MrsStu: Eloise's Unexpected Delivery
Friday, May 14, 2010 11:55 AM
"At this point, all dreams of an intervention-free birth had flown out the window, and I just wanted to get her out..."
I had wanted to have an intervention and med free birth, so of course I actually had almost every intervention out there and multiple (failed) pain medications. Even though this was almost my "worst case scenario" birth, I don't have any regrets. Eloise is here and we are both healthy and in one piece.
For about a week and a half before I went into labor, I had regular contractions that were about 5 to 7 minutes apart almost every day -- sometimes for up to 12 hours. Since I was told not to go into the hospital until the contractions were 3 to 5 minutes apart, this was very frustrating. And, on top of that, at my 37-week appointment I was dilated to 2 cm (almost 3) and was 50 percent effaced. At 38 weeks, I was at 3 cm and 75 percent effaced, and, at my 39-week appointment on February 4, I was dilated to 4 centimeters and 80 percent effaced. At this appointment, I told my doctor about the contractions that I had been having, and he told me if and when it happens again I should just go into the hospital. Even though I am a first-time mom, he said I wasn't acting like one -- first-timers do not walk around while they’re 4 cm dilated and 80% effaced!
At about 6 pm that night, the contractions started up again. They were 5 minutes or so apart for about 5 hours when we finally decided to go into the hospital. I was a little nervous to go in because I was afraid that my contractions were going to magically stop the second that I walked in the hospital, and then I would just be sent home. I wasn't nervous about being in labor or giving birth -- I was nervous about looking silly and being sent home if I wasn't in labor!
Officially in labor
When we got to the hospital, I was checked and then put on a monitor for about 20 minutes. Upon the first examination, I was still at only 4 cm and 90 percent effaced. After the 20 minutes on the monitor (and contractions continued about every 5 minutes) I was rechecked, and I had progressed to being 5 cm dilated. This was like music to my ears. I was so happy that this late-night trip to the hospital wasn't in vain -- I was in labor!
I was admitted to the hospital and I moved into a Labor and Delivery room. The nurses asked me a bunch of medical history questions and then hooked me up to an IV. At my 36-week appointment, I had tested positive for Group B Strep, so IV antibiotics had to be administered every 4 hours while I was in labor. I wasn't too happy about this since I didn't want to be tied down to an IV pole; I wanted to be able to walk around and use the nice big tub in the room. So, there I was – unable to move around – and extremely uncomfortable because the IV was itchy and it hurt if I bent my wrist the slightest way. My agony only increased when the antibiotics began to be administered because they burned all the way up my arm if the dosage was even a little too high. It literally felt like someone was pouring boiling water into my veins.
It was about 1 am when the nurse suggested that my husband and I try to get some sleep while we were still in the early stages of labor so that I would have energy for active labor and pushing. I tried to sleep, but was woken up at least partially with each contraction, so the little sleep I did get wasn’t very restful. Then, I had to wake up at 4:00 am for my next round of antibiotics. Ben slept on the little bench in the room and was able to get at least a few solid hours of sleep. We woke up sometime before 7 am, and I was put back on the monitor. By this time, my contractions had decreased to about one every 10 minutes. I was so disappointed. The nurse said that this was pretty normal after getting some sleep, and that the contractions should pick up again as I'm able to walk around. It turned out that I was also still dilated only 5 cm and 90 percent effaced. The nurse told me that my doctor would be in at about 8:00 am to check in on me, and he would likely break my water to try and help things move along.
Breaking the water
When 8:00 am rolled around, I was started on my third round of antibiotics, and my doctor came in soon after. After checking me, he decided to put an internal heart rate monitor on the baby's head, something that creates a pinprick hole in the amniotic sac. This would let my water break slowly. He said he didn't like to use the amni-hook because there is a greater risk of umbilical cord prolapse, which would require an emergency c-section. After the monitor was in place, I put on one of those massive hospital pads/mesh underwear and stayed in bed to finish my round of antibiotics. While lying there, I could feel my water trickling out slowly. It kind of felt like I was peeing a little, but I knew that wasn’t what it was. When I sat up after I was unhooked from the IV, I felt a larger gush. I went to the bathroom to pee and there was an even larger gush. My water had officially broken. I had to change the massive pad twice before I could start wandering the halls.
Walking the halls
Ben and I walked the halls of the birthing center from about 9 am until 1 pm or so. My contractions increased to about every 5 minutes again after walking around for a short time. They felt pretty strong toward the end and I had to stop to breathe through them. At around t 1 pm, I was checked again -- I hadn't made any progress. My nurse said that my contractions weren't close enough together to cause the cervix to dilate any more. That’s when the doctor approved that I be put on Pitocin. This was not in my birth plan. I wanted to avoid Pitocin like the plague. My main goal in my birthing experience (besides avoiding a c-section) was to go med-free, and I knew if I was put on Pitocin that the chances of that happening dwindled to almost zero. Also, being on Pitocin would mean that the baby would have to be monitored constantly since the drug can cause the baby's heart rate to go down. But, since my water was already broken and my uterus wasn't cooperating, we didn't have much choice. So, that was the end of walking around for me. I was confined to a 3-foot radius around the monitors. All dreams of laboring in the tub also died.
I was started on a very low dose of Pitocin, and the nurse kept increasing the dosage until I wanted to die -- literally. About an hour after the Pitocin started, I was no longer able to breathe through the contractions. It felt like my pelvis was ripping apart with each one, and I had to fight the urge to push. The pressure and pain was unlike anything I had ever experienced. I tried different positions to see if it would help at all. I tried lying on my back, lying on my side, bending over the bed, leaning on the birthing ball, on all fours -- nothing was giving me one iota of relief. At this point, the contractions were happening about every one-and-a-half to two minutes, and lasting about one minute each, which meant that they were right on top of each other. There was no real break in between and I was quickly becoming exhausted and overwhelmed. Every time I heard the Pitocin drip, I would curse it. With every contraction, I would scream and curse so loudly that I'm sure they heard me in the lobby. In the hour between 1:00 pm and 2:00 pm, I progressed from being dilated 5 cm to 7 cm.
Asking for an epidural
Around 2:15pm, between contractions, I looked at Ben with tears in my eyes and said, "I think I need the epidural." I felt like such a failure. He read my mind and reassured me that I wasn't a failure if I got one, and that I should do it if that's what I needed to do. I was so relieved when he said this. When the nurse came in the next time, I told her that I thought I needed the epidural. She agreed that it would probably help me relax enough for my cervix to finish dilating. I was too tense during the contractions at that point for them to do their job. She offered IV pain medication first to see if that was enough to take the edge off, so that I could possibly still avoid the epidural. I agreed and she gave me a dose of Fentanyl. The drug made me feel a little drunk, but didn't do anything to take the edge off the contractions. They were still just as painful and as intense as before. The only difference was that I relaxed a little more in between contractions because I felt all doped up. I asked for the epidural.
The anesthesiologist came in at about 2:30 to administer the epidural. I had to sign a release form, and I remember thinking, "This is going to be the worst signature ever. I am delirious with pain and I'm doped up on narcotics." The nurse checked me one more time before the epidural and I was dilated 9 cm. Yes -- Progress! Apparently the Fentanyl made me relax more than I thought it did. The anesthesiologist had me lie on my side so he could administer the epidural, but it was so hard to lie still through the Pitocin drip and the contractions. Ben and the nurse were practically holding me down to help me stay still. After the epidural was in, I continued to have monstrous contractions. I kept asking how long it takes for the epidural to kick in. Their answer, of course, was, "Just a few minutes." The epidural didn't seem to be working. A little while later, the anesthesiologist came in and asked me if I needed more. He gave me another dose of the epidural and the contractions finally decreased slightly. He told me that he gave me enough that I should now be able to take a nap and rest up for the pushing stage, but to me, the contractions were still incredibly intense. I was able to breathe through them, though just barely, and there was no way that I'd be able to nap. My legs never got numb and I could still move them just fine. So, either the epidural wasn't administered correctly or it just didn't work right on me. The only thing it seemed to do was give me the shakes.
At 4:30 pm, I was finally at 10 cm and ready to start pushing. Ben wasn't sure if he wanted to watch, or if he wanted to stay near my head away from the action. He ended up watching the whole thing, and he actually seemed to enjoy it. The nurse grabbed one leg, Ben grabbed the other and I pushed... and pushed... and pushed. For two hours. I could still feel my contractions and was able to push effectively, but the baby was getting stuck behind my pubic bone. Her head was positioned at a funny angle as well, so it wasn't the narrowest part of her head coming through first. My contractions were still coming about every one-and-a-half to two minutes and lasting about a minute, so I wasn't getting much of a break between pushes. Between every contraction I was demanding water or ice chips and a new cold rag for my forehead because I was so hot. After about 24 hours of labor, two hours of pushing, and not having had anything to eat for about 29 hours, I was getting exhausted. The nurse said that they would probably have to help me by using the vacuum to get the baby out. At this point, all dreams of an intervention-free birth had flown out the window, and I just wanted to get her out.
The nurse called in the doctor and about three more nurses for the big moment. The doctor got all set up and attached the vacuum to the baby's head. And then I pushed. And he pulled. And I felt her starting to crown. I could feel myself stretching and I was sure I was tearing, but that just made me want to push harder so it would be over faster. I felt the head come out and I laid back to rest a minute before pushing the rest of her out, but the doctor told me to keep going. I needed a break so badly, but I kept going. I found out later that her hand was up by her face when she came out, so the doctor had to pull her arm out first (this is what caused all the damage). It took a couple more pushes and at 6:41 pm, she was out. Oh, sweet relief. The doctor put her on my chest for a minute while Ben cut the cord, then the nurses took her away to get suctioned. The doctor told me to push one more time to get the placenta out (I didn't realize I'd have to push it out) and I finally lay back, completely spent. It was over and the sense of relief was astounding. All the pain and pressure was gone in an instant.
When I heard Eloise cry for the first time, it was one of the sweetest things I've ever heard. The nurses weighed her and cleaned her up a bit while the doctor stitched me up. I remember him saying before he started stitching, "I'm not sure how numb she is..." and I just blurted out, "Not at all!" So he numbed me up a little before suturing. Even though I supposedly had an epidural, and he gave me a local anesthetic on top of that, I could still feel the needle occasionally. I asked him where I tore and how bad it was, and he said it was a second degree sulcus tear. I had no idea what a sulcus tear was (I later found out it is a deep internal tear), but I knew second degree meant that the tear went into the muscle tissue.
Once I had my baby in my arms, I knew it was all worth it and I would do it again in a heartbeat. The biggest surprise for me was her full head of dark hair. Most babies in my family come out bald and I was expecting a blondie or a redhead, not a brunette. She was so beautiful and alert, and was just a tiny little peanut at 6 lbs 9.6 ounces, 19.5 inches long. I couldn't believe that my husband and I had made this little person. I was so happy that after all that work, our baby was finally here!
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