Tuesday, December 29, 2009

Labor Story, Part II

Bradley book.  Check.  Birth plan.  Check.  iPod.  Check.  Jolly Ranchers.  Check.  Flavored ice chips.  Check.  Husband/Coach.  Check.

The only thing missing, it seemed, was a little thing I like to call dilation.  I walked the halls carrying my I.V. pole and heard a woman screaming in agony a couple of rooms down.  Later, I watched a male nurse wheel a new mom and her precious new baby to postpartum.  I hadn't seen any action for hours and it was easy to forget why I was there.  When I saw that baby, I suddenly remembered that at some point in the near future, I would meet my Liam.  All of this waiting...all of this pain...would be over soon and it will have been worth it. Besides, by the time my midwife, Tina, finally arrived around 5pm, I was sure I had progressed.  Contractions had resumed, and I was probably a 6 or 7 at least.

It was hard to be mad at Tina for letting her pager batteries die and not getting back to us for HOURS, because we were just so relieved that she was finally there.  Maybe her presence would kick my cervix into high gear (Paging Cervix... Midwife has arrived.   Time to dilate!)  Maybe Liam would remember that he too had a job to do.  17 hours into labor, she checked my progress.

3 cm dilated.  90% effaced.  0 station.

No. Words.  I had postponed getting a second exam for over 9 hours because 1) the risk of infection increases each time you're checked, 2) I didn't want to be disappointed if the number was low and 3) I didn't want the hospital staff to equate a low dilation number to an imminent C-Section.  The Bradley Method teaches that a low dilation number can often result in sudden, RAPID dilation.  We had heard stories of women who were dilated to a 3 for hours and then dilated from 3-10 cm in one hour.  At this point, I was still holding out hope that this would happen to me.  But, 17 hours?  Really?  

We asked Tina for advice and she told us to "get out of here."  She told me to change out of my hospital gown and go outside for a change of scenery.  Take a walk.  Let Wes get a pie at Marie Callender's.  All of this would "expand my world."  The nurse gave Tina disapproving looks at this suggestion and told us that hospital policy required us to stay on hospital grounds once admitted.  We were a liability once we walked out of those sliding glass doors.  Whatever.  I felt like more of a liability in the hospital than out.

We took advantage of the momentary freedom and started on a lap around the hospital grounds.  It was a beautiful fall afternoon and I felt like I hadn't seen the light of day in years.  I stopped every 10 yards or so to handle a contraction and then kept trucking.  Walking supposedly speeds labor by 28%, on average.  I really needed to be on the higher end of that spectrum.  We were shooting for around a 75% increase in speed.  Go Speed Racer, Go!

After a grueling loop around the Women's Pavilion,   I needed a break.  Wes guided me to our car in the underground parking garage so that I could sit down and sneak some bites of a Balance Gold bar.  Processed protein had never tasted so good.  I had just started to get comfortable when POP!  "Umm...my water just broke...AGAIN."

Thank goodness we kept towels in the backseat of the Volvo.  I doubt the guy who ends up buying our car will appreciate amniotic fluid stains on his luxury leather seats.

I now had to figure out how to make my way back up to Labor and Delivery without leaving a trail of fluid behind me.  Wes assured me that if there was a perfect place to walk around with a makeshift towel-diaper tied around me, this was it.  Not to worry.  Pride?  Out the window.  As I waddled into the elevator, we ran into a young boy who had lost his grandma.  Wes decided to take the boy to the front desk and let me go up to the 2nd floor on my own.  (He's such a good samaritan.)  "Don't worry- I've totally got this.  You go ahead..."  Water breaking?  Been there, done that.

I didn't dwell too much on why this was happening again.  I was just looking forward to getting things moving.  Liam probably moved his head or something and released the rest of the water.  Within 20 minutes, I was feeling contractions that were of a different species than I had ever experienced.  Velociraptor contractions.  But these were not even close to the Exorcist contractions that I would experience later on (of course, I didn't know that at the time)...

At this point, I was working very hard-- enlisting every brain cell I had on each contraction that came my way.  It was difficult to find a comfortable position.  I leaned over the counter, sat on the labor ball, and at one point curled up on the (hopefully) sterile hospital floor.  This was what they meant by HARD labor.  I was in it, I thought, and I was committed...but scared.

A few hours after my water broke the second time and after a respectable streak of intense contractions, Tina came in to check my progress once again.  Everyone in the room was certain that delivery was close.  PLEASE PLEASE PLEASE BE DILATED.

Tina was quiet after the exam.  As I was struggling through a painful contraction, I noticed her shake her head at Wes.  Her attempt to avoid scaring me to death failed when a shocked Wes exclaimed "No??" well within earshot of me.   Way to lay it on gently, Wes.

I knew from her tone of voice what was coming.  "Rachael, we need to have a talk."  I was walking straight into the land of Worst Case Scenario.  "What is your ultimate objective?"  In a totally defeated, delirious sort of half-cry, I recalled the Bradley mantra..."Healthy baby, healthy mother, healthy family." She nodded her head in agreement.  "Then, I think it's time to get serious.  For some reason, your cervix is not responding and the baby's head is elongating.  This may be your baby's way of telling you that he needs some help."  PLEASE PLEASE PLEASE DON'T SAY C-SECTION.

"I think we've done everything we can to follow your birth plan, but I'd like to start you on Pitocin."  Suddenly, that scene from The Business of Being Born flashed through my head with the frightening sequence of various Pit-crazed nurses and OBGYNs... "Start her on Pit.", "She's on Pit.", "It's time for a little Pit." "Pit, Pit, Pit."  Attention medical professionals of the world: Pitocin is NOT an equal substitute for Oxytocin.

But Wes and I were in agreement; something wasn't right.  I concluded that I was not in the 86% of Bradley couples experiencing a "normal" childbirth and we were out of options.  They hooked me up and I braced myself for what has often been described as murder.

And murder it was.  I always thought that there is a certain degree of pain that is so intense that your body just rejects it and you go into shock.  The only good thing about being eaten alive by sharks, I thought, is that you wouldn't feel the loss of limbs, etc.  Same thing with being burned alive.  Well, for roughly two hours, I endured a kind of pain just before the point of shock.  Actually, I kept waiting for my body to just reject the pain and for me to slip into a state of shock.  It never happened.  Wes talked me through each contraction and massaged my lower back.  He told me that I was doing a great job, that it would be over soon, and that he loved me.  He let me know when a contraction was about to begin, and when it was about to end.  I literally hung on his every word.  He told me later that he felt completely useless repeating himself a million times, but he'll never understand how crucial his role was.  I wouldn't have lasted half the time without him.

You know that movie Event Horizon where the spaceship accidentally travels to hell and back?  Well, I was the spaceship.  I watched the contraction grapher on the computer draw jagged lines that looked like Mt. Everest reaching far above the thin red line.  The nurse increased the intensity of the Pit every half hour.  After two hours, I was at a level 8 (8 ml/hr).

I asked her how many levels there were.  "30."

It was at that moment that I gave in.  It was not the kind of giving in that they talked about in class, not the surrendering to the pain to let labor happen.  No, I had already done that.  I was surrendering to the world of drugs.  Narcotics, hallucinogens, barbituates, whatever you've got...GIVE IT TO ME NOW.

I begged Wes to call my parents.  They've been so good at "fixing" things for me throughout my life, perhaps they could fix this.  Or maybe nothing could be done.  Even worse, maybe I wouldn't make it out of here alive after all.

I vaguely remember a nurse telling me that she would be starting me on Phentenol.  Someone mentioned the word "narcotic."  This would serve to hold me over until the anesthesiologist could break free from a long night of grueling C-Sections to administer the epidural.  Visions of a limp, drugged-out baby flashed through my mind as I silently apologized to Liam for not being able to give him the drug-free birth I had intended for him.  I put my trust in the medical professionals surrounding me and hoped that the horror stories of never-ending childbirth interventions would not apply to me.

My parents arrived just before the Phentenol kicked in.  I wish they hadn't seen me in my tortured and defeated state.  It wasn't pretty.  Definitely not my best moment.  My mother had gone through natural childbirth for two out of her three children.  I should have been able to do this, right?  I scrunched my face so tightly and closed my eyes attempting to disappear into a contraction and hopefully not DIE, when my mother got in front of my face and started shouting "Rachael- look at me!  Focus on something in the room!  Don't close your eyes!" I should have warned her ahead of time not to do everything she could to distract me from the pain, because there was NO distracting me from this kind of pain.  In a weird way, I had to focus on it to get through it.  I just had to survive.  In true Exorcist fashion, my head spun around a few times and I snapped back "I'M NOT DOING IT THAT WAY!" I had been taught for months to imitate a "sleep-state" while contracting and to visualize my cervix opening to let Liam down.  It was too late to relearn relaxation.  Sorry Mom, not going to happen.

Narcotics are wonderful things.  As the medicine flowed through my veins, I slipped into a sort of magical state...an alternate reality, if you will (That's for you, Wes.  Now you know why I don't care to watch Sci-Fi.  Already been there.)  I knew something awful was happening to me, but I didn't care.  I smiled for the first time in hours.  I was in a forest bower and the fairy sprites would be coming any minute to deliver Liam.   I probably couldn't tell you where I was or why I was there, but I felt great.

Time passed quickly from this point on.  Randy, the anesthesiologist and consequently the nicest man I have ever met (Wes told me later that he reminded him of Dr. Death...all business, no small talk, no smiles.  Whatever- he had the goods!) arrived and plugged in my epidural.  I've talked to many women who have claimed that the epidural needle is the worst part of labor.  LIES!  Okay, so it is like a foot long, but it was a summer day on the beach compared to the misery I had experienced.  It was actually kind of interesting--a little pressure and then ice water running down my spine, gradually numbing the pain I thought would never end.  My parents headed off to the waiting room as Wes and I tried to get some much-needed rest before the pushing stage (assuming everything went as planned and I didn't need a C-Section after all...fingers crossed.)

Tina came in to check my progress after about an hour of being on the epidural.  The nurse had cranked the Pit up to 30 ml/hr, so if there ever was a time for my cervix to wake up, this was it.

6 cm dilated.

YES.  Things were happening.  Now, all we had to do was wait for the Pit to do the rest of the job.  C-Section was not yet off the table.

The room was dark.  Quiet.  Softly in the background, my ipod was on its fourth repetition of my 7-hour "Labor Mix".  Every once in awhile, the automatic blood pressure machine would turn on to check my BP and then make that "Game Over" sound from an old Atari game.  Wes was sleeping like a baby (I've never understood that expression.  Babies are renowned bad sleepers.), or maybe more like someone who hasn't slept in days.  I didn't get one second of actual sleep.  I had some serious shakes.  I had seen this reaction to epidurals over and over again on Birth Day and Baby Story on TLC, so I knew it was considered "normal." It was aggravating to not be able to lie still, but I was counting my blessings.  I shut my eyes and breathed steadily and resigned myself to this state thinking, "This must be what it feels like to have Parkinson's.  Poor Michael J. Fox."

The deep breathing must have helped, because I was finally able to get a few minutes of real rest.  However, just as I settled in and got comfortable with the numbness and shaking,  I started to feel a confusing sensation of enormous pressure and movement within me.  Something was coming out whether I pushed or not.  I called for Wes, who was lying in a reclined chair beside my bed.  "Wes!  Weston!  Wake up! -  -  - Wes?  Are you okay?  Weston!  Hello??  Something's happening.  I have to push!  HELLO??!!"  He was dead to the world.  Totally unresponsive.  Didn't even flinch.  A few more minutes of this, and I was looking for the button I was told I could push in case of an emergency.  I couldn't find the dang button.  One would think they would make it more obvious!  I mean, this baby was coming OUT.

Finally, my loud yells stirred my unconscious husband, but it seemed that he was more drugged-out than even I was.  Maybe he slipped a bit of narcotics by Kathy the nurse while she wasn't looking.  I explained to him what was happening and that he needed to go find Kathy or Tina and tell them that I'm ready to push.  "Okay.  Wait...what?"  I tried to be as patient as a sleep-deprived, tortured, starving, laboring woman could be and explained things a couple more times and sent him on his way.

He came back with Kathy, my parents and my big brother, Bret (aka Scone Delivery Guy.)  Kathy checked me and calmly told me that I was a little over 9 cm with a small lip of cervix left, but that I could start pushing if I felt like it.  It was a little less anti-climactic than I had envisioned...no fireworks, applause, etc.  Just "push if you feel like it."  Awesome.

So I did.  When Tina came in, I really got down to business.  I had a second wind of energy that I didn't think existed, and I pushed with each contraction.  I kept thinking, "Why do I know when to push?  I thought I would be totally numb and someone would be counting for me..."  Tina told me that that's how the epidurals of the 90's worked.  Now, women are able to feel the pushing contractions without the pain so that they can better control the force of their pushes.  Wes held my left leg and my mom held my right.  I told Bret he could stay as long as he "didn't get up in my grill" and my dad was charged with being the labor/delivery photographer while overlooking the gory details.

Liam was coming.  After so many hours (I didn't even know what day it was at this point), he was really coming.  I focused on listening for his first cry.  Tina kept encouraging me "we're not done...keep pushing...you're doing great!"  Wes and my mom told me that they could see his hair.  It was dark and thick.  For some reason, this didn't surprise me because I had dreamed about a sweet little baby with big eyes and a dark brown mohawk.  45 intense minutes went by, but it felt like 10.  No one told me when his head was out.  (Maybe they were focused on my 2nd degree midline tear instead.)  They just kept talking about his hair and kept saying "He's almost here!"

And then, "reach down and grab your baby."






I've heard this moment described before as spiritual, the sweetest moment of your life, indescribable, etc.  It is all of those things and more.  As I reached down to grab my first-born son, all purple and slippery and fragile, as I heard my family weeping in the background, as I looked into his calm and knowing eyes, I knew that this was as close to heaven as I would possibly get on this earth.  I was so full of love and gratitude and joy that I was afraid I would explode.  I thought of all of the women I had talked to over the years who told me they didn't want to have children and I thought, "those people have NO idea what they're talking about."  There is no way to describe it, but believe me, you want this.  This is what life is all about.


This is love.

Liam Rawson Charles was born at 2:53am on October 27, 2009 weighing in at 8 pounds 1/2 ounce and measuring 21 inches long.  After 26 hours and a lifetime of waiting, I looked at my darling husband and my darling baby boy through tears, sweat and runny mascara, and I knew I was home.

And yes, it was all worth it.