dragonpanties: October 2008

On Sunday, October 12th I climbed into bed around 11pm but awoke with a start around 11:30. I wasn't really sure what it was that woke me up other than some sort of internal 'incident'. I got up, went to the bathroom and discovered what I could only assume was the "bloody show." I climbed quietly back into bed but, needless to say, could not sleep. Instead, I lay awake and felt what were my first contractions. I can only describe it as my insides intermittently folding up into themselves. It was not particularly painful at this point but could not be dismissed as anything but the beginning of labor. I knew I should probably sleep but the realization that "it" was likely starting made for an insurmountable adrenaline rush and so I lay awake in the darkness experiencing my insides flexing. Being a light sleeper, it wasn't long before L awoke and asked if I was okay. I think I said 'something is definitely happening' and we both lay awake until around 3:30 talking about finally arriving at this momentous unknown.

At 3:30am, the adrenaline wore off enough for me to doze for a bit but I was awake again at 5:ooam due to the contractions. I got out of bed and called Jaya. We spoke for about an hour and the contractions (probably about 15 minutes apart) were significant enough to silence me but I was able to doze again for another couple of hours after we got off the phone.

The contractions generally quieted down throughout the day on Monday although they never stopped completely (with the exception of a couple hours in the afternoon during which I watched the Red Sox play). They picked up again almost as soon as the sun went down and became suddenly, remarkably stronger around 11:30 pm (exactly 24 hours after they started). Although we had spoken with our doula Anna several times during the day on Monday, it was at this 24 hour mark that I requested she come over as it was very clear to me that the contractions were going to be more difficult to manage. Anna arrived shortly and was immediately well worth the expense. Aside from coaching me through each contraction and suggesting various coping strategies (different positions, walking, sitting in the shower on a yoga ball), she guided L on partnering me (he was wonderful from the beginning) and also enabled him to get a few hours of sleep while she stayed with me. I labored pretty consistently throughout that night although the time between contractions varied every couple hours (about 6 minutes apart for the first half of the night and then 8-10 as morning approached).

While I was pregnant, I was curious about what I would look and sound like during labor. I was also worried that I would be self-conscious about what I would look and sound like. My questions were quickly answered and my worry quickly dismissed during this second night of laboring. Although I was not a panicky laboring woman, I was not exactly quiet or graceful, nor did I care. I moaned loudly throughout each contraction; the volume corresponding to the intensity. Although I felt no compulsion (or ability) to quiet myself, it did cross my mind whether the neighbors could hear me (little did I know what they were in for as darkness fell the next night).

Much like on Monday morning, the contractions slowed once daylight broke on Tuesday and although I continued to have very intense contractions, they were inconsistent in their frequency. After a walk around the neighborhood (with pauses for contractions)...

...we decided to call our midwife again to inquire about possibly going into the office to check my progress (centimeters my cervix had dilated). My midwife sent me into the testing center I had been seen at every week during the final weeks of my pregnancy; after 36 hours of labor (with the last 12 being pretty intense) she wanted the fetal heartbeat monitored and the amniotic fluid measured and felt the nurses there could check the progress of my cervix.

As soon as we got into the car, my contractions became more intense, or perhaps just more painful because of the bumpy roads. This, plus the cumulative exhaustion (I hadn't really slept for 51 hours at that point) was definitely starting to wear on me, and my commitment to staying at home and avoiding medication was starting to erode. L later told me that he and Anna had a discussion right around this time that I appeared to them to be at my 'breaking point'.

The nurses at the testing center determined that the baby's fetal heart rate was good, the Amniotic fluid sufficient, and that I was 4 centimeters dilated. Although I read over and over that the number of centimeters dilated can tell the laboring woman essentially nothing about how long she has to go, hearing that I was 4cm (out of the total 10cm) was somewhat disappointing. It was the exact dilation necessary in order to be admitted to the hospital so it opened up my options in terms of what to do next but it also seemed rather unimpressive considering that I had already been in labor for 36 hours. L and I discussed the situation with Anna and she suggested that I keep my standing appointment with my midwife for that afternoon (approximately four hours later) and, in the meantime, labor in the jacuzzi at her house (she lowered the temperature to a safe level). I agreed and we headed to her house in the Berkeley Hills.

It was a lovely, albeit painful (labor-wise) few hours. Anna's jacuzzi is in her back yard surrounded by trees and L was able to get in the tub with me and the warm water and the bubbles made it easier to cope with the contractions. It was also great to be so close to L during what is, at its essence, a rather solitary journey. By the time I got out, my labor seemed to have turned another corner - more consistent contractions and far less sense of humor in between - and so I reevaluated my plan.

At this point, I had been in labor for 41 hours and awake for 56. I was totally exhausted and having more difficulty coping with the contractions. The thought of the long, bumpy drive all the way back to Alameda just to be checked by the midwife seemed pointless since the thought that I would then, based on whatever the results were, decide to voluntarily return home for a third night of laboring seemed unrealistic (and unbearable). Since I was already close to the hospital and at least 4cm dilated (necessary for admission), admission was the obvious decision for me. Having several years of wonderful experience working in hospitals, I was eager to settle into what are the familiar, even comforting, surroundings of a busy urban hospital. There was also a part of me that actually dared hope that the several hours of laboring in the tub had produced some progress from the 4cm and that I might actually have a baby in the foreseeable future.

Ha.

L and I arrived at Alta Bates around 4:30pm and were, after a short wait, admitted to "triage". Anna remained at her house for the time being (she feared she was getting sick) and expected to join us once we were in a Labor & Delivery room. In triage I was hooked up to a fetal heart monitor and after about 20 minutes, given another internal exam. The babies heart rate was stable and the exam revealed that I was no longer 4cm dilated; I was 3 1/2...

After being totally exhausted but maintaining sanity and composure due only to the anticipated relief of being admitted and settled and perhaps even closer to delivery, hearing that I had actually regressed to 3 1/2 cm and no longer even 'qualified' to be admitted I was, needless to say, a tad disappointed. The thought of driving back to Alameda to face a third night of laboring at home seemed more than I could stand and accordingly, I cried inconsolably and then accepted the morphine shot offered by the nurse. L and I were told that the morphine would alleviate the pain enough to allow me to get several hours of much needed sleep, at which point I could return to the hospital if I desired. L and I headed home with heavy hearts but eager for the relief the morphine would surely bring "as soon as it kicked in". L spoke with Anna who, it turned out, had come down with a flu and could no longer join us for fear of putting me, L, and the alleged baby at risk. Fortunately for us (and perhaps unfortunately for her) our friend Michelle agreed to come over. I wonder if she would have agreed had she known what she was in for over the next 20 hours (not that she didn't deserve it considering she introduced L and I and is therefore responsible for this whole hulabaloo).

After a short time at home it became clear that not only did the morphine do little or nothing to alleviate the contractions, but the intensity of contractions actually increased due, most likely, to the internal exam I underwent at the hospital. As promised, the morphine actually did allow me to sleep for the few minutes in between contractions (in spite of having to sit completely upright in a chair) which, in turn, allowed me to cope much better mentally. My neighbors, had they been asked, might not report what sounded like coping since I was essentially jolted awake every eight minutes or so, practically screaming. It was during this chapter in the epic adventure, that L hit his "breaking point" and claims he went in the back yard to cry inconsolably.

In spite of what I sounded and looked like through this portion of labor - I actually look back on it with some bizarro fondness. It was excruciating, yes - as much from the sheer exhaustion as from the pain - but because I got a little sleep (albeit in 8 minute intervals) my coping mechanisms were up and running again and I was proud and relieved to have been able to come back from the despair of the moment when the nurse at Alta Bates told me I was only 3.5 cm dilated. I was more clear-headed during this period than I had been for some time and felt very sure about how I wanted to proceed; that I wanted to remain at home until the morphine began to wear off at which point we would return to the hospital. It was about six hours from the time I got the morphine shot until I was admitted at Alta Bates and although it was a difficult six hours, I felt good about it. I felt even better when the staff at Alta Bates admitted me directly to Labor & Delivery instead of making me go through triage.

If I was disbelieving about my lack of progress after my time in the hot tub, I was shocked by my lack of progress after the six hours preceding admission - after getting settled in my room, an exam revealed that I was "just 4 cm". Unlike before, I was not disappointed. In fact, I was closer to elated as the news gave me permission to alter my birth plan. My main desire (other than having a healthy baby) was to avoid having a c-section - it was why we chose a midwife and hired a doula and why I had wanted to labor at home for as long as possible. Upon my admission to the hospital - exactly 50 hours after going into labor and 65 hours since any real sleep - it was clear that if I didn't get some much needed rest, I probably would not have the physical energy to push a baby out when and if my cervix ever dilated to 10cm. L and I briefly discussed the decision with our doula (by phone) and she agreed that some real drugs were in order. Prior to labor, the thought of a needle in my spine was horrifying but after getting a nice, long taste of of the baby-having business, I would have done it myself if the anesthesiologist had not shown up when he did. At exactly 2am on Wednesday morning, when that phentenol started to work it's magic, I experienced the second biggest relief of my life (the first biggest relief was going to occur a little over 12 hours later) and drifted off into the best two hours of sleep I've ever had.

I slept intermittently for the rest of the night and throughout the day and I continued to progress at an extremely unimpressive rate. At some point on Tuesday (I think I was around 6cm) the on-call midwife recommended starting pitocin in order to get labor moving. After a few hours and minimal progress, she upped the dose to the highest level and explained that if, after two hours at that dose, significant progress wasn't made we'd have to discuss c-section. I was grateful that the doctor and midwife who were on-call allowed me to progress at my pace for as long as they did and impressed that the baby showed no signs of distress throughout as that would likely have led to a c-section as well.

Around 2pm my epidural became less effective or the contractions became extremely strong or both and I started to panic; It wasn't so much the pain (although it was the pain) but having flashbacks to the days (and nights) of not knowing when and if it would EVER end. It was, however, just as the books had described - right when you feel absolutely positive that you can't take it anymore, is right when it's coming to an end.

I begged for the anesthesiologist to up my epidural medication but he declined, saying he wanted to wait for the midwife to check my progress as I might be going to surgery and would therefore require a different anesthetic protocol. Every second that passed felt like an eternity (that's the first time I can really use that phrase with absolute understanding) and the nurse was trying to prepare L and I for the possibility of having a c-section which caused L to panic but then the midwife finally arrived, did her exam, and announced:

"You are 10 cm. You can start to push."

Unlike the first 64 hours of labor, I really liked the pushing part. It was difficult and it hurt but at least I felt like I was actively participating in the birth whereas the contractions started to feel, at a certain point, like something that was happening to me. There were also the clear and immediate goals of A)avoiding a c-section and B)Meeting this baby I'd been hearing so much about for the last 9 months.

And an hour and half later, at 4:32pm on Wednesday, October 15th, we finally met,