Friday, November 30, 2012

Birth Story Friday: We Like Ours Well Done

My mother had me 3 weeks early, and I naively expected to follow her lead. When I first started getting contractions at 36 weeks I was so excited. Soon! Soon I was going to meet my baby. My first round of regular contractions failed to organize and dissipated after a few frustrating hours. A few days later, the same thing. Contraction after contraction, getting stronger, and then nothing. I called my midwife and learned a lot of techniques to deal with prodromal labor.

38 weeks came and every few days I'd have another bout of fake labor.

39 weeks, more of the same. I was getting discouraged and gave up the hope that I'd have my baby early.

40 weeks and I was taking cohoshes, walking for miles every day, using my breast pump all in a vain attempt to get labor going. Every few days I'd have hours of regular contractions, then nothing. 8 hours, 15 hours, at one point I went a whole 23 hours with regular contractions and no baby.

By this point we figured out my daughter was posterior, and I spent a good deal of time trying to turn her. When it didn't work I kept telling myself she would turn in labor.

41 weeks rolls by and we go see a movie. I spend a lot of time walking around the nearby park. I stop answering my phone and I glare at people who ask me if I've had the baby yet.

42 weeks, the date no pregnant woman ever wants to see. I gave up all induction attempts and told myself I'd allow 2 more days to get into labor naturally before I attempt castor oil. At 43 I'd walk in and ask for a c-section.

I woke up the morning of 42+1 still pregnant. I was frustrated but resigned. I got sick of whining about being pregnant and just went about my day, trying to ignore the large belly and the constant kicks. I took a nap. I ate food. Then at noon BAM! contraction. Those 6 weeks of contractions? Nothing compared to this. 2 minutes later BAM! another one. And another. And another. Apparently I don't do early labor. I start making calls and getting into my groove. I want some time alone so people take their time showing up. Husband comes home from work early and starts setting up the pool, during which I start hanging out in the bath. I need water by this point as labor is pretty intense. My midwife has to leave to go to the hardware store because my faucet is weird and the hose adapter doesn't fit. I labor, whine, and labor some more. We fill the pool and I get in, but quickly it's apparent that there's a leak. We drain the pool, midwife's husband brings over another one, and we keep on going.

Suddenly the pain shifts. I've been in labor for about 6 hours by this point. There's a burning pain in my pelvis that's truly terrifying. I'm trying not to panic from the pain and telling myself it's transition. It hits again and again. There's no way I could walk after this pain, something is WRONG. I beg my midwife to check me, hoping it's just transition, but nope. I'm at 2-3cms and barely effaced. She checks the heartbeat and baby is fine, but asynclitic. In a stroke of brilliance my midwife grabs the pool pump and runs it on my pelvis next to the baby's head, making a loud noise that startles her back center, and in an instant the pain is gone.

This is the point when I learned just how important fetal positioning is. I went from the worst pain imaginable to "eh, labor hurts" in less than 15 seconds. With no drugs. I believe she was pushing on my pelvis in a bad way and my pelvis let me know in no uncertain terms that it was bad.

The next 24 hours are a blur of exhaustion and labor land. Water gets emptied as boiling water is poured into the pool. I walk up and down the stairs, take cohosh, drink some wine to slow labor down and try to rest. My midwife, her assistant, and my husband alternate putting counterpressure on my back. I never eat, but everyone tries to.

24 hours is a long time, but there's something amazing about labor; time doesn't matter. I didn't notice the hours passing, my world was just what was going on inside my body. Occasionally I'd look up and note that the sun had set, or it was coming up again. Contractions would vary in intensity, but never lighten up enough where I got much sleep. Water was added ot the pool and taken away. I walked, I cried, I was on all fours. I lunged, I rested, I even called my chiropractor to come over. A lot happened in those 24 hours but it was all just a blur. I progressed, but slowly. Somewhere in there my water broke; I never felt it. The pool now had flecks of meconium in it, which I knew was a concern, but at that point I couldn't care. Everything was labor.

Then suddenly the pain changed. That burning searing pain in my pelvis came back. I got checked and was 7-8cms. Finally, transition! It hurt like hell, but I could do this. My midwife checked me and said "she's pretty close, you can reach in and feel her." So I did, and low enough that I could easily reach around my giant belly I felt the squishy flesh of my daughter. It was almost over! "It feels squishy" I said. "That's not supposed to be squishy." But the pain soon became more than I could bear and I was convinced I'd never be able to walk again. My pelvis was breaking apart, it as on fire. It was bad.

I told myself that I could endure an hour of that, and if I made good progress it was fine. Unfortunately an hour of the most mind-numbing panic-inducing pain I've ever felt bought me no progress. 34 hours into labor and I was only at 8cms. Something snapped in my head and I was done. "We're transferring. I need an epidural." I hopped out of the pool (with assistance), dried off, and got dressed. I packed my bag in between contractions and with my husband's help. A few months before a good friend of mine transferred during a homebirth and had an awful experience, so we were nervous, but it was clear that a homebirth just wasn't happening.

The 10 minute car ride was the longest of my life. Bumps in the road during advanced labor SUCKS. We pulled up by the emergency room, I waddled in and said "I'm in labor and I want an epidural." I filled out the forms between contractions and waved my GBS- sheet at everyone, as I'm deathly allergic to penicillin and was doing everything I could to avoid it. Every nurse I spoke with heard how I wanted an epidural, and they strapped me onto the monitors, gave me an IV and told me I should get it soon.

The monitors hurt so much. The pain that sent me to the hospital was bad, but let me tell you if you spend 34 hours doing ab work and then strap thick elastic around it tightly it's going to hurt. The monitor belts hurt more than labor itself and I begged to take them off, begged for the epidural. It never came. Apparently there was no anesthesiologist on staff overnight and he wouldn't come in for a homebirth transfer.

The next few hours were some of the worst of my life. The nurse was mean, they wouldn't take off the belts, I got no pain relief, and the nurse gave me instructions that caused me even more pain. At one point she offered IV drugs, I believe nubain and phenergan, and although I knew phenergan and I don't get along I consented. Bad idea. I have no memory of this, but apparently I lost all sense of awareness, almost pulled my IV out, and wandered around the room constantly. I was also obviously in pain.

This would be the point my husband called his mother at 4am.

By 6am the phenergan wore off and my contractions were petering out. I was once again coherent and in the dawn light I knew I needed a c-section. I was fine with this. A while later the on-call OB walked in (the first time I saw a doctor in the hospital) and said "I think you need a c-section." I heartily agreed.

I signed the papers and proceeded through the leisurely surgery prep. I'm talking sauntering down the hall, nurses chatting about their weekend plans, me trying to relax through my weakening contractions. Spinal anesthesia worked perfectly and I had to focus to stay awake for my daughter's birth. They held her up for me and I fell asleep for the first time in almost 3 days.

Evelyn Rose Leslie
Born at 42 weeks 3 days by cesarean after 40 hours of labor
9lbs 12oz 21 3/4" long

My husband stayed with the baby while they were stitching me up and overheard the doctor tell the nurse "occiput posterior face presentation." It turns out that that squishy bit I felt was her forehead. According to Spiritual Midwifery a brow presentation has a 40% larger circumference and is nearly impossible to deliver vaginally. There was almost nothing we could have done to get her out at home.

Evie's apgars were 9 and 9, and she was a robust baby. I woke up from my post-surgery nap and felt great. Despite all we went through we were doing wonderfully. We were home in our own bed the next day.

It was hard, but I wouldn't have changed a thing about it. Through Evie's labor I learned that I can handle just about anything, I learned how to work with my body, I even learned to enjoy the intensity of labor. Her birth transformed me and is why I got into birth activism. It was easily the most important experience of my life, and overall a positive one.

Of course I swore to do anything I could to have an easier birth next time.

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