Birth story - warnings for TMI/overshare. Probably not for the squeamish.
8:00 p.m. Tuesday, February 28th: We went in to the hospital for the scheduled induction with no idea of what to expect, really. I mean, I knew what medicines they'd be using and how, but not how it would all play out. People had told me of inductions that took six hours from start to birth, and of inductions that took three days and multiple trips to the hospital. We were packed - overpacked, in fact, as I'd brought five books to read and the breast pump and pillow and God only knows what else - and that was as prepared as I could get, after the emotional whiplash of the previous week's induction-no-induction turnaround. We got smoothies on the way in, for dinner, because we weren't sure how fast everything would proceed and I didn't want to eat anything I'd be too grossed out to throw up later.
They did the standard testing and administered the Cervadil (a medication designed to make my uterus "efface" - or soften and thin) vaginally at around 9:00. It's this strange little suppository thingy with a string attached, and I couldn't pee for two hours after they put it in...which is tough, when you've been drinking more than a gallon a day for the last month! I wasn't contracting, and I was not effaced at all at this point, so we were starting from scratch. Himself and I hung out and I read a book, and we watched a bit of the DVD the hospital gave us on basic baby care. Neither of us slept very well that night, out of anticipation and being in a strange place and nurses coming in and out to check my vital signs.
Wednesday, March 1: In the morning, Himself brought me a bagel and some coffee. Thank God we didn't ask first, because it was the last food I'd be allowed in a while. When they came in to check my progress, my cervix had softened a bit, but I was not effaced at all, and having only occasional tiny contractions. They started the Pitocin drip at 9:00 a.m. anyway (Pitocin is a medicine designed to bring on uterine contractions) and we settled in to see what would happen. I started having contractions more regularly, but they remained small, relatively speaking.
I think a note on the pain scale is probably apropos right about here. When they're talking about administering medication, they ask you to rate your pain on a scale of 0-10, 0 being none at all, and 10 being the worst pain you can imagine. Eula Biss had a great piece on this in the July 2005 issue of Harper's, but what it boils down to is that this is not a very useful scale. Failures or excesses of imagination make the intervals completely subjective. And, of course, pain is very relative. I never expected that even the worst of labor horror stories would exceed a 6 on the pain scale, because the pain is (a) a productive, a necessary step toward a desirable goal, and (b) temporary, rather than chronic or terminal. When the anaesthesiologist came in to give me the epidural, he said, "so I guess your pain is around a ten right now" - I wonder how other women have used the scale! At that point, I was moaning through contractions and unable to speak or move while they were happening - it was comparable to the worst pain I've been in (with the caveat that I have led a blessedly painless existence, relatively speaking) - and I had rated it at about a 4. But I'm getting ahead of my story.
Wednesday was a slow day. The contractions got steadily stronger and closer together as we increased the Pitocin drip. I don't remember when I started to have to use the breathing exercises I'd read about to get through them, but it was probably by noon or so. I read two more of the books I'd brought with me, and Himself and I watched Microcosmos, one of my favorite movies. With each contraction, to get through the pain, I imagined (geektastically) one of those irising doors they have on a lot of sci-fi; I was thinking about my cervix opening. Apparently a lot of women think about blooming flowers. I thought about spaceships, go figure.
Contractions are not at all how I thought they would feel. I mean, I never felt the ones where you want to push, thanks to the magic of the epidural - maybe those are different - but I somehow thought they would feel...expulsive. Top to bottom, like a ripple or a wave. Instead, they felt mostly like a tightening, and more bottom-to-top if they had any direction at all. For those of you who have had severe period cramping, the kind where you double over and make involuntary noises? It was a lot like that, starting out milder and getting progressively more painful. I started to feel sick and was glad they hadn't been letting me eat after all.
I was hopeful about the progress of labor as my pain levels went from a 1 to a 2 and the contractions became steadier, but a vaginal exam toward the end of the day made it clear that my cervix was no more than 10% effaced, and that I was not dilated at all. They took me off the Pitocin (but left in the fluid drip, so I still had to trundle the damn IV to and from the bathroom!) and allowed me to eat dinner around 5; Himself was totally awesome and ran out to get us sandwiches from my favorite deli, sparing me the scary hospital food.
At this point I was exhausted. I was still contracting, so they couldn't start the second round of Cervadil, but the contractions were getting a little further apart and a little less painful. Still, I asked for a shot of morphine at 7:30 so I could sleep, since it was pretty clear nothing was going to happen that night. I'd been waiting to ask for pain medication, because I didn't want to get the epidural if I wasn't going to be in active labor - it wasn't totally clear to me that there were intermediate options between "au natural" and "immobilized with a catheter in my spine" and once it was made clear to me that I could have temporary pain medication, I waited to be sure we weren't in active labor and then went for it. I'm very glad I made that decision - I was exhausted and discouraged and there was some chance I might go into active labor "naturally" (without Pitocin) later that night, if the contractions didn't taper off - I needed the rest! Around midnight, the nurse came in and woke me up to administer the Cervadil again - my contractions had gone down to almost nothing.
Thursday, March 2: This time, I didn't get contraband breakfast, just juice. I was still a little fuzzy from the morphine, but feeling rested and more hopeful about the day; there was a small chance that we'd have to do one more round of Cervadil that evening, but we were assured that it was unlikely. My contractions were back, at about a 1 on (my own personal interpretation of) the pain scale, and regular, if not close together, so they took me off the Cervadil and put me back on the Pitocin. At that point, the contractions ramped up fast; I was back to pain levels of 2 within an hour or two and they went up to three fairly quickly after that.
When the contraction pain levels hit three, I started having to use not just the breathing, but rhythmic movement to manage the pain. For some reason, for me this involved swinging one leg off the side of the bed, rubbing my palm over my thigh, and doing this very dorky Stevie-Wonder-impersonation thing with my head. Himself kept asking how he could help - but you know, it's not really something that someone else can help with, per se. He was wonderful about keeping track of what was going on and making sure that he was informed, and he got me juice and water whenever I asked, and sat with me through the vaginal exams, which were incredibly painful, but the emotional support of knowing he was there was probably the most helpful thing he did or could have done. He worked on his laptop a bit, until I asked him not to click his mouse while I was having contractions - I didn't mind it the rest of the time, but I couldn't stand it while I was going through contractions, for some reason. Since that was every two minutes or so at that point, he had to leave off. We tried to watch Winged Migration (I was really not up for movies with a plot or characters or storyline!) but he shut it off halfway through, when my pain levels hit a four and I started moaning through them.
I can't remember when I started getting temporary IV pain relief, or what it was called - somewhere between 3 and 4. Every half hour, the nurse would come in and give me 50 ccs of this stuff that made me dizzy but dulled the contractions a little. The first time she gave it to me I was expecting a shot in the ass like the morphine, so when she told me she'd just given me drugs - I was pretty sure the pain of the most recent contraction hadn't been distracting enough that I would have missed an injection - I said, "no you didn't!" She'd given it to me in the IV. I got that about four or five times - the doctor came in and did another vaginal exam after the first one, and I was about 50% effaced and 2 cm dilated - that was a little depressing, because it meant I had a long way to go before we'd even get to what I had always heard was the "hard part." I asked for the epidural around 2:00 p.m., after my pain levels had been at 4 for a while, even through the medication. I felt Iike I had definitely gone past the level where I would have felt like I was "wimping out" to ask for the meds, and I was okay with that. I really didn't want to know what my idea of a pain level of 5 or 6 would feel like.
The anaesthesiologist was wonderful, very reassuring and professional. He talked me through everything he was doing, while Himself and the nurse held me steady through the contractions so he could place the epidural. The relief wasn't immediate - but it was close! I had another cervical exam - 4 cm and 80% effaced this time, and I think this one was when he broke my bag of waters, with something that looked disturbingly like a size E plastic crochet hook - and tried to sleep. The pain was still noticeable enough that I was having to use breathing exercises to get through it, so I asked to have the epidural bumped - I'd been told I shouldn't be feeling my contractions. I don't know if he thought my contractions were milder than they were or what, but he bumped the medication and I was able to sleep - my body was exhausted!
Exhausted or no, I continued to contract in my sleep, of course - just because I wasn't conscious didn't mean the process had halted. It's sort of inexorable that way. The next thing I remember was around 6:20, when the doctor came in to do another cervical check. I woke up, blearily, and Himself and the nurse helped arrange my rubbery heavy frog legs so that the doctor could do the exam - I had no motor control or feeling really below the waist. The doctor started the exam and looked up at me. "Can you feel any pressure?" he asked. I told him I could feel a little...and he kind of grinned and said, "The baby's head is right here."
Suddenly, the room filled with people. I thought it was like the scenes where the court suddenly enters the hall in Rosencrantz and Guildenstern Are Dead - that sudden bustle and noise and overwhelming crowdedness. People were bringing in carts and supplies and giving one another instructions. I looked at Himself, and we both sort of boggled at one another, in an oh-my-God-we're-about-to-have-a-baby kind of way. I had just woken up, of course, and was still muzzy from the meds and it all seemed completely surreal. The doctor had me grab my knees and hold them, and then he went near my crotch with a pair of scissors. He was just cutting the catheter, but I saw them and said, "You're not doing an episiotomy, right?" I was so terrified of episiotomies I had verified with him at least five times by then that he doesn't do them, but I got scared he'd changed his mind! He said, "Why would anyone do anything so barbaric?" I'm so glad he was my doctor!
He had me push once, with Himself standing by me and encouraging me, and then told me one more big push would do it. I still couldn't feel anything, for which I thank God, but I could tell when I was pushing, so I gave another great big push, and I felt the pressure of the doctor's hands reaching to pull the baby. And then he said to me, "Reach down here, and put your hands under his armpits, and pull him out." This was not anything I had planned on doing, but I didn't even think, I just did what he said, and I could feel the (faint!) pressure of something coming out of me, and I was holding a baby.
He was red and bloody and they were suctioning his nose so he could breathe and I just lay there holding him in the air, totally bemused. I said to the doctor, "What do I do with him now?" and I seem to remember him saying, "You'll be asking yourself that for the next few decades." They had me put him on my chest while they took care of the delivery of the placenta and other things, and they covered both of us with a warm blanket. Himself cut the cord, and suddenly we were parents.
The rest of it is a blur. I know they did tests and cleaned and weighed the baby and then we breastfed for the first time (successfully, yay!) but honestly, I don't remember a thing. They took out all the needles and tubes and cleaned me up, and Himself took a bunch of pictures, I know, but it's all a mishmash of barely awake and half-stoned and oh-my-god-we-have-a-baby. My body was in far better shape than I had anticipated - only one minor tear, and no stitches - and the baby was perfectly healthy.
I know this is not how many women want to give birth - they want mobility, awareness, to be present for the process and even for its attendant pain. But for me, this was ideal. While I had hoped to go into labor naturally, that wasn't possible for us after the amniotic fluid complications, and as far as pain management and damage to my body, this was far, far better than I had ever hoped for.
And in the end? We have a baby! And a healthy mom (I'm healing so well that Himself keeps having to remind me that I can't maintain my usual activity levels) and a wonderfully supportive dad, and the breastfeeding is going well, even, though he's a bit jaundiced (not surprising, given his parents' respective worldviews!) and we are currently supplementing with formula. The sleep thing is tough to adjust to (I actually quit drinking coffee, for the first time in years) and we have yet to deal with Himself's full return to work and the various in-law visits, but I am really, deliriously in love with Ray, and that's the essential part, no?
