After seeing the mucus plug on the evening of my due date, I went to bed feeling some contractions that were coming every 15 minutes or so. It was fairly late when I finally shuffled off to bed, although I can’t remember the exact hour. Sometime between 11pm and 1pm, I think.
I woke up several times with the pains and would sometimes half-heartedly time them, but at about 2:45am I woke up with pain that would simply not go away. It felt like gas pain and it was excruciating. I tried using the toilet, crouching on all fours in bed, both of which resulted in some flatulence (sorry if that’s a bit too much info), but not a significant decrease in the pain. A few times I would think that it was fading, but as soon as I'd lie down again to try going back to sleep, I would be overwhelmed by an intense, undeniable pain. When I found myself kneeling on the bed and making a circular motion with my upper body and moaning, I decided that this was a pain that warranted waking Ben up. It didn’t feel like it could be a contraction. According to my timer, the pain had been going on for 34 minutes and there was no change in my belly tightness – it felt equally tight throughout the entire time. Everyone had told me that "real" contractions should have a distinct beginning and end, and they should be about 30-90 seconds in duration.
Ben came in and rubbed my back and we called our doula to ask what it could be. She said she wasn’t sure and advised me to call the midwives. When we called the midwife on call, she told me to take a warm shower and see if that helped. If it didn’t get any better, then she wanted me to come in to the hospital to get checked out.
The pain was on-going and the belly tightness wasn't changing, but I had a hunch because of the bloody show the previous night that this could be labor. I had also noticed that it would get worse at various times, although I couldn't ever really feel it getting better. Once in the shower, I asked Ben to just time the interval between the "peak" pains that were occurring within what I perceived as one long contraction. I stopped trying to feel my belly for changes in tightness or expect the pain to fade significantly. I basically gave up on measuring duration of the contraction, since I couldn't perceive it fading, only getting worse. All I’d do is start moaning when the pain would get worse, Ben would start the timer, and then when the pain would intensify further, I would moan and he’d see how long it had been since the previous "peak." In doing this, we realized that there was a clearer pattern of pains intensifying every 2-5 minutes.
We called our doula back and told her that we were going to go in to the hospital, since we'd done the "shower test" and the pain was definitely not getting any better. Our doula said that, based on our timing of the "peak pains," it seemed as though it was labor and asked whether we wanted to labor at home for awhile with her and see if things became more regular before going to the hospital. I certainly didn't want to go to the hospital if it was just labor -- my plan had been to labor at home as long as possible, so the last thing I wanted was to go to the hospital and be sent home.
Our doula came over and found me squatting on the floor of our den, rocking back and forth on my hands and knees. That's how I spent much of the next 12 hours before going to the hospital. During that time, I also rocked in a rocking chair, showered some more, ate some food, paced around, stressed over my conflicting feelings about having a baby born on St. Patrick's Day, leaned against the wall, and hugged a birthing ball. I finally fell asleep -- strewn haphazardly across the bed, where I'd been clutching my belly and burrowing my face into the pillows -- and was able to take a nap for an hour or so. (Remember that I'd gone to bed the previous night sometime between 11pm and 1am? And that I woke up several times with the contractions before that awful pain at 2:45am? Yeah, so I was laboring on only about 3 hours of sleep, max.) When I woke up, I went to the bathroom, passed a terrifying amount of blood, and then the contractions stepped up even further. We decided that it was time to go to the hospital. (But not until, for the fourth or fifth time, I asked whether the traffic would be bad because of rush hour, only to be reminded that it was a Sunday.)
We got ready to go and I climbed into the back seat of the car, where I held the head rest of the passenger seat in front of me and tried to stay calm on the drive. The drive actually went better than I'd expected. I think that the distraction and excitement was a good thing. We forgot, unfortunately, that we were supposed to call the midwives back and tell them that we were on our way. I called from the car and, as we pulled up, received a phone call from my doula, who told us that she was at the hospital and that the staff was expecting me.
They put me in a room that was near the waterbirthing suite and started to prep the waterbirthing tub. I was really afraid that I would have only progressed slightly, but an extremely painful cervical check revealed that I was 5 cm dilated and 95% effaced when we arrived. My doula assured me that the anxiety and tension that I felt during the check had probably made my cervix contract, and that she estimated that I was probably more like 6 cm dilated, but I was pleased with 5 cm. I had been so afraid it would be only 2 or 3.
It wasn't far enough to get into the waterbirth tub, though, so I labored in the nice HUGE bathtubs that are in the regular labor rooms at our hospital. (Those tubs were basically the reason that we chose that hospital and they were 100% WORTH IT!)
After a few more hours of laboring, a new midwife came on call and needed to check my cervix again to see if I was ready for the waterbirth tub. At this point, I had been laboring unmedicated for 17 hours and I was starting to lose it emotionally. The midwife tried to check my cervix several times, but it was still posterior and the baby's head was very low, making it difficult. It was also impossible for me to relax because I was in so much pain. We ended up having to use lidocaine jelly to help relieve some of the pain before trying the check again. It made it a little better, but the check revealed that I was still only 6cm dilated and 95% effaced, with a "bulging bag of waters."
I felt totally depleted and frustrated. I was getting more and more scared of the cervical checks, since I knew that I was probably going to have to endure at least two more and the contractions were only going to get worse in the meantime. Ben and our doula tried to get me to let go of my fear, but I began to withdraw from them further and further and feel more isolated.
I went to the bathroom and had an intense contraction while sitting on the toilet. I felt a pop and released a lot of fluid that I thought was blood. I looked in the toilet and didn't see anything except some bubbles at the surface of the water. I told everyone that I thought my water had broken. The nurse looked in the toilet, but it wasn't possible for her to see what color the amniotic fluid was. In order to get a waterbirth, the color of the fluid has to be clear. So she gave me a pad and told me that they'd take a look the next time I had another gush.
I never gushed again (my doula hypothesized that the baby's head slipped in and plugged up the opening, since it had already been so low). My contractions got more intense, though, and so I knew it had broken. I labored out of the tub, waiting for the gush to prove that my water had broken, but eventually, I decided that it wasn't worth the pain and so I got back into the bathtub for awhile.
Ben came in and talked to me about pain management. He felt pretty convinced that, if I could get some rest, it would help me progress. I didn't feel convinced of this, but I was warming to the idea of pain medication because the cervical checks had been so traumatic and painful. I know it probably sounds a little crazy, but the cervical checks really were that bad. Labor was bad enough, but the idea of more cervical checks in addition to increasing labor pains was far worse. The midwife came in and talked to me for a bit and I agreed to the epidural.
The first step in getting the epidural was to get an IV and receive fluids, so I got out of the tub and paused to sit on the toilet for another contraction. It was intense one and it peaked with my body totally taking over and involuntarily pushing. I cried out for help as I half stood up from the pain and the shock of my body pushing. Everyone came into the bathroom and said it was a great sign. My doula said maybe I was complete and could hop into the waterbirth tub and start pushing! My midwife said they needed to do another cervical check, though, and at this point I was more terrified of the cervical checks than anything else. I asked if it was necessary to get it done even if I wasn't planning to do the waterbirth anymore . . . or whether I could get the epidural first. The midwife said that, since it had been awhile since the last check and I was already pushing, they needed to do another check before they could give me the epidural, because I might be too far along to get one.
After another round of lidocaine gel and several more pushing contractions, she did the cervical check. I was only 8 cm dilated, so I wasn't complete. I knew then that I'd have to have at least one more cervical check and I felt even more panicked. I was begging them to do the epidural before it got any harder to stay still and not push. Labor was hard enough but I couldn't even contemplate another cervical check without an epidural at that point.
I was so scared during the epidural. I was sure that I would have another contraction and be unable to sit still during the procedure -- resulting in a dangerous situation. Everyone else in the room was confident that it would be fine, though, and it was. It was painful, but it wasn't nearly as bad as the lumbar punctures that I've had (which were the reason I was scared to get one in the first place). I asked what time I'd received the epidural and it was at exactly 24 hours after I had first woken up with that intense pain the night before. I wonder what the longest record is for a non-induced, active labor. I am sure I don't come close to it, but 24 hours is a long time to have painful contractions that are only a few minutes apart. Especially with only 4 hours of sleep over the course of the last 50 hours. I am sure that others could have still avoided the epidural, but the pain of the cervical checks and the pushing before completion made the epidural well worth it, for me.
The epidural did not take effect immediately, the way that it had been described to me. I think that most people get them when they are earlier in labor (like 4-6 cm dilated, instead of during transition) and so that might be why I didn't feel any relief for awhile. The first few contractions felt exactly the same as they had before, but eventually they faded a bit and my legs started to feel like they were asleep. I could still feel the contractions and they still hurt, but the edge came off of them.
The midwife did another cervical check once the epidural had taken full effect. This was much more tolerable and I instantly became very grateful that I'd gotten it. As expected, I was now complete. The midwife told me that I could start pushing whenever I was ready. My husband had just fallen asleep, though, and this was at about hour 26 of an intense labor, so I decided to give him (and myself) some rest.
I think I dozed off a few times while I waited, although I was still waking up with the contractions. Eventually, the urge to push became overwhelming again and I announced to the room that I was ready and needed them to tell me what to do next.
Pushing was hard work and seemed counter-intuitive because people were holding my legs up as though I should be pushing against them for leverage, but they were telling me to relax them at the same time! Eventually, I just started pretending that my goal was to try to poop, since doing that seemed to produce the correct kind of push.
I pushed for awhile -- I have no idea how long, though -- and I started hearing more and more positive feedback as the folks who were watching saw that the head was making more progress. They asked if I wanted to reach down and touch it and I definitely did not! I had way too much to focus on at that point!
There was another shift change amongst the midwives at this point, so the midwife I'd been seeing had to step out to update the new one who was coming on-call. All of a sudden, I could hear a change in the demeanor of everyone in the room as they became much more excited that the head was making more progress and the nurse told someone to go get the midwife back in there. In a blur, the midwife came in and all of a sudden there was even more excitement. Someone told me to stop pushing and I said that I couldn't stop. I didn't know at the time, but the reason they wanted me to stop pushing was that the cord had been wrapped around the baby's neck. The midwife worked quickly to unwrap it, though, so thankfully it wasn't a problem that I continued to push. All of a sudden, my baby was on my chest. The umbilical cord was rubbing me between my legs and I noticed the discomfort of that before I even realized that there was a baby on me!
They told me to look down and see whether it was a boy or a girl, but my chest was in the way and I couldn't lift myself up to get a better view, and the cord was too short for them to be able to position her higher so that I could see. I told Ben to tell me and he said it was a girl. I remember feeling so surprised and wondering if he was sure!
Our back-up doula (our regular doula had needed to leave) cut the cord and I delivered the placenta without any pitocin (I had originally said in my birth plan that I didn't want it, then decided that I was okay with it, but the midwife said that she thought I was actually going to be fine without it). I had a second degree tear, but she thought it was a third degree at first and so they had an OB come in and take a look. In addition to the epidural, they also had to numb me up with lidocaine. I am glad they did, because when she did the injections I could tell that I could still feel a lot of pain!
The epidural went well overall. I don't regret getting it, although I wonder often about what I would do if we had a second child. Would I try to have a natural birth again? Maybe. After all, second labors are usually much shorter than first labors, so it might be easier the second time around. If I know now that I'm able to endure active labor without any medication for 24 hours, and the average labor of a multiparous woman is 8 hours, then that's a pretty good sign that I could manage a natural labor the second time around. Also, the most pressing reason that I got the epidural was that I couldn't stand the cervical checks, but the cervical checks might not be as painful in the future. I've since read that a posterior cervix makes the checks very painful, and having a posterior cervix for as long as I did is not typical. Apparently, the cervix is supposed to move from posterior to anterior in early labor, or even before labor begins. Some sources, in fact, say that if you have a posterior cervix, it means you aren't in labor yet. As you may recall, my cervix never became anterior until just before I was ready to start pushing. Every cervical check (save the last one, after the epidural, when all that could be felt was the baby's head because it was so low in the birth canal), the midwife would remark on how my cervix was "very posterior" still. That fact, in combination with how low the baby's head was, meant that it was incredibly difficult for the midwives to perform the check without causing me excruciating pain. So, in the future, I might still have a stubbornly posterior cervix (which would probably prompt me to get an epidural), or it might move to an anterior position early on, when it's supposed to.
The tricky bit, of course, is that if I were to get an epidural, I'd probably avoid getting it while in transition or while pushing -- it was a scary time to get it. But if I'd gotten it earlier, it might have slowed down my labor. And being confined to the bed and having the IV in my hand was one thing for 4 hours, but I think it would have driven me nuts if I'd had to do it for all 28 hours of my labor. As it was, I think it actually worked out pretty well, since I was able to move around and be free of the IV for a long time, but was able to eventually have significantly decreased pain when it came to the worst parts of labor.
Thankfully, I should have some time to think about whether I'd get an epidural again, and, if so, at what point. For now, I'm just going to enjoy some snuggles with my infant.
.jpg)
No comments:
Post a Comment