Thursday, September 4, 2008

Birth Story Part 3 - Not So Textbook

Within about five minutes of getting into our room, I was hooked up to a much "fancier" monitor for contractions and the baby's heart rate. The nurse left the monitor on just loud enough for me to enjoy the sounds of Little Man's heart beating. I also got a visit from the anesthesiologist, who explained the process of getting the epidural, risk, benefits, blah, blah, blah. I pretty much tuned him out about all of that as another contraction settled in. I had wanted to "feel" labor for awhile and had even played with the idea of not having medicated pain relief. . . three hours into labor and I was ready for the good stuff! To those women who do go without drugs, my hat is off to you, but for me, I was all about medication!

I had really feared the epidural and heard some horror stories about it from some friends. For me, it wasn't that bad. They had me sit on the edge of the bed and lean over the bedside table topped with a pillow. My husband held my arms and I had to kind of push my back into a hump. I felt the cold iodine and then a poke that made me catch my breath - but was nothing compared to the contractions. I then felt a sharp tingle settle over my left lower back and into my upper left leg. It wasn't painful, just kind of sharp. Unfortunately, I also had a couple of contractions during the procedure and did shift without meaning to, so that meant that the doctor had to reposition and try again. By that point, however, I didn't feel a thing. They then had to tape everything into place. The whole thing, even with the reposition, took maybe fifteen minutes.

The epidural was supposed to take about twenty minutes to take effect, but I would say within five minutes, I wasn't feeling the contractions at all, just pressure. By twenty minutes, I felt nothing but sweet relief! They did give me a patient controlled button to get more anesthesia if I needed it, but I would only end up pressing that button once when they were having me labor down. Other than that, I was completely numb over my entire abdomen, back, and bottom. I could still feel my legs, but they felt like rubber and it took all of my concentration to move them.

After I was resettled in bed, I had another dilation check and had dilated another centimeter. In "textbook" labor, dilation should take place at approximately 1 cm per hour. I was chugging right along at exactly that pace. Following that check, the nurse put in my catheter, which I didn't feel at all. I did feel the dilation checks, but only as a dull pressure, not with any pain to speak of.

In between checks and the nurse coming and going, I tried to get some rest, but it was pretty difficult. I was excited, nervous, and just a jumble of emotions. I also felt drugged from the epidural, which was something that I was not expecting. I have talked to some other friends about this and some felt it and some didn't, but I definitely felt a bit "out of it" and light headed. I also got really bad "baby shakes," which were worse when I was lying flat. Once the nurse propped me up a bit, they got better. It also helped when she used pillows and rolled up blankets to keep my legs in good position.

I was only allowed ice chips during this time, so even though I was getting fluids through my IV, I felt thirsty and dehydrated. My husband was really good about keeping my lips well covered with lip balm. I would highly recommend some for your labor bag!

About three hours after getting the epidural, I developed a fever of 101.4. I had to start an antibiotic through the IV, which did sting a bit going in, but was otherwise painless. I was vaguely nauseous throughout labor and eventually, they did give me something for that, although I fought it for awhile, not wanting to feel any more drugged.

My husband was great throughout the whole process. My in-laws arrived in the early afternoon and I felt good enough to chat with them for awhile. The nurse was great about having people leave the room when she did exams. Every time she did one, we were happy to hear that I had dilated the appropriate amount since the last time. My contractions were quite regular and strong according to the monitor, but I felt nothing throughout them. The nurse told me that I was having a "textbook" labor and should be ready to push before her shift ended at 3:00 PM. She said she would even stay a bit later to see the baby delivered.

My regular OB was on vacation, but the on-call OB came in to see me. The first sign that maybe things weren't as textbook as the nurse had kept saying was when the doctor did her first exam. She frowned as she felt around and then felt around for a long time more. She said that the baby was turned incorrectly, facing my back, and had his ear pointed down against my cervix. I was about seven centimeters dilated at this point and was 0 station. Although we had been shifting positions every hour, she wanted me to start shifting every half hour and try to get up on all fours. She didn't seem concerned, however, and patted me on the leg before leaving.

The next three hours, we concentrated on shifting positions. I tried to get up on all fours, but my legs weren't too cooperative. I was still not feeling anything from the contractions, which was great, but I was a little frustrated that I couldn't do something to help the baby turn.

Finally, I was 10 cm dilated, with just a tiny bit of cervical lip. The nurse and doctor suggested that I "labor down," since the baby still hadn't moved from 0 station. This meant that although I was fully dilated, they didn't want me to start pushing with contractions. This was fine by me, as I still couldn't feel a thing and wanted one last chance at rest before starting to push. After about a half hour of this, the doctor tried to move the baby's head so it wasn't ear down, but Little Man was not feeling cooperative. She was able to reposition him, but at the next check, he was right back to where he had been before.

After a little more than an hour, the nurse suggested that we start pushing. In my mind, I remember thinking that it was too soon. I had read on another person's blog that they didn't know that the urge to push would be so strong and that they pushed before they felt that urge. I wanted to protest, but I also wanted to get the show on the road and didn't want to be a difficult patient. Looking back, I kind of wish that I would have waited a bit more to push. I wonder if I didn't waste some of my energy with pushing before my body was truly ready.

Pushing is really hard to describe and also difficult to do. It takes a few pushes to get the hang of it. One thing that the nurse did to help was to put her fingers in my girly bits when I was pushing, so I could feel where to concentrate my efforts. It felt kind of weird but it did seem to give me the focus that I needed. I would say that the first twenty minutes of pushing were kind of a waste, simply because I was learning how to push and also didn't feel anything whatsoever, no urge, no pressure, no nothing.

Then, I did start to feel the pressure and the urge and could tell when I was about to contract. I gave those pushes everything that I had. It actually felt good to push against the pressure, so push, push, push I did. A bit of advice here. . . pushing can be a bit. . . messy. I'll leave that part up to your imagination, but let's just say that more than a baby can get pushed out. I had brought a bottle of lavendar scented room spray, more for the calming effects than anything else, but I ended up really liking it during this part, simply because I got a bit embarrassed. So, perhaps something else to add to your labor bag and have handy when the pushing starts.

I kept push, push, pushing. After an hour, I was getting tired and the nurse kept checking to see if the baby had moved. She kept telling me that he had moved, but I could tell that he wasn't moving as much as she expected. Another nurse came in with a bar that they put on the bed and then wrapped a towel around so that I could grab onto that and curl around it. I found that to be helpful as far as positioning my upper body for the pushes.

At two hours of pushing, the doctor came in again. By this point, I was getting really tired. The nurse had said that we would push for about this long total and I was frustrated that we seemed no closer to meeting Little Man. After the exam, my frustration grew when the doctor had to give us the news that his head was still facing the wrong way, ear down, and he had slid backwards to -1 station. The doctor had me do about fifteen minutes of pushing with her. By this point, I was crying, simply because I felt as if I had to be pushing wrong. How could all of this work be sending the baby the wrong way?

The doctor assured me that I was pushing just fine. She said that she would sometimes turn off an epidural if she felt that a woman wasn't pushing effectively. She said that I was a champion pusher but that the baby just didn't want to come out. She said that with his current position, she couldn't use forceps or a vacuum to assist with getting him out. She offered a c-section, which I promptly refused. Little Man was tolerating the contractions and pushing just fine, so I saw no reason to rush into major surgery, even though my exhaustion was starting to get to me.

We struck a bargain that I would push for another half hour and if no progress had been made, it would be time to do the c-section. I pushed my heart out for that final half hour, but when she checked me at three hours after I had started pushing, there had still been no progress. I turned to M in tears and said, "I'm so sorry, I think I'm done."

I felt like a failure, as if I was giving up too soon, but the fatigue was incredible and I was frustrated. I also felt as if the doctor was basically telling me that Little Man wasn't coming on his own. I do still have a lot of disappointment regarding this, since it was ultimately my decision to make, but as my husband said at the time and since, "It doesn't matter how the baby got here, just that he is here."

Things went pretty quickly after that. We would be meeting our Little Man soon . . .


Jen said...

Oh hon, I know it must have been disappointing. But nobody would consider moving to a c section after 3 whole hours of pushing as giving up. That's a lot to take, especially given the day's diet of ice chips.

Deborah said...

You so did not give up my dear.

Thank you so much for sharing your story. This is truly a remarkable experience.

Since I haven't been around to post in a while, I just wanted to also say, he is absolutely adorable. God bless you both.

Jen said...

You were a champion! That is certainly not giving up.

Baby and Me said...

Oh this is better than any lifetime movie! I am waiting for part 4 to see what happens.
Two hours of pushing is amazing! You did a great job, I have heard about the other effects of pushing...I will remember some pretty spray for the room.

Fertilized said...

Oh honey- It's called Labor for a reason ..It's simply exhausting. You did not fail. Little Man is Here. There is no such thing as failure about that

Kam said...

Awww....must have been so frustrating!!! So excited for Part 3!

Elle Charlie said...

Your Little Man is ADORABLE! I love the pic of your husband gently hugging him!!! So sweet!

Joy said...

Wise words from your hubby! And you did a great job!!! How do I know?! Because your sweet little boy is perfect! I'm so glad to see new pics on the sidebar!!!

Kim said...

the suspense is killing me!

I had the same exact emotions about my c-section.. that's why I warned you ;o).

Geohde said...

Don't feel like a failure or guilty- Little Man's head was just malpresented and probably no amount of pushing would have fixed it.It's just one of those things- the combination of the shape of your pelvis, his head and where he was positioned and a bit of bad luck.