Labor

BH

Except. You know. When you go into labor shortly after they arrive.

On August 13th I had minor cramps, referred to as Braxton-Hicks contractions, which I began to notice around 6pm. They were annoying and uncomfortable, but otherwise without need for mention. Joel and I went to Costco to get some last minute things before our scheduled c-section on the 15th. We wanted to have some simple quick foods to cook after arriving home in non-perishable form. And I wanted to get out and get some air. I had no idea I was starting labor.

We ate some greasy fast food at Costco and I figured I’d be too uncomfortable to sleep soundly due to the size of the baby. I’d also been having trouble sleeping due to heartburn, my bladder always feeling full, and general discomfort. I remember being surprised that my rib wasn’t throbbing like it usually did. Sisu loved sitting under my right rib, and I was convinced that I had a cracked rib due to the fact that her head was just plain too big for where she liked to sit. As the evening wore on I was very restless. I paced around the house completing small household tasks as Joel wound down for the evening. I started working on a blog, planning on making quick work of a post.

Joel called me to bed a few times starting around midnight. I could tell my cramps were getting worse and something compelled me to finish my 38 week wrap-up blog, which I wanted to post the day of my c-section. That way everyone would have something to read while I was recovering.

I finished my blog around 1:30 and after a trip to the bathroom and noticing the discomfort these “cramps” were giving me, I started researching how to slow labor. My c-section was a day away. If I could coax my body to relax enough, perhaps I could still make it to the scheduled time and not throw off plans or drag us to the hospital prematurely, where things would be beyond my control. One website recommended laying on your left side. I tried this but was too uncomfortable to keep still. Another website recommended taking a warm (but not hot) bath. I liked this idea. I liked it very much. A hot bath would have been uncomfortable, but a warm bath sounded just right. I set up my normal bath routine around 2:30 and an hour later I knew this wasn’t working. I could not slow my labor. In fact, by consciously relaxing my body I was probably progressing my labor.

Time to give the on-call physician a ring. The operator connected me to my practice’s on-call physician, Dr. Sun. She sounded like she had just rolled out of bed, and probably had. It was 4am, after all. I explained I was having increasingly intense contractions for the past hour. They were five minutes apart and lasting about a minute or so. She instructed me to wait and see if they continued getting more intense and asked me to call back in an hour. I told her the contractions had steadily intensified for the past three hours. “Come to the hospital.” “what, right now?” my voice, a poorly masked whine. She told me she’d meet me there.

I putzed around finishing to pack our hospital bag. I’d expected to have the rest of the day to finish the few tasks left for us prior to the scheduled ceserean. I hadn’t printed out my birth plan, the hospital bag wasn’t fully packed, the car seat wasn’t installed. So many loose ends. I quickly prioritized. I needed my hospital bag and I needed the car seat. Everything else could slide.

After the hospital bag was packed, I woke Joel. I told him I was in labor and we needed to go to the hospital. It was about 4:30am by then. I asked him if he was awake enough to drive me. He rubbed his face, said he was, and flopped back towards the bed as if he was going back to sleep. After some rousing and a few extra items tossed into our hospital bag we were out the door and into the car, the car seat brought down and tossed in unceremoniously with our hospital duffle. I instructed my husband to take it easy driving. He did over speed bumps but took a sharp turn to run a yellow. I told him to slow down. I could handle the red lights, but not the force of a fast turn. He acknowledged, and we chatted like we had in the car on late nights when we were dating. Lots of chatter over nothing in particular. We were excited, chattering like a couple of school kids. I notice that I can feel my hips widening, a creaking in my bones.

Upon arriving we found a close spot and I insisted on walking across the parking lot to the hospital, though it was chilly and I was wearing only a sun dress. The cold air felt great on my face but intensified my contractions. We entered HCG through the side security door. The guard asked if I was in labor. Emphatic yes. He slapped a visitor pass on Joel and instructed us to proceed to the labor and delivery ward. I had to ask where it was. As we began to turn away he asked if I wanted a wheelchair, fumbling for the phone. Feeling the squeeze of another contraction and seeing how lethargic he was I declined, sure that walking would be much quicker. Sign in at Labor and Delivery. Paperwork. Get into a room. Nurses take vitals and a urine sample. By the time I’m in a hospital gown, sitting in the gurney-style bed is a welcome relief. My contractions are not letting up. They’ve hit the point where I need to breathe through them. I’m shocked my water hasn’t broken yet.

Hint: this photo is a lie.

The nurses ask me questions about my contractions. I’m surprised that the first course of action once I’m in the gown on the bed is to shave me from navel to bikini line. I expected that to come later, but I suppose it’s best to be done while I’m not squirming in contractions. They then hook me up to an external fetal monitor and another monitor which records my contractions. Due to my anterior placenta the nurses have a hard time finding Sisu’s heartbeat. I instruct them, as I instruct every medical professional looking for her heartbeat, to look at my hips. It’s the most consistent place where her heartbeat would be found. They ignore this and try to keep it consistently on the side of my belly. This lands me in a most uncomfortable position half on my side, half on my back, where I remain for a half hour or so as the monitor is going. The more experienced nurse is walking the new nurse through admission procedures of a labor patient. I appreciate the learning process, but the speed of the admission process is a bit taxing. They ask my pain level. It’s about on track with my worst period cramps and I guess about a 4. Once we’re done with paperwork and questions Joel and I chat a bit and he makes fun of the infomercials on the TV. I’ve lost track of what time it is.

What’s that? Surgery? Sure, we’re taking out your kidney, right? Baby? Okay I can do that too.

When the doctor arrives she still looks half asleep. She has bed head, her eyes are drowsy, and she speaks very groggily. She checks the contraction monitor, confirms that I am having contractions (thanks, I hadn’t noticed), and wheels in an ultrasound. For this I am laid flat so that Sisu’s position can be verified, which means I can’t see the screen. She and the nurses hover around the monitor while she says things like, “oh man would you look at that? Wild. Hey, take a look at this! Good thing this baby’s ready to go.” She turns to me and says, “Well your baby is still breech and it looks like your placenta is pretty calcified so we’re gonna wanna get that baby out before something happens to it.” Thanks, doc. I’m certainly not worried now. No anxiety at all. -.-‘

At this point I tell her I want general anesthesia. I explain that I’m concerned about anxiety and passing out. She rubs her face and tells me general anesthesia is not gonna happen. I ask if the anesthesiologist doesn’t do general. She explains the anesthesiologist won’t want to do general during a cesarean because it’s too risky for both mother and baby, but acknowledges it’ll be a final call by the anesthesiologist. My pain is now a 5.

The nurses began buzzing around prepping me for surgery. I was very uneasy about being conscious, but my nervousness never gave way to blurred vision. I warned the nurses that I have small veins that are hard to find as they began gathering IV supplies.

They also hand Joel a sterile disposable jumpsuit, hairnet, and face mask. They tell him that he’ll need to wear them in the OR. He also gets fun little nets to go over his shoes. I’m surprised they don’t give him a net to cover his beard as well. The jumpsuit looks absurd and hilarious. He somehow manages to put it on inside out. I wish I had my phone on me to get a picture of that. It might have been the most comical thing in the course of our time in the labor ward.

Around this time the anesthesiologist came in to talk to me. She declined general anesthesia immediately. I would be given an epidural after I walked into the OR. I asked if Joel would be with me. No. Joel wouldn’t be allowed in the OR until they were completely ready to begin surgery. I fought back tears. Not only would I be awake during surgery, but I would be walking into the OR on my own two feet, administered an epidural alone, and would be completely prepped in isolation from my husband, who had been my rock all this time.

This was not the birth I had planned. This is not what I wanted. I started to cry. I was exhausted, awake for well over 24 hours with poor sleep the entire week. I’d hit my emotional limit.

Even so, I didn’t focus on what I wanted. Getting the baby out safely and promptly was what was most important. I was scared and upset, but anything for my baby. I could feel my contractions intensifying with every new contraction and as the anesthesiologist left I knew my pain had hit 6. The contractions took my breath away and I was surprised that I could feel my body preparing for birth, even though Sisu wasn’t in any position to come out by the force of my body alone. My hips were widening and my body was slowly opening. I could feel my bones creaking further apart as the contractions came and went. I knew it was increasingly important that we get Sisu out promptly.

The nurses placed my IV and began fluids and antibiotics, and we’re ready to go to the OR. They hold my bags and help me walk into the OR. I did my best to look at as little medical equipment as possible. I didn’t want anything to set off a fainting spell. The nurses get me along side the operating table and ask me to sit down. I’m too short, so they have to get me a step stool. One of my nurses, Tyra, stands in front of me and keeps me calm, informing me about what’s going on around me. She holds both my hands as I go through strong contractions. She never let go. The anesthesiologist is present and preparing her tools to administer my epidural. I am shaking with nerves, fatigue, and strain of the contractions. As another strong contraction comes on (at least a 7), I realize I’m starting to feel them in my vagina as well as in my uterus. I inform the nurse and anesthesiologist as such. They don’t seem too interested in the new information. I later realized they weren’t interested because we were too close to game time.

I keep my eyes decidedly away from the anesthesiologist and her tools as she prepares to administer my epidural. I am extremely anxious. I focus on my contractions. Tyra rubs my hands as I breathe through them. In my earlier contractions I kept my breathing quiet, but at this point my breathing is decidedly boisterous in order to drown out everything else going on. I’m barely aware of nurses trickling into the room, preparing for surgery, greeting each other, etc. I’m instructed that I’ll be swabbed with some prepping germ-killing agent and it will be cold. It is cold, and my bodily temperature plummets as I tense up. I’ve been having trouble regulating my temperature throughout labor and I’m never quite sure if I’m shaking from nerves or cold.

Next, I’m warned that a local anesthetic is being administered and it might burn a little, but not to be alarmed because it’s not the epidural. I can feel the needle go in and it smarts, but it’s secondary to the intensity of my contractions. The small amount of pain from the shot sends me into another contraction and we all wait for it to pass before we progress. Once it’s gone the anesthesiologist informs me (via Tyra) that she’s ready to administer the epidural, and that she needs me to arch my back and hold very, very still. Only a needle to the spine, no pressure. As I arch my back I can feel her poking at my backbone to locate a space between bone. She informs me she’s found a site, is going to do an additional swab, and then will attempt to administer the epidural. I’m instructed to arch my back, the anesthesiologist begins directly communicating with me, quiets everyone in the room so we can hear each other plainly. She tells me I should feel pressure, but not pain.

Through the administration of my epidural, Tyra is my constant encouragement. She never leaves my side, never stops soothing and encouraging. She coaxes me to arch my back just a little more, breathe through contractions, take a deep breath because it will all be okay. She helped me get over the peak of my anxiety when my husband was not allowed to be at my side, and for that there is no amount of thanks which will suffice.

As the needle is administered I feel pain, distinctly. I inform the anesthesiologist and after attempting to salvage the site a couple of times she removes the needle. Every pain from the administering of the epidural, however minor, brings on another contraction and delays the epidural from being placed. After more local anesthetic and the clearing of a new site, we try again. I put all of my focus on arching my back and warn them that a contraction is coming on. This time the site is good and I can’t even feel the needle go in. She has to ask if I feel pain to even make me aware that the needle has been placed at all.

Once the needle is in, the catheter is quickly placed and I’m warned that they are going to administer a test of the epidural drug, and that I’ll be immediately laid down. At this point four people surround me and I’m not sure why until the drug is administered. The moment the drug hits my system I lose control of every muscle below the site, which is a rib or two from the bottom of my ribcage (just below my chest). The pain instantly vanishes and any muscle that I was holding tense is instantly relaxed, whether by my intention or not. This means I lose control of the muscles telling my body to sit up, and I’m suddenly glad I’m surrounded. The people who are surrounding me flip me onto the table laying down, and I’m surprised at how much my lower half feels like dead weight. It almost feels like it doesn’t belong to me. As they flip me I’m quite sure I’ve lost any waste in my bowels and apologize to the staff on hand for the unintentional vacation of my bowels. Everyone in the OR laughs, probably because they’re not use to patients saying “vacate my bowels.”

I’m then strapped to the operating table, which isn’t concerning, but reassuring. I can’t feel my lower half, let alone control it. It’s just as well that it’s not left to it’s devices when it could potentially ooze off the table. My arms are also strapped down outstretched to either side. I’m strapped helpless to an operating slab crucifixion style. My nurses perform their final task of sterilizing my nethers and giving me a catheter. I am so glad this was done post-epidural.

But all my anxiety is dissipating. The pain having been removed, I find I can start to relax. I’m no longer concerned about being alert during the surgery. I can’t see much of anything from my current position and can’t move in a manner that would gain me a better look. The anesthesiologist begins discussing the possibility of calming drugs once Sisu has been removed from my body, but I assure her that I’m feeling okay and would like to remain alert. In fact, my own fatigue alone is a strong sedative. Everything is very dreamy.

At this point the nursing staff put on classic rock and begin re-shaving me and oozing various surgical prepping washes over my skin. Now that the epidural is placed and the anesthesiologist is easily within earshot of me they all chat freely. I realize that surgery is a bit of a party for these people, and the general mood is contagious. Why shouldn’t I party? I’m having a baby! I’d get up and dance on a table if I could feel my legs!

At this point Dr. Sun re-enters and has clearly had her coffee. She’s super perky and I’m not even a little concerned that she had bed head about an hour ago. She greets me briefly, asks if I’m excited with caffeine-induced wide eyes, and continues to her fellow staff to ensure prep is going as planned. She helps instruct a staff member how to procedurally wash my belly. My L&D nurses put in my catheter, the senior nurse instructing the younger. The surgical staff are getting chatty with everyone, including me.

One of the nurses asks if the baby is a boy or a girl. She then asks if we have a name picked, and when I tell her the name she asks for a meaning. I can’t help but laugh out a single tear. I have been so silly to be anxious.

“Her name means strength through adversity. Perseverance. Strength of will. Grit.” which is exactly what I need to show. I consciously push away any remaining anxiety and I couldn’t be more ready for surgery.

I will not fear. Fear is the mind-killer. Thank God for this reminder.

My upper body began shaking and I realized I was a bit cold, but didn’t feel cold enough to need to shiver. Was I excited? I ask the anesthesiologist for some blankets and have a few laid across my chest and arms. She reassures me that shaking can be a side effect of the anesthesia and that I shouldn’t let it worry me. She ensures that I’m warm and tells me that I did very well with the epidural. She then begins to check the effectiveness of the anesthesia by poking down my legs with something which I assume was pointy, possibly rather sharp.

With the epidural anesthesia everything feels like it’s happening on the opposite side of a fingernail. I can feel pressures that indicate that a movement is taking place, but I can’t feel any fine senses and I can’t feel any pain. She adjusts the anesthesia a bit to further numb my left side and the anesthesia is cold as it travels down the narrow tube taped to my back, but I can’t feel it once it hits my spine. My anesthesia is stable and she will continue to monitor me from just above my head. I never turned to look at her, but she spoke with me constantly to reassure me that she was there.

A large sticky sheet is placed over my belly and falls onto my face a bit. I know that this is the screen that will prevent me from seeing any gory detail during surgery. It’s stuck in place, I’m pretty sure a marker is used on my belly, and the surgical staff request that a nurse goes and gets my husband as they’re nearly ready to start.

I take the opportunity to look around a little bit. My right arm is strapped down to the table and there are a few sticky monitor pads stuck there. I realize that I also have a few stuck to my chest, though I don’t remember exactly when they got there. I may have had one or two on my face as well. My dreamy state puts everything after epidural in an exhausted haze. At this point I realize just how tired I am, and that I’m feeling rather drowsy. I’ve been awake for so long and my last night of sleep was far from restful. The absence of the pain below my waist has relaxed me and I realize that I also can’t feel the pain in my ribs where Sisu had her head as far north as possible. I can still feel pressure in my stomach, that there is a “foreign object” pushing it’s way into my body, but I can’t feel Sisu’s fine movements or any discomfort caused by that pressure. It’s a very strange sensation, to have that pressure without the pain.

To my left I catch a glimpse of my anesthesiologist before she disappears above my head again. She tells me that a chair is being brought over for my husband. I ask if he’s on his way and realize I have some small anxiety that they will start without him. I push said anxiety away and chalk it up to being tired and silly. She thinks he is, but asks a nurse and people start wondering if he’s been brought over yet. He’s not outside the door, so another nurse goes to find him. I realize it’s probably been at least ten minutes since someone was sent to fetch him, but my sense of time is poor when I’m fully rested and awake, and it’s practically non-existent now.

Also on my left I notice there’s an observation room and in front of it a long counter with cabinets and a sink, similar to what you’d see in a medical office. In front of this counter a woman is standing chatting with a couple of nurses. She is wearing the necessary mask and hair net, but she isn’t done-up in full surgery barriers as all the other surgical staff are. I wonder why she’s there. I can barely see about four staff members in the corner of a room prepping what looks like a scale and assume these are the pediatricians who will weigh and measure Sisu once she is born.

There are other personnel whizzing about and I ask again where my husband is. They say they’re trying to track him down, and that he should be there soon.I have a mental picture of Joel standing in his sterile jumpsuit fighting with a vending machine to take his dollar bill and laugh at it.

Someone comes in and announces that they’ve found Joel and can they bring him in. Dr. Sun gives an emphatic YES and Joel is walked in to my side. He describes his entrance of one met with great anticipation. Apparently the surgeon was watching the door, scalpel hovering over my belly, and she began to cut as soon as he set foot in the door. I was oblivious. Joel sat down by my side and I ask where he was, not in an accusing manner, but out of curiosity. I wondered what he’d been up to the past however long I’d been in the OR prepping. He said a medical student or new nurse had walked him to the wrong OR door so he’d been waiting in the wrong place for a while before one of the nurses brought him to the proper door. He asked if I had been giving any sedative-type drugs because I was very calm and seemed a little drowsy. I told him I was just tired. I also told him the epidural wasn’t so bad and that it was a really bizarre sensation. We joked a bit about me being strapped to the table and other things. I don’t remember particulars of the conversation.

I could tell that the surgery was progressing. The sensation was completely bizarre and I feel that describing it can not come close to giving you, dear reader, an accurate idea of how it felt, but I shall do my best. I could not feel finer strokes, like the incision being made, but I could feel gross movements and pressure alterations. Bear in mind that every movement I felt was distant and completely devoid of pain or discomfort. It just was. The first thing I could feel was that my skin and/or tissue and muscle was being cranked apart. I’m not sure that they used cranks and I don’t posses any knowledge of surgical instruments, but this is how I can best relate the sensation. Once my body was open enough I could feel things being moved inside of my body. I could tell that this was not movement inside of an organ, as you feel during a bowel movement or as women would feel during a pelvic exam, but that there was movement inside of my abdomen where there are usually only intestines and recently a baby.

The most jarring movement I felt was once they had entered the uterus. I could tell they had a hold on Sisu and were trying to remove her, but (surprise surprise) she was just so cozy she didn’t want to go anywhere. I was talking to Joel as this was going on, and then I felt a great tug which jarred me out of our conversation. I remarked to the surgical staff that I could feel that motion, which in hindsight seems silly. Of course I could feel them tugging, it had shaken my entire body (thank goodness I was strapped down, it might have knocked me off the table). The anesthesiologist ensured that I could feel the pressure and that there was still no pain. Still no pain, I verified.

After a few more great tugs I heard a noise like a suction cup being taken forcefully from something it’d had a strong hold on, and I felt a great pressure shift in my stomach. I could tell that the being that had pushed my stomach wide across and cracked my rib and kicked my bladder was out of my belly and I felt strangely deflated physically but not emotionally. Almost instantly my baby started crying. I heard someone exclaim “she’s out!” and moments later her cord was clamped, cut and they held her to my left so I could see her. She was a healthy-sized baby, grey with her capillaries sticking out on her skin, giving her a red netted look, and she still had some blood left on her from my body. I was surprised at how big she was. One of the midwives had told me she was going to be a tiny baby, so I was surprised to see her such a healthy weight and size.

It was all I could do to keep repeating “wow” and Joel was exclaiming similarly. We had a daughter.

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