Sunday, March 11, 2007

Labor story

If I don't write it now, I probably never will. So here's my labor story:

After two days of increasingly intense and regular contractions that suddenly stalled, I should have realized that my body did not, as promised, know how to do this without help. Wednesday morning at 9 a.m., JW and I headed to the hospital for our scheduled induction. As soon as we got there, I was hooked up to an IV with saline, two kinds of antibiotics (because my water had broken about 36 hours ago), and Pitocin. A blood pressure cuff was put on my arm and a fetal monitor attached to my abdomen. I felt like a patient, which was pretty much the opposite of what I had hoped for out of my birthing experience. I couldn't get comfortable in bed or in either chair -- the nurse shrugged and said, "Honey, you're short."

I became even more unhappy when the Pitocin kicked in. I still didn't want the epidural, which is usually pretty much automatic with an induction, because it would mean I'd be stuck in bed the entire time with even more tubes hooked up to me. But the induced contractions were much more painful than the ones I'd had on my own, and I barely got a break between them -- there would be about thirty seconds between one and the next. The midwife said this was because of the baby's face-up position. My body was trying to turn the baby with these continuous contractions. I stuck it out, but the only way I could do it was to go into deep relaxation immediately and remain there, breathing deeply and concentrating with each contraction. This went on for about four hours. I tried changing positions and at one point sobbed to JW, "Why is this happening?" He was there the entire time, holding my hand and literally supporting me through the contractions. He wouldn't even leave to eat lunch even though I told him he should keep his strength up.

Around 1:30 in the afternoon, the midwife decided that my natural contractions had kicked in and she could turn down the Pitocin drip. Thank god. I was fine after that for a while, but in the evening my natural contractions started following the pattern of the induced ones -- wave after wave with only seconds of relief in between. At that point I had also started sweating and shaking uncontrollably. I had to muster all my hypnobirthing skills to get my muscles to release and relax. I started asking for an epidural. The midwife encouraged me to stick with the hypnobirthing, telling me, "You can do this. Stay on top of it." I kept repeating that to myself. Stay on top of it. The amazing part is, I could. I could actually get my muscles to relax and stop shaking momentarily. But it took an enormous amount of concentration, and by that time I just didn't have the energy left. I didn't see the point of having all that pain when I was already confined to bed with tubes sticking out of me.

The third time I asked for pain relief, I had to wait about half an hour for the midwife to come back from another laboring mother. She told me that my increased pain might be a sign of progress, that I was almost ready for pushing, so before giving the order for the epidural she examined my cervix. It was completely soft and seven centimeters dilated. If there were any pressure on it, she said, it would fall right open and the baby could come out. But the baby hadn't moved down at all. They measure the descent of the baby's head in stations -- 0 is right against your cervix, +5 is crowning. My baby was at -2 and wasn't budging. She wanted to increase the Pitocin drip and I insisted on the epidural before that happened.

I waited another fifteen minutes or so for the anesthesiologist to finish with someone else. With each contraction I kept telling myself, This could be the last time. Soon I won't feel this pain. When I finally got the epidural, I felt almost instant relief. I didn't care about being stuck in bed, since I didn't have the energy to get out of bed by that time anyway. I took a nap.

Two hours later, the midwife gently woke me and said there was a problem. The baby wasn't tolerating the stronger contractions. Not only was he not moving down, but also his heartbeat was dipping slightly after each contraction. She said I could wait it out and see what happened, but that might result in an emergency C-section. We decided to give it just a few more minutes and plan for a C-section in the likely event that it didn't improve.

The doctor covering for my OB came in a little later to introduce himself and explain the procedure. He said JW would be given scrubs and allowed to come in once I was on the table and prepped. Since I already had the epidural, they would just increase the dosage. A little more waiting for another delivery to be done, and then I was wheeled in, placed on the table, and given an oxygen mask. They unfolded a curtain in front of my head so I couldn't see what was happening. I could feel the pressure of what they were doing, but I didn't feel any pain. The whole thing was even stranger because my ear was all clogged when I woke up from my nap and I could barely hear, so I felt even more in a fog. After what seemed like only a few minutes, I could hear a cry. My baby! By this time I could barely keep my eyes open. I thought I saw the baby go by out of the corner of my eye, and JW went to see him. They stitched me up -- I guess, I really don't remember that part -- and JW brought the baby over to me. I vaguely thought, "He's finally here," and then, "How do I know he's mine? I didn't see him come out." I managed to turn my head for a few seconds to look at him, then I gave in to the urge to go to sleep.

In the recovery room, I had the shakes worse than before, and even more things sticking out of me (they had added pressure cuffs on my legs, a catheter, and the connection for the epidural). The nurse told me to nap but I was shaking too hard. After an hour or so, JW and the baby came back from the nursery. I fed the baby for the first time -- the nurse showed me how to use the football hold for breastfeeding so that he wasn't on top of my incision scar. He was alert and latched on right away. Maybe being lifted out was less traumatic for him than being pushed out would have been.

I'll end the story here, even though it lacks a heartwarming moment. Those came later -- in the morning, when I got to see my baby for the first time, drug-free; over the next few days in the hospital, when we got to know him and hold him and learn how to care for him; every time I saw JW's face soften as he looked at his son; after we got home, when it suddenly hit me in the middle of a nursing session: I'm his mother.

I'm glad I got over my vision of the perfect labor well before it happened. Looking back, if I could do it over without knowing the ultimate outcome, I would have made the same decisions except for requesting the epidural about two hours earlier. (Of course, if I knew in advance I'd need the C-section, I'd just have them slice me open in the first place.) But we did our best to have the birth we wanted, accepted the birth we got, and most importantly, we have a beautiful and healthy baby boy to show for it. Definitely worth it.

Update: Just to clarify, this isn't meant to be a macho labor horror story. My labor was long and at times excruciating, but it was purely because of the unusual choices I made -- first, to spend so much time at home after my water broke, and second, to refuse pain relief along with the induction. My story could just as easily have read, "Late Monday night my water broke. We went to the hospital and started the Pitocin drip with an epidural. After a pain-free day in labor, we hadn't made any progress and I ended up having a C-section. After 16 hours in labor, most of it lying in bed, I had a beautiful baby boy." If I had the natural birth I wanted, I still believe that the relaxation techniques I learned would have gotten me through it, even though I may never know for sure. So please don't read this and be terrified of ever having a child!