Monday, June 22, 2009 (39w 1d)
Ryan and I were watching our usual Monday night TV, commiserating over TLC?s ?Jon & Kate Plus 8? where the couple announced they had filed for divorce. We were mourning the loss of their marriage and the effect it would have on their 8 kids. It was around 9 PM, and Ryan, tired from a day at the lab trying to do projects that needed to be done without having any that would carry over day-to-day in case Sam decided to be born anytime, said ?Sam, I don?t want to go to work tomorrow. Why don?t you be born tonight so I don?t have to go to work tomorrow?? I laughed, but got up to go to the restroom, and while there, my water broke?an obvious gush. I hollered for Ryan and told him through the door that Sam was listening to his daddy and would be here soon because my water had broken.
I called my on-call midwife, Julia, to let her know and got her permission to labor at home as long as I could. She would check in with me in the morning if she didn?t hear from me before then. She advised me to get some rest to save my energy for the next day?s work to deliver the baby. I took a shower, and Ryan and I headed to bed after making sure some last-minute items were in the hospital bag and ready to go. We didn?t get much sleep as we were both very anxious and excited that our little guy would be arriving soon.
Around 11:20, I woke up to some cramping feelings, but they were only coming every 20 minutes and were bearable, so I kept trying to sleep between them.
Tuesday, June 23, 2009 (39w 2d)
Then around 12:30, I got up and moved from the bed to the couch, which sounded more comfortable for me. After about 30 minutes there, I decided to take a shower just to relax myself. While in the shower, my cramps started coming about every 3 minutes and were stronger than before, but still manageable with some of the coping techniques I had studied and learned ? moaning, breathing, swaying, rocking, etc. When I got out, Ryan woke up and we started timing the pains as coming every 2-4 minutes for about 90 minutes. The contractions were only lasting about 30-90 seconds and should have consistently been around a minute long, but since they were so close together for that time, we decided we wanted to go on into the hospital. I called the midwife to let her know we were going in.
We arrived to Meriter?s ER (the overnight entrance) around 3:30 and were escorted up to Labor & Delivery Triage. There a nurse checked my vitals and confirmed my water had broken (not that I had questioned it!) and I was admitted to my room by around 5 AM (there was a delay because another woman came in after me that they thought would be delivering imminently and needed more urgent attention ? turns out, she wasn?t any closer than I was but was just not handling her labor well). Ryan and I continued to work through contractions, and I relaxed in the room?s whirlpool tub for a while to ease the stress on my muscles. Around 11:30, the midwife for the day, Jodi, came to check my cervix for the first time. Because Sam had not dropped before, we all assumed I was starting labor with no effacement, no dilation, and that he was still up at -3 station (high). We were all excited to hear that I was at -1 station, 100% effaced, and already 4 centimeters dilated (the first 3-4 always are the hardest to progress through to get the ball rolling). I continued contracting and walking and changing positions to ease the manageable pains and assumed Sam would be arriving that evening around dinner time.
Around 2:00, another midwife, Judith, came in to check my progress just to make sure things were happening (the regular midwife for the day was busy with several other patients and called for back-up help!)?we were all greatly disappointed to hear I had made no further progress. She mentioned the ?P? word but I refused?it was far too early for me to give up laboring on my own. So I kept at it naturally. I sat in the whirlpool more, walked, rocked, swayed, got on all-4s and did all the positions to encourage Sam to move down, get into position, and encourage my cervix to relax and open. My contractions had been regularly coming 2-4 minutes apart all day and felt stronger to me than before, so I had every confidence that I was progressing and was mentally willing my cervix to open and allow this baby room to come out.
Around 5:30 PM, the day?s midwife (Jodi) came back hoping that we had progressed by then. She also mentioned the ?P? word but I begged to be allowed to keep laboring until around 7 PM (22 hours after labor started when my water broke) just to keep trying on my own. She was busy at 7 but came back at 7:30 and checked to find that my cervix still had not changed any further since 11:30 that morning. Though I had the right to refuse, time was getting closer to the ?dreaded get-the-baby-out-within-24-hours-of-water-breaking standard? and she suggested Pitocin and encouraged me that I could continue to labor naturally with the Pitocin and that many women continue to deliver without pain medication even when Pitocin is used and that she believed I could be one of them because of the strength I?d shown at relatively easily coping with pain all day to this point. She had every faith that just using a small dose would jumpstart my cervix to resume dilating on its own. After many tears in fear of the inflicted pain of drug-caused contractions, I agreed to let them start it. So around 8 PM, the nurse, Sandy (my favorite during labor who had been with me all that day and had encouraged me about how strong I was and how good I was doing) started the IV Pitocin drip. She also put a ?tube top? like cloth around my abdomen to hold two wireless sensors onto my stomach: one to track Sam?s heartbeat and make sure he was still doing okay since the water had broken and he was inside with less of his homey fluid to keep him comfortable; the other probe would tell the monitors when I was contracting and give an idea of how strong the contraction was based on the tightness and tension of my uterine muscle. Unfortunately, that?s also when Sandy?s shift ended, and another nurse, Rachel, came in for the night. She was nice, but she was drug-happy and kept upping my Pitocin even though Sandy had said it wouldn?t need to go very high. Needless to say, in my exhausted and pained state, I was angry at Rachel and whined to her a lot.
I was able to drowse for minutes at a time between contractions, but the pain was very unreal. Pain that is inflicted on your body that your body isn?t allowing to happen naturally to itself is unbearable. Around 10:30, I couldn?t stand the pain anymore and was having a hard time breathing through the contractions and could not force myself to relax through them any longer?I asked for an injection of Neumorphan, a narcotic dose to ?take the edge off? and make me groggy to get some rest. Well, the latter part was immediate?I couldn?t stay awake between contractions. But the former part was hardly affected once ?evil Rachel? kept upping the Pitocin drip strength causing me to jolt awake in pain I could not breathe through. The Neumorphan would last about 2-3 hours.
Wednesday, June 24, 2009 (39w 3d)
Around 2:30 AM, Jodi came in to check my cervix to find it was only at 6 centimeters. I?d still have a ways to go to dilate to 10 centimeters for this baby to be ready to come out, and the Pitocin would have to get stronger to do that for me. She offered another shot of Neumorphan, but I was not helped enough by it yet and knew the pain would only get worse as the Pitocin increased ever stronger. It had been over 29 hours of laboring at this point, and if I still had 4 centimeters to dilate before needing energy to push the baby out, I knew I needed rest. Although I feared and dreaded the Epidural option, I knew it was the right decision and that I had done everything I could do on my own strength up to that point. I asked for the anesthesiologist to come insert an Epidural catheter before allowing them to increase my Pitocin any further. Within 30 minutes, he was there and answered all my questions and assured me that my fears were very valid but low-risk issues. The pain was so bad even while he was talking to me that I lost all my fear and just wanted him to get busy putting it in. The insertion was nothing to be scared of at all, and I even blocked out my memory of seeing how large the needle was when the anesthesiologist showed it in our birthing class weeks before, so I wasn?t so worried. Somehow I even sat still, as needed, during a bad contraction for him to insert the catheter. Within just moments, the dose started working and my legs got heavy and numb. Rachel, Jodi, and Ryan helped me lay back in bed on my left side (I couldn?t lay on my back in order to avoid the pressure of my uterus on blood vessels and lack of sensation in them to cause my blood pressure to drop), where I?d be now until a few hours after the birth since I couldn?t move on numbed legs, and Rachel inserted the Foley catheter since I?d no longer be able to get up to use the restroom (as I had been doing all day to encourage Sam to drop if my bladder wasn?t full and blocking his way). Then I immediately went to sleep to rest up and get some energy for pushing time to come later. Ryan also got some rest on the pull-out couch-bed in the room for him. The poor thing was exhausted after standing by my side for that long with no rest!
I only woke up when Rachel came in to have me roll over to my other side, allowing gravity to pull the drugs evenly throughout my lower half. I woke up around 6 AM and felt some change in pressure. Jodi inserted an IUCD catheter to check my contraction strength from inside rather than the external probe that had been monitoring them to this point. This would allow them to make sure the Pitocin was doing enough work since my numbed body would no longer allow them to read the signs of the strength of the contractions. Jodi checked my cervix and was pleased to announce I was dilated to an 8-almost-9! We were well on our way! Within another hour, I was to 10! Now we just had to wait for the ?urge to push.? Jodi sat by my bedside and talked to me about her kids and my family and the baby?s name and about our lives until I mentioned that I felt some more pressure down below. Not exactly an urge to push, but a definite pressure that felt like Sam was moving closer to the exit. Within an hour, I said that though I didn?t feel the urge to push just yet, I felt like I was working hard to keep him in and that if I started pushing, I felt like it would help. The nurses and midwives changed shifts, and my new nurse Linda came in to help me start practice pushing at 8 AM while the midwife Julia checked on some other patients knowing that I had a little while to go but would need her full attention soon.
Linda and Julia were both very encouraging of my pushing and said that I was doing everything right and that they could feel and see Sam moving closer and closer. They showed me a mirror so that I could watch his head getting closer and closer to coming out. That was all of an image I needed to keep going! I never really felt the ?ring of fire? as he crowned but felt the pressure of his body being in my lower pelvis (which was more uncomfortable since had never previously dropped to allow that space to spread with the Relaxin hormone later in the pregnancy). At 11:00 AM on the dot, Sam?s beautiful head and perfect little boy body came out, and he was placed on my chest.
He opened his eyes immediately and spent some quality time just looking at my face and looking at Ryan who was right next to me. He nursed a bit and wrapped his fingers around my finger. I will never forget those moments as long as I live. After some skin-to-skin time on my chest, he was weighed, measured, and cleaned up. He was perfectly healthy, scoring 9 and 9 on the 2 APGAR scores they judge based on his coloring, reflexes, and responsiveness, and he weighed 7 lbs, 15 oz, and was 20 ? inches long.
After 38 hours of labor and the whole process going exactly the route I had hoped to avoid when I wanted to labor and deliver naturally and pain-med free, I was so happy that Sam was healthy and here and that we made it, that I couldn?t be disappointed in myself. I had done everything I could do and my body just needed the boost of things I couldn?t withstand that long without help to get the baby out.