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Friday, May 22, 2015

My Labor Story

I actually wrote 90% of this a week after giving birth. However, I never finished and it got put on the back burner and a few months ago I decided I'd save it for her birthday.

So, one year ago...

Vex, the cat, was the first one to know something was about to happen.

In the night he came snuggling into our bed, meowing and rubbing against us, waking us up. He
started nibbling on our toes, which he does when he was hungry. Ryan got up and, sure enough, the cats needed food so Ryan fed them. But I wasn't convinced that was it. Vex doesn't normally wake us like that, and while sure he nibbles on our toes to tell us he needs food, it's really just because it's an effective way for him to get our attention. In the ten minutes or so I'd been awake I realized I hadn't felt the baby move. I lay still, but still nothing. Trying not to be alarmist I just asked Ryan to get me a cold glass of juice and he did. After I took it and lay down, I told him that I hadn't felt the baby move so I'd taken the juice to try to spur some action. He rolled his eyes at me and told me to go back to sleep, that obviously the baby was just sleeping too. I told him maybe, but even though I was exhausted I wouldn't be able to sleep until I felt movement. Then I thought I felt something, but wasn't sure, so I asked Ryan to talk to my stomach. He did, and the baby responded, kicking me three or four times. That made both Ryan and I happy, and we went back to sleep...

In the morning I woke up and stumbled out of bed and ate breakfast in my normal just woke up haze. After I ate I realized I didn't think I'd felt the baby move, again. Unsure whether there was a real lack of movement or just me psyching myself out I didn't really concern myself much but just became more aware. I also was surprised in that I hadn't had any contractions. I'd been in early labor for a week and a half and was used to having contractions at least every half hour or as close together as every eight minutes. I'd already been up about an hour at this point. Still, I told myself to be happy for the break and Ryan and I were busy doing chores, cleaning up the house a bit.

Ryan's been tense about paying for the delivery. Our insurance would cover the majority, but not the totality of it and of course we didn't know exactly how much it'd come to, with variables like pain relief in the picture. So one of the things he'd been saying for months is the baby had to stay in until he got his monthly paycheck, which would be that Saturday. However, I pointed out that since we'd be in the hospital for 48 hours and wouldn't have to pay until checkout the baby just had to wait until 48 hours before his paycheck would go into his bank account. Which would be today. So I told Ryan, teasingly, that if the baby was waiting for Daddy's sake for the paycheck then I was allowed to go into labor in the next hour.

Probably ten minutes or so later I felt a contraction. I then went to the restroom and while I wiping I thought it seemed like a strange consistency... then I stood up and continued seeping. I paused, was this what I thought it was?

"Ryan, I think my water broke."

I was pretty excited, and pretty calm. I had a list in my head for days about the stuff we needed to do before leaving the house. First we called my doctor. I told her and she told me to call her again when we reached the hospital. I told her that we'd probably take a half hour before leaving the house and then it'd be a half hour drive to the hospital, but the contractions still weren't intense. She was fine with that, but told me not to delay too much.

I changed the litter boxes so that we wouldn't come back to a surprise from the kitties. I took a
shower. We called my parents and let them know, then called Ryan's parents to come pick us up. They have a car and were going to be our ride. I also made myself pancakes and tea. My mother had been in labor with her first, my older sister, for 36 hours and my older sister had been in labor with her first for 29 hours and I knew they didn't let you eat once you got to the hospital, so I thought making sure my stomach was full before my labor fast began made sense in order to keep my stamina up to get through. I was going to make Ryan pancakes too but by the time I made some for myself my contractions were getting closer together and I was starting to hurt. Ryan's dad had arrived so I told Ryan that since they weren't going to tell him he couldn't eat he'd have to wait and we left. (I did give Ryan tea, telling him he better not fall asleep on me! Haha.)

We got to the hospital and I was still doing pretty well. Mainly excited, a little scared. We'd booked a twin sharing room and they led us up to it. No one else was there yet, so I asked to pick the bed farther from the door, figuring it'd be less annoying to be away from the hall and people coming in and out. They didn't have the sheets on that one so we waited while they went to get them... Then they appeared and told us they wanted to move us to a different floor. They'd taken us to the third floor but they said due to where the nursing staff was on duty today it'd be more convenient for them for us to be on the second floor. I honestly didn't care where we were, I just wanted to settle into a room. However my father-in-law thought it was annoying we were being moved so he went off to see if it was necessary and told us to wait on the third floor. Then after he left Ryan talked to someone on staff who told us that the room we were being moved to on the second floor was actually a private room. Since we were being moved for the staff's convenience, they were upgrading us! Ryan called his dad and let him know and we allowed them to move us.

Ryan went and completed the paperwork for checking me in and my in-laws left. I was offered juice
and they put one of those IV receiving things in my hand (but at this time didn't hook me up to anything), took a blood sample for some test and took some of my medical records. My doctor came and found I was still at 3 cm. I had had a doctor's appointment the day before and had already been that then. She left telling me she'd have the in house doctor check my progress later, but unless things went not as expected she'd be back at 8pm that night and not leave until the baby came. This was at one pm. Then basically we went into the process of laboring. My doctor had ordered me put on intravenous antibiotics (due to my infection history) and this was mentioned to me because they gave me the small "check to make sure you don't have an allergic reaction" shot, but they didn't come back to give me the antibiotics for a while. She also said they'd give me an enema, but they didn't do that right away either. I'm not really blaming them as I am a first time mom and traditionally first time moms have long labors so they probably thought they had more hours. Especially since when my doctor visited I was still calm and laughing, as it hadn't become intense yet, and since I had mentioned the family history of long labors several times, as that was what I had fully expected. When my doctor had left I was still not really in any pain and was smiling and she laughed and commented on how calm I was and how she didn't need to worry about me...

Mainly I was left alone with Ryan. I called my mom and she asked me if I knew any breathing exercises. I said no, as we'd not had a birthing class, so she taught me one. We stayed on the phone a while and my contractions increased in pain and intensity. They were less than two minutes apart when we got off. I kept having to get up to use the restroom, my body clearing itself out, and each time I did I gushed, which made the contractions stronger. Ryan tried to walk me through the exercises. The contractions were getting stronger and stronger. I was able to maintain the breathing exercises for probably about an hour after Mom taught them to me, but then it was too painful to concentrate enough. At that point Ryan told me to call on the name of Jesus, which helped. I basically was saying, "Jesus, Jesus, Jesus, Jesus have mercy, Jesus!" the rest of this labor story.

They came in to give me the enema at this point but my contractions were less than 90 seconds apart and painful and I just couldn't imagine doing both at the same time so I called my doctor and told her I'd visited the bathroom three times since she left so I was just going to skip the enema and she conceded.

I was writhing in pain at this point during the contractions and the 90 seconds changed to be less than 60, and really the pain was never going away. That is it was excruciating during the contractions, but the break in between my whole body was still hurting, all my muscles everywhere were tensing and I was starting to shake. At this point I asked for pain relief, but didn't expect to be allowed to get it as I knew they didn't generally give you an epidural until you've made some progress in dilation. They came and checked me and said I had only progressed by maybe 10% (so like 3.3 cm dilated) and so they wanted to wait another hour before doing an epidural. I asked if there was some form of pain relief I could have in the meantime and they said they could give me some drug, whose name eludes me, in a IV drip which would take a small bit of the edge off. I said fine, fine. But then they looked at my chart and realized no on had done the antibiotics so they said they had to do that first. I put on my MP3 player and prayed and held Ryan's hand and just tried to focus on anything but the pain.

Finally they put the IV pain med in. I can't say it didn't work, but it didn't work long. The first four contractions after they put it in were less, and finally I got a break between them, that is, I could actually think for the 20 seconds between them. But this only lasted the first 4 contractions, so about 8 minutes probably before the fifth contraction was just as intense as the one before they put the drip in. I realize that the meds were still working, of course, it was just the contractions were getting that much worse that fast. Still, I was thankful to have it going, better than nothing.

They came in after the hour saying they had to move me upstairs to the delivery room to get my epidural. I told them I couldn't move, hoping they'd wheel the hospital bed as a gurney. Literally every muscle in my body but especially my legs were tensed up so moving at all, even rolling over onto my back (I was on my side sort of fetal position) was excruciatingly painful. And I could not stop shaking. But they insisted and I knew that I had to move up to delivery eventually anyway and hopefully going in there now I'd get an epidural and going through the pain of moving would lead to the pain's end. But still it took a very long time to move. I was pleasantly surprised though that sitting down in the wheelchair to be wheeled upstairs the lumbar support in the wheelchair seemed to help ease my labor enough in the few minutes it took to get there I only had one contraction.

The anesthesiologist was way too cheerful. I think he must have been used to getting women whose pain hadn't gotten quite as bad as mine yet as he was telling me to smile and trying to get me to talk. Honestly, I'd been unable to really answer anyone's questions for over an hour. He kept telling me to tell him when I got a contraction and he'd stop, but he wasn't really listening. I'd tell him one was going on, then it'd go on for like two minutes or so and then I'd say "it's gone" and he'd say "you're getting a pain?" NO, it was just leaving. He seemed to think contractions lasted five seconds. In reality they were more like two minutes of  a contraction, then ten seconds of no contractions, then another two minutes. I was praying and grabbing onto the nurse who was bracing me to hold me still. I was praying fervently not to move, as I was having trouble having control over my body due to the pain. I did manage to hold still.

The epidural didn't work.

Well it had a tiny effect, I stopped shaking like a leaf. The anesthesiologist showed me the enormous
needle... and basically told me in my case it wasn't long enough! Maybe it's because I'm overweight, or maybe just because I'm large in general (the average woman in India is 5 foot, I'm 5 foot 7, but with short arms and legs. So proportionally my torso is the torso of probably of a 5 foot 10 woman.) But he didn't have a bigger needle and well, it didn't really work. He said it might, it could take a while, so I told myself that maybe it would kick in and they laid me down. I was screaming for Jesus and writhing in pain pretty immediately. The anesthesiologist was irritatingly cheerful but I could tell he felt bad and was concerned. A doctor came to check me and found out I'd dilated to five centimeters. I was despondent: only halfway there? Ryan was annoyingly cheerful telling me that meant it was almost over. I snapped at him "NO IT DOESN'T!" Turns out he was right though...

They told me they'd called my doctor to come in to the hospital. The in house doctor was asking me to do something, I forget what now, but I was telling her I was having trouble moving. Even having the ability to tell her that was expending valuable energy, it was hard to talk at all. She was impatient and barking at me to move and I ended up yelling at her, "I'M TRYING!" She looked really taken aback and I felt bad as I didn't want to be unkind to the staff, I knew they weren't to blame for my pain, but seriously it took a TON of effort to move even a few inches.

They came over and tried to put something in my IV. I asked what it was and they were all smiles saying it was something to speed things up. I asked what and they said it was pitocin. I told them no.

I'd read a lot about pitocin before and honestly there's not a lot of moms who had had pitocin labors who had a lot of good to say. Now it has its place, like for a mom who has been in labor so long she's got nothing left in her and of course it's used in inductions. But it causes contractions to be both longer and stronger and I felt like I'd break in half if my contractions got any longer or stronger! They were confused and tried to talk me into it but I told them not before my doctor arrived... or my epidural kicked in. If my epidural was working then I wouldn't be able to feel the contractions enough that it'd make a difference, after all. But as it was I was feeling everything and I just couldn't conceive of experiencing a pitocin induced contraction on top of it. I said firmly, "I refuse" and they backed away.

They brought in nitrous oxide for me to try. It helped. The anesthesiologist kept repeating over and over for me to stop breathing into the mask when a contraction stopped. Again, he seemed to have a very unrealistic idea of how long they went on for, as I was stopping when they were stopping. But I only had about four breaths of regular air in between contractions at this point, so I was staying on it most of the time.

Probably pretty simultaneously with the gas arriving my doctor did. I had taken two or three contractions with the nitrous oxide when suddenly there was the overwhelming urge to push. I was incapable of communicating and I was pushing without anyone knowing. Then during the two seconds or so between contractions I was catching my breath, so I still couldn't communicate. During the next contraction I made the effort to remove my mask long enough to say "BEARING DOWN PRESSURE" as they'd told me to tell me if I'd felt any "bearing down pressure."

Everyone paused for a second, then my doctor said "that must mean the baby is engaged" and spread
my legs to examine me and said, "She's fully dilated!"

Oh, what a relief to hear that!

They maneuvered my legs into stirrups (I was incapable of helping them, but I purposefully tried to relax my legs so it was easy for them) and tilted the bed.  Some random hospital staff had appeared in the room and they'd ushered Ryan away from my left side, where he'd been holding my hand. This panicked me. They were trying to move him to my right side, which was where the nitrous oxide was hooked up and I was holding the gas mask with that one and didn't want to let it go. I screamed no, that I had to have Ryan! They told me I would, but I said no, he had to hold THIS hand and I held it up. In a rational state now, it'd probably have been no big deal for him to be on my right, but throughout the labor he'd been holding my left hand and losing that reassurance now seemed impossible. The doctor said fine and Ryan squeezed in beside two staff members who were also stationed at my left.

However, I only got one more contraction in with the nitrous oxide before my doctor told me to stop using it as she wanted me to hold on to the handles on the bed to aid in pushing. I did, and I pushed. Somewhere around this point Ryan was forced to let go of my hand, but it was mid push and I was beyond caring as I knew he was still there somewhere. This random guy from my left leaned over and pushed on my belly from the outside! I cried out, a real scream, in surprise and pain. I think I may have said "What are you doing??" though I may have just thought it. They told me the baby was laying over to my side (the left) and he had to push the baby more towards the middle to come out. Looking back, I think maybe they did this to help the shoulder rotate, but they didn't say that. It was excruciating, but honestly at this point a little more pain didn't make any difference and I put it out of my mind and concentrated on pushing.

I remembered my mom telling me that pushing was hard work so I was telling myself to put more effort into it. Honestly though, while I'd heard pushing was the worst part of labor, I did not find it that way. Pushing had a satisfaction. Sure, it hurt. But I had been in excruciating pain for hours, pain that didn't seem to be doing anything (though obviously it had been). But it had been passive pain, my body doing something but not me. Pushing allowed me to actively participate in the labor and so it was a relief, as I knew if I applied myself I could bring myself to the completion of this agony and the arrival of my child. I also figured the faster I pushed the better it'd be for the baby, as I knew labor is intense for the infant as well, so I was able to do something as a mother.

Before I knew it, my doctor was saying "One final push!" I felt my baby slide out and within seconds there was a cry. I felt relief and joy and sank back with a big smile. The doctor asked Ryan if he wanted to cut the cord and he declined, overwhelmed. I opened my eyes and I only got to see them wrapping a blanket around our little one and rushing off to the other side of the room.

"Is it a boy or a girl?" I asked. My doctor looked at me surprised. In India there's a gender bias, so I guess maybe she thought I was betraying one by being so concerned, but I just wanted to know if I had a son or daughter!

It was probably another ten to twenty seconds before I got my answer, during which time I'd asked again. "It's a girl!" someone declared and I sank back again with a smile, saying her name to myself. My darling daughter!

Someone came over and plopped her on my chest, all swaddled up. I looked into her beautiful face and said her name. The guy holding her said, "Okay?" and would have taken her away after just literally a second or two, but I put my hand up and said no, wait.

"I love you, I love you, I love you," I murmured to her and stroked her cheek. I had been told here that they would take her to the nursery for observation immediately. I hated that, but it seemed to be procedure at all the places here in India. I would have preferred to get to hold her for five to twenty minutes if nothing was wrong (and no one had said anything was and I'd heard her crying so I knew she was breathing) and maybe even get to do skin to skin, but while American hospitals allow this, apparently Indian ones don't seem to work that way. So after thirty to forty-five seconds I let them take her.

I sunk back and for the next twenty minutes I just rested while my doctor continued to do things to me. I'd prepared to deliver the placenta, but apparently I didn't really have to, it just came out. I'd had an episiotomy, apparently so the doctor was caring for that. I was oblivious to what else was going on and just breathing.

After my doctor cleaned me up she told me a little about my care. I asked about my daughter, but she said a pediatrician would have to talk to me. She was cheerful and I was grateful and she left.

Ryan told me about how it was for him when she was born; he burst into tears of joy. He has been an utterly devoted dad.

From when I was dilated 5 cm to when I was fully dilated was less than hour, probably around 45 minutes. I only pushed for less than ten minutes, probably more than five. Let's say 8 minutes. It was lightning fast!

My water broke at around 9:30-10 in the morning (I didn't look at the clock) and my girl arrived at 5:47 pm, so all in all it was about 8 hours. I was so shocked when I found that out!

I was really glad I had refused the pitocin and I pointed this out to my doctor later, who was confused as since I'd been fully dilated less than ten minutes after she'd arrived, she hadn't been aware I hadn't had it! But I told her that considering how fast it all went when she did come, if I had let them give it to me there's no way she would have been there for the birth.

After the first twenty minutes of catching my breath, I just wanted my baby. But she wasn't coming yet. I was told that they could keep her for observation for 2-4 hours. I started asking my nurse questions. How much did she weigh? She was okay, right? Where was my husband?

She left and brought back a sheet of paper and told me she weighed 2.63 kilograms and was 32 cms long. That meant nothing to me. My brain was still foggy from the nitrous oxide and pain, so I couldn't do the math. I asked what that was in pounds. She didn't know. I asked what the average baby was and she didn't know. I basically asked her to guess and she said something about 2.5 kilograms and so I said slightly bigger than average and she agreed. Actually what she was telling me was that under 2.5 kilograms is considered low birth weight, so basically my baby was normal, but small.

Ryan arrived and told me she was doing well, he'd gone to the nursery. He didn't really have anymore info for me though. I asked him to pull out his phone and convert the weight for me, but he was like "I don't have a converter on my phone and I don't know the formula for the calculator" I told him to get online, but he said, "Later, baby" and I think his phone rang then. Apparently his mom was calling everyone we know at this point and some of them were calling Ryan to congratulate him. He gushed about our daughter but told me he wasn't sure we should have anymore kids because he didn't think he could see me in that kind of pain again. I laughed. I told him I'd be happy to wait a few more years for the next time.

I asked him to call my mom and I got to tell her that she had another granddaughter. I could hear the
tears of joy in her voice. My father wasn't there, so I didn't get to tell him. I told her to tell relatives, but not to put on facebook yet since we wanted to do that. She asked about the weight immediately, of course, and I told her what I knew and she was just as clueless. Yes, we're American and we think in pounds and inches. I told her to convert it. Then I got off the phone.

Ryan disappeared again around this point and I was left alone for a long time.

Finally, they brought her to me. I'd guess it was about an hour and a half to an hour and forty-five minutes after she was born. Ryan swears it wasn't that long and maybe he's right as it obviously felt like a really long time to me, so maybe my brain exaggerated it. They gave her to me for breastfeeding and with a nurses help she latched on immediately! She kept going for a long time, probably forty-five minutes. When she finished they moved me into a wheelchair and gave her to me to hold and wheeled us back to our room.

Oh, she is so beautiful! We are so happy. She has gotten a perfect bill of health. She had no jaundice, no nothing. She never needed any formula supplementation.

Later this week I'll be giving a "one year" post that will not only be like a month post talking about recent milestones, but also looking back on the first year of my baby girl's life.

1 comment:

  1. Hi Pamela,
    I am your neighbor on Proverbs31 Wife. You'll be so glad you captured all of this years from now when you can't remember it!
    Good job, mom! Congrats on making it to one year :)


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