It's only been 4 weeks, may as well get this going before I forget everything. It's very long (we started at 8:00 and she was born 15 hours and 58 minutes later), so skip it if you don't want lots and lots of details.
Short version: Pitocin induction at 41 weeks, no pain meds, shoulder dystocia, healthy baby girl.
Long version:
So after all of my attempts at natural labor induction
failed, I broke down and scheduled a hospital induction for 41 weeks,
exactly. My anxiety just wouldn't allow me to go any further - visions
of Many Awful Things danced through my head. I spent the weekend visiting with my sister and resting up for the main event, though I did get one last pregnant workout in on Sunday, and even managed to PR on my bench press. Hooray for strong pregnant women!
As I posted early that morning, I got pretty much zero minutes of sleep that Monday night. I had woken up at some point with contractions so I spent the night pacing around the house and wandering the neighborhood in hopes of getting things going before they had to drug me. Of course, it didn't work. By the time the sun came up the contractions were weakening and eventually stopped altogether. I made sad faces and ugly cried.
We spent the last morning as a family of three at
Dunkin. I enjoyed a last meal of a bacon egg and cheese bagel with a
caramel latte on the side. I knew I wasn't going to be eating anything
until the baby made her appearance, so I made sure to get something
good. At that point, I was still expecting to eat dinner, so I didn't feel like I needed to load up on calories. We dropped
Charlie off at school and headed to the hospital, where we filled out a
ridiculous amount of paperwork (really, why did I fill out all of that
pre enrollment stuff?). After I signed over my life, we were shown to
our labor room and I changed into an uber-fashionable backless gown. I
insisted on keeping my sports bra on but the tongue ring had to go. My nurse seemed ok, a very nice
older woman, but when she asked me about my pain management plan and I
told her that I planned to go med-free, she pretty much laughed at me. Upon examination, I was barely 2cm dilated. More sad faces, that was incredibly disappointing. If I only knew what was coming. She
got the IV started (ironically, the very thing I was hoping to avoid by
going natural), checked in with my OB, and we were off.
I had heard horrible things about pito.cin, even having
friends go so far as to call it the "devil drug" because the
contractions were so horrible. I requested that we start with a
small dosage and gradually increase it, and my OB was on board with that
plan, so that's exactly what we did - started with the smallest dose and turned it up when they checked my vitals every 30 minutes. Within minutes I started to feel the tightening of contractions, and braced myself for the pain. Nothing. No pain, whatsoever. That was at 8:30. The next few hours were spent walking up and down the short hospital hallways, alternated with time on the yoga ball while watching new episodes of Arrested Development. It was a good timing pattern - wander the halls, come back for vitals check and med adjustment, bounce on the ball while watching 20 minutes of TV, another vitals check, back out into the hallway. Rinse and repeat. Over and over again. At some point, the nurse insisted that I meet with the anesthesiologist so that my history would be on file when I finally broke down and asked for the epidural. Thanks for the vote of confidence, lady. The hours continued to tick by and I still wasn't feeling any pain from the contractions. Husband thought that was a good thing, but I knew better. No pain, no gain - I was sure that the contractions were completely unproductive. An internal exam mid-afternoon confirmed my suspicion - I was about 3cm. How's that for no fucking progress? Insert more sad faces and some frustrated tears. At this point, it was almost time for shift change and I knew that there was going to be no baby that evening. My OB finally swung by around 6:00 to check on things. He was pretty much zero help. He confirmed that I had made very little progress and gave me three options - I could stop the induction, go home, and try again in a few days (absofuckinglutely not!), I could stop the induction for a few hours and then start it again (hoping that maybe it was just a bad batch of meds), or he could break my water and see if that sped things along. I opted for the water breaking. By that time I was having strong (but still painless) contractions every two minutes. Increasing the dosage wasn't going to do anything for me, and there was no way I was leaving that hospital without a baby. He got the crochet hook out, and the flood began around 7:00. And I thought I'd be cuddling a new baby by then. Ha!
A few days prior to the induction, a friend shared that walking and sitting around after your water breaks is pretty much the most disgusting thing ever. She was 100% right. I felt gross and uncomfortable, but I still kept walking the hallways in my giant diaper hoping for progress. And finally, at the far end of the hospital hallway, things started to get uncomfortable. I started to have to stop and breathe through every contraction. I had to hold onto the wall. Husband started applying counter pressure on my lower back, which helped with the pain. Finally, I felt like I was in labor. We went on walking for an hour before heading back to the room for a progress check. 5 measly fucking cm, and just barely. I was losing my mind at that point, certain that we were headed for a C-section for failure to progress. And then the new nurse stepped in and made a suggestion - she asked my OB if he could tell where the baby was positioned. He said that he couldn't, but that she hadn't descended very far yet, which was part of the reason I was going nowhere fast. It was 9:00, and she immediately had me lay on my belly in the hospital bed to try to get the baby to flip into position. Holy shit, was that ever effective. The very next contraction hit me like a ton of bricks. At this point it wasn't a matter of needing to breathe through the contractions, it was a matter of not screaming out in agony every time a new one started, which was still about every two minutes. I texted my birth assistant and told her that she should probably make her way down to the hospital. That was when time started to get away from me - the next three hours were the most painful hours that I can remember ever experiencing.
When she got there, I was lying in the hospital bed on my side, death grip on the bedrails, wailing like a banshee. She conferenced with the nurse (and I think the husband) and they all helped to pry me off of the bed into a standing position so that we could let gravity help things along. There was also talk about it being a more comfortable position to labor in - that was bullshit. It fucking hurt no matter where I was. That and I was afraid that I was going to poop on the floor - so certain it would happen that I was pre-emptively apologizing in between contractions. I actually ended up laboring on the toilet through a few contractions and found that it was a good place for me - the positioning made it a teeny bit more bearable. Of course, by "more bearable" I mean that I could go 30 seconds into the contraction before I started screaming and begging for drugs rather than only 10. When I started asking for drugs, they suggested that I try laboring in the shower. I stripped down into my sports bra and giant pad and hot mesh undies and walked into the spray. I wish that I could report feeling instant relief, but I'd be a lying liar who lies. The best I can say for the shower is that it took the edge off. A little. The biggest problem with the shower was that there was nothing to grab onto when the contractions hit, so I was literally clawing at the walls trying to make it through each one. And they were still right on top of each other. I made my way back to the bed for a vitals check and asked for an internal while I was over there - much disappointment when they told me I was only at 7cm. By that point I was absolutely exhausted and in so much pain that I couldn't think straight. The worst part was when I begged the nurse to turn off the pito.cin, just for a few minutes so that I could rest - she broke the news that the drugs had been off for a while, and now my body was actually in labor and doing what it was supposed to be doing. I can only remember little bits and pieces of what was going on during this time. The one conversation (if you can even call it that) that I do recall is the husband telling me that I didn't need the drugs - that I had run marathons and that I had run in Leadville and that if I could do that, I could do anything. I distinctly remember screaming back at him that "There are no medals in the pain Olympics!" I guess the Bump has rubbed off on me. There was no end in sight. Or so it seemed. A few big contractions later, my body suddenly developed a mind of its own and I could feel myself involuntarily bearing down and pushing. I yelled for the nurse, who came running insisting that it was way too soon since I was only at 7 ten minutes earlier. It was a surprise to all of us when she declared me fully dilated, and then ran out to call my OB. They didn't think he'd make it in time, so they also had the hospital OB paged to the room. They put me in the bed on my hands and knees and I started the next phase of labor, getting the baby out.
For as long as the day was, this part was super fast. Again, I only remember little bits and pieces, plus things that have been relayed to me after the fact. Early on, things were going smoothly. I was making good progress and using my breathing techniques and vocalizations (I can't even type that without feeling like a tool, but it actually worked) to focus on the muscles I was using. The nurse, birth assistant, and husband were really great at helping me to refocus when the pain got too intense and I started screeching and resisting, rather than being productive. They kept telling me that I was "almost there" and (from what I've been told) I kept accusing them of lying to me and tricking me and just being big meanies, overall (apparently this is also when I went on a rant about scientology and their silent birth technique and how it's got to be total bullshit because no one could possibly be silent through that kind of agony). Perhaps most embarrassingly, at one point when they said (in encouragement) "I can see the head!" I told them to "just pull it the hell out already!" I was a real treat to be around, it's probably for the best that I don't remember this very clearly. I pushed and pushed and busted a blood vessel in my eye and just kept waiting for that "ring of fire" that I knew was coming, except that it never did. And then all of a sudden there was a big commotion and everyone was rushing around and telling me that I needed to stop screaming and focus and there were hands on my flipping me over onto my back and someone else jumping and pushing on my stomach and I didn't know what was going on except that I heard the nurse call for a special care team to come to the room and then I got scared and panicked and had to be redirected to breathe and concentrate and be productive. The nurse very calmly but clearly told me that I needed to get my shit together and focus, because I needed to get the baby out NOW. And then I knew that something wasn't going right, and I pushed with all of my might and ohmyfuckinggod it hurt but she finally popped out - but she was purple and not making any noise and then I totally lost my shit and started crying and yelling for someone to tell me that she was ok and asking why she was purple and why she wasn't crying. They held her up to show me while they were cutting the cord and then whisked her away to the incubator. The 30 seconds before I actually heard her cry felt like an eternity, especially because no one was telling me what was going on. And then she did, and it was the most wonderful sound ever. And I heard them calling out the apgars and she passed with flying colors. And then they called out the birth weight - 8 pounds 8 ounces. And my exact words were "Are you fucking kidding me?!" A full pound and some change bigger than Charlie was. Figures this would be the time I'd decide to go med-free. But I didn't tear! It's a minor miracle.
After the drama was over I got the full story - shoulder dystocia. Her shoulders were too wide and were getting stuck on my pubic bone. The flipping over and jumping/pushing on my stomach was the attempt to get her shoulders free and to slide under the bone. I was eventually told that there's a four minute window that they have to get the babies unstuck and delivered before they go long enough without oxygen that brain damage becomes an issue - she was stuck for two minutes. It was a horrible birth experience, and it could have ended very badly. Thankfully, I have a happy and healthy 4 week old. No nerve damage, which is another concern with shoulder dystocia. And ever so cute. I'm so glad that I had such a great support team. The next morning, my OB came to check up on me and said that if I had given in and gotten the epidural the birth certainly would have ended with an emergency C-section, at best, because I wouldn't have been able to actively help get her out. I have to say, that if this had been my first birth experience I probably wouldn't have had another baby. We're done at two, anyway, but I have no desire to ever go through something like that again. It hurt. A lot.
Other random thoughts:
1. It's completely inappropriate for nurses to weigh in on politics. I didn't need to know that my first nurse was anti-Obama. I ignored her many comments because she let me cheat and drink water while I was in labor.
2. Pain does funny things to people - one of the other conversations I don't remember was me continually referring to my hospital garb as my "fashion gown." Between that, the scientology, and the medal for the pain Olympics, my second nurse specifically came to tell my recovery nurse how much she enjoyed my sarcasm.
3. Older medical personnel struggle mightily with electronic health records. I'm oddly fascinated with them, so I watched every time she made an update. I caught quite a few mistakes, including her pulling up the wrong patient on two occasions. That could have been a very serious mistake. This is a problem.
4. My recovery this time was nothing. I was up and walking around within hours and started working out two weeks later. I had an episiotomy the first time and I'm pretty sure I still couldn't sit two weeks later. Yay for no tearing!
5. Going pain med free was totally worth it, just for the fact that I avoided a C-section. There was clearly no way that I could have known that in advance, but I'm glad I made that decision. Even though it sucked and I begged for drugs during transition. I didn't realize how rare it was to go epi-free at this hospital and I'm still annoyed that the first nurse was so dismissive of my plans.
6. The next day my OB told me not to worry about the screaming and yelling. Ummm, ok... I wasn't, until you said that. WTF?
7. If you're going to use a birth assistant, make sure they're willing to stand up FOR you and stand up TO you. When I was begging for the drugs, both my assistant and my husband did a great job at reminding me why I was going without it to begin with (even though I kept pointing at the IV bags and telling them "THAT is the reason why I was doing it, so it doesn't fucking matter anymore." And yes, direct quote. When it was all said and done, husband told me that he knew I didn't "mean it" because I was asking for permission, not telling them that I wanted the drugs. He said that he knew me best, and that if I had really NEEDED them then I would have DEMANDED them. Not asked for permission. True story.
8. When I received my hospital bill I was shocked to see a line item for an epidural. I guess they just assume that everyone gets one, and when I called to argue the bill they insisted that I must be mistaken and just not understood that I had an epi. So look carefully!
