Warning- this is a birth story. Nuff said.
After the ultrasound, the technician told me to go upstairs and wait for someone. This made me a little nervous. I went up to the birth center and one of the nurses put me in an unused birthing suite and hooked me up to an EFM. Why, you ask? Probably just to make me more nervous, I think.
I waited for over an hour, nobody knew or would tell me anything. Finally, my husband was getting off work and I called him to come over. We both waited some more, until finally my OBGYN came in and told me I didn't have enough amniotic fluid. We asked lots of questions, like if I could be dehydrated, etc, but she said, bottomline, I have to be induced first thing the next day.
This was not what we wanted to hear. We were very much hoping for a completely natural childbirth- not just free from drugs, but also from unnecessary interference in general. We believed (and still do, for the most part) that the body knows what its supposed to do and our job is to let it get on with it.
We went home, terrified, and did research and talked with our doula. We decided to try some natural induction methods, hoping to avoid pitocin or anything else that might start us down the slippery slope of necessary medical interventions. I also drank a lot of water because while my doctor said that hydration levels don't affect amniotic fluid levels, many authoritative medical institutions DO.
After a night filled with all kinds of curious hijinx, very few of which involving sleep, we were having some contractions! I called the doc on call at our hospital and he gave us the ok to stay home. Yay!
Fast forward two weeks of early labor, crazy amounts of walking, regular checks by Fred with the fetoscope, and no little amount of stress.
November 9, 2010, 4 am - something is different. Yup, definitely different. Different in a distinctly hurt-y way. I woke Fred up and we went downstairs so I could spend the next few hours in varying hand/elbow/knee combinations hollering at Fred to stop doing the damn dishes and COUNTERPRESS ME ALREADY!
We waited until 7 or so to call the doula, it seemed the polite thing to do. We weren't really in any hurry, but I also figured we would have a baby by the end of the day...
At some point during that day, I started throwing up. I could no longer hold anything down, including water. Not that I had any desire to eat or drink anything, but it is kind of important for survival. I spent some time on a birthing ball- did NOT like that, quite a while in the bath tub- would never have gotten out if we had a full-size one, and various other positions.
We were using noninvasive midwife techniques to estimate how far I was dilated (we wanted to stay at home as long as possible) and by around 8 pm I was about 8 cm and starting to feel nervous about not making it to the hospital in time.
We packed up and loaded me into the car with my puke bucket for the 3 minute ride to the hospital.
I made what seemed like a ten mile walk from the emergency entrance all the way to the birth center and met the nurses on shift for the night. I was nervous that we were really going to have to fight for our birth plan, but they were great, they just kept telling me that it was my birth. I did get a bag of IV fluids, but they didn't give me any static that time about taking the IV out when it was done. The bad news: I was only about 6 cm, so I either went backwards or was never as far along as we thought.
Over the next two days, we went through quite a number of nurses and two docs, the vast majority of which were amazing and wonderful. Nobody ever offered me any pain medication, we were never pushed to use anything to speed up the process, although that was at least partly due to my water being unbroken.
My husband and our doula were amazing. They were always there for me, watching for the subtlest of clues to know how to help- and they did get crazy subtle, we're talking miniscule head shakes and politician-sized thumbs ups. Our doula (who I am choosing to leave unnamed so as to protect her privacy) was constantly researching every development, staying as informed as humanly possible about everything that was going on.
Amidst long showers, naked duckwalking, insane amounts of counterpressure, and lots of elbows and knees, we also had some more IV fluids (I don't even know how much) and discovered that our baby, who had been in optimal position for the entire freakin' pregnancy, had rotated. Such a stinker, even before he was born!
After 48 hours of natural labor, I had progressed to a whopping 7 cm. Hmmm. I hadn't slept for more than 12 minutes and hadn't eaten or had anything to drink. We were all starting to wonder where I might come up with the energy to push this baby out. At this point, our beautiful, crunchy, home-birthing, earth mama doula suggested that epidurals may have been invented for this exact situation.
She had been researching and found that the dosing could be adjusted if one were so inclined and perhaps we could make use of one without losing the ability to push effectively. I called in the nurse and asked her to tell us everything she knew about epidurals. As it turned out, she was the perfect person to talk to. Apparently, epidurals are usually started at a dose called "10" and women can have them turned up from there if it's not enough. Our nurse had had one with her last child, but she had turned it down to 8.
This part is a little fuzzy, because I was definitely losing my mind, but I think we talked to the doc on call and told him we were going to do a low dose epidural and a very low dose of pitocin after we get a little bit of sleep. I can't be sure, because he was fairly inscrutable, but I think he was relieved.
Just after we made this decision, I got up to pee and fell down. I heard a very un-pee-like pop and my water broke. This show was finally getting on the road...
Around 3 in the morning (this is now November 11) the anesthesiologist got in. He was kind of surreal, like a benevolent David Lynch character. It's funny, because I decided I wanted to have a natural childbirth when I was like 8 or 9 and found out exactly what an epidural was. I was THAT creeped out by it, and honestly, if I hadn't already been in labor for 48 hours, I would STILL have been too creeped out by it. I'm really glad I couldn't see any of his instruments because our doula did and practically had nightmares about them. Yes, it hurt, in a really weird and icky way that I never want to ever feel again, but the scariest and hardest part was that I had to hold COMPLETELY STILL while he was doing all of this. Yeah, I had to hold still through 2 or 3 contractions. Not so easy. I was shaking uncontrollably. But, I was already in better spirits. Fred and our doula were actually alarmed at how fast I went from out-of-my-mind to joking about nursing school accreditations.
So, pain relieved, we all slept for three hours. Ta Da! Humanity returned!
I think it was after we woke up that they started the pitocin. At our hospital at least, they start the dosing at 1 and it goes up by 1 every half hour. I requested to stay at 2. I'm pretty sensitive to drugs and didn't want to mess around with this stuff.
I should also mention at this point that once the epidural went in, I was as good as strapped to the bed. I had all kinds of tubes going in and coming out and a giant sticker on my back. I was no longer allowed to do occasional EFM, but had it going all the time. Not the way I wanted to labor, but...
During a nurse shift change, my pitocin somehow got all the way up to 4. I was feeling the contractions through the epidural- not good. The new nurse turned it down immediately (but this is where I think the damage was done).
After 3 hours on pitocin I was fully dilated. I had them turn my epidural down from 7 to 4. None of the staff there had ever had anyone with a dose that low, so they couldn't give me any idea of what I might or might not be able to feel. I had initially wanted to turn it completely off once I was ready to push, but our doula said that the intensity of the sensation after epidural wore off might be too big of a shock, so I decided to leave it on a little.
I told the staff that I would not be taking any orders to push thankyouverymuch and would be pushing only when my body told me to. That sounds kind of snarky, but really, it wasn't. I just hate the idea of someone else telling me when my body wants to be doing something. Thankfully, I did feel the urge to push and could feel quite a lot with the epidural turned down so low. It took about 2 hours of pushing and a number of different positions. The doctor tried to get me into lithotomy at which point I nearly cried and told him I simply couldn't do that. I finally ended up sitting almost completely upright with my husband holding one of my legs up and our doula holding the other.
Meconium had been discovered a few hours ago so there were probably 10 other people in the room by now, ready and waiting. At 11:43, once our baby's head was about halfway out, the doctor reached in and pulled him out. Because of the meconium, we didn't get to wait to cut the cord, or any of our other good stuff, they whisked him away. In fact, the only reason I knew he was a boy was because I overheard one nurse talking to another. They suctioned out a lot of meconium and it apparently got down lower than is considered normal or safe so they took him to the nursery to run a bunch of tests. Fred went with him so we had one of us with him at least.
This part was really difficult. I lost a fair amount of blood, and like, all of my hemoglobin, and was too exhausted to even stand. I felt really lucky to have our doula to take care of me while Fred was with our precious new baby. After an hour and a half, my fantastic delivery nurse said I had to go see my baby and she and my doula picked me up and got me into a wheelchair to go into the nursery.
As a rather ugly baby, I was completely ready to love a homely baby and had been preparing Fred for months, but he was CUTE! So sweet and perfect, it was heartbreaking that I could only hold him for about a minute before my arms gave out. The pediatrician said he needed to go to the NICU (neonatal intensive care unit) in Marquette, 2 hours away.
The rest of this story is for another time as it is more the after-birth story. I know it seems like not a very good ending, but if you've been reading my blog at all, you know that we did get our happy ending, it just took a little longer. 5 is perfect and healthy and had no lasting ill-effects.
Also, while Fred and I did not get to follow our birth plan, we felt very empowered in our decision-making, and that has really helped us to feel good about our birth story.