It’s taken me more than a month to get this down and out onto the interwebs partly because of the hazy fog that is my brain in these early newborn days, partly because I haven’t yet figured out how to blog without using my arms (which are rarely free these days) but largely because whenever I actually sat down to write this out, the words just wouldn’t arrange themselves properly. Much like trying to get a wriggling, hungry newborn’s leg into a sleeper just a little bit too large for him, the words have been resistant and fussy.
Before I begin, I have to tell you one more time how much I enjoyed your collective company in the long final days of my pregnancy, and especially during the wet – if not terribly productive – day of liveblogging the labour. Who knew captchas could be so much fun? And now, I bring you back to the morning of the induction. If you remember, my water broke Thursday morning but I had been relatively contraction-free all day, and so they called me in for an induction the morning of Friday, February 8.
It’s a mundane start to what promises to be an exciting day. Beloved and I arrive at the hospital with my mother just after 8:30 in the morning. There’s paperwork to be completed, and my vital signs are recorded. Amanda, the almost-certified student midwife who has been my primary contact in these past few weeks puts an IV in my arm, struggling with my small, rolling veins. The midwives work in teams of two, and the presence of Amanda is a nice bonus. My primary midwife, Sandra, is off call, so Denise will attend throughout the day and Stephanie, who I think is the senior midwife on the team, will arrive in time to “catch” the baby. All in all, I have a great team and feel very well cared for.
The hospital’s induction protocol calls for the on-call OB and nurses to supervise the first part of an induced labour, so after hooking me up with the drugs and assuring me they’ll be back when things get exciting – that is, when active labour begins – the midwives leave me in the care of a nurse and a student nurse. The OB breezes in, and I like him immediately. He’s very genial and cheerful, and lays one hand on my belly and says, “Yep, that’s a 10 pounder alright.” (Eeek!) As the pitocin starts to drip into the IV, I’m only 2 to 3 cm dilated, and while my cervix is softening, baby is still pretty high in my cervix.
We settle in to wait. After some nervous playful chatter, my mother, Beloved and I – all cut from the same cloth – pull out books and begin to read. After the baby is born, I’ll go to the page marked by my bookmark (I’m in the middle of Book IV of Stephen King’s Dark Tower series, Wizards and Glass) and realize that I have absorbed exactly nothing of the 40 pages or so I’ll read through that morning and will return to where I started and re-read those pages for the first time. (And, more than a month later, I’m still only half way through that book. I read six novels in the last six weeks of my pregnancy, and only about eight pages in the five weeks since.)
My natural curiousity is thwarted by the fact that the primary language of business in the hospital is French. While everyone speaks perfectly comprehensible English to me, they speak to each other in a rapid and colloquial French that I can’t hope to follow or, more importantly, eavesdrop on. I peek over their shoulders at the computer monitor they keep updating, and realize the interface and all the notes are in French, too. Foiled by my unilingualism yet again.
You might remember way back when I was trying to decide between a midwife and an OB for this pregnancy, one of the things that alarmed me about the idea of a midwife was the reduced amount of fetal monitoring during labour. However, after reading your comments and researching the matter, I realized that continuous fetal monitoring is not only not required or recommended, but sometimes causes more interventions than might otherwise be necessary. It’s therefore quite ironic that as we wait for the pitocin to do its work, I am becoming increasingly agitated by being strapped to the fetal monitoring machines. I instinctively want to move, to get up and stretch and walk. I know that walking will help motivate contractions (even if shovelling the driveway did not!) and my hips and back are screaming for movement. I keep asking the nurses to unhook me, and while they do free me from time to time, they want to strap me back after a 20 to 30 minute interval to continue to monitor the baby. I begin to pine for my midwives almost immediately.
The pitocin works its magic and contractions begin to come regularly, and frequently, but without intensity. Lunch arrives in the delivery room just before noon, and while I decide to forgo the pork stew (seriously, they served PORK STEW to the DELIVERY ROOM!) I do partake of the fruit salad and vegetable soup. Not surprisingly, both my mother and Beloved also pass on the free
shit on a shingle pork stew.
I continue to be agitated to be strapped into the bed, and once again ask the nurses to liberate me. We take a few short walks in the hallway, but my hips ache so much from lying in the bed that I’m hardly mobile. Even walking small circles in the delivery room helps to strengthen the contractions and, more importantly, soothes my agitation somewhat.
Shortly after 1:30, the contractions are coming two minutes apart, increasing slightly in intensity but still quite manageable. The nurse checks my dilation again, and I’m still only 2 to 3 cm dilated, but she turns down the dosage of pitocin because she’s concerned about the lack of rest time between the contractions – not so much for right now, I suspect, but for when that intensity finally kicks in. She asks if I mind if the student nurse also checks my dilation, and I concur. I realize, when her hand is wedged deep in my hoochie, that she has no experience whatsoever in checking someone’s cervix. She looks to the nurse quizzically when she cannot “find” my cervix. Feeling magnanimous, I assure her it’s there and encourage her to go ahead and root a little deeper as I suspect I have endured more cervical exams in my lifetime than she has administered, and can tell she is not quite in the right place. To my growing alarm, she spends what seems like an eternity groping my innards. Finally, I politely suggest maybe I’ve had enough, and she gives up.
Apparently it’s neither walking nor shovelling nor pitocin that stimulates contractions, but having an unexperienced student nurse wedging her arm up to her elbow in your hoochie certainly seems to do the trick. Within 15 minutes or so, I have abandoned my book and any thoughts of wandering the hallway as I breath through the rapidly escalating contractions. My assessment of the pain goes from a three to a five to a seven in about six contractions, and I gasp for the nurse to call the midwives back. I also begin to seriously doubt my decision to experience this whole act without the benefit of drugs.
My mother has been skeptical all along of my tentative desire to birth this child without the epidural. To her credit, she remains respectful of my wishes, but a few times during the morning she has asked me if I’m sure, telling me it’s okay if I want to ask for the drugs. When I assure her that I won’t be shy about asking for them if I feel I need them, she seems mollified but still obviously perplexed by my choice. As the contractions intensify, I begin to panic and want to make sure that the epidural is in fact available if I want it. The contractions are bearable, but I’m afraid that eventually they won’t be. The nurses ask me to sign some sort of release form, and I’d love to see exactly what my signature on that form must look like. This is the handwriting of a person who is beginning to freak out.
As the pain of the contractions ratchets up, my awareness of the world contracts as well until I am barely aware of the activity in the room. There is a steel bowl on the table beside the bed, and as I lie on my side and try not to give in to abject panic, I finger the smooth coolness of the steel between contractions and find it oddly comforting. I don’t want to be touched or spoken to as the contractions escalate — I just want my midwives, or the epidural. Or a wormhole to open and rescue me from my delivery, perhaps depositing me somewhere about three days into the future, babe in arms. I’m in the bathroom trying to time a pee between contractions when the midwives finally return at approximately 2:30 pm.
As I stumble out of the bathroom and lean on the bed into another contraction, the newly arrived midwives are trying to evaluate how far along I am and how long we have until baby makes his way out. They’re trying to convince me to try the bath for some relief from the contractions, but I’m thinking that the bath is a poor substitute for drugs at this point. I find myself leaning against the wall, barely able to speak or think coherently, and manage to say, “I might be able to do this for an hour, or I can do this for ten more minutes. But I cannot do this for an hour and ten minutes. I just can’t do it.” They laugh, and I tell them, with teeth gritted, that I am not joking.
The midwives finally convince me to try the bath, and I remember pulling my socks off and muttering curses about their stupid bathtub under my breath. They check my dilation again, and it’s now around 5 cm, which is promising but still a long way from 10 cm. I find myself standing up again – I must have been on my way to the infernal bathtub to placate them – and leaning against the wall for support. The contractions are now so intense and so close together that I can barely communicate my admittedly truncated thoughts. What I want to say is, “The contractions are really REALLY intense right now, and while I can handle them at this point, I’m afraid I won’t be able to if they get stronger than this or if we go on for hours like this. Is there some way to judge whether they will get more painful, or how much longer this might go on?” What I actually say is, “Please — I need the epidural! NOW!” That’s all my mother needs to hear. If I want that epidural, in the name of all things holy she will see to it that I get that epidural. Beloved later tells me he begins to fear for the safety of the midwives if they don’t capitulate to my mother’s formidable will. I can hear her
arguing rationally discussing the issue with the midwives and advocating for some sort of pain relief for me, but I am powerless to join the conversation at this point. My eyes are closed and everything happening around me seems oddly distant.
As I stand there against the wall, shuddering with the intensity of another four or so contractions with barely any respite in between, I become aware of a new sensation. Once again, my brain and my mouth are in disagreement as to the sentiment to be expressed. What I want to say is, “I’m aware from my previous birthing experiences that pressure that feels like a bowel movement may in fact be the baby making his way down the birth canal. But, that can’t possibly be – it’s much too early for that.” What I manage to gasp out is a rather alarmed, “Um, I feel like I have to poop. I don’t think I have to poop.”
I stumble back to the bed and this time when Amanda (or maybe it was Denise – really, the whole thing is a giant blur by this point) checks my dilation, in just a few minutes I’ve dilated to 8 cm. I’m teetering on the edge of panic, but Amanda’s warm hand rubbing the small of my back through each contraction keeps me grounded, and in that moment I am happy with my choice of a midwife-attended birth. The nurse had been hands-off through my contractions and tended toward being reactive instead of proactive. Where the nurse simply crouched in my line of view to ask me if there was anything I wanted (the answer being, “DRUGS!”), Amanda does not wait for me to ask for help but uses her words and her touch to reassure me and guide me through this panicked fog of escalating pain.
I begin to realize that the time for epidurals – and, for that matter, baths – has passed. Barely two or three contractions later, and I further realize that my conscious brain is no longer running this show. With a feeling that is vividly reminiscent of a manual-transmission car stuck in first gear, my body shudders into push mode and I manage to gasp out that I have to push, which terrifies the small functioning part of my rational brain that realizes this is all going far too quickly. I am astonished at the primal intensity of this urge, and how my body is now working completely independently of my brain. Amanda checks my dilation one last time, and finds me fully dilated save for a small lip of cervix, which she reaches in to ease over the emerging baby’s head.
The desire to push is overwhelming and I am powerless to resist it. While I’d heard women speak of how much a relief it is to finally be able to push, I’d never felt that sensation before. When I push, it’s as if all the pain dissipates instantly in the act of pushing. It’s blissfully sweet relief. Unfortunately, a 10 lbs baby crowning carries it’s own set of pain triggers, and I’m surprised to find I’m not nearly as stoic as I have expected myself to be. As the baby’s head emerges, I let out a primal yell, and that too feels surprisingly good. An oxygen mask has been slipped on to my face at some point, but I have no idea how long ago, and I have vague recollections of someone telling me to calm my breathing. And suddenly, I am out of steam. With his shoulders left to emerge, I find the concept of pushing completely alien. Push? Push what? What is this “push” thing you speak of? I must have said something like, “I don’t want to push anymore” because Beloved is at my shoulder talking me through it and encouraging one last burst of energy. Listening to him and only him, I find another reserve and with a few final pushes, Lucas’ shoulders emerge and the rest of his body slips out. He is born at 3:23 pm, on Friday February 8, 2008. I hold out my arms and open my eyes just enough to confirm that he’s safe and perfect as I wrap my arms around the warm, slippery bundle that is my third son.
Beloved later tells me that although this was the quickest of all my deliveries, it was also the most harrowing for him. The sheer speed of the delivery has unnerved him as badly as it unnerved me. The midwives later tease him lightly, telling him it’s been a while since they’d seen anyone pace a delivery room so frantically.
My mother, who I’m told watched the whole delivery over the midwife’s shoulder, cuts the cord. Here’s what she said in the comment thread to an earlier post:
I WAS THERE!!! Thanks to Jen and Papa Lou for babysitting. I can tell you that Dani is a very strong woman!! With â€œBelovedâ€ by her side, she brought into the world another beautiful baby boy. Although I have birthed two of the best – I have never seen a baby being born. It was an awesome experience that I will never forget. I was honoured to be asked to cut the cord!!. How lucky I am to have such a loving and caring family – 5 grandchildren in 6 years.
After a lingering cuddle, they take Lucas over to the warming table to clean him up. Although he scored a 9 on his first APGAR test, they are worried enough about his chalky white palour to call in the on-call pediatrician for a consult. (This, to me, represents the best of both worlds – midwife care in a hospital with on-site doctors.) They fit Lucas’ wrist with some sort of oxygen monitor, but find his levels acceptable. The ped says the chalky palour is likely from shock, due to his rather rudely abrupt delivery, and that he is otherwise fine. (He will show other signs of his speedy delivery as well: he will spend the night spitting up mucous that did not have a chance to disappate, nearly scaring me to death the first of many times he seems to choke on it throughout the first 24 hours, and he will have small bloodblisters in his eyes and a bit of a fat lip from where his poor face smacked into my pelvic bones on the way out!) Stephanie, the second midwife on the team, arrives around this point and I realize that the delivery went much more quickly than even the midwives were anticipating.
As they tend to Lucas, I am dealing with my own residual shock issues. With a very low blood pressure of 80-something over 50 something I am shaking badly and having weird visual hallucinations that give everything in the room bright and dark auras. Amanda gives me a few stitches – not nearly so many as with Simon, who was born with his hand raised above his head in victory – while Denise and the ped minister to Lucas. Finally, after what seems like an eternity and in which time I am becoming even more agitated than I was to be strapped in the bed earlier, Lucas comes back to me. As I hold him and then let him latch on for a well-earned snack, Denise keeps her fingers ringed around his wrist to hold the oxygen monitor in place.
After a while, my own vision has cleared and Denise takes Lucas back to weigh him, administer some vitamin K and put the antibiotic drops in his eyes. While she does this and I eat the cold vegetables and mashed potatoes of my salisbury steak dinner delivered some time in the last hour or so, Amanda takes my mother and I on a “tour” of my expelled placenta while Beloved tries to ignore us. If you ever find yourself with the opportunity to tour a placenta, I highly recommend it, even if you do it while you are eating cold mashed potatoes and congealed gravy. Though I had read about everything she showed us in years of (obsessive) research, it is still fascinating to see Amanda hold open the amniotic sac and show us how all the parts work together. More reasons to recommend a midwife-attended birth!
After the tour, my mom heads out to relieve Papa Lou of Tristan and Simon, and Beloved and I have more chances to cuddle with Lucas. The midwives are laughing as they complete the reams of paperwork required by the hospital. “You weren’t kidding when you said you didn’t want that labour to last longer than an hour, were you?” Amanda asks. No wonder Lucas and I were both feeling a little shocky after the fact! Turns out the active labour clocked in at 58 minutes.
Surviving the labour and delivery without the epidural was an incredibly empowering act. It truly was a completely different experience from my deliveries of Tristan and Simon, and I’m so glad to end my childbirthing experiences with this one. I don’t think I’d recommend a medication-free delivery for a first labour, but I’m glad I was brave enough to try it. (Yes, I am claiming the victory that was actually forced upon me by the speed with which Lucas arrived. It’s my story and I can spin it as I see fit!)
Even at its most intense, the pain was not unbearable. It was almost unbearable, though, and what frightened me was the unknowable: will it get worse, and how long will it last? My recovery from the delivery was also nothing short of amazing to me, and I can only assume the lack of drugs contributed to that. Despite the stitches from a tear, I was able to sit relatively comfortably to feed Lucas that first night in the hospital, and I didn’t even need to take the Tylenol and Motrin that the nurses provided. I felt physically back to normal within just a few hours, even though I had residual issues with my, erm, digestive system a week or so later.
I had more or less planned to stay at the hospital as long as they’d let me, and joked that it was more of a hotel than a hospital stay – free meals delivered to your bed, does it get any better than that? – but with Lucas’ arrival, I was beginning to waffle and think maybe I would prefer to go home after all. Unfortunately, I needed an IV drip of pitocin to assist the contraction of my uterus until after midnight, and the hospital protocol for babies larger than 10 lbs requires a heel prick to check his blood sugar a few times in the first twelve hours. Even more unfortunately, there were no private rooms available, so Lucas and I spent his first night on earth rooming with Shania, the newborn who wails like a stuck pig (I swear, I’ve never heard such an unpleasant sound uttered by a newborn) and her inconsiderate parents. They didn’t bother to turn down the full volume of the DVD player they were watching when I arrived; around 10 pm, they decide to shower – together! (ick!!) – for more than 20 minutes, leaving me with such a full bladder and so desperate to pee that I had to drag my IV pole and the baby in the plastic bassinet out into the hallway in search of an available toilet; and, the mother allowed the baby to build up to a full wail before tending to her in the night. It was a very long, very unpleasant night. I was not overly impressed by the nursing staff, either. When my IV pole ran out of battery power at 12:45 am and an alarm began to beep, no one responded to my call button and after 15 minutes I wandered out into the hallway and to flag down a nurse to silence the infernal thing. After an endless night, I called Beloved early in the morning and begged him to “come and rescue me”. I couldn’t get home fast enough!
And that’s how Lucas Sawyer made his way into the world, one full week after his due date. Oh, and the reason he was so stubborn and waited that extra week, and dilly-dallied a whole extra day after my water broke? Well, Tristan was 9 lbs even and Simon was 10 lbs even but Lucas topped them both at 10 lbs 1 oz. I’m quite sure that Lucas was waiting for that extra ounce to accrue, just so for once in his life he could be the big brother, too.