Monday, June 14, 2010

My Trip Through Laborland (7.1.08)

When an intense contraction jerked me awake at 2:00 am, I gasped without thinking, “God is Great!” And this from a confirmed atheist. Not so much a prayer, but instead, the last and only thing I could say when brought all at once and unstoppably to the brink of one life and the mysterious opening of another.

There was no let up in the contractions – it was immediately clear the baby was coming.

I walked around the couch, swept up some pebbles from our rough basement floor (after all, she might crawl here someday) and drew a bath.

Time moved in irregular waves, not discrete units, just like the contractions. I could say when I was inside the vise grip of a contraction, but I was not as sure when they actually stopped or started so I couldn’t tell Randy, “wake up, honey, they’re two minutes apart.” It felt like they were only moments apart.

I found an information sheet from the “Birthing from Within” book that I had been too shy to give Randy before this and went to the bedroom where he was sleeping. When I turned on the closet light and he mumbled something, I walked over to the bed, silently held up the birthing coaches tip sheet and pointed to the item that said, “Don’t ask too many questions. Maintain a respectful silence.” Understandably, Randy did not understand.

“What’s wrong?! Are you in labor? Did your water break?”

Once I was in the warm tub with a cold compress on my head and a plastic wastebasket for nausea nearby, he sat next to me quietly and let me rub the chubby part of his thumb -- far more comforting than any worry stone I had searched shop after shop for. I think my seriousness shocked him into silence. My head lay to the side, my eyes were closed. When the pain came, I blew out loud breaths through my mouth, nothing I’d learned, just a natural reaction to help sink into the pain, relax into it.

We tried to time a contraction as Randy read the paper about what to do when. Even with all my planning, we had no clock with a second hand and I couldn’t tell when a contraction started or ended. We tried to wing it with Randy counting “one Mississippi, two . . . .” He left and got a digital alarm clock and we tried to calculate by when the minutes clicked over.

“It says here, ‘go to the hospital when they are less than ten minutes apart,’” he said and I tried to point out the range can go as low as three to five. I didn’t want to leave the comfort of this bath. I had to do some persuading. Panting, I said slowly, “Labor progresses fastest when you are most comfortable. I need to stay in the tub for a while. I promise you I won’t be giving birth at home,” but he felt better by calling Natasha the doula.

I was glad he went for the doula first, before the doctor. Natasha was tremendously reassuring and calm and Randy had seemed to approve once he met her at our home – before that point he’d been reluctant. “Once she gives me an order, she’s out” he had said, jerking his thumb to the door, when I first broached the idea of a labor helper. Later, he burst out, “I’m incredibly hurt. The most important day of my life and I have to share it with a stranger.” But this was before he met her and it turned out the delivery room was full of people anyway. And when the night finally arrived, there was no time nor desire for her to come to our house for labor.

It was getting hard for me to talk, hard to listen. I had a dry heaves and vomit episode that Randy sweetly cleaned up

When Randy next called Dr. S.. the ob-gyn, he said carefully, in the language of the coaches’ handout, “We think my wife is going into active labor.” When I got on the phone, leaning against the side of the tub, compress on my forehead, I whispered "I want to stay in the tub longer." Dr. S., always argumentative, replied, “I thought he said you wanted to go to the hospital.” A well-timed contraction and irritation with her lack of tact made me answer “hold on” and just give the phone back to Randy. She gave him the OK to stay at home a while. I was happy to find out one of her parters would deliver the baby.

So I lay back in a stupor, rubbing his comforting thumb until Randy said, “I’ve got to get the car ready.” “Okay,” I said, “but you need to come back in one minute.” I don’t think he realized I was serious about the one minute part. When he was gone, I could hear all sorts of horrible sounds, probably just him moving suitcases and pillows, but it sounded more like crashes and furniture moving.

Managing contractions was better when I pictured my cervix and chanted “Stretch” to open it up. I was expecting back pain, all over pain, moving pain, but it was isolated in a curving smile in my lower abdomen. It was enough.

Once when Randy came in to sit on the toilet and hold my hand, I pulled his face close and said, “I’m getting the epidural as soon as we get to the hospital.” During the pregnancy I had read Henci Goer’s book The Thinking Woman’s Guide to a Better Birth. It analyzes the current research on obstetric methods such as epidurals, C-sections and pitocin so I felt well informed about the risks of medical pain relief, and the benefits of a natural birth. But this wasn’t an intellectual decision to get pain relief. This was lizard instinct talking – take the pain away NOW.

There were two bad contractions that I couldn’t cope with – I had to squirm and say “Ow” which doesn’t help, so I thought getting out and lying on my side on the couch would help. Oh no. After the buoyancy of the tub, the weight of my belly on my side was awful. The couch felt like stone.

As Randy tells it, “I thought I had her out of the tub and on the way but I come back upstairs and she’s in the tub again.”

At what point did I want to go to the hospital? I had been afraid of chaos and people asking too many questions. In the tub I was in control – I could add more warm water with my toe – and there was minimum input. It was quiet while I worked. But when Randy finally brought up a shirt, underpants and stretchy pants and slippers, I relinquished control. Dried off and dressed with his help and walked out of the house with nothing. No checking for keys, alarm, lights, luggage, wallet, nothing. Just walked away from my old life.

The early October night was cool. There was little traffic at four a.m. Randy told me later it was only really hit him at Division Street on the way to the hospital. He said he realized then that it was really happening and started to grin.

I, on the other hand, was enjoying the ride a little less.

Every bump was agony and I had to gasp, “Stop the car. Stop the f***ing car!” one block from the house, then again, yards from the door of the hospital when contractions hit. But most of the trip was spent slipping into my stupor – head resting on my fist, plastic wastebasket gripped in my lap for vomit.

My fears of the hospital were left unrealized as we got to the entrance and the valet parking guy sprinted to our car door. This sweet man got me a wheelchair, took my hand to help me in and put a sweetly cologned and comforting hand on my shoulder as we went straight and quickly to the express elevator. Two nurses make no extraneous noise as they quickly checked us in on the silent triage floor. No hard questions. They asked for our birth-plan and already had our registration papers and my medical file.

In a back room I was given a robe and I tore off my clothes even with no curtains on the window and a lighted window across the street. No modesty left and no sense of humor are the markers for late stages of labor – someone said a piece of clothing flies off for every centimeter dilated. Peed in a cup, lied down and vomited again. “Oh,” murmured the nurses sympathetically. Got monitors strapped on and the nurse exams me and says, “Eight centimeters.” They start moving really fast at that. “Let’s get you upstairs.”

One of the swim class women had told a war story of deciding to get the epidural, then having to wait an hour for it. I didn’t get her story until now. Each minute was hard - an hour would have been agony. We did not wait that long. Dr. Diaz, the anesthesiologist, was not as hushed and gentle as the nurses (I forgave him a thousand times over when the medicine kicked in) so it was satisfying to let Randy answer many questions – unspoken teamwork.

I didn’t mind in the least Randy leaving during the epidural, a hospital policy and bone of contention during labor planning. Nothing mattered to me at this point. I was in my own world, eyes closed most of the time, dealing with contractions by thinking, “STREEEEEECH” with each one. It helped.

I sat up for the needle and I felt a cool spray on my back, then a pinch like a dentist shot. Dr. D. said, “you should feel better in about three minutes.”

“What if I get the headache?” I asked.

“You won’t get the headache.” His confidence that felt so loud and harsh when I was in quiet Labor-land was now bracing as the meds kicked in.

Sure enough, the epidural went to work right away and I felt like I was waking slowly from a pleasant sleep as the pain passed away.

Now I could notice that the room was large. We could see the morning light from the wide bank of north facing windows.

I struggled to sit up and I could. I could move my legs – what a relief of my fears. The gown had snaps at the shoulder so I could breastfeed. The IV went into my wrist, not the vulnerable back of my hand. Two straps around my belly were hooked to the monitor behind my left shoulder. But none of this mattered because the pain was gone. I cried a little with the sweet relief.

We spent a couple of blissful hours waiting for full dilation – Natasha the doula arrived to my delighted hug. Sally was our nurse and Angela was an intern.

I chortled and chattered, amazed that I felt so little, a little disappointed that the feeling of work was behind me. It was not behind me.

At nine a.m., a few hours after we arrived, tiny Dr. L. said "It’s time to push." I pushed for three hours.

Once after a contraction when I didn’t get the big cheer that I had come to expect and like and need, I opened my eyes and everyone - Randy, nurse, doula, intern - was looking at the monitor.

The doctor suggested Pitocin. I said a reluctant okay, and regretted it quickly. Pitocin took the contractions beyond my control – they were harder and faster than I was ready for. I am convinced the Pitocin would not have been necessary without the epidural. I would never use it again.

In retrospect, I was a little disappointed by the hospital staff’s attitude of contempt for pain. I obviously did not enjoy the pain, but I respected the necessity of my body’s work. I also understand that the medical community’s focus is to relieve suffering, not to wait and do nothing, which is often all a woman in labor needs.

When she came out, all ten pounds and one ounce of her, I was amazed at the child that had just arrived into the room. Not an infant, not a newborn, this was a CHILD with fat thigh, rounded haunch.

We named her Amelia Jones. As I was wheeled to our room, holding her in a bundle in my arms, I felt so proud.

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