Drugs? Yes, please.
Epic Birth Story, Part 2
I really should have listened to Frank.
Countless times during our labor practice, Frank said to me, “Here’s a suggested book about back labor. Maybe you should get it.” But I wouldn’t need that. Our baby had been head down and facing in the right direction for months. Isn’t back labor caused by sunny side up babies? I’m thinking, no. As we walked to the waiting car service, all of my labor pain pulsed and surged through my lower back.
The view of the Hudson along the West Side Highway, soothed me as we sped to the hospital. Thankfully, Dr. Y spotted my chart in triage and sent me directly to a labor and delivery room. However, due to HIPAA regulations, I was separated from Frank while a nursing assistant asked me 100,000 admission questions. Didn’t we pre-register to avoid this? I constantly repeated to anyone who would listen, “My husband has a copy of my medical records.” Yet the hospital’s system required that I give fresh answers to inane questions such as, “Do you remember when you had your last period?” while I was having intense contractions. There were also incredibly vague questions like “Do you have any medical issues?” Later, a resident came in to ask me the same questions yet again and when I mentioned a tonsillectomy a few years back, the nurse’s aide admonished me, “You didn’t tell me that!”
Well, you didn’t ask about surgeries, Lady. “Medical Issues” is a really freaking vague topic. Oh, and have I mentioned that I am in extreme pain? After doing a cervical check for dilation, the resident said with a quizzical tone, “Wow, you seem to really be suffering. Do you want something for that?” Yes. I wanted to leap off of the bed and strangle her.
A few times, a higher-level nurse came into the room and asked, “Is she done? Her husband really wants to see her.” I felt like a widget. I appreciate that the staff needed me alone so they could ask me several times if I was a victim of domestic violence, but I don’t understand how my husband is by default the administrator of my healthcare directives, yet couldn’t be in the room with me while I was quizzed relentlessly about my medical history. Finally, the powers let Frank in and I was shocked by how visibly upset he looked. Separated from my primary labor support and in my haze of pain and annoyance, I had not realized Frank had been trying to get in to see me for an hour while I dealt with my contractions and hospital bureaucracy on my own.
Finally, the room emptied of staff and Frank hurriedly tried to set-up the laboring system we had used at home. Out came the yoga ball, my iPod and speakers. In our bedroom, I had been bouncing along to my “Rock This Baby” play list, but I suddenly felt self-conscious about singing along loudly to Prince’s “Let’s Go Crazy” and The Ramones’ “I Believe in Miracles.” Was I disturbing the other moms? Were the staff members laughing at my warbling?
In between soothing me during contractions, Frank handed out copies of our birth preferences, posted signs stating we were using HypnoBabies, and delivered the treats bag I had packed for the nurses. On our birth preferences sheet, we requested a nurse who supported natural childbirth and at 7:30pm my dream nurse walked into the room.
Andrea Crossman introduced herself to us and explained she was the most “earth mama” of the nurses on duty. Fate sent us the doula we could not afford on our own. Andrea understood my request to not talk about how dilated I was (HypnoBabies suggests against knowing, as your body does not give birth on a schedule), but did ask if she could talk about early vs. active labor. Sure, no problem, because this baby is on it’s way out!
“Well,” Andrea said, “you are in early labor.”
WHAT? It’s going to get worse than this? Andrea tried to assure me. There were many things we could do to alleviate my pain naturally. She reported being in water would cut my pain by 50% and suggested I take a shower. Just thinking about stepping into the hospital shower increased my pain tenfold. Yes, I brought flip flops, but what about Staph! Cooties! Mutating Who-Knows-What From Overuse of Antibiotics? Andrea then recommended I get on my hands and knees with my bottom higher than my shoulders to move the baby off of my spine. That I could do.
Dr. Y came into check on me between birthing other babies and told me I was doing wonderfully. She reported the birth of a 10+ pounder on the floor and let me know she would be back in the morning to check on me.
Wait. I would still have a baby inside come morning? Nooooooo.
After supporting my big belly on my forearms for as long as possible, the butt elevations had not relieved my back labor. I said to Andrea, “I don’t think I can do this.”
“What exactly can’t you do? Because this baby is going to come out.”
With a sense of shame, I said, “I can’t take the pain. What are my other options?”
Andrea waved away my remorse. In addition to being all-around awesome, I loved that Andrea completely supported whatever I needed to get through labor. Although she was assigned to us specifically because we wanted encouragement for a natural childbirth, as soon as I said I needed more intense intervention, she offered medical options based on her years of experience. She didn’t judge me or try to talk me out of pain relief. After consulting with Dr. Y, we decided to try an analgesic in my IV. It was amazing. For about a minute. Subsequently, I was flying high, yet still in pain. Every body is different and I knew my body’s dismissal of the pain relief was no fault of Dr. Y or Andrea.
I tried to be a trooper, honestly. But I could not manage. Perhaps I would have had more tolerance for the pain if we had stayed home, but I had to make decisions based on being in the hospital and I was terrified I would be too exhausted to push whenever the baby decided to arrive. I asked for the epidural.
I only wish I had asked for it sooner. Insertion was swift and the relief was nearly immediate. I could move my legs, wiggle my toes, and still feel the contractions. I merely no longer felt like I was going to die from the pain. And I know what dying pain feels like. As I’ve mentioned in previous posts, in 2008 I was hours away from dying from a torturous bowel obstruction I thought was merely the World’s Most Epic Case of Gas when I finally decided that I needed to go to the ER.
Post-epidural, I rested. Andrea came in whenever I knocked the fetal monitor out of position (which was often- sorry!) and she showed Frank how to fully recline the partner chair. When I was awake, Andrea and I chatted about haphazard topics as if we were old friends. In the morning, I was terribly sad to see her go, but she let me know I was in good hands. Dr. Y came by and I asked how I was progressing. She said brightly, “You’re at 4cm. This is the best induction ever!”
The balance of the morning was uneventful. Nice Day Nurse would come in and tell Frank and I to sleep whenever she caught us with our eyes open. Around noonish, Dr. Y checked my progress. I was continuing to dilate, but the baby wasn’t moving down into position. Dr. Y returned with a resident to help her break my amniotic sac. It was like Angel Falls down there. Dr. Y spotted a bit of meconium in the waters and told me a pediatrician would have to examine our baby immediately after birth. Oh well, there goes our plan to have direct skin to skin contact and delayed cord cutting. But Dr. Y passed along this news in such a calm manner, I decided not to worry about it.
As expected, breaking my sac allowed the baby to move down, but Dr. Y was concerned my contractions weren’t strong enough to complete the job. She suggested a small dose of oxytocin to advance the babe down the canal. Oh heck, I’ve gone this far down the intervention road to ruin, why not?
Dr. Y hooked me up to the bag of oxytocin and things were fine. Until she was called to the OR and everything went to hell.
I hadn’t been on the oxytocin long when I started to feel increased pain in my right leg. I would push the epidural booster button, but I did not notice any relief. I asked Nice Day Nurse to call anesthesia, but she said being so close to delivery, I couldn’t get additional pain medication. As my suffering continued to increase, I became more insistent. The resident who had helped Dr. Y break my waters came to check on my dilation and the baby’s station. She suggested I could be feeling additional pain because it was time to deliver and pushing could offer relief. I seriously doubted her reasoning, as I couldn’t feel the baby in my canal at all. But I pushed to test her hypothesis, confirming for myself she was wrong.
Now here’s where things might get a bit cinematic as my extreme pain may have colored my memories of this interaction.
Snotty Resident reported she called Dr. Y and Dr. Y concurred it was time to push. I firmly stated it was not. Although I was no longer following my birth plan, I clearly remembered from our training that pushing before the baby was far enough down could truly lead to exhaustion for the mother and distress for the child. I knew with every cell in my body it was not time for me to push. The pain I was having was not a sign of impending delivery. Something was wrong with my epidural.
Snotty Resident may or may not have put her hand on her waist, but she certainly said in a dismissive tone, “Well, you have to tell me what you want.”
I wanted to scream, “Send the Expletive Anesthesiologist, like I’ve asked 500 times!” But I’m pretty sure I didn’t scream and I know I didn’t curse. I do think Snotty Resident huffed and/or flounced out of the room.
I was in tears when Anesthesia Resident arrived. While the pain in the left side of my body was tolerable, my right side was causing me anguish. I was lying on my back and could barely manage to turn to my side to give Anesthesia Resident access to my epidural. Then she said what no one wants to hear when there is a catheter in your spine: “Where is it?”
My epidural had broken and so had my spirit. I sobbed and wailed into Frank’s shoulder, “No one listened to me! I told you something was wrong and no one listened!”
It has taken me a long time to write this birth story and I thought the block was due to the exhaustion and the lack of time of a new mother. And while those two things have played a part now that I am here, I see I simply did not want to relive these moments.
I have never felt so utterly alone with physical and psychological pain or so completely helpless in my life. My truth is no matter how much support you have, giving birth is something each woman faces alone. No one else can do the work of birthing. My extreme pain narrowed my view to a tunnel of isolation. And now that it is over, the worst part is trying not to beat myself up for not speaking up sooner or not speaking louder or not being more demanding – for not listening to my gut when I knew something was wrong and how this all could have been avoided if I had just been better at giving birth.
Anesthesia Resident explained she couldn’t place a new epidural on her own and because it was the weekend there was only one attending anesthesiologist to supervise her. I would have to wait behind the other mothers. No jumping the line because the epidural broke or because I was also receiving a drug to intensify my contractions. Frank gave it his all, but I was too far gone to receive much relief from our labor cues. As the never-ending waves of contractions rolled over me, I felt as though I would drown in the pain.
When Anesthesia Resident and The Attending came back 45 minutes later, I thought I would have relief lickety split. The night before, the epidural insertion had taken moments. This resident, while sweet, was not as skilled. I don’t know how long she poked around back there as The Attending instructed me to “straighten my back” or “sit further forward,” but eventually I cracked. Again, I somehow managed not to curse as I said something along the lines of, “I know this is a teaching hospital, but this is not the time for someone to be learning on me.” I may or may not have added, “Get back there. Now.”
The exchange must have been heated as The Attending quickly pulled on his gloves. Later, he returned to make nice with me after my new epidural had been working for some time.
My two epidural scars.
A mortified Dr. Y came to see me as soon as she was done in the OR. She turned the oxytocin off and gave me time to rest. I closed my eyes and suddenly it was 7:30pm, again. Andrea was back – hurray! And the baby was at +3. It was time to push. Yay!
As horrific as my last hours had been, while Dr. Y and Andrea calmly prepped their areas of the room, an easy tide of relief washed over me. Back in the hands of the team of women I trusted, my body relaxed beyond the limits of the drugs in my system. Frank asked if I wanted to hear the HypnoBabies push track, but I knew Dr. Y and Andrea would do a great job of guiding me through birth.
With the lights dimmed and only the four of us in the room, delivery wasn’t at all what I expected. Dr. Y instructed me to give three pushes with each contraction as Frank and Andrea helped to support my legs. I could feel pressure, but no pain. In between contractions the four of us chatted about the world’s declining population of redheads, the latest trends in enemas, and work/life balance. There was no shrieking or shouting, simply my earnest pushing, laughter, and quality conversation.
And then she was here! Dalia made a small squawk on the way to the on-call pediatrician. I could see her skinny arms and legs waving about as she was checked over. Although Dalia’s Apgars were 8 and 9, the pediatrician was concerned about her lack of wailing. Andrea said, “Babies born in calmness tend to be calm.” And she was right.
Now if I can just borrow a bit of Dalia’s serenity to deal with the $12, 300 anesthesia bill I received this week. I wonder, if I received the broken epidural discount?
Amazing Andrea with Miss D tied to me with a sheet (hospital policy for transport to recovery!)
