Wow! The past two days have been crazy! I am going to attempt to give as accurate an account of my labor and delivery as possible, but I was pretty woozy for some of it, so the details may not be perfect.
Sunday, March 11th was my due date and came and went with no signs of labor. We spent a lot of time walking in the park, napping and just trying to both rest and convince the baby it was time to come out. Thursday morning I woke up around 4am because I needed to pee (not unusual). When I went to the bathroom I realized I had lost my mucous plug. I went back to bed and almost immediate began having contractions. I had a lot of Braxton Hicks and “pre-labor” contractions, so I knew that this was the real thing! We continued to rest until about 5am when I got up and ate a bagel and called the mid-wife on duty. She told me to take some Benadryl and try to sleep as much as possible. So, I took one Benadryl, followed by a nice relaxing shower and got back in bed. At this point (about 6;30am) my contractions were about 4 minutes apart and about a 7 on a pain scale of 1-10. It quickly became apparent that I was not going to be getting any more sleep, but I stayed in bed and tried to rest and relax as much as I could. We called my doula to give her the heads-up, as well. I got up to go to the bathroom at 7:45am and by getting up and sitting on the toilet my contractions got closer (1-2 mins apart) and stronger. At that point we decided it was time to get our things together and leave for the Birth Center, which is about an hour drive from our house.
We left our house about 8am and arrived at the Birth Center just a little after 9, having informed our parents on the way. The mid-wife examined me upon arrival and found that I was about 3 cm dilated and 75% effaced. We settled in and used a number of different techniques to work through the contractions including: hot shower, lower back massage/pressure, leaning on a ball, and squatting. My contractions were consistently 2 mins (or less) apart and quite intense but I was moaning through them and over-all handling it pretty well. By the afternoon the intensity was increasing so around 12 pm, the mid-wife checked me again and found that I was still only 3 cm dilated but 100% effaced. I was extremely disappointed. Here, I had been working my butt off for 8 hours and had gotten pretty much no where. My contractions continued to intensify in pain so that I was crying and screaming and no longer able to control myself enough to moan through them. It wasn’t long before I told my dear husband, who had been such a great support and source of stability and calmness, that I didn’t think I could do this much longer, especially since we weren’t seeing any progress. He had become so distressed by my complete and utter misery that he was also crying. We agreed that we would wait until 2:30pm, which is when the mid-wife had said she would be back to check me for more progress. I spent this time in the tub, hoping that this would help me relax enough for my body to dilate further. By now, my contractions were still only about 2 mins apart and a definite 10 on the pain scale so that I was begging for help of any kind. When the mid-wife examined me again and found that I was 4 cm, she presented our options.
She expressed that mine was a very difficult labor, even by normal standards and that it wasn’t just me not handling the pain well. The fact that labor started so suddenly and without any real “warm-up” phase had alot to do with it and she suspected that the baby was in the Occipital Posterior position, or “sunny-side up”, meaning that instead of facing my spine, he was facing my stomach which was causing me extreme and almost constant back-pain, even in-between contractions. Her concern was that the extreme pain I was feeling was preventing my body from relaxing enough to allow the contractions to loosen up and dilate my cervix, like they were supposed to. My options for medical pain relief were to either receive an injection of morphine and remain at the Birth Center or to go to the Hospital and receive an epidural. She explained that the morphine would not stop the pain, but that it would remove me from the situation enough that I would, hopefully, be able to tolerate the contractions better. Unfortunately, it would also make me loopy and possibly cause hallucinations, etc.
This was not a decision I was anticipating having to make. We had been planning a non-medicated, out-of-hospital, birth even before I found out I was pregnant. To admit that I couldn’t handle the pain seemed like an admission of failure and weakness on my behalf, but there was no doubt in mind that I needed help. At this point I had been in labor for over 10 hrs with very little to show for it and I was exhausted. After discussing our options, we decided that it was important for me to be fully conscious and aware for the birth so we prepared to transfer to the hospital. Once the decision was made, I couldn’t get there fast enough! It was only about an 8 minute car ride from the birth center, but that meant 4 contractions and me writhing and crying in pain through each one. When we arrived, one of our doulas dropped us off at the front door, but I had another contraction as I was getting out of the car, which left me kneeling on the ground, screaming and crying and generally terrifying everyone else who happened to be entering/exiting the hospital at that time. A hospital employee immediately recognized that I was in labor, brought a wheel chair and rushed me up to Labor and Delivery. The midwife had called ahead, so they were expecting us and got us into a room pretty quickly (2 more contractions) and immediately notified the anesthesiologist that his services were needed ASAP. The nurse started my IV (two more contractions) and explained that I needed to be able to sit still for 10-15 minutes in order for them to administer the epidural. Well, they had by this time witnessed my complete inability to sit or stand still during a contraction (by this point I was begging any and everyone within earshot for help), so they gave me some Fentynal (sp?), a narcotic, which while not taking away the pain, would relax me enough that I should be able to cope better with the pain. Fortunately, it kicked in almost immediately (one more contraction) and I was able to sit on the bed and remain still enough through three more contractions as they administered the spinal and epidural.
They explained to me that the spinal would kick in very quickly and leave me feeling absolutely nothing for about an hour. After that, it would begin to wear off and leave just the epidural working which would allow me to feel pressure from the contractions but not the agonizing pain I had been enduring. They were true to their word and within five minutes I was sitting in bed feeling great and so thankful we had decided to transfer. The nurse put in a catheter while I couldn’t feel it and suggested that I get some sleep. I didn’t need to be told twice! It was now about 3:45pm and I had been awake and laboring for almost 12 hrs. I told my husband and doulas to feel free to go and eat or rest, since I was now feeling great and didn’t need their constant support; then I fell asleep.
At 5pm the midwife checked me again and I was 5 cm dilated, by 7pm I was 8 cm dilated and still feeling good. It was clear that she had been correct in saying that my pain had prevented me from relaxing which prevented my body from being able to dilate. With the epidural and some rest, my body quickly loosened up and dilated. For some reason, my body did not react evenly to the epidural, so that it worked better on my right side than my left and twice I had to have the anesthesiologist give me an extra dose because of pain in my lower left back. I also had a button to press that would release extra medication every 15 mins if I needed it.
By 10:45pm I was fully dilated, the baby’s head was in my pelvis low enough that I could reach in and touch it, so we decided to begin pushing. An unfortunate side-effect of the epidural was that I did not feel any need to push and found it difficult at first to know if I was pushing effectively or not. At 1am, the midwife suggested that I get some pitocin because I had been pushing for a couple of hours and the baby still had not moved any lower. She hoped that the pitocin would help make my contractions stronger and more efficient. It worked and I could now feel to push better and so I got down to business and pushed as much and as long as I could for the next hour. At that time, it was clear that this baby was just not coming out. So, once again we were faced with the difficult decision to have a C-section.
Never in my wildest dreams would I have thought that I would be willing to even consider a C-section. The mid-wife explained to us that we had exhausted all other options and nothing was happening. If I continued to try and push and nothing happened, I would simply become exhausted and eventually the strain of labor would begin to wear on the baby as well. At that point in time, both the baby and I were healthy and tolerating labor well, we just weren’t progressing and she felt it was time to consider the C-section. So, she called in the OB for a consult and she quickly agreed. It was probably about 2:15am at that point and I had now been in labor for 22 hours.
Again, once the decision was made, I just wanted it over with. The sooner we did this, the sooner I could hold my baby. Surgery prep went very quickly and it wasn’t long before I was shivering on the operating table with a paper sheet in front of my face and my hubby, in scrubs, beside my head. The combination of the medications and my extreme exhaustion meant that I was coming in and out of consciousness, struggling to stay awake enough to see and hear what was going on. At 2:47am, Friday, March 16th, our son, Micah was finally born. He was cleaned up and handed to his father who was able to sit beside me and keep Micah skin-to-skin as the team finished the surgery. I had been told that I could have the baby laid on my chest, skin-to-skin, as well and even try to nurse, but the meds hit me harder than they had anticipated and I did not have sufficient control of my arms to be able to hold him. Instead, they laid him beside my head so I could rub my face against his and kiss him.
I really have no idea how long the surgery lasted because, despite my joy and excitement, I continued to slip in and out of sleep. Once the meds started to wear off a little as they were sewing me up, I was able to focus and talk to some of the doctors and nurses around me. My midwife stayed with me the entire time, observing the surgery and helping with the care of Micah. She was able to answer questions we had and took his picture for the first time. Once we got to recovery, I had sufficient use of my arms that, with help and the support of pillows, I could finally hold him. By 6am he was latched on and nursing; I couldn’t have been happier. My parents were there and were able to come in and see both of us before heading home for the night…I mean morning? It was so confusing having been awake so long, and my days and nights are still mixed up (thus why I am writing this account at 1:45am).
By about 7am, Friday morning, we were assigned a room on the maternity ward and finally able to just sleep. Of course, life with a newborn means that you can never “just sleep.” So, the rest of the day, Friday consisted of nap, feed baby, hold baby until I start to doze off, another nap, repeat. At this point, it looks like we will probably be in the hospital until Sunday or Monday. They took my catheter out around 6pm and I was able to get up and walk around some. Getting up and down is the hardest part, I really don’t have much pain while standing. I am extremely bloated because of all the extra space inside of my belly, my intestines are taking advantage to bloat to enormous proportions, unfortunately. Right now, I am receiving Motrin and Perkacet (sp?) around the clock for pain management and this is working well. As I type this, Micah is asleep in his bassinet and his father is asleep on the couch. I am due for my next 2 hr nap and getting a little bit hungry (for the first time in two days!), so I am going to find something to munch on, and go back to bed.
Thank you everyone for your thoughts, prayers and well-wishes. As I said, we hope to be home early next week and will probably begin receiving visitors by Wednesday. I have a projected recovery time of about 6 weeks, so I don’t know that I will feel up to having a lot of people over all at one time, but we do want to show off our handsome little man! Fortunately, I have a lot of family near by and the in-laws will also be visiting soon, so I should have lots of helping hands to take care of things around the house and allow me to focus on healing and taking care of Micah.
I also feel the need to add that, even though this birth was about as far from the birth I had planned as possible, it really was not a bad experience. I had never been to this hospital before, as either visitor or patient, and I have been pleasantly surprised. As it turns out, the C-section was the best decision to be made under the circumstance. Not only was Micah “sunny-side up,” he was also presenting forehead first and he is a hefty little fellow (8lbs 8oz) and the doctor believes his shoulders may have been too wide for my body anyways. He was very firmly lodged in my pelvis, so that instead of just pulling him out through the C-section incision, they had to have someone help push him out from the other side! But, aside from a bruise on his forehead from being pushed against my pelvic bones, he came through just fine! My nurses have all been great and everyone is very respectful of us. They work very closely with the Birth Center and respect my wishes to have a natural birth and are very kind and understanding, not at all judgemental, as a lot of doctor’s are (“Well, if you had just come to us to start off with…”) So, all-in-all, I can’t complain: I have beautiful, healthy baby boy, I am healthy and recovering well…what more could I ask for?