weeks early. Happily, they're all fine, but that thwarted my plan... so I'm just finishing it when I'm finishing it.

By around midnight Tuesday night, I felt like we were down to the business of getting this kid born: my water had broken on its own, my contractions were becoming intense, and when I took a bathroom break, the second dose of Cervadil just... um... fell out.

Ick. Sorry.

Frankly, that kind of grossed me out, too, but it told me that my cervix was open enough that it couldn't hold the weird dosage suppository thing in place anymore, so I was making progress! Apparently every gross thing was a sign of progress.

I called the nurses to tell them about the Cervadil, and the midwives showed up to talk things over with me. I would have a few hours to labor without meds, and then they'd hook me up to an IV of pitocin. I wasn't looking forward to that, and I was briefly sad that I couldn't use the bath tub because my bag of waters was already broken... but the midwives said that was crazy, I should feel free to labor in the tub. So DH and I shuffled over to the bathroom.

(As an aside: I've read and heard plenty of stories about women being in shared rooms during their labor and delivery, and I just don't know how they did it. I would have murdered someone if I'd been sharing the room with other laboring women. As it was, there were several times over the three days when we could hear women in other delivery rooms SCREAMING while they were pushing, followed by the crying of a newborn baby. Early on, that made me anxious. Toward the end of my labor, it made me sad because I kind of knew that wouldn't be me.)

At some point around the breaking of my waters, DH's presence went from "nice and comforting" to "absolutely required". I was starting to have trouble getting through contractions without his coaching, and I think the real shift to seriousness happened in that bathroom, while I was laboring in the bath tub and he was perched on the toilet lid, timing contractions and talking me through them. While I was in the tub, the contractions got considerably more intense, and I found myself starting to vocalize: making "aaaaaah" or "haaaaah" sounds to get through them, relaxing my jaw at the same time.

When each contraction started, I would turn on the jacuzzi jets and roll on to my side so they were hitting me in the lower back, where it really hurt (um, back labor! But my brain wouldn't consider that, because back labor is hard, y'all). DH would time the contraction and tell me when it was halfway over: we learned in childbirth class that, around 30 seconds in, the pain won't get any worse and would start to dissipate. It became absolutely vital to me that he tell me when I'd passed 30 seconds. For the next entire day, he did just that, every 3 to 7 minutes: "you're halfway there". "OK, it's halfway over"; "You're past 30 seconds, you can make it." Over and over and over. Later in the process I recall he ran to the bathroom, and I had a contraction while he was away, and I thought I was actually going to die.

Also around this time, I think it was about 1:00am on Wednesday, time began to flow in a different manner. I began to lose any idea about what time or day it was - time was either a contraction or the pause between contractions. (This is why writing this has been so difficult. For the rest of this story, I've made a good-faith effort to keep things in chronological order, but I may be mis-remembering the order of things.)

Unfortunately, the contractions still weren't coming regularly - there could be anywhere from 3 to 7 minutes between contractions, which is a big difference.

We passed several hours this way: first I labored in the tub, then I got my gown back on and tried various positions in the room: squat-sitting on the birthing ball and leaning over on to the foot of the bed, standing up with the birthing ball on the bed so I could collapse over it (this became one of my favorites because someone could easily apply hard pressure to my lower back), and others. I absolutely couldn't just sit through a contraction, and even lying on my side was becoming difficult.

At some point during the night, they started me on pitocin, which made the contractions even more intense.

At 8:00am, Gina - my absolute favorite midwife - started her 24-hour shift. For months I'd been telling myself I wanted to have the baby on Gina's watch, and now it seemed like my dreams were coming true.

Some time around 9am Wednesday, Gina came in. She checked me, and I was dilated to 3.5 centimeters... no progress since the last midwife check earlier in the night, but she said that wasn't an issue - I'd still made some progress with the Cervadil, my water had broken on its own, and there were no signs of distress for me or the baby, so we were just going to keep things rolling along. That sounded good to us. She did offer to call the volunteer doula, which we'd shown an interest in before. DH and I thought about it for a second and said to go ahead.

Breakfast was brought in - eggs and stuff - and I knew I needed to eat to keep up my energy (plus we'd chosen this hospital because they let moms eat during labor) but food was starting to lose its appeal. I forced down some oatmeal. DH ate most of the rest, because he was starving, too.

Jessica the volunteer doula arrived later in the morning. Calling her was the Greatest. Decision. Ever. We automatically felt at ease with her, and I was so relieved to have someone on the team with DH so he could do things like take bathroom breaks or get a snack or just not be "on" the whole time. Plus, she was able to run some interference with the nurses and midwives, which was awesome because they were all ridiculously busy, this being approximately 9 months after Blizzaster 2011 - a bumper crop of babies were being born the week we were in the hospital. As a trained doula, Jessica made suggestions for labor positions/vocalizations, said all the right encouraging things during contractions, made sure I always had super-hot soaked chux pads on my lower back (a Godsend for back labor) and even went out to the waiting room and calmed down my family, who were all trying not to freak out about how long everything was taking. I was so, so grateful for her being there. I didn't expect to even really want a doula, and she ended up being such an integral part of the process for us... it still amazes me.

By midafternoon I became even more charming: after every third contraction or so, I started vomiting. Jessica, dear heart, held the puke tray while DH pressed down on my lower back. I honestly got a little excited about the puking. I thought, "hey, this is progress! Don't you puke during transition? Maybe I'm dilated to, like, 7 or something..."

Labor messes with your head.

Here's where someone might ask: OK, Schmei, the whole labor process wasn't going the way you'd hoped - why not get some painkilling meds? And the truth is, I was totally open to the idea of something like an epidural to help me rest. I was, in fact, asking Gina about it - but I hadn't progressed enough. If they administer an epidural before "active labor" - usually at 4 centimeters - it often has the effect of slowing labor or stopping it completely. Since I was already being induced (forcing labor against my body's wishes), that would have been counterproductive. So I had to work up to 4 centimeters. And at this point in the day, my thinking was moving to that: let's get far enough so I can get an epidural and get some rest before I have to push this kid out.

Also, that the hours and hours of contractions didn't count as active labor still kind of pisses me off. I was active! And laboring! What more did the universe want?


Sometime in the late afternoon, Gina checked me again. We were all hoping for progress.

She reluctantly told me the news:

"Three and a half."

No way. NO. WAY. After HOURS of pitocin and God knows how many contractions? Still? What was I doing wrong? I wasn't visualizing enough, or breathing deeply enough, or something... and how much longer could I do this? I hadn't slept in two days, I couldn't keep food down... I was tired. More tired, actually, than I had ever been in my life. I was starting to wonder how on earth I'd have the energy to push him out whenever I did finally dilate to 10.

And in the back of my mind, there was the kernel of a thought that I just wouldn't dilate to 10... that we were looking at a c-section. But I mostly ignored that thought. I went back to what I was doing wrong. Maybe I was too tense during contractions, despite all my efforts to relax.

I asked Gina what my options were for pain relief. Since I hadn't progressed enough for the epidural, that was out, but she could give me a narcotic to dull the pain. I accepted it, leading to one of the only regrets I have about that process: that stuff (Nubain? I'm not sure) sucked. I did get a little pain relief, but I was mostly just out of it - half-asleep, disconnected from the world for a while. And since I was so fatigued, I never completely recovered from it: for the rest of the labor process I had difficulties keeping my eyes open for more than a few seconds, and many times I would have one eye closed while the other struggled to focus on something. It was weird.

And that was the start, I think, of the slow march to the operating room.

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