September 1, 2009

birth story, part II

For part I of the story, go here:

So- when we left off, we had just resigned ourselves to the fact that we were not going to be having a baby that night, and I was convinced that I had gulped down 10 oz of emulsified Ensure and castor oil deliciousness for absolutely nothing.

And then...

All of a sudden I started having pretty powerful contractions. It started at 7:45 pm and they were almost instantly 3 minutes apart and over one minute long. Our instructions from the midwives and all of our training told us that it was the real deal when we got to 4-1-1. That is: contractions four minutes apart, one minute long, and that pattern continuing for one hour. I had been expecting to gradually work up to that though, not to dive right in, and I was still skeptical that this was anything more than another false alarm. I took a shower and things didn't slow down, and I was having bloody show, so I started to pay a little closer attention.

By 8:25 we contacted our doula to let her know that there had been a turn-around from earlier. Things seemed to be progressing pretty quickly, but we were still fine.

At 8:45 we contacted her again, and told her that we didn't need her to come yet, but we were wondering if we should order the tub. She suggested that we do that, as it takes a couple of hours for them to get everything set up and the tub filled.

I started to really have to focus on the contractions at this point, and I was pacing the house and trying to remember to breathe and relax through the contractions when they came. I was having a lot of back pain with each contraction, and it was essential that Gus be there to apply serious pressure to my lower back in order for me to tolerate them. He was forced to basically follow me around the house and then start pushing when I turned around and started breathing deeply. Despite the fact that I wasn't able to communicate my needs very well, he was so patient and eager to help, I'm so grateful for that.

By 9 pm we decided that it was time to get Betsy the doula over. I was getting more serious and I could tell that this was "it". I didn't think it was time for the midwife yet, but I wanted someone else to be there that had been through this before. When Betsy arrived at 9:45, my contractions were coming 2 minutes apart and were 1 minute long. She spent her first few minutes just observing the scene, she said that she didn't want to change the dynamic of what we had going on. I appreciated that, as I felt that we were doing pretty well on our own and I didn't want anyone telling me what to do at that point.

I remember telling her that I felt "indecisive" when she asked me how I was, and that was really the best word I could think of for what I was feeling. Her and hubby were asking me if I wanted to call the midwife, and if I wanted to change positions or eat something, and all I could think was "I don't know!" I'd never been through anything like this before, and despite all of our preparation, I didn't have any idea what would help or not at the time. I was trying to just listen to my body and respond in what seemed like the most natural way, and most often that involved just pacing and bracing myself on the wall for each contraction.

Betsy commented that I seemed to be handling things really well, and that to look at me you wouldn't even know that I was in hard labor. I remember being kind of irritated by that comment, because it was so real and intense for me and I felt like she was downplaying my experience. I told her "Oh believe me, it hurts like hell. If this isn't the real deal, then I don't want it."

The labor tub had arrived by this point, and the woman who was setting it up was moving back and forth between our kitchen and dining room getting it filled. Betsy helped her out and Gus and I moved to the bedroom to labor for awhile. By 10:45 the contractions were really strong and they were coming one on top of the next with very little break. By 11 I was shaking and crying and felt like I was losing control.

I was kneeling on the bed over the yoga ball so I could get my requisite back rub for each contraction when my water broke. I felt a little pop and a gush and I jumped up from the bed and tried to get onto the hardwood as quickly as I could. Even in the middle of labor, I remember still being concerned about dripping blood and fluid on the bed and the rug, and Betsy had to tell me more than once that this was going to be a messy project and I really should probably give my OCD a break for the evening.

With amniotic fluid still running down my legs, I made my way to the shower and cleaned up. Gus was there on back-rub duty, although my contractions had slowed and spaced out a little at this point. The midwives arrived at about 11:30 and took my vitals and checked on Baby. They needed to administer the group b strep antibiotics before they could give me an internal exam, since my ruptured membranes meant that there was an increased risk of infection. There was some trouble getting my veins to cooperate, and as I'm writing this two weeks later, I still have a bruise on my hand from the botched job!

I was really shaky and vomited after the antibiotics but by 1 am I was in my warm, wonderful labor tub and I was feeling so much better. The midwives were concerned that the tub would slow my labor, but the opposite actually proved to be true. Soon my contractions were coming 20-30 seconds apart and they were each over a minute and a half long. After about an hour and a half in the tub, I started feeling like I needed to push. It seemed too early to me, but the relief that came with pushing with each contraction was awesome, so they told me to just listen to my body and do what I felt like I needed to do.

An exam around 3 am revealed that I was only about 7 cm dilated, but my cervix was soft and flexible. The midwife suggested that I try not to push anymore until I was completely dilated, and I got out of the tub to try some walking. In the tub I was falling asleep between each contraction, but walking around forced me to focus on the work we were doing. Another exam at 4:45 revealed that my cervix had not dilated any more and Baby's head had not descended any more. I was getting frustrated by the lack of progress we were making, so our midwife Heather suggested that we start working harder to see if we could get things going.

Heather's idea involved Gus and I walking the stairs, and spending each contraction in a lunge position with one leg up two stairs higher than the one below. This position was supposed to help open my pelvis and encourage Baby to turn into a more favorable position. By this time, it was obvious that he was Occiput Posterior, or "sunny-side-up", meaning that he was facing straight up in my pelvis instead of to one side or the other. This position means that baby's spine is grating right along mom's spine, and that explained my persistent back labor. OP also has a tendency to give a mother a premature urge to push, which doesn't do anyone any good.

So we spent about an hour working our way down and then back up the stairs, leaning and pushing through each contraction despite the horrendous misery it was causing me. I was pretty fed up by this point, to be honest. I was exhausted, and my body was still being racked by contractions every couple of minutes.

The contractions had a new element after this point, and instead of peaking and then fading away, they came with a bonus end feature that made me feel as though my uterus was folding in half and flexing with the most intense force I have ever experienced. I was doubling up and pushing against the hallway wall, moaning and attempting to ride out the extreme urge to push that I was feeling. There was no rest, and I remember just wishing that I would reach transition so I could have a break.

Everything we read and learned in class said that transition was often marked by a feeling of hopelessness and the sense that you just couldn't do it anymore, so my attitude was actually giving me some hope that I was getting close to being done. Unfortunately, another exam at 6am showed no further progress. I was holding at 7 cm dilation, and Heather could feel Baby's head fixed in the same position that he had been, no lower and no closer to being born.

My cervix was starting to swell, but Heather offered to try pushing back on my cervix while I tried to push, to see if we could get him past this stuck point. I was willing to try anything, and it was just as awful as you would imagine. Her fingers were inside of me stretching my cervix tight, pushing up while I gave my best effort to push him down. Unfortunately, it was all for nothing, and the midwives had a chat about options with Betsy while Gus and I worked through some more contractions in the hall.

Betsy came to us a few minutes later, and said that the midwives agreed that it was probably time to start thinking about a transfer. They had been monitoring me and Baby regularly all night long, and there was no indication that it was dangerous for me to continue laboring if that was what I wanted to do, but there was also no indication that anything would change if we did. It seemed as though our not-so-little Lincoln had gotten himself good and wedged, and our efforts to correct that didn't appear to be working.

We had spent months preparing for this labor, and we had a very definite idea of what we wanted to have happen. A trip to the hospital had no place in our plan, and in fact I had even had a hard time writing the worst-case scenario "plan c" birth plan that even allowed for the possibility of this event.

That being said, however, I was more than ready to go when they suggested that we pack up and move our project at this point. I was absolutely ready for a rest and some relief from the non-stop discomfort that I had been experiencing for the last 11 hours straight. Hubby was not so amenable to the decision, and in fact the decision to leave home really upset him.

Once we made up our minds to leave, the midwives and doula were amazing. They went into overdrive and got us packed up and out the door in record time. Jenny (one of the student midwives) offered to drive our car so Gus could sit in the back with me holding my head in his lap and rubbing my back while I had contractions during the million-year long drive to UW Medical Center during the morning commute hours.

Alright. That's enough for tonight- stay tuned for the finale!