Three Makes Five

Tuesday, November 08, 2005

It's been slightly more than a week....

I really owe this blog a birth story! It's going to be hard to order my thoughts, but here goes...

This all really starts the Monday after my due date. I woke up at around four-thirty in the morning with contractions. Tried to ignore them. Didn't mention them to Rob as he got dressed and left for PT. Realized eventually that they were 2 minutes apart, so I started trying to call him and of course didn't get an answer, since he was in the pool by then. Got ahold of him finally and he started trying to get off work. I got in the tub. Finally got him home by lying and telling his boss my water'd broken. (He screwed up by telling them I only "thought" I was in labor.)

Around noon, the contrax took a break. I took a nap and was woken up from it around 2 or 3 with more contractions. These lasted, though not nearly as regular, through the night. Next morning he called in and got permission to stay home from work. Around ten or so, they dissipated altogether. I had Rob check my cervix (which he did by looking at it) & he said it appeared to be a fingertip dialated. I was also losing little pieces of my mucous plug, so I took some heart in that.

Throughout the week, I'd have irregular contractions. I was reassured by several people that this meant I'd certainly have a short labor, when it did kick in for real. Great! I figured I deserved a short labor after a week or more of the prodromal stuff.

Saturday morning, it started all over again. Once again, contractions woke me up at four in the morning. Coincidentally, Rob had to work that day. I had him set up the pool and fill it before he left for work. We had this set up outside on the front porch. I watched the sun rise and then went in to try to get some more sleep. I tried really hard to sleep between contractions, but it wasn't happening.

That morning, the contractions were two minutes apart. They eventually spaced out to five mintes apart, then ten minutes apart. I was hoping by then for another break in contractions so I could get some rest, but it wasn't happening this time.

And it hurt! Dear God, it hurt. It was like being ripped apart. My back felt like someone had hit me a few times with a baseball bat. I could barely walk. I knew the baby was completely posterior; I felt her little hands slapping at my pelvis. I squatted and swayed. I did some bellydancing (it was originally a labor aid). Earlier in the week I'd sat on the birthing ball, even gotten on my hands and knees and rocked. It didn't help. Nor did being in the pool, though that at least allowed me to relax somewhat between contractions.

The contractions continued, as I said, though irregularly. I made sure Rob went to bed with the girls; told him I'd wake him when I needed him. I tried to sleep too, but it wasn't happening. Laying down made the contractions get worse. Throughout all of this, of course, Linda kept wanting to nurse and I couldn't let her because it also made the contractions worse. It just hurt too much. Of course she didn't understand, so her temper started fraying and started fraying mine.

Around midnight, two hours after we'd all tried to sleep, I woke Rob up. Thought it would be nice to have his support. Too bad I didn't actually get it. I tried to lean on him through one contraction and he just stood there. I do believe his attitude is in part what kept me from really progressing. I wound up sitting beside him on the couch with the heating pad against my back, crying while he snored. Not exactly the right attitude to have during childbirth. I kept thinking "Well, they always say you lose it during transition."

Through all this, I was sticking with the desire not to check dialation. I wouldn't have been able to reach my cervix on my own, and by then it really seemed pointless to ask my husband to check again. I was losing my mucous plug in big long strings now, so I knew something was happening.

Not sure exactly when, but some time in the early morning Linda woke up and came downstairs crying. I pushed her away a couple of times but in the end gave up and carried her upstairs and nursed her back to sleep, even though laying down and nursing of course made things about ten times worse.

By Sunday morning, I was finished. I was just completely exhausted. I told Rob I wanted to go get the morning paper and drive by Kapi'olani hospital, just to see where it was. Well, when were we going there, he wanted to know. I said around four, because by then it would have been 36 hours, but I planned to tell them it had been only 12. Through all of this I was still having contractions, about every five minutes apart or less. And they were still excruciating.

We got home and I said to hell with it, I wanted to go to the hospital. They already had me in their system, they'd already said they'd be more than happy to have me. I went and took a shower and then we packed a bag. I'd never intended to go to the hospital. We'd been fighting with his parents about it all week, in fact. They wanted me to go and we didn't see any need. But I was totally out of it. I wasn't having a baby, I wasn't able to take care of my current children. I knew that if I went to the hospital and told them how long I'd been in labor, I'd get Pitocin and that would get my contractions regular and I'd actually progress. I was honestly pretty scared that I hadn't progressed at all. My first labor, I was for eight hours at 2cm dialated. This was because of the presentation of the baby (footling breech) combined with laboring flat on my back because of the magnesium sulfate.

I knew that if I went in, I'd wind up with a very medical birth. It wasn't something I wanted, but having a totally natural, unassisted birth was becoming less important with each contraction. I was crying by then with pain and frustration. I wanted Pitocin and I wanted some sort of pain relief. I needed to have the baby that day. There was no way I could handle another day of labor, and I was also afraid it would just stop again and I'd have another week of prodromal labor. So we packed up and loaded up the kids and went in (Rob had called ahead while I was in the shower to let them know we were coming).

We got there and they put me in a labor & delivery triage room. Coincidentally, this was the same one I got put in after my fall at the zoo. A nurse came in and talked to me. What did I want to happen? Did I realize this was going to be very far from the birth I'd planned? I consented to AROM (something I'd really wanted to avoid) for placement of a pressure monitor inside my uterus; standard procedure for VBACs at the hospital and also to an IV and the possibility of Pitocin. No problem. Go ahead, draw blood. Go ahead, test me for HIV and whatever the hell else you want. I was totally beyond caring at that point; I was still out of my mind with pain.

They checked my dialation when I was in the triage after asking me if I'd been checked before all this and what I'd been at. I told them 2cm, by then I was 5cm. So over (by then) 36 hours, I'd dialated maybe halfway. No guarantee that I'd have continued at that pace, but I had the thought that I'd never have been able to take another 36 hours to get complete. Once they had convinced themselves that I was contracting (every 7 minutes while I was there; it had been every three on the way to the hospital), I was moved back to a labor/delivery/recovery room.

And there began what I now think of as my downward spiral into medicalization. But I'd taken it all on myself, and at the time it was the only choice that could preserve my sanity. I went to the bathroom one last time, then got on the bed and let them start poking at me. The IV is nearly always my downfall. The first nurse blew out two different veins trying to get a needle in me. Then, thankfully, that nurse and "mine" conferred to figure out who could come in and get a needle in me without blowing any more veins. That nurse's idea of bedside conversation was to lecture me for having planned an HBAC. I ignored her, which I am not certain she noticed.

Once the IV was in someone--I honestly don't remember if it was a doctor or a nurse--came in and broke my bag of waters and inserted the pressure monitor, which I didn't even feel. Some short time later the nurse came in and said they were going to start Pitocin because my contractions still weren't regular. I'd known this was coming, even sort of hoped for it. I told her if she was going to start Pit I wanted some sort of pain relief (it was in my chart that I wouldn't have an epidural but I would ask for something else when I wanted it). This request was pretty much ignored.

I can say that the Pit didn't make the contractions any worse. Of course, the contractions to begin with were hurting worse than the Pit-induced ones with my first daughter. It started to dawn on me around this time that I really should have reviewed my Bradley stuff. The rare times I was able to relax and let my body work, it felt much better, though it was still incredibly painful.

I'd also asked for a blanket right around this time, and the nurse said she'd heat one up and bring it to me. And that also never happened.

Time really compresses during labor. Getting the Pit got the contractions regular, and that made them somewhat easier to deal with. Relatively speaking. There was a shift change somewhere in all this, and Rob managed to convince the next nurse to bring me some pain medication and a blanket. This nurse told me the baby was posterior (duh!) and to lay on my side to try to dislodge it. I didn't figure this would work, but by then I was ready to do about anything.

Before I got the med, which I don't recall the name of, I had to be checked one more time, to make sure there was still enough time before pushing. They checked me again and I was at "a stretchy seven". So I got the medicine, the downside of which was it had to be given during contractions, and couldn't be given all at once. Two contractions later, the edge was taken off somewhat. I was given a heating pad for my back; between that and the narcotic I was able to doze off a bit between contractions. Rob took the girls for a walk around this time (yes, the kids were there for the whole thing; it's not like we had anyone to leave them with).

It seemed like only a short time later--that time compression thing again--that a nurse came in and handed me an oxygen mask. Thought it was a bit odd, but then I was checked and pronounced complete. "Get ready to start pushing." Um, OK. Hmm, should have mentioned that whole "don't coach my pushing" thing before then.

By then, though, I just really wanted it all to be over. So I pushed when they told me to, but not the way they wanted. The instruction to pull my legs up to my chest and curl my head down just, well, hurt. Actually, the whole freaking thing hurt, so when Rob and the girls came back it was, sadly, to me screaming and crying and saying I couldn't. This "I can't" was taken to mean I couldn't push. That wasn't what I had problems with; it was the whole 'hold your legs' thing. So I wound up with a couple of nurses holding onto my legs and Rob's hand on my shoulder (which was nice, and pretty much the sum total of the freely offered support).

The pushing thing was something I wasn't prepared for, mentally. It hurt and it was for some reason a reminder of very bad things in my past. I'd heard of it happening but didn't expect it to happen to me, for whatever reason. It doesn't make logical sense, which is why it took me by surprise.

I actually did OK, though, once I got the mechanics of pushing down. I totally ignored the "hold your breath while you push" thing, and also mostly ignored the "two pushes per contraction" thing. I breathed as normally as I could while pushing, and pushed when I felt the urge, whether I got in the correct number or not. I wasn't mentally able to tell them to take the Valsalva pushing and screw themselves with it, but I was able to physically do what I felt right doing.

I started out pushing on my back, then went to one side for a while, and that finally turned the baby. Then it was back onto my back, and pretty soon they collapsed the bed and the doctor got into position. I vaguely noticed she was wearing a face shield, which makes sense but struck me as pretty funny at the time.

The one good thing about all of this was that I was no longer feeling the contractions, just an urge to push. The bad part is that the ring of fire thing rang true and lasted a lot longer than the single push I'd hoped for. I think I was told "Just one more push" about three or four times.

Eventually, though, the baby was out. I don't know how long I pushed, but it seemed like only a very short time. The doctor who caught was a resident; the OB overseeing her I think was the one who made the announcement that it was a third girl. This really caught me by surprise. I had been told so often by so many people that I was having a boy that it'd knocked aside my usual deep conviction that I can have only girls (I have no idea why I usually believe this, but it has been borne out in experience). I was then shocked farther by being handed my squalling baby; my only prior experience was with c-sections where I was merely shown my baby. It was wonderful, the most amazing & overwhelming thing to be able to hold her. They told me to try to nurse her; she didn't have any interest to begin with.

The placenta was delivered while I was holding her, and they saw then that there was a knot in the cord. This is something that can be deadly, but usually isn't. The reaction though was that it is almost always deadly (perhaps they don't notice unless something goes wrong?); we were told that she was what they call a "true knot miracle baby." I knew she was a miracle anyway.

Rob was holding her while they stitched me up, which was a good thing. As I have been joking since, I didn't feel the numbing shot. I did feel the needle, though. No episiotomy, but I tore both up and down. The down was partially into my perineum, but mostly (going by feel here) along my left labium. It's not the most wonderful thing in the world to be stitched up by a woman who is being coached. I pretty much begged them to not stitch the top tear if it was at all possible. At least the stitches self-dissolve!

Once they were done with that, I took Esther back from Robert. We decided on her name more or less on the spur of the moment. We'd been wavering between Esther and Judith, but when she was born I pretty much knew I had to name her after my friend from high school. That Esther is just such a wonderful person I had to use her name. Rosemary was the only three-syllable name that we really knew we liked. Joy I sort of snuck in on Rob's adrenaline I think; he's vetoed that name every time it's come up in the past, but I have always loved it. Esther turns out to be the most popular name I've given a child--304 last year. Rosemary was 718, and Joy 483. I just looked that up. It really has no bearing on the birth at all.

Esther did nurse that second time I held her. She latched on perfectly. Just perfectly. Lips turned out and everything. And she has been a very good nurser since. Which makes sense, as she's prone to nursing twice an hour!

It has been nine days since her birth, and she fits in already as if she has always been here. I was marvelling today that we had a life without her. I am glad I had my VBA2C, somewhat guilty that I didn't stick it out and go unassissted, but mostly just elated that I have her. I spent a very long time that first night after she was born just sitting there in bed smiling and thinking how wonderful it was that I had a third daughter. I'd have loved to have had a son (I wanted to use the name Randolph!), but I am just over the moon with another baby girl.


At 3:50 AM, Anonymous Anonymous said...

She looks wonderful. Congratulations Mama!

At 7:09 PM, Blogger Cathi Cogle said...

Posterior labors are really hard to deal with. And sometimes the babes don't turn when we want them to. I think you did wonderfully, given the circumstances. Kudos to the staff as well, for not trying to manipulate you into another surgery...Maybe you will get your UC next time :) PS, my two hbs were both posterior, and turned about 15-20 min before maybe next time. Esther is a beautiful baby...congrats.

At 6:48 PM, Anonymous Anonymous said...

I'm not sure if you still check this, but congrats on the baby and the vbac! I would love to talk to you, I am trying to have a vbacx2 but having very little luck finding someone. Basically my option now is a c-section, unless I find a midwife. I'd like to talk to someone who is going through the same situation as me, help and coach me through it! My email address is:, please feel free to contact me! Congrats again!


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