Monday, February 17, 2014

birth story (1)

Kiddo is six weeks old now, and it's been both a very long time and an instant.  I'm not sure how that works.  I look at her newborn photos and can't believe how much different she is, yet how is it already the end of February?

In the haze that was our first month as new parents, I recorded much of what I remembered from the birth, though it's amazing how quickly it fades.  No wonder people manage to have more than one kid.   If birth stories are not your thing, that's all there is here, so skip this one.

We were due on Christmas and kiddo showed up on January 4th, so that was its own adventure.  After our successful ECV, she still refused to budge, and there was nothing going on that suggested she would be arriving any time soon.  On the 3rd I had an appointment with my midwife, who told me to report to the hospital that afternoon for induction.  It's weird to show up in labor and delivery with nothing imminent occurring, just waiting around for the nurses to have time to deal with you, but that was also a Friday and apparently the busiest day they'd had in a while, so we were lucky to even get a room.  My midwife is awesome, though, and had reserved us a room with a tub.

We settled in, I was put on an IV, and a nurse inserted a foley catheter since my midwife didn't want to use pitocin right away.  Partner and I watched TV, and I will now forever associate the Star Wars prequels with the birth of my daughter (maybe that's unfortunate, depending upon your Star Wars affiliations).  It wasn't terrible, I had pretty mild cramps for a few hours before a nurse was able to pull it out at 3 cm dilation.  Luckily I continued to progress on my own, which is not always the case, so they held off on the pitocin and gave me permission to eat/sleep/whatever.  Contractions got more intense, I spent some time in the tub (which was awesome), my water broke.  I threw up a few times, which was not awesome and made me glad I hadn't eaten much when they told me I could.

At this point I was back in the bed, and I was bleeding a lot more than they were comfortable with, so we still held off on the pitocin since they were worried about placental abruption.  A little while later they gave me a lowered dose of pitocin and waited to see how I would respond.  Contractions were increasingly tough, but perhaps they were getting us somewhere.

12 hours after we started, I was only 4 cm dilated, I was tired and in a lot of pain, and I was really disheartened by the lack of progress.  I asked for an epidural, though apparently there was still a bleeding issue and I had to wait while they figured out what was the most likely cause.  I remember being really annoyed that it was taking so long, and I was about to say something unkind just as the anesthesiologist walked in.  We did the forward-lean for the needle, and I honestly don't remember feeling anything after the local anesthetic.  That could be the labor pain talking, but the catheter was in (and slightly too far to the left, which was important later) almost immediately.  A minute later I was pain-free and wondering why there weren't songs and poems written in praise of the epidural.

The next 8 hours were pretty good - I was still pain-free, I didn't have to get out of bed and drag my IV stand to the bathroom any more, and I napped off and on.  Things progressed slowly, and pain management slowly became a problem.  Eventually the epidural stopped working as well on the right side - the issue of pain meds being delivered more on the left.  By the time I was 10 cm, the right side was feeling it and the left was not as numb as it had been, but I was still not able to stand, so it was a "worst of all worlds" kind of situation by the time I had to push - I could feel it, but I couldn't get myself into a better position for pushing and was stuck on my back.

I started pushing almost exactly 24 hours after we started the induction, and I remember it being very non-intuitive but doable with coaching.  I had no idea whether anything was happening, except that I was told that I was doing well.  I got myself into a decent pattern with each contraction, doing a long push and then two short ones each time.  Throwing up a few times.  For two hours (and poor Partner held up a leg for that entire time).  It turns out that kiddo was finally head down, but decided to come out face-up (posterior), making it more difficult for her to descend through the birth canal.  I was told that they could see hair, but she was still too high for any external help and she wasn't making progress.  The doctor (who had also done my ECV) came in to try to turn her head, but she wasn't going anywhere.  I couldn't stand up, I had a fever, baby was tachycardic, especially when I turned on my side.  I was told that we should really think about a c-section.

From my perspective, it wasn't presented as an emergency, but as serious concern.  My midwife told me that she estimated another 3-4 hours of pushing at the rate we had been going, and told me the c-section would be safer.  She offered me another attempt to see if we could get somewhere without causing problems for the baby, but I was so tired at that point that I said no and agreed to the c-section.  I think part of me had been prepared for that anyway, given the fact that the baby had been breech for so long and my sister had followed almost the exact same scenario with her son's birth a few years ago (long labor ending in c-section).

I don't know whether the epidural caused any of the problems we had, like the slow progress.  I don't feel bad about it as a "what if", as I know a lot of women do.  After 12 hours without any meds and with minimal progress, I was ready for the epidural and don't feel bad about having it, even if it slowed things down.  Given the induction, that might have happened regardless, and her posterior presentation may have led to a c-section no matter what I had done.  I say this not to cover some sort of secret guilt, but just because so many women who write about epidurals also write about how they feel guilty and responsible for bad things that come after, and fuck that ladies, medical science has some awesome perks and we should totally take advantage of pain medication when we are in labor for 28 hours. /rant

And...this is long!  To be continued!

No comments: