When last we met our hero, she was cussing out medical equipment in the dark but had just met a new doctor and nurse for the evening shift. Dr. Riesen had been there for my howling and cussing and patiently waited for me to get to a lull so she could explain her proposal. In two minute segments separated by a minute of my howling, she explained what she and my new nurse Miranda wanted to try. The idea was to figure out why I was not dilating and getting on with having a baby. Dr. Riesen said there were three factors they wanted to try to eliminate - power (the strength of my contractions), passage (amount of time) and passenger (the size and position of the baby). We knew passage of time wasn't an issue since I'd been there since 4am working hard. The issue was to figure out if my contractions were strong enough or if the baby was possibly too big to descend. She wanted to insert an internal monitor to measure the contractions. If the contractions were not strong enough, I would need more Pitocin and most likely an epidural to cope with that. If the contractions were strong enough, that most likely meant our little "passenger" was either too big or some other factor was keeping him from dropping and helping me dilate. Since it was already 9:30pm we were getting close to the hour when I was expecting someone to wheel me off to surgery as my water had been broken for nearly 24 hours. And if I needed a cesarean, I was going to need an epidural.
I agreed to the monitor (it's not painful, just traps me in the bed, where I was already trapped anyways). As they left to prep for that, I started reviewing the game plan in my head. Either way I was going to need an epidural, it was just a matter of why. I was wiped out and frustrated, so I figured someone should go find me an anesthesiologist to get that ball rolling. I told Rich that I needed that epidural sooner rather than later but first I needed something to knock me out enough to sit still for the epidural in the first place. Shortly after that statement (remember all conversation has to happen in spurts between my howling episodes), I had another contraction that sent me rolling around on the bed and further shredding my vocal chords one howl at a time. As soon as that passed, I blurted out, "I'm done. I can't do this anymore."
My eyes were closed, but I could feel the whoosh of air as Rich left my side and went sprinting down the hall to find Miranda and get me some pain meds pronto. Poor guy, he'd watched his wife go through all this for a day and a half and probably wanted me to ask for meds for quite a while. He was just waiting for my signal.
They still did the internal monitor and checked to see how dilated I was - 4cm. I had been on Pitocin for five hours and had gone from 3cm to 4cm. If I hadn't been discouraged before, I sure was at that point. They hooked up the internal monitor and waited for my next contraction. As it rolled over me, the monitored spiked and stayed that way until it was over. Well, that answered that. My contractions were plenty powerful. The only explanation then was my passenger. The only thing that kept me from crying over the prospect of a cesarean was my exhaustion. If they'd told me the only way to get the baby out was my amputating my legs, I probably would have agreed to that too. This is why doulas rock! Someone has to stay rational.
When Rich sprinted down the hall to get me some relief, he ran into another doctor - Dr. Hutchison. She pulled Rich aside and said she'd been discussing my situation with Dr. Riesen and it sounded very similar to her own births. She too had held off on Pitocin for as long as possible and wasn't dilating, but the epidural itself helped relax her enough to dilate and push her baby out. They thought the same might happen to me if given a chance so they wanted to try that. I got enough Nubain to help me relax and sit still for an epidural. At 11:35pm, seven hours after they started Pitocin, I got my epidural. And lo, it was good.
Miranda came back about 30 minutes after the epidural kicked in to see if I had dilated anymore. I remember seeing her face down by my knees break out into this huge grin. She looked at me and said, "nine!" Nine! I had gone from 4cm to 9cm in under an hour! Woo! I was going to get a chance to push this baby out after all! Miranda said, "This is great news but I think we should just keep this to ourselves for now. If I go out there and tell them you're at 9cm, there will be half a dozen residents in here all clamoring to get you to push a baby out right now and I think you'd do better resting a little longer." She smiled slyly and quietly walked out. And I proceeded to nap for over an hour while the Pitocin and epidural helped push my baby down. It was just what I needed.
I was officially 10cm by 2:30 Thursday morning. They spent the next hour leisurely prepping the room while the Pitocin and epidural kept pushing him down the birth canal. By 3:30am we were ready for business.
During all of this labor, my parents, Rich's parents and Rich's brother Lee were in the hospital waiting room down the hall. All along we had said we only wanted Rich and Amara with me in the labor room because we wanted to keep the circus of people to a minimum. Occasionally, Lee or one of my parents would stop by for a few minutes but there was never much to tell them. As luck would have it, my mother dropped in just as they were converting my bed for pushing and getting out all the supplies. Mom asked, "what's going on?" and I told her, "we're gonna push a baby out!"
As I started to push, my mother was there right by my side. She said she didn't want to be in the way and everyone in the room said at once, "you're not in the way!", guiding her to a space right by my head. Rich held my right leg, Amara held my left and my mom petted my head occasionally. I pushed for about an hour but we weren't getting very far. Dr. Hutchison, the doctor with a labor story so similar to mine, was actually my delivering doctor. And Miranda was right there too, coating my lady parts in containers of mineral oil that Amara was opening. The oil actually looked like individual servings of syrup like McDonald's carries and I'm convinced we must have gone through a gallon of it. It was a well-oiled machine of an operation (no pun intended), but alas we still didn't have a baby. It was about 4:30am or so at this point.
Dr. Hutchison turned off my epidural and upped the Pitocin (according to Rich, I have no memory of this). Finally I could feel where I was supposed to be pushing! We might get somewhere now! I still wasn't allowed to have water but only ice chips. And it's hard to eat ice chips when contractions are coming every minute and you're hoping the next one is the one that will give you your baby. I just remember my mouth being so dry. This was the strongest feeling of my entire labor. Not the pressure, not the tearing, not the contractions. I just remember thinking I was going to choke on my own tongue because it kept sticking to the roof of my mouth. And THEN they'd be sorry they wouldn't let me have water!
During the entire pushing part, I lost complete track of time. It could have been 15 minutes for all I knew. I was having a hard time bracing on anything to push, so Miranda tied a loop in the end of a bed sheet and had me hold onto that while she wrapped the other end around her waist and acted as belay. For two hours, she in her little 5'4" frame braced against me as I pulled on that sheet with all my might trying to push our son out. At one point Dr. Hutchison offered me $20 to let go just so we could all watch Miranda go ass over tea kettle into the cabinets behind her.
I remember lamenting at some point that I was running out of steam. Amara said that I was strong and I could do this. And from right next to my ear, I heard my mother say, "she's the strongest person I know." Let me tell you, I could have stopped a bullet in my teeth I was so pumped after that. I remember thinking that no matter how this all worked out it was worth it just to have my mother next to me saying that.
Time was getting short, though. My water had been broken for almost 36 hours and I had been pushing for about three. Dr. Hutchison's arms were shaking from the effort she was putting into making sure my perineum didn't tear under the pressure. She later joked I gave her carpel tunnel. So at 6am, Dr. Hutchison told me I was only getting one more chance to push him out before she did an episiotomy. I remember her saying, "I'm serious now. Only one more time. You've got to do this on your own."
And after three hours of idle banter amongst everyone in the room passing the time while I tried to push our baby out, a hush fell over the crowd. It was like a sporting event where the score was tied and this last play was going to decide if we won the baby championship or had to go into obstetric overtime. Everyone was watching the fetal monitor and waiting for me to tell them when the next contraction was coming. As it started to build, Dr. Hutchison told me to wait until it was at full force to get the most out of it. As that last contraction rolled over me I pushed with every cell in my body. The doctor and nurse were saying "pushpushpushpush" but then my mother blurted out in breathless excitement, "oh he's moving! He's moving! He's moving!" and I have never heard her so excited about anything in my entire life. I could feel his head pushing out. I didn't feel pain; I felt satisfaction, progress and excitement. The next thing I knew he was born! They were all concerned about his shoulders getting stuck, but once his head passed he shot right out.
They put him on my chest and he was absolutely beautiful! Rich cut his umbilical cord and someone said he was born at 6:14am. Really I had no idea what time or even what day it was. None of it mattered, though, because he was finally here. We'd done it, my little boy and I.
to be continued ...