Birth Story [part I – labor]

I thought I would need to write this up immediately so I didn’t forget anything.  Turns out, this is one experience that I will never ever forget.  Even the itty bitty details are etched in my brain.

It’s taken a few weeks for me to get to the point where I can reflect without my emotions flooding over me.  The first time I tried to begin the story, I couldn’t get very far.  My hormones were still freshly surging and I got cramps just from recalling (and writing about) the pains of labor. 

So here it goes.  Again.

 

It’s been a crazy 24 hours since we met our son and yet it feels like a week has gone by.  It’s a mix of time standing still and racing ahead.  And I’m still trying to process everything.

2/11/13

On Monday (2/11/13) the contractions were what woke me up.  At 6 am.  But I should go further back.

On Sunday (2/10/13) I suspected labor was definitely in the near future.  I lost my mucus plug in the afternoon and had some cramping sensations on an almost hourly basis.  They weren’t too bad (so I didn’t tell any family), but when I went to bed that night I kinda thought things were about to happen.  Kyle massaged my feet, focusing on the pressure points, and I went to sleep optimistic that we’d be canceling our 2 pm NST/AFI appointment that was scheduled for the next day.

I woke up at 2 hour intervals over the course of the night with cramps, but went back to sleep each time.  They weren’t terribly painful so I assumed they were really early signs of labor, if anything.  I know some people have contractions that go on for a long time, so I really didn’t think much of it.  But then at 6 am on Monday morning I woke up again with pain and this time I couldn’t get back to sleep.  Since I had a contraction timer app on my iPhone I figured I may as well track the cramps, in case they were more than cramps (read: contractions).  I had no clue how far apart they actually were since I had been sleeping.  I figured they were probably 2 hours apart given that was my wake up cycle.  Turns out, they were about 10 minutes apart.  I decided I should probably tell Kyle, so I woke him up.  Between 6 and 7 am I had about 5 contractions (now that I know that’s what they were I can call them contractions instead of cramps).  I texted my mom and dad to give them a heads up.  And since I couldn’t go back to sleep I decided to be productive.  I made Kyle breakfast, packed the rest of the hospital bag – including snacks and food, and then I showered.  After that the contractions started coming more frequently (like 6-8 minutes apart) and they were getting painful.  We called the hospital just to check in and confirm the fact that we should wait as long as possible and they reassured us to wait until they were 5 minutes apart for 2 hours.  That was fine with me because I’d rather be at home as long as possible.  By 9 am, my mom and Marie were on the road, heading down to LA.  And by 9:30 I was on the way to the hospital.  My contractions were 4 minutes apart at that point but (I didn’t know it at the time) not as strong as they were going to get.  Not by a long shot.  Proof?  I was stubborn enough to convince Kyle to use my hospital pass to park in the employee lot and walk to L&D.  It took a while, but I did it.  Valet my ass.

At the hospital, they checked my progress to see if I was ready to be admitted, but I was only 70% effaced and 2 cm dilated.  They checked to make sure P was okay so I didn’t have to come back for the NST, and then we went back home to continue with labor.

On the way home the contractions started to get pretty intense.  Maybe it was labor advancing, or maybe it was walking to and from the parking garage and up and down the 4 flights of stairs.  In any event, I felt like crap.  I was both hungry and nauseous with strong contractions.  We stopped at Whole Foods for breakfast/lunch and I think I stared at the odwalla juice fridge for about 20 minutes while my mind scattered between contraction pain, juice flavors, and the overwhelming nature of everything.  How to choose a juice!?!  I know there was a WF employee eyeing me as I hunched over in 4 minute sequences between reading the back of each bottle.  By the time we got home I was having full on minute long painful contractions.  Suddenly the food was the last thing on my mind.  I made a GF toaster waffle that took a while to get down.  Good thing I had the odwalla juice too.

My position of choice was standing, hips flexed at a 90 degree angle, over the couch corner or table.  It was brutal.  They were still ~4 minutes apart.  I tried to distract myself with food and a movie (we only got through 30 minutes of Meet the Parents, which I now think is ruined for me).  I went upstairs to try a lying position.  Kyle sat with me and timed them on my app.  He was so good coaching me through them, even though I’m sure he had no clue what he was doing or saying it was exactly what I needed.

My mom and Marie arrived around 3 pm when I thought I could hardly bear it anymore.  At the time I couldn’t even lift my head to greet them, but the extra support was awesome.  My mom rubbed my back and told me to breathe.  Marie squeezed my hand (too much).  The contractions were horrible.  Thankfully the three of them kept reminding me to breathe.  Walking was a no go (I couldn’t even make it to the bathroom and back in between contractions), so I just kept trying different ways of standing.  I didn’t want to lie down anymore because I wanted labor to progress and if I couldn’t walk, I was at least going to stay upright.  Plus, it actually was the most comfortable way to take the pain.

Breathing through it

Pretty soon it was obvious we had to make a decision about going to the hospital (both for contraction and traffic reasons).  Traffic in LA is a beast in and of itself, and we were nearing the time when it would go from bad to ridiculous.  We only live 6 miles from the hospital but it can take up to an hour at certain times of the day (that’s why I rode my bike to night shift).  We left at 4:30 pm.  The worst.

There’s an app for that

The next 2-3 hours are a total blur.  The car ride to the hospital was far and away the worst part of my whole labor.  Truly.  We weren’t even moving and I was writhing in the front seat.  Writhing!!  Like a crazy fool.  It was nonsense.  But it was honestly the worst pain ever.  Kyle was completely helpless.  We were inching down Wilshire Blvd.  Needless to say, there was no friggin chance I was walking from the employee parking lot this time.  After an eternity of traffic (light and light where no cars went through the signal), we got to the ED.  My mom and Marie were right behind us, and next thing I know I’m in a wheelchair that Marie is racing toward L&D.  By the time we arrived on the unit I was in no condition to talk.  I was barely holding on and the second I got into my room the tears started flowing.  As strong as I was trying to be, I couldn’t hold it together any more.  It was a lot to process, but mostly I was just relieved.  We were there and we were (hopefully) staying.

The nurse immediately recognized my need for direction and took charge (bless her!).  She asked about my pain management plan and I said epidural without any hesitation.  I always planned on getting an epidural during labor and I knew the time had come.  My nurse distracted me with admissions stuff while giving me the perfect combination of tough love coaching and empathy.  She told me to focus on Marie’s eyes with each contraction (no closing them like I was doing before) and to breathe slow and deep as they came and went.  Its amazing how other people talking you through pain can be all the difference in the world because I was able to tolerate them much better that way.  They still sucked, but I had a better time with the advice.

My pain was 10 out of 10 and I’m not into self torture, so they contacted anesthesia to get ready to give me an epidural.  I’m not a hero and I’m not trying to be.  Bring on the anesthesiologist!

Pre-epidural

The doctor came in (same one from earlier that day) to do another cervical exam to see how much I had progressed over the day.  I was 3-4 cm dilated and 90% effaced.  She gave me a few options (go walk around to make sure things kept progressing or stay there with the chance that I may need drugs if I didn’t advance as fast as they needed me to).  Well, walking was out.  So I stayed and hoped my body would cooperate and continue labor so I could avoid pitocin (or other interventions).

The next step was getting the epidural placed.  This was something I was actually not looking forward to.  I was scared, really.  Yes, I liked the idea of the epidural after it was placed, but the act of inserting it gave me the chills.  I was also unsure of how the heck the anesthesiologist was going to get it done in the 3 minutes between contractions.  Not a huge window.  But Kyle was there holding my hand, keeping me calm, and in the end, it was a breeze.  The doctor was fantastic and the whole thing was nothing like I expected.  It was basically like nothing at all.  Easy peasy.  And 10 minutes later I was already feeling soooo much better.  With each contraction the pain lessened and lessened until I had tingly legs and zero pain.  Modern medicine is miraculous.

Post-epidural

After that I got the catheter, which was also a breeze since I had no feeling.  I think I’d like to put catheters into all my patients that way from now on.  And then we waited.  Kyle’s parents joined the party at that point and so it was a group of us.  I took the liberty of finding Bravo on the TV so I could catch up on my housewives (oh how I miss certain cable shows).  Talk about the perfect distraction!  Since I wasn’t able to eat anymore, every one else was nice and took shifts enjoying dinner not in my presence.  I wanted to sneak food so badly, but everyone else convinced me it was a bad idea.  I was really going to do it too, until my dad (on the phone) gave me a definite no.  I’m a horrible patient.

Contractions + the moms

The rest of the night was uneventful.  My family left so it was just me and Kyle.  I kept the TV on for some white noise and dozed off.  I actually slept really well, even as the nurse popped in to check on me every once in a while.  My contractions were still strong and steady, but I was completely unaware of them.  I was hungry and kinda nauseous but some IV Zofran did the trick.
Around midnight the doctor did another cervical exam and I was fully effaced but still only ~5 cm dilated.  Again, she presented my options and gave her advice.  I could have her break my water and hope that got things going (with the risk of having to use pitocin if I wasn’t advancing fast enough) or I could wait it out a little longer.  I decided to have her break my water.  I trusted my body and the doctors and that’s what they seemed to think was best.  An hour afterwards, she did another cervical exam and I was fully effaced and dilated 10 cm.  It was go time!!!  She told me she’d let me “labor down” for an hour (basically let gravity help P come down the birth canal) and then it was time to start pushing.  At this point it was 4 am, so I asked if I should call my family or what.  I had no idea how long pushing typically took or how soon I’d deliver.  Her estimate was 3-4 hours so Kyle and I texted our family – we were going to be parents that morning!  This time they had a way easier commute to the hospital (because nobody is on the road at that hour) so everyone made it in time to say hi before I started pushing.

The pushing part of labor was totally unlike what I thought it would be.  I had vague visions in my head about it, mostly involving pain or screaming or who knows what else, but it was nothing like that.  It was still dark in the room and there were only the three of us – my nurse on one side of me, Kyle on the other.  It was very mellow.  No big production.  No fanfare.  My nurse told me that as I felt a contraction come, I’d do 3 big pushes.  She would count to ten each time, and I’d take a breath in between.  And that’s what we did.  I could feel the contractions at that point (I thought they had turned off the epidural actually!) so every time I felt one starting up, I’d tell them and they’d holding my legs up and I’d push.  1 2 3 4 5 6 7 8 9 10.  Breathe.  1 2 3 4 5 6 7 8 9 10.  Breathe.  1 2 3 4 5 6 7 8 9 10.  Breathe.  And wait for the next one.

They both just talked to me as we did this for a while.  The doctor stepped in every so often to see how I was doing.  Everyone said I was pushing great and it was going so well.  I was proud.  I wanted to keep it up.  The pushing didn’t hurt, but the contractions did.  So pushing through them was a nice distraction that made me totally forget about the pain.  It wasn’t actually that painful (truly!) when I was pushing.  Even though my nurse told me I could go every other (so I didn’t get exhausted when we were ~30-45 minutes in) I didn’t skip a single contraction.  I remember Kyle peeing twice in between contractions and thinking geez dude, can’t you hold it?  I also know my mom came in at some point and I was happy to have her stay.  Like I said, it was a calm room.  I knew I was getting close because Kyle and my nurse told me so. They could see his hair and I thought that was so cool.  Before I knew it the nurse was telling me to stop pushing because he was about to come and they called in the doctor.  The rest of the team followed, but I wasn’t really paying much attention to who was there.  At that point I’d been pushing about 1 1/2 hours and I was so excited that I was about to meet my baby!  The doctor came in, I gave a small push, and out he came.

My son!

But there was no cry.  No wailing baby like they have in the movies.  They suctioned him and rubbed him, trying to get him to breathe, but he wasn’t cooperating.  He finally made a tiny little cry, but it wasn’t the best effort.  He was on my stomach at that point, but rather than go to my chest they took him to the warmer in the back to try and get him more alert.

Respiratory distress

Next thing I know the whole NICU code team is in the room working on him.  It’s a complete blur.  As a nurse, I knew way too much about what exactly was happening.  Kyle was about to pass out and had to sit down.  My mom was playing it cool, but I’m sure she was freaked too.  As I delivered the placenta and got stitched up, I watched them suction P and give him oxygen.  They had a bag over his airway and I kept trying to see the monitors to figure out what his sats were.  I wasn’t paying any attention to what was going on with me at all.  The doctor asked me something at one point about if I could feel the suturing (I guess they turned the epidural off before that), but I wasn’t focused on her or me.  All eyes were on my baby behind her.  His cries were sporadic so at least I knew he was breathing.  And I could see a rhythm on the tele monitor.  They brought him to me briefly so I could see him (and tell everyone his name) before they whisked him off to the NICU.

To be continued…