(no subject)
A little bit of background:
Danica's due date was June 27, 2010. By the time July 11 rolled around, I was 42 weeks pregnant. I had tried acupuncture, acupressure, aromatherapy, psychotherapy, chiropractic, spicy food, nipple stimulation, exercise, herbal remedies, had my cervix swept twice and stretched once, and was left with nothing more than 5cm dilation but no labor, and a midwife who was freaking out (as most care providers would do) that I was still pregnant. We had been weighing the pros and cons over the past two weeks about continuing to let nature take its course or choosing to get induced. Initially, we were very anti-induction. We wanted to do everything naturally. I consulted with several experts in the field about the risks of going past 42 weeks vs the risks of induction.
Eventually, I came to realize and accept three basic things.
1. Sometimes there comes a time when proving a point ("my body knows what to do") is no longer the most important goal.
2. My body, in particular, DOESN'T always know what to do, and I've got the health history to prove it.
3. If everyone's bodies always knew what to do, there would be no need for doctors or any healthcare providers at all.
So on July 10, after several frustrating weeks of trying and failing to help my body go into labor "naturally", I came to accept that pursuing more aggressive induction measures at the 42 week mark would be the appropriate thing to do. Sheila and I researched the different options that were available to us (namely Foley catheters, breaking my water, Pitocin, or Cervidil). We decided that since I was already 5cm dilated (2cm of which was stretched manually by the midwife two days prior) and nothing was going on, a Foley catheter could likely be a waste of time. The same went for Cervidil because my cervix was already pretty ripe & favorable (anterior and 50% effaced). Preferring to stay drug-free as much as possible, we decided to have my water broken first (assuming Danica was in a good position) to see if that would kick start things.
We notified our doula (Linda) of our plans so she could be on stand-by with her cell phone, but I was pretty sure I wouldn't want anyone other than Sheila there until things started getting tough, and we didn't know how long that would take.
Sunday, July 11, 2010:
Sheila & I went out for breakfast early so we could enjoy one last child-free meal together. We had already made arrangements with the midwife (Megan) to show up at the hospital at 9am. Once we got there, there was paperwork, blood work, busy work, etc. I was hooked up to a fetal monitor for about half an hour to watch Danica's heart rate and my Braxton Hicks contractions, and everything looked good. Eventually Megan came in and we discussed the plan. Since my body was already about halfway there (minus the contractions) we went ahead and broke my water to see what that would accomplish. Megan made sure we knew that once my water was broken, I was committed to not leaving the hospital without a baby in my arms since carrying on with broken waters for days on end increases the chances of infection. We agreed to give my body 12 hours after breaking the water before trying more aggressive techniques.
Once my water was broken around 11:30am and we got most of the gushing under control (I was very thankful for the endless supply of maxi pads and disposable underwear), we started walking around in the halls to try to encourage things along. Around and around we went, then we would come back into the room and try squats, lunges, lying in different positions, etc. The nurses came in about once an hour to monitor Danica's and my vitals. I drank tons and tons of water, as my amniotic fluid was continuing to replenish itself and come right out the other end. Sheila kept joking about it being just like a Betsy Wetsy doll. One of the nurses wanted me to try nipple stimulation to strengthen the contractions (which I had already been trying for a couple weeks with no results) so she brought in an electric breast pump. Several rounds didn't do anything for my contractions, but everyone was amazed that I got almost 2oz of colostrum out (nothing new for me, but the nurse insisted on saving the "liquid gold" that I had been washing out of my shirts for months already).
I didn't want to tire myself out too much before active labor even started, so we also spent some time playing cards, messing around online, and watching part of a movie. I was encouraged to take a nap since I hadn't slept the night before, so I dozed for a couple hours during the afternoon.
I was still pretty comfortable and had a good appetite, so we had lunch and later dinner together. My mom stopped by to visit that evening and brought homemade cookies "to induce labor". We listened to more of Danica's heartbeat on the monitor and eventually decided it sounded like a cat trying to barf. All the nurses would comment on how happy she sounded in there. It was like she was trying to tell us, "Don't worry, I won't fall out!"
Around 11:30pm, we regrouped with Megan since it had become obvious that breaking my water wasn't going to be enough. We decided to start Pitocin to bring on some contractions.
Monday, July 12, 2010:
My Pitocin IV was started sometime near midnight. I remember feeling kind of frustrated because no one could tell me if it would start working within minutes or hours. We started on a very low dose because the goal was to get contractions going and then hopefully be able to turn off the Pitocin and my body would take it from there. Since the Pitocin was started so low, it was quite a while before I was able to feel any change in my contractions. The nurse came in fairly regularly to hook me up to the monitor and watch Danica's heart rate through the contractions and monitor their frequency and duration. After a few hours of this and nothing exciting happening, Sheila fell asleep on the couch. I was awake all night and spent most of the time in bed, watching a movie and listening to music on the laptop (Depeche Mode, The Cure, and Pink Floyd). The Pitocin was increased every hour and I gradually started to feel my body doing more powerful things. At one point, they had to turn it down because the contractions were coming too close together, although it still didn't feel particularly painful.
Around 4am, my contractions started to become painful rather than just uncomfortable. I started walking and swaying through them, and I woke Sheila up and told her I was finally in labor. I asked her to call Linda at 5am, and Linda arrived at 6am. Shortly after that, someone suggested that I take a bath, and I remember being concerned that it would slow down the labor, but whoever suggested it said that was unlikely to happen, so I got in the tub. After a while, Megan was getting ready to leave because her shift ended at 8am, and she wanted to check my cervix before she left so the new midwife on call would know where things were at. I asked if Megan could check me in the bathtub, and she did. She got her sleeve wet all the way up to her shoulder and I was amused by that, though I apologized for making her get her sleeve wet. I was still at 5cm dilated, but was 100% effaced. I was disappointed that there had been no change in dilation, but Megan explained that often with first-time moms, the cervix needs to finish effacing before it can dilate further, so I had still made good progress.
The new midwife (Theresa) came in to introduce herself a while later and to try to talk me into IV antibiotics since my water had been broken almost 24 hours. I was kind of upset at myself for not anticipating this pressure, but seriously, who would still expect to be pregnant 24 hours after having their water broken at 42 weeks? I did eventually consent to the antibiotics, but not before butting heads with Theresa.
Several other things happened that morning/afternoon, and I'm not sure what order they happened in as I lost track of time at that point, so I will put them in a list.
*We ordered breakfast but I was well into labor and not very hungry. I wound up eating maybe 1/2 c of dry Rice Krispies and a couple sips of milk. I was still drinking tons of water.
*I labored in many different positions. Nothing was more painful than lying in bed during a contraction. One of my favorite positions was sitting on the birth ball with Sheila behind me and leaning back into her during contractions, or sliding forward down the ball and squatting during contractions while holding Sheila's hands behind me for support.
*At one point I did spend some time in bed so they could get a fetal monitoring strip and it was very painful. I held Sheila's hands and squeezed them as hard as I could during each contraction. After 20 minutes, I ripped the probes off my skin and got up because the nurse hadn't come back in yet to unhook me.
*I became fixated on the IV pole that I was attached to. I leaned on it and swayed with it during contractions and wound up making a really cheesy joke about redefining the term "pole dancing".
*The Pitocin had to be turned back up several times. I was worried that my uterus would near hyperstimulation again and it would have to be turned back down, and that we would go around and around in that cycle forever. Even though my contractions were a lot stronger, they still weren't regular enough, so up went the Pitocin again.
*Theresa wanted to check my cervix and I asked her if she could do it fast between contractions and she said she would try. I sat down on the edge of the bed as she was putting on her gloves and immediately a contraction hit, I shot up on my feet, and said, "you're too slow!" and everyone laughed.
*As soon as Theresa checked my cervix (I was 7-8cm dilated) she tried to get another fetal monitoring strip done while I was still in bed. One of the nurses started trying to find Danica's heartbeat as another contraction started. They wanted me to stay in bed, but I pushed her off me and said, "this is NOT happening" and got back up.
As I neared transition, I got on the birth ball again, this time with Sheila in front of me on the floor and Linda behind me in a chair. Between contractions, I would sit back and Linda would rub my shoulders. During contractions, I would collapse into Sheila's lap, completely doubled over, while she leaned back against the wall. I started to get nauseous after a while, and spent a few contractions feeling like I was going to throw up but knowing I wasn't quite there yet. The pain was quite intense. Someone put the trash can by my head. A bath was suggested, and it sounded good so I went into the bathroom. I sat on the toilet and eventually threw up into the trash can. I threw up several times through an entire contraction, and it was at that point that my body began pushing all on its own. I got into the tub and labored for a while longer. I began pushing along with my body at each contraction. Sheila was there holding my hand, but I didn't tell her I was pushing because I knew that as soon as the nurses found out I was pushing, they would make me get out of the tub. She later told me that she suspected I was pushing, but was afraid to ask. As soon as I said, "I'm pushing...", Sheila told Linda, Linda told the nurses, and half a dozen people flooded into my hospital room, demanding that I get out of the tub.
Also at just about that time, I had several contractions in a row with no break in between. It was during this time that I had to stand up and climb out of the tub and walk across the room, which was nearly impossible. When I mentioned that the contractions were coming without a break, the Pitocin was turned off. But several minutes later my contractions started slowing, and I said, "turn it back on!" I never thought I would WANT Pitocin so badly, but I had come so far and desperately didn't want things to stall out. I've never had such mixed feelings about something before. As much as I never wanted to have to be induced, I was grateful for the Pitocin for helping me deliver my baby.
Theresa tried to get me to get into bed to push and I told her that wasn't going to happen. I wound up on my knees on the floor, leaning forward over the birth ball and holding Linda's hands. I pushed like this for a while, then Theresa started getting concerned about my legs. I was really annoyed by this because my legs felt fine, but I was too distracted to argue. I moved onto the bed, which I think made her happy, but I was on my hands & knees with my feet dangling over the side of the bed. More pushing, then she told me my feet were turning purple. I told her I didn't care about my feet, but she wanted me to move again, so I swiveled around so that I was still on my hands & knees only facing the other way. Every time I pushed into a contraction, I would nearly squat. I moved around a lot. There were a lot of people in the room at that point... Sheila, Linda, Theresa, and it seemed like at least half a dozen nurses, though they were all behind me so I'm not sure of the exact number. Someone made a comment about how I was doing a good job of listening to my body and moving around instinctively to help my baby come out. I was very glad that I had chosen not to numb myself to the sensations of labor.
Pushing was a huge relief. It wasn't any less painful or intense than the rest of labor, but it was a change of pace and it meant that things were progressing and my baby was almost there, so it really gave me a second wind. Crowning was incredibly painful. Some women refer to the "ring of fire", but to me it just felt like crotch of fire. There was no ring. There was some perineal massage being done, but it didn't really help. I got to the point after a while when I realized that the only way to make the pain stop would be to push through it rather than trying to avoid it, so that's what I did. I gritted my teeth and growled like a rabid bear and pushed as hard as I could through the most searing pain of my life. I tore in two places. Danica's head came out, and then I felt something sharp (her shoulders) and realized I wasn't done.
During this process, I totally lost track of time. If I didn't know better, I'd think I pushed for maybe 30 or 40 minutes, but it was actually 90 minutes total. Danica was born at 2:14pm. Sheila caught her and she was brought immediately to my chest and was breastfeeding within just a few minutes. She cried very briefly, and then made some kitten-like noises. She was incredibly calm. Her Apgar scores were 8 and 9. She was weighed and measured after an hour of skin-to-skin... 8 lbs 10 oz & 21.75 inches long.
In conclusion, I'm very happy with how things went with the exception of the Pitocin. I wish my body had been able to go into labor on its own. But I feel like we made the best decisions given the circumstances, and I don't have any regrets.
One bizarre turn of events involves how I now feel about hospital birth vs. homebirth. Before I got pregnant, I had my heart set on having a homebirth. When I got pregnant and realized that we couldn't afford a homebirth, I was devastated. But then, not only did I go past 42 weeks gestation (which will risk you out of homebirth with many midwives), but I also wound up having a very positive experience with the supportive people in the hospital, and now I'm not sure that I would want to have a homebirth in the future even if it were an option. Coming home from the hospital was really very difficult for me because being at home all I saw was stuff that needed to be done everywhere I looked, and there was no time to do it. I didn't even have time to take care of myself. I was only eating once a day for the first couple weeks because I spent every spare moment away from Danica sleeping. I was totally unprepared for how much I would feel like I had been trampled by a train, over and over again. Even though I weathered the storm of labor with a tough facade, the effects that birth had on my body really hit me hard in the first couple weeks after Danica was born. I was having hot and cold flashes, waking up soaked in a cold sweat and shaking violently, blurry vision, intense cramping, fatigue like I've never felt before in my life, and emotional crashes left and right. I was so weak in the first couple days that I was afraid to hold Danica while I was standing up because I was stumbling and shuffling and doubled over all the time. If I hadn't been in the hospital with people taking care of me, I can only imagine that it would have been even more difficult. After we got home, no one came by the house to help us out. I would have stayed an extra day or two at the hospital if I could have.
Anyway, I'm feeling much better now at 4 weeks post-partum. My energy level is nearly back to normal, much of the pain from my tearing and sutures is gone, I've lost all the weight I gained during pregnancy, and breastfeeding is going well. Danica is up to 10 lbs 4 oz and 23 inches long. I'm also adjusting to the bizarre sleep schedule (or lack thereof) that Danica has me on. I have found that I'm unable to sleep for longer than 3 or 4 hours at a time. I wake up when she needs to eat, even if she's not home! I am very bonded to my little daughter, even in moments of intense frustration and exhaustion. Motherhood is one of the strongest forces I have ever experienced and I'm so glad I've made this journey.