By Eileen, mostly...
All throughout my pregnancy, I read as many birth stories as I possibly could find. I loved reading them, mostly to find out what I could or might expect as a first-time mom. I felt much more prepared after reading them because they gave me a picture of what "usually" happens, and what can happen that's not so usual. We also took Lamaze classes, which did help somewhat when I was laboring.
Although we did a lot of preparation, I don't think I was really ready for what happened.
At 5 am on August 3rd, 1999, I came half awake thinking I had felt a gush of something, but having just gone to the bathroom at 4 am, I was certain it was not urine. I sat up, and a larger gush came out. I woke my husband up and said to him, "Ed, I'm having this baby today." When I stood up, a huge gush of fluid came out. It was clear, so we didn't have to worry about the baby. It was four days before my due date, and being a first time mom, I was sure I'd go late. At my 39 week appointment a few days earlier, I was 0 cm dilated, not effaced at all, and that baby was "way up there". It was a surprise to go into labor early, but I wasn't too afraid. I should mention that we had just finished writing our birth plan a few days earlier, but hadn't discussed it with our doctor yet--as I said, first babies are late--and I thought I had time to talk to him about it.
We called the doctor on call, who told us to go to the hospital, but to take our time. First time babies take a while, as she said. So I took a shower, shaved my legs, called my parents, and finished packing my bag. We went to the hospital when I ran out of maxi-pads--I was still leaking a lot. We stopped for breakfast at Dunkin Donuts along the way, since I knew that as soon as I got to the hospital, that would be it for food and water. We arrived at the hospital at 8:30 or so.
They got me settled in and put me on the external fetal monitor. I was having very sporadic light contractions (about the same as a menstrual cramp) on my own. The new doctor on call from my OB practice, who had come on at 7:00, came to see me at 9:45 am--it was a busy day in Labor and Delivery. I was glad to see that it was one of the doctors that I liked a lot from the practice. He did a check and I was found to still be 0 cm dilated, 0% effaced, and the baby at -2 station. I asked if I could walk for an hour to try to get things going naturally. I dreaded being induced, because I knew that pitocin makes the drug-free childbirth we wanted more difficult. He agreed to let me walk for an hour, but we both knew that since my water had broken, the clock was on, and I could not wait too long lest I risk an infection.
During this hour, my parents arrived. They remained with me for the duration of the labor, except when I was pushing. It was great to have them around, because it let my husband have a few breaks, while I still had someone with me.
After an hour of walking, my contractions were still very light and very sporadic. At 11 am I got back into my LDR room and they put in an IV with pitocin. The pit was increased every half-hour. As the day progressed, the contractions got more difficult. But I was hopeful that my baby was getting closer with every contraction. The Lamaze breathing helped a lot. Ed had made some tapes of music to help with labor, and those helped a lot as well. I really needed something else to focus on.
After seven hours of laboring, I was getting tired, and the contractions, coming less than three minutes apart, were getting harder and harder to handle. I could feel myself getting worn out. I asked to be checked. The nurse informed me that since my water had broken, I could only be checked if I wanted pain medication. I really, really had wanted to go through the labor and delivery without narcotics, so wasn't all that willing to ask for them. My dilemma was this: If the labor was going to be just a few more hours I felt I could have made it without medication. If the labor was going to be many more hours, I didn't think I could handle it without meds. The only way to find out was to be checked, but they wouldn't just check me unless I wanted medication! Finally, I decided to "ask" for meds, just so I could be checked. What made me do this was that the doctor said that he believed it was going to be several more hours, not just a few.
I was checked at 6 pm and found to be only a fingertip dilated, and 20% effaced. I was VERY upset by my lack of progress. Since it was going to be a long while, I agreed that it was time for medication. They wanted to give me Demerol, but I had been given that during a surgical procedure some years ago, and I knew from that experience that it did not work well for me at all. After telling the doctor this, he agreed to give me a shot of morphine. It was just as it had been described to me: It didn't kill the pain outright, but it definitely helped take the edge off, which got me though the next five hours. At 11 pm, the plan was to turn the pitocin off and put some cervadil on my cervix. I would try to get some sleep, and we would resume the pit in the morning. After turning the pit off, we found that I was still contracting on my own, but not as much as with the pitocin. By then, the morphine was definitely wearing off as well.
I was checked before they put the cervadil in, and to everyone's surprise, found to be 3 cm and 80% effaced, with the baby still at -2. We then decided to turn the pitocin back on. I also opted at this point for an epidural so that I could get some sleep. They were nice enough to put the epidural in before turning the pit back on.
The epidural worked really well all night. I was able to get some sleep. The nurse did keep coming in to check my blood pressure, and to increase the pit every half-hour. By the end of the night, the pitocin was at the maximum setting. The epidural did slow down the contractions somewhat, to once every seven minutes or so.
At some point towards morning, I was checked again and found to be 9 cm dilated. I was thrilled, and sure I would be pushing soon. The baby was still high up, though. It had been 24 hours since my water broke. I had been given antibiotics every six hours to help fight off infection.
At 7 am the on-call doctor for my OB changed. This was not one of my favorite doctors. He was of the personality type that says the doctor knows best and the patient should not interfere. He checked me and found me to be 8-9 cm, with the baby still high up.
The epidural had started getting "spotty": there was a spot on my lower left side where I started to feel some pain. I rolled over to my left, and got some more medication pushed in. This helped somewhat, but the spot remained. The nurses changed at this point as well. The new nurse, Evelyn, was excellent. She warned me that the doctor was thinking of letting the epidural wear off and having me push without it. She was definitely an advocate for us with this doctor. I think the doctor really wanted to do a C-section at this point, but she convinced him to let us try pushing. Being the daughter of a midwife, Evelyn was going to make sure that we had done absolutely everything possible to have a vaginal birth before resorting to a C-section.
We turned the epidural down to half strength, and started to push. Ed and Evelyn were great cheerleaders. At some point, the epidural medication ran out. By the end of an hour of pushing I was going without any medication whatsoever. Let me say that I'm glad that I got the chance to try to push this baby out. I think I would have regretted not trying had I not been given the chance. At the end of the hour, I was in PAIN. There was a pain on my lower left side that did not go away with contractions. We think it might have been a ligament tearing. Whatever it was, it was excruciating. I could deal with the pain of contractions, but this other pain was horrible. I couldn't get on top of it.
The doctor checked me again. The baby was still up very high and I still had some cervix left. I just would not dilate past 8-9. We decided to do a C-section. The reason was "failure to descend" or CPD (cephalo-pelvic disproportion). Basically, my baby would not fit.
I was transferred to the OR. I was still in constant pain on my lower left. The pitocin had been turned off, but this pain would not go away. They put in a new epidural for the C-section. Let me say that having had two put in, it's a much more pleasant experience when you're not fighting the urge to scream out in pain. There was a huge flurry of activity around me. Apparently the OR was not quite all set up as they had been told, and so they were setting that up while prepping me. Unfortunately, the new epidural was not working well. They kept adding more medication up to the maximum, and I still could feel them pinch me in spots. They gave me other medication as well, to try to dope me up, but I could still feel them pinching.
All of a sudden (at least from my perspective) they told me they were going to use a general anesthetic, and they immediately put a mask on me. Ed had gotten into scrubs (and had at some point told my parents what was happening) and was with me in the OR, and would have stayed had the epidural worked. But, once the decision was made to use a general, he had to leave. I remember being afraid something was wrong with my baby or me and that's why they were in such a hurry. I remember also being sad even at that point when I realized that I couldn't see the birth of my child. I also remember a feeling of relief that I wouldn't be in pain in a second or so.
It turns out that even though he was not permitted to stay in the OR, Ed was able to watch the procedure through a window, and had seen Brian being lifted out of me. Evelyn was part of the team doing the C-section, and having seen how Ed was during the hour I pushed, decided it would be OK for him to come back into the OR once Brian had been cleaned up. They let him cut the cord as we had originally wanted, but it was only a second, symbolic cut, as the "true" cord-cutting happened just after Brian had been lifted out. Ed was also allowed to take a picture of Brian on the weighing table. When this was finished, Ed returned to his spot outside the OR, and a few minutes later, Brian, now wrapped up and warm, was given to him to bond for about fifteen minutes. Then Brian was wheeled into one of the nurseries for some tests, accompanied by Ed and my father.
I came to in the recovery room a while later. Ed was there. He told me we had a beautiful baby boy at 12:09 pm, 31 hours after my water broke. I cried because I wanted to see Brian--I wanted to know he was OK with my own senses. It seemed so surreal to have had a baby but not "been" there. I realize this was the way my mother had her children, but it felt so unfair. It still does. I was transferred to a maternity room and got to see him at 3:30. I had to ask for him several times before they brought him. At one point they implied since we'd had such a tough delivery that they might not let him room in with me the first night. It was more heartache that I didn't need at that point. I think the nurse (not Evelyn) could have been more sensitive. In the end, I got to hold my son, and I melted. He is perfect. And he did room in with us for the rest of our stay. The pain of those two days is fading.
Breastfeeding has been difficult for us. Brian's sucking reflex was not good. Plus with the stress of labor, we had to give him supplemental formula due to low blood sugar on his first day, which I believe led to some nipple preference problems. My milk took six days to come in, and only with a lot of cajoling. I was pumping after every time he ate for several days. That was exhausting. Brian got hungry on his second day, and lost a lot of weight, so we had to supplement with formula. We tried a supplemental nursing system, which did not work well for us, and so we used bottles. It was hard to see him fed a bottle, knowing my supply was not enough. Eventually, with the help of two excellent lactation consultants, we got things worked out. Brian is a happy, chubby cheeked, totally breast-fed baby.
As I said in the beginning, I thought I was prepared for every eventuality by reading all those birth stories. I guess you never really can be prepared for EVERYTHING. I certainly was not ready for a C-section with a general anesthetic. In the end, the important thing is that Brian and I are both healthy, and my husband and I have a beautiful son.