I started this post 2, no 4 weeks ago. I'm a shit blogger. Those of you who stop by regularly already know this. I frequently go months between posts...luckily I'm a better mother than blogger. Could these things even be compared? Probably not.
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**Reader discretion is advised: Gross information below, this is childbirth after all!**
We arrived in triage and were quickly shown to an exam room. I peed in the cup and changed into a gown. The midwife was paged (still my regular prenatal midwife) and arrived swiftly. I was already on the monitor and the sound of baby's heartbeat filled the room. The nurse walked out of the bathroom with my pee results. Apparently I was passing ketones. Meaning I was undernourished. I was also apparently dehydrated. The midwife examined my cervix...I was holding my breath for this, hoping I was at least 5 cm...I was only dilated 2-3 cm. All information was not pleasing to my ears. It meant that I needed fluids and that we still had a looooooong way to go. As an aside, I'd like to mention that the midwife said I could be sent home to labor longer if I wanted but if I wanted to stay, I could. For a myriad of reasons I stayed. One being, who wants to get back in the car and ride home again only to have to turn around at some later point to come back to the hospital? No thanks. On a related point, I just wanted to settle in for the long haul. Also I felt more comfortable with the hospital staff around, just in case.
Another nurse arrived to start the IV. First she tried the back of my left hand then the back of my right. Since I was dehydrated, my veins were not cooperating and she kept getting hung up on the valves. So where did she end up putting the IV? In the crook of my left elbow, thank you very much. It wasn't a needle, but one of those plastic cannula thingies, but still not a good location for an IV regardless of the situation. But that was what we got and we worked with it. Eventually, we were shown to our room. I hopped (ha-ha) into another wheel chair and went for a ride.
When we arrived in the room the great irritation of getting me properly monitored began. Since I was receiving IV fluids I had to be monitored continuously. They wanted to use the wireless waterproof devices but I had shit equipment in my room and they wouldn't work. I wonder if they are kept in better working order in the tub rooms...well, I wouldn't be finding out on this trip. After getting connected to the regular monitoring equipment I got back down to the business of laboring. Oops, not yet, my dear, someone is here to see you. Someone from the anesthesiology staff dropped in to give me the skinny on my options. I informed her that I was trying to do this naturally, thank you very much, that I did not want to be offered pain control and that if I needed it I would ask for it. I also said that if I needed anything I would have an epidural and she ran down the risks/benefits portion of the informed consent. I wasn't asked to sign anything at this point.
Remember the birth plan I forgot on the kitchen table? Well, as luck would have it, my husband works at this hospital. And as further luck would have it I had the document saved in Google, so he was able to go to his department, print off the plan and bring it back. When he brought the plan back, I saw the nurse look it over for a second and put it in the back of my chart which momentarily annoyed me. Let me say at this point that having the plan on hand was nice in theory but in practice it just didn't work out...details to follow.
So despite all this stuff, I was still in labor, right? I would say over this time the contractions were getting steadily more intense, but I was doing my level best to breathe through them. It was evening time, I guess during my breaks I was sucking on popsicles and eating applesauce. During the contractions, I was breathing, moaning, getting my back rubbed by my husband and generally just trying to get through. I recall lying on my left side in the bed and looking at this tiny screw in the hospital bed, a six-sided star shaped screw. And I was trying to visualize that tiny star-screw opening up into huge fireworks. I desperately hoped that this visualization technique would speedily open my cervix.
There were many trips to the bathroom during these hours of labor. On one of them, I felt something slippery and wet between my legs. I complete freaked, fearing that my water broke while I was peeing and that the umbilical cord had come out first. I called my husband over to check what was hanging between my legs. Turns out it was just the bloody show. It was much larger than I was expecting. Sometime after losing the bloody show my water broke. It was an unmistakable pop/gush breaking of water. The midwife came back to measure me and I was now dilated to 5-6 cm. This must have been around 10 pm.
At this point my contractions were beyond intense. In fact, I lost all control over my body at this point. This was the scariest part of labor by far. What actually happened is so clear in my mind, although I can't remember how many contractions we allowed to go by before something was done about it. Dilated to 6 my body involuntarily started trying to push the baby out. Now, going through these intense ass contractions and focusing and breathing and then also trying to fight a war against my body to stop the pushing was so fucking hard. I was making crazy sounds and flopping all over the bed like a fish out of water. I told my husband I wanted to die. I was terrified. The midwife advised me that if I couldn't stop the pushing that I would damage my cervix. Around 11:30 I told them to bring back the anesthesiologist. NOW. I signed the consent faster than I've endorsed any check, even when I was flat broke. Then I got the epidural. Despite the freaky contractions I was able to hold my body perfectly still for the Dr. And then...sweet relief. I told the anesthesiologist and nurse anesthetist that I loved them. Three times. The nurse then placed the catheter and I was fully bed bound for the rest of the event. It was around midnight and we settled down to try to get some rest.
My husband fell asleep immediately and I may have dozed but was too excited to really sleep. I was also really itchy about which it didn't really occur to me to complain until much later. In any case, I was hanging out, craning my neck around to watch the monitor since I couldn't feel anything any longer and see how often the contractions were occurring-about every 3 to 4 minutes. A few hours passed like this and around 2 or 3 am the midwife came in to talk to me (I think we were on our 3rd midwife at this point). She was concerned about the decelerations and also monitoring equipment. She was also worried I was low on amniotic fluid and that the position I was lying in was not good for the labor pressures. So the first thing she asked if we could do was set up continuous internal fetal monitoring. I consented. Then she wanted to do an amniofusion, basically to infuse saline into my uterus and replace some fluids. Then I changed positions from sitting on my butt to kneeling with my arms resting on the back of the bed. This improved the baby's heart rate as well as our ability to measure it. I continued on in this position for what seemed like hours. My husband woke up to hang out with me and shared a concern about my knees. Namely that I was crushing them with my monstrous weight. I assured him I was comfortable (duh, epidural) but that I would change positions when I could no longer kneel. I got some Benadryl for the itching and settled in to labor without feeling.
Eventually, hours passed like this, a new day broke, and a new midwife arrived, lovely Mary. She measured my progress and I was now 7-8 cm dilated. So, overnight I only gained 2 cm. I was not that surprised. I knew this was likely to happen with the epidural. So, it was now time to add pitocin to the mix. We had to get this baby out after all. The morning passed with the epidural slowly wearing off and the contractions getting more intense aided by the Pit. Finally around noon I was dilated to 9.5. I only had anterior lip of cervix that impeded my pushing. Mary tried moving it out of the way while I gave pushing a try, but it kept moving back into place. She said we could wait for me to dilate the rest of the way before I started pushing and left for a bit. Thing was, I had an overwhelming urge to push. So I did. For the next few contractions, and with my husband's help I pushed. They came back after a bit to measure me and I was finally 10. So I was now pushing with every contraction. I was also changing position between each 2nd or 3rd contraction because the decelerations were getting too low with each push. An MFM specialist, Dr K, came to see me about assisting the delivery (meaning forceps, vacuum or section). I asked to stay in the room and try to push the baby out myself. She gave me a half hour. I asked the staff to bring in a mirror so I could watch the baby's head come out. I pushed and pushed (it felt so good to push) and I was able to feel the baby moving down. Then I could see the top of her head and I pushed and pushed but she wouldn't come out and the heart rate was going and staying so low. Dr K came back and said we've got to help you get this baby out, we can't wait any longer. And I cried...I desperately wanted to do it myself. I thought somehow despite all the interventions I would be able to do this myself. But I didn't seem to have a choice, we had to get the baby out before something bad happened. So around 2 I stopped pushing, signed the consent for forceps assisted delivery with the possibility of a section if they couldn't pull her out. I was wheeled to the OR in my bed. I cried the whole way there. Upon entering the OR I saw what seemed like 20 health care professionals (maybe closer to 12-15). I completely freaked out, I was wailing, heaving sobs. This was so not going to be the birth I had imagined. Everyone was so kind to me, they calmed me down and were so reassuring. I am convinced that one of the reasons they needed so many in there, besides the obvious, was so that they could heft me from my hospital bed onto the operating table. They got me situated, and the anesthesiologists turned the epidural up to the max. My husband was holding my left hand and Mary was holding my right. I looked down and I could see Dr K placing the forceps. The head of the maternal fetal medicine division was sitting by my left knee and patting me reassuringly. They said they would tell me to push when I was having a contraction. They told me to push once and I could feel her head coming out. Then they told me to stop pushing. They had to reduce the cord which was around her neck and the reason for the bad decels. Then they told me to push again and I felt her come out. Then she was here!
Sunday, June 29, 2008
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2 comments:
Oh wow. That was a pretty scary birth story to me. We sometimes have to remember the important part is having a healthy mom and baby at the end - even if it is not the birth we envisioned.
Not a smooth ride. Still, I'm glad things have turned out since, as, I'm sure, are you. That sobbing brings back memories...
Bea
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