Childbirth

What a difference a few hours make. Shortly after I published that last post I went in for what I assumed would be a routine prenatal check of my blood pressure and the baby's in utero movements. I didn't realize a year would have passed before I stepped foot outside the medical center again.

Okay, maybe I did have a bit of a premonition. Before leaving for my 3pm appointment I added a few last things to my hospital bag and made up a separate bag for David. I took a nice long shower and shaved my legs, coated my dry skin in lotion, and made sure the last of my laundry was in the dryer. Also, my doctor had told me that on these checks, if results were not as they expect then tests would escalate and could ultimately result in my being admitted for baby delivery.

But in the back of my mind I operated from an expectation that I'd be headed for a family dinner that evening as planned. I felt no signs of labor (wasn't even having Braxton Hicks or other early labor symptoms). Both David and I had been born late, so the "estimated due date" being 2 days hence was not much of a concern for me. The one hiccup was that my blood pressure was measuring consistently high when I went in for my last checks, even though at home each day it was within non-worrisome range. In short, I was comfortable with the idea that there was still time before baby came.

If nature had run its course, maybe I'd have been proven right. Who knows, who cares. Long story short, my blood pressure was high again and the baby did not cooperate with any of the fetal monitoring (he basically "failed" or didn't meet the protocol for 3 different, consecutive tests). After 6 hours of monitoring (plus 1 surreptitious dinner and a pros/cons talk with David) I ended up agreeing to be admitted and induced into labor. I was put into a lovely private labor and delivery room at 10pm, was sucking down fluids via IV by 11pm (apparently I was dehydrated on top of everything else), and dilated to 8cm (out of 10), by 11pm...the next day. Yup, a whole day passed of drug induced contractions before I would be considered to be in active labor.

Meanwhile the entire family arrived in eager anticipation. I wasn't writhing in pain for most of the day and company provided a nice distraction from the twinges and boredom. I enjoyed hearing reports of life in the waiting room and bets the family had made on when baby would be born. Nurses kept asking me what my pain level was, and I hemmed and hawed over how to characterize generally minor or at least completely manageable discomfort. I put the TV on a soothing music/nature images channel and dozed for minutes at a time. Early on I asked for and got a telemetry monitoring unit so I could walk around my room. I had a birthing ball to sit on during contractions, and David rubbed my back and offered me my iPod loaded with "labor tunes". After a while though even these things lost their comforting effectiveness. The waiting room crowd grew restless and started considering going home for the night. I wished I could join them, if only for a change of scenery.

As night settled in, the augmentation really started getting somewhere. I felt steady and painful contractions. Noting the time elapsed, progress left to be made, and my tired and hungry state, I asked for and got an epidural. Suddenly things were looking up. The intravenous pitocin (augmentation method #3) sent me from 5.5 to 8cm dilated in a little over 2 hours. The nurse who was set to leave at 11pm was optimistic that baby would arrive on her shift. Family settled back into their uncomfortable chairs and inane chitchat. David tidied up our stuff in the room in anticipation of the final phase. The only hiccup was that the fetal monitors kept moving out of position, and the nurses would have to readjust them constantly. Somewhere along the way the pitocin got dialed way down (basically, off). Progress slowed.

So I've been in my fashionable hospital gown for 24 hours at this point. Nurses cranked pitocin back up, at a faster rate than before. Contractions and pain built back up and then some. They switched to a fetal scalp monitor for baby, and hooked me up to some other monitor to measure intensity of contractions, plus gave me oxygen. However, even well after the amniotic sac had been broken, the baby hadn't dropped much more than where he was when I started all this, and certainly not enough to warrant pushing. So on with the contractions and monitoring and bedriddenness and "how's your pain level now?" we continue.

The epidural helped some with the discomforts of labor, but by the time I was 9.5cm (and holding) I had developed these weird muscle spasms in my hip that made virtually every position I could be in unsustainable and distracting. (And David tells me now that my epidural line might have been dislodged at some point, I dunno about that.) I was excited for what was to come, but with little dramatic progress and going into day 2 of no rest or substantive food, I started wearing down. I wanted to get up and move around, but the epidural made that impossible. I think I might have started dwelling on this deep desire to just stand up for a moment, but no one else thought attempting to do so was a safe idea. Again, in hindsight, who knows, who cares.

Doctors checked and rechecked the baby's position. There's a bit of cervix in the way of baby's dropping; I'm sort of stalled out at 9.5 cm. Dr. Mason tried to ease baby's head past this spot. More checking ("Sorry, you'll feel a bit of pressure" they'd all begin with, which always made me laugh.) Two people think Mason's maneuver has done the trick, but another thinks it hasn't. Okay, not an insurmountable issue. Another hour of contractions and we decide I'm dilated enough (turns out it's a subjective thing). Start pushing. Great, I thought, I can do something other than just lay here waiting for pain. It would be a relief to help things along, and I gathered my energy for the final stage.

Four hours later I was nearly useless. My concentration was completely erratic. I'd be in the zone for one contraction, then could only manage half hearted pushing on the next. The shift change had brought two nice but not terribly helpful nurses. David seemed eager to help but at a loss as to what I needed. Looking back I think my difficulty stemmed from being too "in my head" about things. I feel most confident and comfortable with new tasks when I get to process, attempt, evaluate, and retry. Good or bad, it's just who I am and generally it works for me. Well that sort of process just doesn't work when time is of the essence.

During childbirth there are contractions coming one after another with little time in between to regroup, more less think about things coherently and plan a better attempt on the next round. You have to just push, breathe, push. Let go of the pain in the hip, ignore the uncontrollable body shakes, block out the well intentioned queries from your partner, and forget watching the electronic monitor for a visual on when each contraction begins, peaks, and ends. Push. Breathe. Push. I'm doing what I can, but baby is still not dropping.

At the next doctor check David and I asked what our options were. She reported that baby still had a ways to go, but of course things can change rapidly. Pushing was making some headway, if I could just continue with it. That was the question. The doctor had me push through a few contractions, and I did my best. But the shaking and the hip pain and the inability to focus my eyes and the headache that came from holding my breath while I pushed (which was only productive method at that point) took up more of my attention than the urging of the baby to drop down and head on out. Doctor would gladly let me push as long as I was willing, but the lack of progress would warrant a c-section, if I wanted it. David and I did not hesitate to accept that offer.

From then on, everything went absolutely smoothly. The doctors and nurses who prepped me and did the surgery were wonderfully courteous, informative, and professional. The procedure was complication-free, my recovery was swift, and we had a perfect little year-end tax deduction, I mean, baby boy. ;)

I'm sorry to report I couldn't clear my head when faced with the pain and exhaustion of childbirth. Sorry only because I would have liked to learn to do it. You don't get many such opportunities. However, don't read too much into this, because I am not in the least bit sorry about choosing the c-section in this instance. I did not then, nor do I now, feel in any way cheated out of a natural birth experience. I would have preferred not to have had my labor induced because I know where it tends to lead, but at the same time I know why medically all the doctors who saw me that first day recommended doing so. My body and mind were not ready to deliver the baby naturally that day. However, as soon as Adam was delivered we could see that he was completely ready to be out in the world, and we were more than happy to have him with us at last.