Wanted natural, ended up with pit and epi

At 37w3d (and the day after my final baby shower), I woke up at 5 am with my underwear soaked.  I thought for sure I had peed on myself.  I went to the bathroom, and a big gush came out on the toilet.  A small leak continued, and I started thinking that this might not be urine.  As gross as this sounds, I pulled off my underwear and sniffed it.  When it didn't smell like urine, I started to panic.  DH and I had been procrastinating big time.  On Saturday, we'd made a long list of stuff we planned to do on Sunday, including installing the car seat, packing a hospital bag, wash all of LO's clothes, and finish off our registry so we could finally organize the nursery. 

I woke DH up and told him I thought my water broke.  We started frantically packing for the hospital.  I ate a protein filled breakfast because I knew I wouldn't be eating for awhile, and we took off for the hospital associated birthing center where we wanted to deliver. 

I got checked in and they did a quick test to check and see if my water did indeed break, which came back positive.  They also hooked up the external fetal monitor and contraction monitor, which they said could remove after 20 minutes.  During my initial vital sign check, my blood pressure was about 160/100.  I thought it was due to nerves, so they rechecked it every five minutes a few more times.  I never got below 150/90.  During my last few appointments, my blood pressure had been in the 130s/80s, but never this high.  My doctor had been concerned, especially since I had gained about 20 pounds in 3 weeks due to swelling.  Her plan was to continue to monitor it unless it got over 140/90. 

They called the on call doctor for my practice, and she said she wanted to do some lab work.  In the mean time, she didn't want me getting out of bed except to use the bathroom, which was the first blow to my wishes for a natural birth.  By this point, it had been a couple hours since my water broke, and I'd only had a couple of noticeable contractions.  Even those were very mild.  I really wanted to be up walking around to get my contractions going.  A while later, my lab work came back, and a few things were slightly elevated.  At that point, the doctor decided to transfer me to the hospital across the street with instructions to remain in bed and be on the monitors indefinitely.

After I got across the street, a resident came by and did an exam.  I was only 2-3 cm, 70% effaced, and -2 station.  She looked at my contraction monitor and said that she thought Pitocin would be necessary to start generating some regular contractions.  I really really wanted to avoid Pitocin.  I had great confidence in myself to make it through a natural labor without pain meds, but I had very little confidence to do it with the Pitocin.  The Pitocin was hooked up about 1, and they turned it up every 15 minutes.  My contractions started to get more regular throughout the afternoon, but they weren't any more intense than a bad period. 

Around 4:30, the resident did another exam.  I was now 4 cm/80% effaced/-1 station, but she felt another bag of water.  She said that it would be a good idea to break it, which she did.  My contractions picked up significantly after that.  By 5:15, they were getting very intense.  On one trip back from the bathroom, I couldn't bring myself to climb back in bed.  I spent a good 15 minutes leaning on the bed swaying back and forth.  For some reason, I started repeating "Move down, baby" over and over.  I also started letting out low moans that didn't sound like me at all.  I wanted to stay out of bed because even though it was incredibly painful, it was better than being in bed, but I finally had to get back in.

At 5:45, I wasn't sure I could go any longer without an epidural.  I had been trying my best, but I was stuck on my back in bed with my contractions were right on top of each other.  I couldn't even catch my breath.  I told DH that I was thinking about getting an epidural.  I was hoping that my intense contractions were moving things along quickly, so I said that my goal was to make it 1 hour, and if I still wanted an epidural, I would get one.

A little after 6:00, 6:45 was seeming a long way away.  DH asked our nurse if I could get checked again.  I told myself that if I was getting close, I would try to make it, but if I hadn't progressed very much, I would get an epidural.  It was about 6:15 when the resident came by.  She said I was 5-6 cm, 80% effaced, +1 station.  I was hoping for 8-9 cm, so I requested an epidural.  Unfortunately for me, the patient in the room next door and requested hers only minutes before, so I was second in line. 

I really didn't know how I was going to make it.  My wonderful DH asked if they could turn down the Pitocin just until I got my epidural.  They gave him a look, but they did turn it down.  I don't remember exactly how the Pitocin rate is measured, but I do know that at one point we asked how high it could go.  They said the max rate was 40.  Before they turned it down, I was at 32.  They reduced the rate down to 20.  My contractions continued right on top of each other for another 15 minutes.  Then I finally started to have breaks in between each one.  They were still very intense, but it made a huge difference to be able to take a breather in between each one.

The anesthesiologist finally arrived about 6:55.  It was a little uncomfortable when he put the epidural in, but not too bad.  By 7:15, I was feeling much better.  I still had a lot of pressure/pain in my vaginal area, but the contraction pain was gone.  When I was still complaining about the pain (I said it felt like I was being ripped in two) at 7:30, my nurse offered to check me because it sounded like I was getting close.  She said I was still only 6 cm, but that the baby had dropped all the way to +3 station.  About 8, the pressure was unbelievable.  My nurse checked me again, and said I was complete.  The resident was called in, and she disagreed.  She said I was almost there, but I still had a lip of cervix left.

Just about 5 minutes later, I started feeling like I needed to push.  The resident checked me again, and she said I was complete.  They called the on call doctor, and told me not to push.  I had no idea how difficult it would be to not push.  I could hardly stand it.  Around 8:25, I was told that the on call doctor said I could start pushing with only the resident and nurse because she would be there soon.

Pushing was incredibly hard work.  I've heard people say that it doesn't hurt.  Well, I disagree.  It hurt!  However, I will say that it hurt less to push than to not push.  The on call doctor arrived about 8:30  A few minutes later, she asked me to breathe through an oxygen mask in between contractions due to the baby's heart rate dropping.  The last few minutes before delivery were very difficult.  Even with the epidural, I was in a lot of pain.  I said several times that I didn't think I could do it.  DH, the doctors, and the nurses were all very encouraging.  I think I started to panic at the end when I felt his head out, and I pushed longer and harder than I ever had before even though I knew I was in between contractions.  DH was watching the whole thing, and he said it was this final push when I tore.

At 8:47, Robert James was born.  He weighed 7 lbs 3 oz and was 19 inches long.  When they assessed his gestational age as part of his workup, they estimated him to be only 36.5 weeks.  Since this was less than 37 weeks, this meant he had to do a carseat test before he was allowed to leave the hospital.  He passed it without any problems, and we went home about 36 hours after delivery.  I can't believe how much I'm already in love with my little Robbie.

My birth did not go at all according to what I wanted, but I was thankful that I ended up with a healthy baby.  I'm also thankful that my high blood pressure stayed stable in the 150s/90s, because they otherwise my situation could have quickly gone from bad to worse. 

While I do not regret my choice to get an epidural, I would like to try again to go med free next time.  After being through labor once, I really think I could do it if I could stay away from Pitocin and use different positions to cope with the contractions.  Hopefully I won't have the blood pressure issues next time.