Thursday, November 4, 2010

Lots of Labor, Very Little Delivery

So there I was, being wheeled down into the Labor and Delivery Department (L&D) while my husband frantically packed some of my things from our antepardum suite. When I got situated in the room, Casey came barreling in with a backpack filled with: several books to read (including a copy of The Bradley Method, which clearly wasn’t going to happen), a newspaper (for the crosswords…if you know my husband, you know he had a bit of an addiction), a container of sushi (he hadn’t finished lunch yet) and 20 or so Hershey’s Kisses and Mint Life Savers. 

I knew that we were in for a long process- I just didn’t know at the time exactly how long that would be. 

Now, beyond this point- this entry may be a little TMI; but for the sake of the story and full disclosure- I feel its important information.

Once in the room, I was given a quick ultrasound to confirm that our baby was, in fact, head down so we could continue with a vaginal delivery. When the attending doctor caught a glimpse of the baby, her first words were, “My Lord, look at the head on that one”. For the first time in 2 weeks, I felt proud, like I had finally done something right in all of this mess. Because of my diligence in taking prenatal vitamins and having a nutritious diet (save for a few cravings), our baby’s skull was perfectly shaped and perfectly thick! (I guess I also should give credit to the other half of this baby for his giant headed genes as well.)

Then it was time to get the show on the road…

Because very few women’s bodies are prepared to give birth at 29 weeks, I was hooked up to two IVS: one to induce labor with a Pitocin drip and one for the very dreaded, much hated Magnesium Sulfate. The Pitocin would signal to my body to start contracting. In a normal birth, most women are given this when they stall during active labor. I hadn’t even begun having Braxton-Hicks (or practice) contractions; so for me, the Pitocin was starting at ground zero. Every hour, I was told, they would increase the amount administered by a little until they reached the maximum allowable dose. The Magnesium Sulfate was for, yet again, to protect our baby’s head from brain bleeds/injuries and reduce the risk of cerebral palsy. 

Before any of this (the whole premature baby thing) happened, I wanted as minimal interference as possible during my delivery. As Bradley method students, we were taught to delay going to the hospital as long as possible, until you are in or near active labor. This is because once you’re at the hospital- you play by their rules. No eating, no drinking, little movement in some cases and constant intrusion from the medical staff. 

I knew we weren’t going to have this dream birth. I accepted that when we were admitted to the hospital, when we toured the NICU, when I was hooked to the Pitocin. But, that didn’t mean I couldn’t have a “natural”, medication-free birth (at least I thought so).  I desperately wanted something to go “our way” and having a natural delivery was my last ditch effort at regaining control over the situation. We were told that we had about an 85% chance of having this happen.

After the first 12 hours, I was “checked” to see how much progress we had made. Now, if you’ve never been in labor, then you can’t appreciate it when I say… I just knew we had to be almost there. How could the pain get any more intense?  

Apparently, a lot more. We were only 2 cm dilated. 2. As in 2 out of 10 before they’ll let you start pushing 2. I took it in stride though and kept telling myself, “It takes a lot longer when you’re not ready for labor.” I asked the resident doctor what my percent chance of a vaginal delivery was at this point, and she said about 60%. So there was still a chance.

At 24 hours, another check showed no progress. Still at 2 cm, my chances diminished to about 40%. My team of doctors thought that maybe breaking my water would speed things along. I knew that once my water was broken- I would be on a 24 time clock to produce this baby my way because the risk of infection would greatly increase after that point. Let me just say this- having your water manually broken is NOT comfortable. They use a wooden dowel to pierce your amniotic sac and it feels like fingernails digging into you. 

The doctors also wanted to put an “internal” monitor in place as well. This would give a more accurate picture of my contractions. The external monitor was of very little use because (when your baby is so tiny) there’s a lot of room for the baby to move around in and “get lost”. I knew when contractions were coming, because I could feel them- but it was very helpful to be able to visualize when they were over or coming close to an end.
After the water sac was broken, things intensified a lot. Apparently, I freaked out all the residents and high-risk doctors by my refusal of an epidural. At one point, my “head” resident, who turned out to be AMAZING, took the other doctors aside and told them to stop offering. It was just pissing me off. 

After another 8 hours of no progress, our chances now at around 20% and Casey and I were both physically and emotionally exhausted; but we held out hope. Let me say this: If we had not been educated, research driven people who at least took part of a childbirth education class- this entire birth would have been a hell of a lot scarier than it was (and it was pretty scary).  We knew what to expect about labor.  We knew how contractions would ebb and flow. We knew we could deal with the pain through calm breathing and movement. We didn’t know how to deal with this “worst case scenario” that we found ourselves in.

At about 33 hours of labor, no progress and a consistently high sky-high (seriously, stroke level) blood pressure reading, the doctors wouldn’t allow me to continue with my natural delivery birth plan. I was not only putting myself at risk, I was putting the baby at risk too. In order to continue with a vaginal delivery, I would have to agree to an epidural to bring down my blood pressure.

I was heartbroken. If for nothing else, I wanted to be able to say “I did it without medication”. I couldn’t do that now. When the resident came in to prep me for the epidural insertion, I saw that he had a ridiculous moustache. I ordered him out of the room, saying something to the tune of, “I will not have an 80’s porn star look alike insert an epidural into my spinal system.” The attending anesthesiologist then came in to assure me that, though he does look stupid, he is in fact, one of the best residents she had. I agreed to it only if she stayed in the room for supervision.

When the guy handed me the “pain med button” and said, “Ok, Ms. Collins, when you want more medicine, push this little red button,” and I promptly threw it at him- everyone knew just how upset I was that this was all happening.

The epidural worked and it lowered my blood pressure to an acceptable number; but it also lowered something more important- the baby’s heart rate. Within thirty minutes of getting the medication- I was being rushed back  (Casey following behind putting on disposal scrubs) to have an emergency C-section. The dreaded words. C-Section. Now, not only was I never going to be able to say “I had a natural delivery”, I would always bear the tell-tell sign of medically intervened birth. There are no words to capture the disappointment I felt in that moment.

Disappointment at the entire situation. Disappointed that my body, which failed at incubating our baby, now failed at delivering it too. Fail. Fail. Fail. A word that seemed to be a reoccurring theme throughout this ordeal.

Anyway, I was rushed back, put on an operating table and the operation began. I had 8-10 doctors  and nurses present for me; another 4-5 for the baby ready and waiting. The doctor began the procedure, I felt tugging and a lot of pressure.  Then he says, “OK, Daddy tell us what it is”. 

I will never, ever, ever forget the feeling of hearing my husband say the words, “Oh my God. It’s a girl.” Shock. Utter Shock. Shock and complete joy. We were so convinced that this baby was a boy. I had bought boy clothes, dreamed it was a boy, shopped for things in blue and green because I just knew. I even got into a small argument with my doctor about the sex of the baby. When I questioned if he was right about six times, he calmly reminded me that, in fact, he had gone to medical school and he knows what a girl looks like. Right- the epidural made me a crazy person.

Like so many things throughout this pregnancy- I was wrong. We were blessed with a baby girl. A feisty, tiny, beautiful girl. We never told a single soul the names we had decided on before the birth. I was so proud to announce, “Beatrice Kate. Her name is Beatrice Kate.”

Casey got up from my side (well, my head) and went to look at her. They lifted her up so I could see her too, though only briefly. I didn’t get a good look and I didn’t see her little face. She was struggling to breathe, her lungs were working so hard to produce the blissful, kitten-like cry we heard.Her team of doctors and nurses jumped into action, swarming around her as if she were their queen bee.

Then, she was gone. As she was wheeled out- I saw a tiny, postage-stamp sized hand sticking up, waving to me. Her mother. Failure no more. I was a mother. It would be the last glimpse I would catch of my new baby girl for 24-excruciatingly long hours.

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