Friday, May 14, 2010

Avery's Birth Story Part Two

The baby is almost three weeks old, oh my heart! I have to say I am so glad she's here on the outside already and I'm not still waiting on the birth, suffering my endless anxieties over the whole thing. I'm so glad it's over already! Now I can spend my time obsessively reflecting on what a mind-blowing experience it was.


I remember watching the Business of Being Born in the very early days of my pregnancy. I highly recommend the movie if you are considering an unmedicated birth because there is lots of footage of peaceful home births that will inspire your confidence in your own abilities to ... um... survive?... the birthing process.

Of course, being that it's her film, one of the women whose home births is featured is Ricki Lake. You can watch the footage of her home labor, including when she actually gives birth in her bathtub. Her birth is not one of the peaceful ones. During her labor and birth, she is downright out of her head - she is stalking around the house like a madwoman, yelling that she wants to go to the hospital and get an epidural, yelling that she can't do it, she can't take it anymore, etc.

When we watched it, I remember thinking, HELLO DRAMA! I also smugly told Adam I didn't think I would be anything like that when I gave birth. Just judging by my personality - I'm a pretty even-keeled, rational, level headed person - I figured I would be more like one of the serene women quietly laboring while they swayed around their living rooms and then squatting to silently push the baby out on their kitchen floor. HA.


I think I mentioned before that I started to lose my mind when we were in the triage room waiting to be admitted to the hospital. The pain and pressure were quickly becoming overwhelming and my contractions seemed like they were coming one on top of the other, never really letting up.

They wheeled me down the hall to my room and I got up in the bed, still wearing my pajama top and the paper around my waist. The nurse came in and introduced herself, and I immediately disliked her. She had this tone about her that just didn't seem very kind or helpful. She started asking me a bunch of questions about Lord Knows What, and meanwhile I'm in the throes of contractions piled up on top of each other and trying mightily not to be snappy towards her. I can't be sure, but I think she asked us several times about cord blood banking. Good grief! We don't want to bank the baby's cord blood! Stop asking!

Another nurse came in with an IV lock and I asked if I had to have it. The nurse said I had to take it up with the midwife. The nurse also told me I had to have 10 minutes on the fetal monitor every 30 minutes. Later when the midwife came back in she told the nurse I didn't have to have the IV, and she could just to the monitor for one contraction, not 10 minutes. I ended up consenting to the hep lock anyway, because the nurses told me if I wanted any pain medication I had to have the IV, and if I couldn't keep water down I needed IV fluids. Well, I was still feeling super nauseated and close to yakking every contraction... plus, I was really thinking hard at that point that I might want some pain medication. So I told them they could set me up. So began what could have been the worst 20 minutes of the whole ordeal!

I can't say for sure, but I think the nurse who was trying to start my IV was incompetent. I was yowling in pain from a) contractions, and b) her literally digging around in the back of my hand trying to get the needle in my vein. She never did succeed! She put the thing in and it was hurting so bad, I was yelping and telling her it really hurt. I don't know what the heck they were thinking. She went ahead and taped it off and they tried to start a bag of fluids, but the needle wasn't even in my vein so nothing was going in. It was really painful! Then they left it taped on my hand! I was so overcome by the contractions I hardly knew what was going on or cared.

Poor Adam nearly passed out, though! He said later that watching that nurse dig around ineffectively in my hand, and the blood pouring down, and me yowling in pain, and he had his legs locked and his jaw clenched - it just made him lightheaded. He said looking back he should have said something to her like, hey I don't think that's working.

So I was still sitting there in the bed, still wearing my own pajama top, with an ineffective IV taped in my left hand, and telling anyone who would listen that I wanted some pain medication with every contraction. The pain was much more overwhelming than I imagined it would be. I knew it would be painful, but I thought I would be able to manage the pain better and not feel so completely overcome by it. And my contractions were happening so fast I really never felt like I got a break from the pain, it was just one big gut-rending contraction. I was groaning loudly through every contraction, and as soon as the peak of it was over, telling everyone who would listen that I can't do this anymore, I need pain medication!

The nurses were more than ready to drug me. I'm sure it's much easier and less annoying for them to have a woman labor with pain medication than without. After all, they can talk to you and do all their procedures and monitoring and make nice pretty contraction charts on the machine without the patient writing in pain, occasionally ripping off the fetal monitor because GET THIS DAMN THING OFF ME! and making all kinds of noise. Luckily, the midwife had come back in and convinced me to try laboring in some different positions before going ahead with the pain meds.

She wanted to check me again before I got up, and I was only 5 cm dilated! I was so disappointed, as I really felt like my labor was incredibly intense and more progress should have been made by that point. Again, I should have remembered our Bradley training that dilation doesn't really matter that much because it can happen all at once really quickly. But the nurses are trained to think one centimeter per hour, so they kept telling me it was going to be a while longer before we would meet our baby. I kept thinking - and saying - I can't do this! The midwife suggested I get on the birthing ball and then try getting in the tub.

I didn't feel like I could MOVE, let alone get out of bed and get on the birthing ball, but I was really at the end of my coping abilities and nearly out of my head, so I let Adam pull me out of bed and into the bathroom. I sat on the birthing ball, leaning my arms and head in Adam's lap as he sat on the edge of the bathtub and the nurse ran a hot bath for me. The room had a huge jacuzzi tub in it, and even though they don't usually let you get in the tub after your water has broken, the midwife ok'd it for me.

As a side note, I never would have thought I would be completely naked in a room full of people I don't even know, but amazingly, I DID NOT CARE ONE IOTA! Yes. Things you should know about giving birth naturally: you will be naked in front of strangers and not care. They will see all your lady parts, in gory detail, and you will not care! You will in all likelihood poop and/or pee in front of these people and you will not care. You might even poop and/or pee on YOURSELF in front of them and YOU WILL NOT CARE!! I know this blows your mind right now if you've never given birth and you're thinking oh no, not me, *I* will care, that is horrifying! You must trust me on this one...

I labored for 15 or 20 minutes on the ball, then got out of my pajama top and into the tub. Oh man, it was immediate relief. Being in the tub actually slowed my labor down, but that was a good thing at that point because I was totally overwhelmed. Right away my contractions spaced out to being a minute or two apart, so I could actually get a break in between. And it's kind of amazing how you feel totally fine between contractions. Of course, you feel like an elephant is stepping on your pelvis DURING the contractions! Which is why I kept asking for the epidural every time I had one!

I was really trying to remember the relaxation skills we had practiced, so I was focusing on relaxing my face, arms, legs, etc, during every contraction. But they were too painful, I couldn't help but tense up. I was moaning and trying not to be tense. I was trying to imagine my cervix opening and the baby coming down. Adam kept reminding me I was doing this for the baby. I was so out of my mind, though that there weren't any rational thoughts happening in my head. In fact, looking back I was somewhat surprised that all the spiritual preparation I had done pretty much went out the window. It didn't even occur to me to pray or to give a single thought to God or the circle of life or what an intensely spiritual experience giving birth really is - bringing a soul into this world. I had spent so much time thinking about how I would meditate on these thoughts during the birth as a means of coping with the pain, but I am disappointed to say that in the heat of the moment, it didn't even come into my head. All I could think about was I can't do much more of this, make the pain stop. It didn't help that the nurse kept telling me I would probably be there until lunchtime! Holy shit, I thought, if I'm going to be doing this for another 5 hours I really will not make it. I think there was a little voice in the back of my head though that told me it would not be that much longer, because the nurses kept telling me - we know your support people are trying to help you stick to your unmedicated birth plan, but if you really want pain meds, we will give them to you - and something in me kept pushing it off (even though I was irrationally asking for relief every few minutes!).

I was probably in the tub for at least 45 minutes. As time went on, I was feeling intense pressure in my lower back and hips. It felt like a huge bowling ball was sitting in my abdomen, pushing on my tailbone and my hipbones. Since I was laying back in the tub, I tried to get on my hands and knees in the water, but my legs kept cramping up in that position, so I just sat upright. I could really feel the baby's head coming down, and I could feel my contractions sort of changing to where I was kind of pushing a little bit when they hit. I never felt that intense urge to push that some women describe. It was more of a gradual urge that built up over time. I told the nurse I thought I was pushing a little and that I could feel the baby's head coming down. She wanted me to get out of the tub so they could check me.

I got out, dried off and put on a hospital gown and somehow made it back into the bed where the midwife came to check me again. NINE CENTIMETERS!! Only one more centimeter to go! Holy cow, I went from a 5 to a 9 in an hour! NO WONDER it was so painful and intense. I was sitting there cross legged, and the pressure was KILLING ME in my back and hips. I tried to get on my knees leaning over the back of the bed, but my legs were cramping again, so I just sat there indian-style for a while. (Don't forget this whole time, the moaning and frantic requesting of pain meds was ongoing. Once I heard I was nine centimeters, though, it was like the point of no return in my mind. Even though I asked and was offered pain meds a few more times, I knew in my head this was it, I was going the full distance without, like it or not!)

There were a LOT of fluids coming out of me. The nurse said pretty soon I would need to pee as the baby's head came down and put pressure on my bladder. Right after she said that, sure enough I had to go. But there was no way I could get up to the bathroom. She brought a towel over and stuffed it between my legs and said, there, just pee! I was like, right here in the bed? On myself? She said yeah don't worry about it, there's all kinds of mess already in that bed. Well, the next contraction that came I could hardly even help it. The pressure was so great, I don't know if I could have NOT peed. Remember what I said before, though... at that point I did not even care!

I was complaining about the pressure in my back and hips, so the nurse set up the squat bar so I could pull myself up on it and showed Adam and my mom how to apply counterpressure on my back. I was really pushing now, the moaning I was doing with each contraction turned to primal grunting as I held onto the squat bar leaning over Adam's arm. Instead of asking for pain medication, I started yelling "push on my back!" whenever a contraction hit. That counterpressure really helped. I labored like that for a while - maybe 30 minutes or so? The midwife came back again and I told her I had been pushing through contractions. I couldn't help it! My body was taking over and doing what it needed to get that baby out. She said she wanted to check me and see if it was time to start pushing for real.

Well, I didn't want to lay back again because of the pressure on my spine and hips, but I had to so she could check me. Ten centimeters! Ready to go. Suddenly there was a small flurry of activity as they changed the position of the bed, got the table with all the birthing instruments on it ready, and got the fetal monitor back on my belly (HATE!). I didn't really want to push leaning back, it felt more comfortable to be upright and I think I would have preferred to push in the squatting position. But I was kind of along for the ride at that point and the midwife felt that the baby's head would clear my pelvic bone better if I was reclined.

So Adam was on my right side with the midwife. He was holding my right leg up and my mom and the nurse were holding my left leg. I remembered learning how to push in the birth class, but it wasn't at all how I imagined it would be. First of all, I didn't feel a really overwhelming desire to push. I mean, when a contraction came, I pretty much couldn't help but bear down, but actual pushing, no. The nurse and midwife kept telling me to push through my bottom and not in my face. I could feel a difference when the pushing was really effective versus when I was just straining to no avail, but it seemed like I didn't really have control over it one way or the other. I kind of felt like I wasn't doing a good job of it - the nurse and midwife kept saying, PUSH! PUSH! PUSH THROUGH YOUR BOTTOM! And I was like, I am doing all I can! Actually I wasn't forming any coherent sentences. I was grunting and yowling like a madwoman.

I could feel the baby's head as it was crowning - the so-called ring of fire. Remember when kids would give you an indian burn on your arm at the playground? Yeah, it's kind of like that, except it doesn't go away! The whole time the baby's head is pressing against the exit, it burns. This phase of labor is kind of a blur for me. It really only lasted about 30 minutes or so... I don't know how many times I pushed... maybe 7? I remember being really exhausted, and worn out from the pain, ready for it to be over already. I had no idea of where I was progress-wise. Once the baby's head was showing, it felt like she should be out already, but when the contraction ended, there we were still waiting.

At one point the midwife told me to reach down and feel the baby's head, but I was like no, I don't want to I just need to stay up here and focus on getting this baby out! I was in another dimension. I'm pretty sure the next contraction was the last one - I pushed with everything I had and let out a wall-rattling scream as her head came out and I felt my skin ripping open. Her shoulders were still in there and I think I yelled, "get her out!" and then suddenly everyone was saying, "look down, here she is!!" and I opened my eyes and looked and there was this little blue gooey creature halfway out of me with the midwife supporting her head. I said, oh my god! and reached down and grabbed her under the arms and pulled her up on my chest and suddenly it was over though I could hardly believe it. I expected to feel a huge sense of relief once she came out, but I didn't even know it was over until everyone was yelling at me to look down.

Once she was up on my chest, though, my brain finally connected, and I thought, it's over! Thank God it's finally over! She was crying the tiniest little kitten mewls and blinking at me like, "whaaat...??" I kept asking if she was ok because she was so quiet, only letting out the softest little cries. She was fine. APGAR scores were 8 and 9. Our Little Elf was finally here! But it wasn't quite over for me yet.


Nina said...

I have read a lot of birth stories, but this one was amazing! Amazing that you stuck with the med-free process and amazingly well-written...

The weird thing about birth stories is that I can read that description of mind-numbing pain and still be weirdly jealous because I ended up in the OR. BUT we both got babies out of it...and coincidentally some of the best, sweetest ones ever!

Bisous said...

Congrats on the birth!

Lindsey Broere said...

Great post...I agree...your thought are on survival--not modesty, that's for sure. I totally peed on myself and the bed multiple times...and it felt AMAZING.