Saturday, June 11, 2011

Long, indulgent birth story


On Tuesday, regular contractions began late afternoon.  Since I’d had a few episodes of contractions that came and went, I figured it wouldn’t hurt to be up and around to try to keep them going.  Ikea trip!

After dinner and browsing, with contractions getting stronger and closer, I began to suspect we might be going into labor, so we left and talked about how to arrange ourselves:  what to do with the kids, when to call the doc and get to the hospital.  With this birth, I didn’t want to be in the hospital for all the business, but I also wanted to be sure baby was fine.  It was a trade-off that required some sacrifice from me, but one I was willing to make.
 
Around 10 pm, I called my practice and was pleased to find that Dr. Wolf was on call (he was the one who promised to allow me a trial of labor).  Contractions were coming every 4-5 minutes and lasting nearly a minute, and they had been coming for several hours, so it didn’t seem premature to go in.  We arrived at the hospital just before midnight:  the kids were in bed and settled, the ride in was relaxed, and both of us were feeling optimistic.

Although I was found to be only 3 cm, 70% and -2, still we felt confident that we were in early labor.  Contractions had continued through the car trip, and even with all of the distractions and annoyances at the hospital, their intensity had not subsided. After 2 hours of laying in the bed, though, there was no progress, and my contractions were spacing out.  I knew that if I could just shed the monitors and get up and walk, we’d be on the way in no time. 

I was given two options:  go home or augment my fast-dying labor.  A quick ultrasound found my fluids low, so augmentation begun.  Before they started pitocin, they placed the epidural.  This was around 4 am. 

I think I get why people in their minds want epidurals, but ladies:  those things are no fun.  The resident working on me tried four times to get it in the right spot.  I was numbed, but I couldn’t help but feel every attempt to get that catheter just so.  Ick.  It was the only time during the birth that my heart raced.

At 5 am the pitocin started, and that low-dose epidural was barely effective.  Having suffered through the placement of the dreaded thing, I just wanted to reap some benefits, get the labor going and meet the baby.  Increasing anxieties about using pitocin with little pain relief creeped in:  I was concerned that residents weren’t listening to my requests for more relief, and I knew that the pitocin would be increased regularly.

In an hour, I had progressed to a measly 4 cm, and though my contractions were regular, stronger and more painful, I still had very little epidural coverage.  There was a cycle of anesthesia residents, with none of them solving what seemed like a simple problem (add more stuff, please!).  The resident caring for me swept my membranes.  The dayshift nurse took over at 7 am and informed me that the on call anesthesiologist was on her way.   She found me to be 4-5 cm, which was discouraging.

I laid there laboring in fear and anxiety, laying in the bed, convinced that my position and lack of mobility would cause the labor to stretch out over the whole day.  I imagined a painful, slow progress, laying in bed as I was.  Though I used relaxation as much as I could, which helped me to stay on top of things, I couldn’t move as I needed to.  I was either on my back (BAD!!!) only slightly inclined, or on my side, which was somewhat more comfortable. 

Dr. Wolf came to check on me, too, and asked me if I still wanted a VBAC.  To be honest, at this point, I was seriously considering ending the whole attempt.  It was hard to labor in bed with no end in clear view.  His suggestion, though, only strengthened my will to avoid surgery if possible.  It wasn’t nice to push (even gently) me into an unnecessary surgery.  I was able to convince myself that the hours of laboring discomfort would still outweigh the days of recovery from surgery.  

My nurse was completely optimistic and encouraging.  When she told me that I would have this baby by lunchtime, I believed her.  She promised to get the epidural issues resolved, and reassured me that once I could rest and relax, we would see better progress.  

Though time dragged so slowly and it seemed like forever until that anesthesiologist arrived, by 8 am she had fixed everything.  She added medicine to the existing line for immediate relief, and then replaced the bag with a stronger dose.  The new OB took over, too, and in a short space broke my water, put in an internal monitor and sat by waiting.  I don’t think she left my side after coming on. 

Relief and relaxation came within minutes.  As the sharp pain of contractions were blunted, I willed myself to rest.  I turned over, closed my eyes and prayed the Divine Mercy chaplet.  Peace filled my whole body as I allowed myself to fully trust in Him and place myself in his presence. 

30 minutes later, I felt a searing, aching pain in my lower abdomen, like deep stretching, tearing pain.  I was certain my c-section scar was separating.  My nurse, though, was calm and objective:  was the pain coming with contractions?  Did it subside if we shifted positions or massaged it?  She decided to check me and lo! I was fully and +2!  If I pushed, she informed me, the pain would diminish.

Here was a whirlwind of emotion:  joy at the incredible progress, excitement that he was so close, and a stinking fear of pushing.  My new doc and the nurse both agreed that laboring down was fine, but probably unnecessary.  They encouraged me to try to gently push, reminding me that thus far my heart had been strong and stable.  Not even a blip.  As if to show me her confidence, Dr. Shlansky asked me to wait for her to get on a gown. 

While she prepared, I secretly tested their theory.  With the next contraction, I pushed a little, and that pain did go away.  I could feel him moving down, too!  It was an odd sensation, having the baby move down without the intense pressure that accompanies an unmedicated birth.  Let’s do it, I thought.  It was incredible to have a quiet confidence that wasn’t entirely my own.

In one contraction, with my first push, his head delivered, and we find his little fist tucked up to his chin.  In another gentle push, he was born.  I didn't even really push--just kind of eased him out.  It was amazing, easy, and quick.  I had no arrhythmia, no mechanical assistance, and no complications whatsoever.  Dr. Shlansky remarked that the birth was so uneventful that she had nothing to write up.  

After I pushed him out, I got to hold him, dry him off and cuddle him.  No one took him from me, and there was no interruption from the attendants.  I nursed him, talked to him, and basked in relief and joy--it was tremendous.

My favorite part (aside from the baby, the ease of delivery and the quick end!) was when Dr. Wolf stopped in an hour later to check on me.  His face when he walked in the room to see me un-tethered,  fully recovered and nursing a baby--it was beautiful!  Clearly astonished, he asked, "Did you deliver already?!"  Indeed!  And without any cuts!

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