Whoa. Kid. Part 3: The Labor & Birth

About a million years ago, I wrote about waiting for labor and going to the hospital for a false alarm.

I figure I need to finish this at some point, and I might as well try now. Who knows how far I’ll get.

After the false alarm, the nursing staff and doctor sent me on my way with the proviso that no matter what, I need to come back by Monday night. If I had started labor by then, fine. If not, they were going to induce. People always joke about the threat of induction starting labor, but I really think when you get that late in the game, many times, the body suddenly decides to go forward.

After returning home that morning (still Sunday), I don’t know what I did, but I have this note I took on my phone that Seppo and I took Mobi for a walk. After we got back, at 4:40pm I noted in the bathroom that I lost my mucus plug. Unlike the incident with thinking my water had broken, the mucus plug had definitely come out, and completely whole. It was gross looking and pretty shocking to see, so I’ll refrain from describing it here, but suffice it to say that I won’t be forgetting what that looks like for years to come.

I informed Seppo of this. Due to the water breaking debacle (and emotional rollercoaster — people are right that it is really deflating to get sent back home), he was somewhat skeptical and asked me if I were 100% sure. I was but it was hard to convince him. Heh. I now felt confident that labor was going to start for real at some point soon. Mind you that I’d had Braxton Hicks for weeks at that point, occurring ridiculously regularly but going nowhere into real contraction territory.

Huh. I had forgotten this bit, but my iPhone note tells me that we watched Kung Fu Panda between 8pm and 10pm that night. *waves at Holly* It was awesome, by the way. 😀 Half way through the movie, contractions that had felt significantly different from those I had had before started. I don’t recall, but I think I didn’t tell Seppo until the movie ended because I wanted to savor the secret little thrill by myself for a bit.

When I told him, Seppo immediately declared that he was going to sleep right away, which was exactly the right thing to do. I took a bath at 10:30pm, expecting it to be the last such experience for at least several days, and tried to sleep. Obviously, I was excited because I couldn’t fall asleep until midnight or so.

At this point in the early labor, there was no pain, just a twinge of discomfort. The level was like if you clenched your stomach muscles or your calf muscle somewhat for 30 seconds to a minute, every 13-20 minutes (what my notes say — shaddap! I knew I wouldn’t remember unless I wrote it down!), maybe not even that intense. It was at the level of “hmm, something is happening but it’s interesting” not “ouch!” Another difference is that it was actually spaced out more than the BH contractions I had been having, which were spaced about 7 minutes apart, I think.

Despite my complete and utter gleeful excitement, I was finally able to fall asleep, because the next thing I knew, I woke up in actual pain at 3:15am. I was a bit dazed, so I didn’t start timing the contractions until 3:33am. I don’t recall precisely, but I have the pain logged at between 4 and 5 on the 1-10 pain scale, where 10 is the greatest possible pain you can ever imagine any human being ever suffering and you wish for death.

Note that I hate the stupid pain scale because I couldn’t tell how to report the amount of pain I was in. How do I know how much pain I can imagine? What if I reported something a 10 because that was what I could imagine, but upon greater pain later, I figure that was a 3? I don’t know. 5 is labelled as “Moderate” on some scales I had seen. How do we go from “no pain” at 0 to 5 being moderate, if 10 is “I wish for death”?!! I figure any pain I’d describe as “moderate” would be a 1 or a 2 if 10 is a deathwish. Anyway, 4-5 seems about right for all the different pain scales I had looked up. It was obviously painful enough to wake me up, but not yet enough to keep me from breathing, walking, or talking. It was already worse than the some of the worst (but not THE worst) stomach cramps I had had in the past.

Anyway, the contractions were already at about a minute long and about 3 minutes apart. They said come to the hospital when all these were true:

• I was having contractions less than 4 minutes apart
• for at least one minute each contraction
• for at least one hour

By 4:30am, this had all been true, but there was one more metric to consider: was the pain so bad that I could not longer walk/talk/breath/carry on with whatever normal thing I was doing while the contraction was happening? The answer was no. So I spent the time thinking and focusing and trying to be quiet so I didn’t wake Seppo. After all, I was going to need him to be as well-rested as possible, and nothing too exciting was happening yet. I think I stood up and leaned against the wall through a couple of contractions as advised in my birthing class. I was expecting that the process was going to take hours and hours to get to a point where we’d get to the hospital.

By 5am, it was too hard to try to bear the pain in the room without extra help, so I snuck out of the room and managed to fetch my yoga ball and some water. Oh, right, I was also trying to keep from waking up my mom until the last possible moment, so I was extra ninja-like in my quick jaunt out of the bedroom. It would have been a lot better, with the benefit of hindsight, to have paced around the livingroom, but I didn’t want to talk to others, even my mom. I know, it’s weird but when I feel pain, I go to a place inside myself and the touch and speech of other people rarely, if ever, help.

Still, I was excited. The pain was getting pretty bad, but it was manageable. I had done some meditation the week before with the help of the internets, to breathe and relax through the pain, and it was working for me. I think that if I hadn’t had gone through those exercises, I would have been doubled over in pain and agony, but I managed well because of it. Later, I ended up thinking that the combination of becoming quiet through pain and meditating through some of the worse stuff led to some of the nursing staff not taking my level of pain seriously, but I digress.

I got the ball, and soon found that I could not bear the pain unless I was sitting on the ball and rolling it back and forth. The nature of the pain is hard to describe. I think of it as a broad spectrum pain. I’m sure it’s different for everyone, but for me, when it was not very strong, it reminded me of getting an electric shock. Have you ever held a 9-volt battery to your tongue? You know how the tongue nerves all buzz for a second because they are all getting stimulated at once? The pain was like that, both sharp and dull and high and low amplitude, everything at once, but worse. Maybe you’ve accidentally touched an exposed outlet? That’s actually more like it. And you know how when it’s really cold and you are holding ice or have your hands in icy water or maybe your hands got wet in the snow, it’s like a deep, bone pain, rather than a sharp pain, and you can’t tell where it starts and ends on your hands? So take the electric shock and have it come in long waves, covering large ground in the pervasive way cold can be, and that’s pretty similar to what I felt.

The sensation of wanting to close my eyes through it was like how I want to do the same when I bang my toe really hard and you see stars. Everyone’s done that at least once; the pain takes over the peripheries of your mind and you can’t hold any thought in your head but the pain.

The pain hadn’t gotten there yet but had ramped up noticeably by 6am. I was hanging in there. I think I ended up waking Seppo around then, or maybe it was around 7am. Around 7:40am, I thought it was time to notify my mom to go to the hospital because I was at the point where I could not breathe through the pain. Even when I woke her, I figured we had like 30 minutes before we left, but as the minutes went by, it intensified really quickly. Within minutes, I was not able to move or talk or even keep my eyes open during a contraction. I felt like this was the last possible moments we could feasibly be home because if we waited any longer, they would not be able to move me without carrying me out, or we’d possibly have the baby right there.

Still, I noted the pain as between a 6 and a 7, because I was not near wanting to die, since that was the metric I thought was correct.

Trying to leave the house was a difficult ordeal. Walking down the steps triggered the contractions to happen every minute, lasting for a minute, so basically, I was in peak pain for about 55 seconds of every minute, and I had to stop at just about every step down. The car ride was excruciating. Every bump tore through me and amplified the pain to where I couldn’t imagine how I’d last the rest of the ride to the hospital, which was only about 8 minutes away. I started to cry in the car, I think, but I am not sure.

We got to the hospital, where Seppo dropped me and my mom off as closely as he possibly could to the door and went to park. My mom helped me walk to the door, but I don’t think I got to the doors by the time Seppo parked and caught up with us. I leaned on my mom physically to keep from collapsing or passing out.

Still, I see I logged the pain as 7s in the brief respites from the pain.

I’m trying to describe the pain as accurately as I can, but I have to say that despite how much it hurt, I was still excited, still enthralled with the idea that we were going to meet our wonderful baby soon, so that kept my morale high. It was painful, but it was physical pain. In the inside, I was as calm as I was ever going to be.

Sometime between 8:15 and 8:45, we got up to the check-in desk upstairs in the labor ward. Despite having done all the paperwork in advance the day before (the nurse had been quite nice and said she’d enter us into the system in advance for today, and the attending doctor that we had called said we’d skip triage and go directly into a private room, as we had the day before, since I was so overdue), there wasn’t a room ready, which didn’t seem like a big deal. After all, they reassured us that it would only be 5 minutes of waiting before we can get access to the room and settle in.

Then, they asked us a key question that I really, really regret having answered the wrong way: Would we like to get triaged while waiting for the room, as they would have to check us out anyway when we got into the room? Seppo and I briefly conferred and said ok. So my mom and I went off to the triage area, where I could only have one person with me at any given moment, while Seppo finished answering administrative questions and filling out paperwork that we had already filled out the day before.

In triage, the very nice nurse examined me and said I was only 0.5 cm dilated and that they might send me back home. This was the first time I started to feel worried, though I knew what the doctor had said so I wasn’t too worried. She said I should try to walk around the hallways for an hour or “for as long as I could stand” (this phrase will come back to haunt me) and come back to her to get checked out again then.

At this point, I was having contractions every two minutes or more frequently, at consistent 7s and probably edging to 8. This meant, for me, that I had to stop and lean on something for the entire minute to minute and a half the contraction happened, with helpless tears streaming down my face every moment I wasn’t contracting. It took me and my mom forever to walk the 20 feet or so to where Seppo was waiting so that he and I could walk up and down the hallways. Well, we thought we’d be walking up and down the hallways.

What actually transpired was that we made it almost down one long hallway in about 30 minutes, and before we got to the end, I begged Seppo to go back. Actually, it’s possible it was our second trip, but I’m not sure. I told him, “I can’t do this anymore. I want to go back. They have to take me,” or something similar to that. What I meant was, I didn’t want to be out in the hallway with people watching me cry, feeling exposed, and I am ready to get checked into my room and start laboring the way we were taught in class, with my yoga ball and squatting if I needed to and pulling and kneeling with a bar if I needed to, or running warm water over me in the shower as they advised or any of a million other things they had suggested in class, all of which sounded much better than crying in the cold, depressing hallway and being by now terrified that despite the crushing pain and wave after wave of contractions, that they would send me home. The baby was coming; there was no doubt, and they were saying that instead of having the nice room we were in the day before, I may have to endure the bumpy car ride back home and come back at another time.

The pain was terrible. I felt the weakest I had ever felt in my life. I was whimpering to Seppo that I couldn’t go back the 15 more feet to where the triage entry was, and I wanted him to bring back a wheelchair for me. Never had 15 feet looked so far away to me. It seemed impossible. By now, I was meeting each wave of pain with fear, but I tried to stay calm.

Seppo was a pillar of quiet, gentle support and strength. He calmed me and gently encouraged me and we made it back, after an excruciating period of time, which was still far, far short of the hour the nurse has proscribed, and she checked my vitals again. She told me that I had only dilated to 1cm, which I thought was impossible. She said she didn’t want me to get sent home (again, filling me with panic and blind terror), so she actually increased my dilation manually to 1.5cm, which hurt like a mother.

I think at this point, they let me go to our room, so I was flooded with relief. I don’t even remember if they wheeled me in or walked me over. I have zero memory of this. I just know that we had a ridiculous amount of stuff with us, which was piled up in the waiting area outside of triage, so Seppo brought all of that and my mom came with me.

The contractions didn’t let up, but first, because I was group b strep positive, they had to hook me up to antibiotics for 45 minutes. I think they said they had to do this every three hours for 45 minutes, but we had been informed by the birthing class, by our doctor, and by the hospital tour that we wouldn’t be hooked up to IV the whole time, that I’d have basically a tap in my hand where they could hook me up to antibiotics without having to reinsert a needle all the time, which was great news.

Anyway, the nurse hooked me up to that and some other IV fluids, and I waited, lying on my back, shifted slightly to one side to monitor my contractions. We had also been told that they don’t continuously monitor unless something is really wrong, so I knew they would take that off at some point. I was used to the contraction measuring equipment and the discomfort of lying down that way from previous visits to the hospital once I went past due date, which was bad enough without the contractions but got really terrible with the contractions.

So in a tragicomedy of miscommunication and misunderstanding, I kept waiting and waiting for them to take the IV out of me and take the belt off me and give me the ok to “really labor”. I waited for hours. Meanwhile, Seppo had thought that when I said I was done, that I was done trying to move through labor, so he didn’t try to push me to get up, which, given what he thought was the right thing to do. If I was really through, it would have pushed me into a black rage and despair if he had tried to push me to go longer.

I don’t know how long I laid there. I know it was around 2:30pm when I asked for drugs — maybe by then it was already my second round, I am not sure of the timeline at all — because I adjusted the bed a little off the horizontal to alleviate the blinding pain, when the nurse told me that it was “distressing the baby” and I didn’t want to do that, did I? I’m sure that she must have said it fairly innocuously, but at the time, it felt like she was plunging a knife into my heart. I felt like she was acting like she had told me that I’d endanger the baby if I sat up, and despite her warning, I was being selfish and doing so, even though I had zero indication before that that was the case. Or if so, I was so out of it that I had no idea. If I thought it would distress the baby at all, I wouldn’t have moved a muscle.

So I was made to get back to lying down and I felt so lost and hopeless. The doctor had already broken my water earlier with hopes I’d dilate more, but I hadn’t progressed past 1.5 cm. The nurses had changed shifts at some point. They all asked me about my pain on the pain scale. I had said 8 to someone and they told me to reconsider, so I adjusted it back to 6, even though I found it impossible to think of what I was going through as one notch above “moderate”. It was crushing, demoralizing, mindnumbing pain. I was so out of it that I never thought to ask them to remove the IV or the baby monitor. I just kept waiting for someone to say it was ok to remove and that I could get up. When would I get to sit on the ball again like I did at home? Or have Seppo massage my back?

As the nurse told me I can’t adjust my position, and the doctor told me that my labor wasn’t progressing, and the other nurse had told me that my pain couldn’t possibly be an 8, I felt so… lost and helpless. Like my body wasn’t doing what it was supposed to and the hospital staff wasn’t taking me seriously. Honestly, after nine months of distance and Seppo remembering things differently, I must have already had my first bout of narcotics by the time I had felt this way.

The narcotics, which I specifically chose over the epidural because the epidural would mean being confined to the bed and not being able to move around the room for labor, did what they said: make it so that you still felt the pain, but you didn’t care about feeling the pain. I was even able to doze off for a little bit while it was kicked in, but it didn’t last long enough. I had two bouts and I was asking for a third when the epidural was suggested to me. I was still hoping that I could get up for some part of labor, so I hadn’t wanted to do it, but I felt so helpless by then (this was definitely after the nurse said moving endangered the baby) that I said ok. After all, it looked like they weren’t going to let me off the IV and the monitor.

I wish I had asked them. This is my biggest regret and still haunts me.

My doctor came in at some point and measured the contractions with this other thing that doesn’t just measure the frequency but the strength of the contractions as well, and commented that my contractions were “definitely strong enough to do their work,” meaning that I should be dilating and that I was definitely contracting like I was going to go into active labor any moment, except no dilation was happening. I think if I were able to walk or move, things would have happened more. Sure, maybe I couldn’t have walked because the pain was too much, but I wish I had been given the chance to try, without the fear of not being taken seriously and sent home hanging over me.

The anesthesiologist came and put in the epidural. He was nice enough and said it would take some time but that I won’t feel a thing after it kicked it. We waited a while and while some small part of the pain was lessened, it still hurt really, really intensely, such that I still couldn’t think or talk through the pain, which was really coming wave upon wave by then. I told the nurse that I didn’t think the epidural was working, and she asked me if I was sure. I said I didn’t think so but I was so timid and terrified by the process and afraid of the nurse and offending/displeasing her in any way that I didn’t assert myself. Again, I think the narcotics led to my feeling this freaked out by the nurse, who was brusk but by no means a monster. The pain, which probably had hit a 9 before the epidural, only ever decreased to about an 8, rather than the total lack of any feeling I was supposed to be feeling.

We were supposed to wait another 30 minutes, but I think we waited more like an hour and the pain was still crippling, and more so, the fear of the pain was incapacitating. I was terrified now that nothing could stop the pain, since the epidural was supposed to and it didn’t. It has been our last resort, our last safe haven. All this time, I was supposed to be hitting a button if I needed more pain control, but I was hitting it and NOTHING CHANGED. NOTHING. I was so desperate. I kept hitting it, and the nurse kept reminding me to hit it, but I stopped at some point because what was the point? It didn’t do anything. Nothing I did helped the pain, nothing I did made the labor progress at all. The single action I had taken all day had hurt the baby, according to the staff. I was desolate.

The anesthesiologist came back and either gave me more meds or something, but that actually didn’t help me either. Some excruciating amount of time passed, and I started to hyperventilate when the nurse said something to me that I don’t even remember any more. Then she asked me if I ever hyperventilated before and I told her it was my first time, and, again, I’m sure it was drug-induced paranoia, but I felt like she thought I was lying and that I was weak and hyperventilated all the time. I think it was the drugs, but at the time, and for months afterwards, that changed nothing. She mad me face to my right, away from Seppo and toward her, so she could check some stuff and talk in my face to try to calm me. I was scared of her, angry at her, hated her, dependent on her. She kept saying that I had to calm down for the sake of the baby and that if I kept hyperventilating, it would hurt the baby, which scared me more and made me hyperventilate more.

She left the room at some point to get a bag for me to breathe into. In the interim, Seppo talked to me and I calmed a bit. All this time, he had been by my side, not eating or sleeping or even sitting most of the time, holding my hand tightly and reassuring me that it was all going to be ok. When I looked at him, I felt calmer. When the nurse made me look at her and talk to her, I got more and more panicked. I tried to focus inwardly through the pain fog and the hyperventilation, but every time I had to answer her or pay attention to her, I got worse and worse.

My doctor came in at this time, while I had the bag to my face, and talked me down. She was such a calming influence. I wish it had just been me and Seppo and the doctor the whole time… She checked me again and I hadn’t made any progress, dilation-wise. It was nearly 6pm by then, and I had been in labor since 9pm the night before (21 hours), and in painful labor for 14 of those hours, and in excruciating pain for 10 of those hours, with almost zero progress.

She said that there would be no point in giving me pitocin, which is the synthetic form of the naturally-occurring oxytocin, to either strengthen or regulate my contractions because they were plenty strong enough and regular enough that additional pitocin would have zero effect. And at this point, this is what I knew:

• I was stuck in bed and I couldn’t do anything personally to alleviate the pain or help the labor
• The drugs were not helping me
• They told me the baby was distressed from the length of labor and from my actions (sitting up that one time and hyperventilating)
• The labor had not progressed at all since 9:30am that morning, AT ALL

The doctor gently suggested the possibility of a c-section and, despite my deep and abiding desire not to get a c-section unless the baby was in trouble (before and after the birth, a lot of literature I had read suggested that babies are falsely diagnosed as “being in distress” when they have slightly elevated heartrates during contractions, which is normal all on its own, and this is the only thing they ever mentioned), I said yes right away. I conferred with Seppo, who was as white as a sheet, but in my pain-and-narcotic-addled-and-sleep-deprived mind, this was the right and only choice and pretty much bullied him into agreeing with me.

As soon as I gave the word, there was a rush of people (like half a dozen) to get me prepped the emergency c-section, and I was getting wheeled away within minutes. My hyperventilation had stopped immediately either with the nurse getting out of my face and telling me to breathe or with my doctor checking on me. Now I’m not sure which. I thought it was the doctor, but who can say.

Seppo put on his scrubs and my mom had to wait out in the waiting room. There was a different anesthesiologist for the OR and whatever he did or gave me kicked in and I felt no pain. It was great. I could focus on what was happening for the first time in hours. When they said the baby was coming out, I tried to see his reflection on the mirrored light over me. I begged Seppo to look, even though he didn’t want to (refer to: white as a sheet). 🙂 He did, for me. Then he went with the baby while I lay there, trying to peek beyond the curtain, seeing only the big pump full of my blood and amniotic fluid to my left. I listened desperately and tried to imagine what was happening. I heard him cry at some point. Seppo came back and told me he is fine. I cried.

They didn’t bring the baby to me until I was out in recovery, and then, he was all bundled up and his eyes had that medicine goop in them. I had thought they would put him on me right away so he could be on my skin and feed in that first hour like everyone says is good, and delay the non-critical testing/medicating until later. But I don’t think I saw him in the first hour. They said it was ok to unwrap him to put him on my chest so we did, and I wept to see his spindly little legs. I hadn’t expected to see such skinny, fragile looking legs.

This is all I can write today. I’m weeping like a baby.