Monday, May 18, 2015

Labor and Delivery: Part One

This is how I thought it would go down:

I would slowly go into labor naturally.  There would be the excited "This is it!" moment where twinges of pain are realized as labor pains.  We live a mile from the hospital so I'd tough it out in the comfort of my home, using my breathing techniques and labor ball and husband for support.  We'd go on a walk, I'd take a bath, I'd listen to relaxing music, I'd time carefully.  When contractions were 4 to 5 minutes apart for an hour, we'd head to the hospital.  If I decided I needed meds, I'd get them. Then I'd deliver my baby naturally.  I'd see him enter the world and in a moment of euphoria I'd remember forever, he'd be placed on my chest, all gooey and fresh, for skin-to-skin bonding time.  We'd weep with joy and be overwhelmed with love.  And all would be right with the world.

None of that happened.

Here is what did.

***

I woke up around 6:00AM on Friday, Feb. 22, which is pretty standard.  My husband works for an east coast company and so that's when his day starts.  Since his office is in our bedroom again (because the nursery took over his office) I always get up when he does and move into the nursery so I can get a little more sleep.  But on this morning I had some slight cramping.  Nothing severe but enough to breathe consciously through it.  Since I was two days past my due date I got a little excited.  Maybe this was it!  I tried to fall back asleep and about a half hour later, the cramps were back.  This could be it!  Again, I tried to fall back asleep.  About a half hour later, the cramps came back again.  I went back into our bedroom and told Dan, "I'm not sure what's happening but I'm having some cramps and they are happening at half hour intervals."  He packed his bag.  We waited for the next one.  A half hour passed.  Then another thirty minutes.  Then another.  And nothing happened.  The cramps were gone.  We felt a little deflated but encouraged that something seemed to be happening.  My cousin and his wife had their c-section scheduled for the 22nd and it was exciting to think that our children might share a birthday.  But that didn't seem to be in the cards.

***

I went about my day and noticed that I was leaking some fluid. I put on a panty liner and it didn't get soaked so I assumed that the fluid was urine.  The baby was definitely laying low and I thought maybe he was pushing on my bladder, causing some incontinence.  I also noticed that there seemed to be some sloughing off of something every time I urinated.  But since my doctor had swept my membranes on Wednesday, I assumed that the residue I saw was a result of that.  It was light brown, not bloody.  Again, the cramps I had in the morning were gone and whatever was leaking was so slow that I didn't need to change my panty liner until a few hours had gone by.

A friend stopped by in the afternoon to visit and I mentioned to her jokingly that, "Who knows? I might be in labor right now and not realize it."  She laughed and said, "I'm pretty sure you'll know when you're in labor."  This was around 2:00PM.  There were a few more cramps during the day but nothing consistent and nothing that lasted longer than a few seconds.  I figured it was Braxton Hicks.

Dan and I made a steak dinner around 6:30.  Big steak, baked potato and a salad.  My cousin's baby had just been born.  There hadn't been anymore signs of labor.  As we started eating, I toasted with my water and said, "Hope to see you again later, Steak."  I've read that most women vomit from the pain of labor.  It was a joke.  I didn't expect it to be foreshadowing.

As we finished dinner, I felt a rush of fluid.  More than I had felt throughout the day.  I went to the bathroom to check things out and noticed that the fluid now had a pinkish tinge.  Hmm...maybe I should call the doctor.  This might not be pee after all. (Duh Meagan!)

I called my doctor's office and the doctor on call listened impatiently to me.  "I'm 40 weeks, 2 days and I've been leaking some sort of fluid..." "You have to go to labor and delivery." "But could it be...?" "You have to go get checked out now."

There was an urgency to her voice that annoyed me.  She didn't even let me explain the color or that it had been happening in small amounts or that I wasn't having any contractions or explain anything really.  She heard the "f-word" and cut me off.  I rolled my eyes and told Dan we had to go to the hospital.  "They're going to send us home but I guess 'better safe than sorry.'  They probably have to tell you to go in when they hear the word fluid. Some sort of liability thing, I bet."  So we shrugged our shoulders, finished cleaning up dinner and gathered our things.  I already had my bag packed, so we grabbed the car seat just in case and made our way down the road.

***

We checked in at the hospital at 8:00pm.  The woman checking us in said, "Are you ready to have your baby today?"  I said, "Ha, well, I doubt that I will but sure, why not?"  I was still in complete denial. There were two things that I did not want with this birth:
  1. To be induced
  2. To have a C-section
I think you know where this is headed.

The nurse that helped us in triage was a doll.  I wish that she could have stayed with us throughout the labor and birth.  She also asked me if I was ready to have this baby and again, like I was in some sort of denial fog, I said, "Sure, but I doubt that's happening."  I mean, I wasn't in labor.  I wasn't in pain.  It wasn't like the movies or like the books said or stories I'd heard from friends. So how could I possibly be about to have a baby?

A medical student came in and introduced herself.  She asked if I would be ok with her helping out the doctor while they ran some tests to figure out if my water had broken.  Sure. Why not?  So the doctor on call came in and she was also lovely and nice.  She explained that there were several tests they had to conduct to see if my water had actually broken. She would check visually, do an ultrasound and insert a speculum to see if there was any pooling and if there was, they would check the liquid to determine if it was amniotic fluid.

When she just checked visually, she didn't notice anything to be concerned about.  Which, in the end, made me feel much more justified and less stupid about not going to the hospital sooner!  I mean, I could only check visually...everything seemed normal.  Then she did the speculum and sure enough, there was pooling.  Which didn't necessarily mean my water had broken.  They still had to test the liquid.  So she explained that and then checked my water levels via ultrasound while the liquid was tested.  Hmm...my water levels were at a 5.  Two days before at my check-up the levels were at a 12.  In fact, it was difficult for her to find water at all in my ultrasound.  She finally found a little pocket on the upper left.  And then the results were in on the liquid: amniotic fluid.

My water had broken.

And I had no idea.

Was I ready to have this baby?  I guess I had better get ready.

The doctor then explained the next hammer to my heart:  It would be in mine and the baby's best interest to be induced.  Since I wasn't in active labor but my water had broken, we were at risk for infection the longer that we waited for my body to catch up.  I could choose to wait but the likelihood for complications would increase. I was not interested in being induced. She said she'd give me some time to think about it and come back.

Here was my problem with induction:  from what I had heard, it was nearly impossible to avoid an epidural with Pitocin in play.  The contractions would be too strong, too fast and too unbearable. My fear was that once I got the epidural, things would slow down and the likelihood for a c-section would increase.  I did NOT want a c-section.  I flat out had avoided thinking of it as even a possibility.  You read my fantasy of how I wanted my birth story to go.  I wanted to see him enter into the world.  I wanted to be able to hold him right away.  I wanted to avoid drugs.  My world was spinning and I was still only in the triage section of the maternity ward.

Our sweet nurse was very understanding about my hesitation.  And she very calmly convinced me that being induced would be best.  I could try to go without drugs for as long as I wanted.  No one would try to force me to do anything I didn't want to do, including a c-section.  So Dan and I talked and decided, ok.  Bring it on.  Let's have our baby.  Maybe even tonight! (insert laughter here)

***

The doctor and the med student came back and brought with them the nurse that would be taking care of me through the night.  I don't remember her name.  I do remember that she looked like a rounder-faced Anna Kendrick with too much eyeliner.  She even kind of talked like her.  I didn't find any of this comforting.

Turns out, our nurse for the night was only at our hospital once a week. Upside of this was that she had a favorite room she liked and since it was available, she snagged it.  And it was a nice room.  The whole wall was windows looking out at the Hollywood Hills, which we got to see the sunrise from. We'd also get to see the sunset...which was unexpected. But we'll get to that part of the story soon enough.





The downfall of her being there only once a week was that she couldn't seem to remember where anything was or how to work the computer system.  Which when you're in the middle of full-blown labor, those extra few seconds fumbling around looking for the birthing ball or where to input information in your chart are excruciating.  This would all become more annoying as the night wore on.

When they started me on Pitocin around 10PM, I was only a centimeter dilated.  One.  Fun fact: since you and your baby are at greater risk for infection if your water breaks, the medical staff attending to you limits the amount of internal exams they perform.  If you're curious about how dilated you are, doesn't matter.  Say you want to wait until you're about 4 or 5 centimeters dilated to receive an epidural because you've been told that if you wait until then, the chances that you'll need a c-section will decrease.  Too bad.

Another fun fact: when they start you on the Pitocin drip, the contractions are immediate.  And intense. And unbearable. However I wanted to wait as long as I could to get my epidural because I was hell bent on avoiding a c-section.  But I had no idea how much my dilation had progressed because they couldn't check me!

My Anna Kendrick-esque nurse also reminded me of the six-fingered man from The Princess Bride. Remember when Wesley is taken to be tortured in the Pit of Despair and the six-fingered man slowly increases the voltage to shock him?  And he keeps going higher because Wesley can tolerate more than he expects?  That's what my nurse did.  She'd say, "Hmm.  You're handling this level of Pitocin pretty well.  I think I'll increase it to a four."  And she'd say it with no emotion but a slight glimmer in her eyes like she was enjoying this experiment.  And then the next contraction would hit like a freight train.

***

I'm one of those people that actually prefers running on a treadmill because of the clock. I can see how long I've been running and I can see how much further until my goal.  That's how I felt about labor.  I felt that if I knew, "Ok, I'm at 3 centimeters, I can tough this out until 4" then maybe I could have held on longer.  I don't know.  All I know is that around 3:30AM, I was puking from the pain. Yes, I saw my steak again.  And that's when I said, "GET ME THE EPIDURAL! NOW! I DON'T CARE WHAT I SAID BEFORE! I NEED IT NOW!"  Ha.  Just kidding.  I wasn't that coherent.  I think I nodded with tears streaming down my face between retching and that translated to, "Yes, please. I will take the drugs now."

The anesthesiologist came and prepped me.  The tricky thing with the epidural is that you have to be absolutely still when they inject you.  Which is difficult to do when you're in unbearable pain.  But we waited until a contraction passed and then he slipped the sweet relief into my back.  A bonus:  The doc administering happened to be the head anesthesiologist so I couldn't have been in better hands, which helped ease my anxiety.  The epidural kicked in and it was the best decision I made my entire labor.  I laugh at myself now when I think about how I wanted to go without it.  After the epidural took effect, I tried to rest but that was difficult to do. Around 6AM the nurse finally decided it would be ok to do an internal exam to see how far I was dilated.  I was at a 6.  I said, "Is that good?"  She said yes.  That it meant I was probably was at a 4 or 5 when I got my epidural, just like I had hoped to be.  This made me feel better.

And now, with the drugs keeping me calm and knowing that my dilation was progressing nicely, I started to get a little excited.  The sun was rising over the Hollywood Hills and it finally sunk in: I was going to meet my son today.  Within a matter of hours, he'd be here.  This was his birthday.  I even posed for a picture:



Six centimeters!  A few hours later:



Nine centimeters!

By this time, Nurse Six-Fingered-Goth-Anna-Kendrick was gone and we had a jolly new nurse.  She wore a bit too much perfume for my nauseous self but she was warmer and kinder and I wish I could remember her name.  They should really give you a print out at the hospital of all the people who cared for you.  Anyway, the especially good news of this nine centimeters happening on Saturday was that my doctor was the one on-call for the weekend.  She works as part of a group so it wasn't guaranteed that she'd be my delivering doctor, so I felt very reassured that she was there.  She knew how fervently I wanted to avoid a c-section and I knew she would be supportive of that. She came in to check on me now and then and as we got closer to full dilation, my nurse told me that my doctor likes to wait until the baby is low enough that I would likely only be pushing for an hour.  Sounded good to me!

Side note:  notice the balled up tissue in the above picture?  That is because the woman in the room next to me must not have gotten an epidural.  Or if she did, it had worn off (which I didn't realize could happen...until it did to me.  More on that soon).  She was screaming the most animalistic sounds I had ever heard.  I was in pain listening to her  and I was starting to get really stressed.  So we turned on the Counting Crows's album "August and Everything After" to help drown out her screams. It worked only slightly. It did provide comic relief though: Everyone that came into our room - nurses, custodians, doctors - would start singing along immediately to whatever song happened to be on (everyone has a soft spot for The Counting Crows, whether they like to admit it or not). And then, after one of the biggest yells, the frantic, beautiful cries of her newborn child. It was the most moving thing I had ever heard.  And I couldn't stop crying. And I was so excited to hear my baby's first cries.  We were getting closer...I thought.

And then it was noon.  And my doctor checked on my progress.  And then she asked, "Are you ready to start pushing?" 

The time had come.  


And I was finally ready.

* * *

But I wasn't, really. I thought I'd be pushing for an hour or less and then I'd meet Owen. I was so excited to push! But this post is broken into to parts because the rest of the labor did not go as expected. 

We still had a long road ahead...

Tomorrow....Labor and Delivery: Part Two

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