Isla’s Birth Story (Part 2)

Read Part 1 here

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Somewhere along the way I called the doctor to report that my water had broken.  They asked about my contractions and told me I should probably go in anyway even though my contractions weren’t super regular.  Once that decision had been finalized I plodded through my various tasks between contractions. I looked for pants that wouldn’t be ruined if I leaked on them for the entire 45 minute drive to the hospital.  After locating a seemingly appropriate pair (black yoga pants) I looked for a shirt that seemed comfy enough to avoid irritating me mercilessly while we drove.  Not thinking, I grabbed a tank and grey sweater from the clean laundry basket but quickly reconsidered when I remembered wearing the same sweater to the emergency room when we lost Mara.  It seemed too risky to me to repeat any part of that wardrobe under different circumstances – like it would be an invitation for fate to revisit us.  So I quickly discarded the sweater for something different.

One thing I couldn’t leave behind was a sweet little etsy necklace my parents had given me for Christmas.  I couldn’t help but love it when I saw it on Pinterest, and when it surprised me under the tree on Christmas morning I loved it even more.  It’s a pearl-and-silver necklace with a small bird charm and a bird’s nest containing three pearl eggs.

When you wait for six years for your dreams to come true you have time to plan the many details.  One, like the necklace, just fell into place and I knew I wanted to give birth wearing that special reminder of the three precious birds in my nest.  Other details took more time and consideration.  One of those things was hypnobirthing.

While pregnant with Gabe I became familiar with a childbirth preparation course called “Hypnobabies.”  The basic premise is that you can have an easier, faster, more comfortable birthing experience if you learn self-hypnosis and how to apply that skill to the demands of birth.  I ordered the program around 24 weeks and proceeded to practice it periodically from that point onward, and eagerly fired up my ipod playlist when we got into the car.

As a side note, I will say that if you decide to use Hypnobabies it would be helpful if you give your birth partner a primer on what you’ll be doing.  I did not, and Tahd found it quite bizarre that I’d go into these quiet trances and refuse to respond to his questions. 😉  See?  Trance.  I was completely unaware that anyone was taking my picture.

Me in hypnosis later at the hospital

I immediately noticed that the hypnosis scripts helped.  In fact, in retrospect I think they helped too much.  Each time I went into hypnosis my contractions got easier and further apart.  I didn’t complete the entire program so I don’t know if there’s something I missed – or perhaps I wasn’t doing everything correctly?  But they certainly made my early labor experience easier and more comfortable, so I’d call that a win.  I sat, entranced, in the car seat, focusing on the calming voice of the hypnosis instructor and trying to imagine my calm, peaceful birthing experience as well as the anesthesia that was supposedly flooding my abdomen.  It sounds hokey to see it in print, but it really was quite soothing.  I’m a fan.  Granted, I’m also anxiety prone so I also spent a fair amount of time trying to feel the baby move to make sure she was still okay.  Not sure that’s what the hypnosis people had in mind, but I alternated between the two extremes fairly smoothly.

Upon arrival at the hospital I was triaged in the hall.  Triage went something like this…

Nurse: So you’re in labor?

Me: I think so. It’s not super regular but I’m definitely having some contractions.

Nurse: Did your water break?

Me: Um, I’m not sure. I think so.

Nurse: What do you mean, you think so?

Me: Well, I’m wearing a diaper and it’s not enough to prevent the leaking.

 

That answer earned me a trip past the triage holding rooms and directly to the labor and delivery room – Room 2005 – as the nurse assumed that anyone with broken water wouldn’t be leaving without a baby.  She got us settled into our room and began the arduous paperwork process.

I could tell right away that I loved her because she led with a discussion of my birth plan.  When I’d had Gabe my nurse was, at the very most, content to pay lip service to my birth wishes.  She read them and then proceeded to ignore them for the next 8 hours.  This nurse, Greta, went over everything with me and was so reassuring.  Like with Gabe my blood pressure was again high – not as high as 200/100, but high enough (145/90) to make her pay attention, but even at that she helped accommodate my wishes and I felt completely cared for in her hands.

Bless attentive, caring nurses! They make all the difference!

My last “official” belly shot

We did the first round of monitoring and she assured me the baby was handling the contractions fine and I needn’t worry, and once her records were complete she left us to labor for a while.

Gabe stopped in for a visit 🙂

When she eventually came back around 11:30, it was with news that surprised both me and her.  My doctor, apparently bothered by my inefficient contractions, had ordered an immediate iv and pitocin drip in spite of the fact that I had expressly asked to do whatever I could to avoid The Devil Drug.  I expressed my dismay to the nurse, and she said it had surprised her, too, since my water had only been broken for 4 hours and I was, in fact, contracting on my own.  She said it had surprised her so much, in fact,that she actually asked the doctor four times to confirm that she wanted the pitocin started, and each time the doctor said yes.

Not wanting to consent immediately I asked Greta if it was reasonable of me to ask to speak with the doctor before I accepted the medication, and she said she felt it a conversation was definitely in order, and that perhaps I could ask to wait an hour or two before the pitocin had to be administered.  She said that midwives typically allow their patients to wait up to 12 hours before encouraging pitocin and understood that in light of our preferences we might want more time than 4 hours.  She also assured us that the baby was fine and there was no indication on the monitor strip that she was under distress.  I felt really good about asking to talk with the doctor and felt confident that we could reach an agreement.

How wrong I was!

The doctor eventually called us, and it quickly became evident that she had no interest in helping me experience the birth I wanted.  She explained her rationale (my waters had already been ruptured for 4 hours with little progress) and I requested additional time.  She replied with a line I came to hate, “Well, if you just want to do things your own way I have no reason to keep you and you might as well go home.”  Over and over again she’d say the same thing, no matter what question I asked.  It seemed so manipulative to me, like she was trying to back me into a corner but make me think I actually had a choice in the matter.  Finally, I got very direct.

“I don’t understand my options,” I said.  “Are you telling me that I have two options – to accept pitocin now or be discharged to go home?”

“Well,” she started, “If you just want to do things your own way there’s no reason for me to keep you in the hospital.”

Again.

“No,” I answered, “I don’t understand.  Are those my two and only two options? Do I have any other options?”

“Yes,” she finally directed, “those are your only two options.”

My mind whirled with anger and fear.  I was fine.  The baby was fine. What was the hurry?  I wasn’t asking for an indefinitely period of time, or even all day!  Just two hours.  I was contracting.  I was 4.5 centimeters dilated.  My water was broken. How could she possibly send me home?  And yet she could, and I didn’t know what to do.

To buy myself some time I told her I’d discuss the options with my husband and would inform my nurse of our choice.  We hung up, me fuming and in tears and Tahd completely incredulous.  What was our doctor thinking?  Did she have a hot date later that night and didn’t want to miss it?  Or did she really believe I needed the pitocin for the health and safety of the baby and me?

I guess I’ll never know, because when the nurse came back I cried and told her that I never wanted to be spoken to that way again and that I did not want that doctor to have any part in the delivery of my baby.  I asked her if there was any possibility that I could switch from the care of my doctor to the care of the midwives who were part of the same practice.  I held my breath, knowing I could be creating an awkward situation and it might be a long shot to switch at the last minute – while I was in labor.  But thankfully, she said she’d investigate that option and left to see what she could find out.

I don’t know what I would have done had she said it wasn’t an option.  I was fully prepared to check out, just on principle.  However, I knew I’d never make it home, let alone home and back again, before I’d be laboring more regularly.  I considered setting up shop in the hospital lobby if necessary, figuring at least I’d be close.  I also considered accepting the discharge and when I eventually asked to be readmitted to request midwife care at that point.  And of course, I considered just taking the pitocin right away.  More than anything, I was afraid to leave the hospital.  By this point I knew I was in labor, knew my water had broken, and knew the baby needed to come out sooner rather than later.  In no way did I want to be without monitoring and medical care at the ready.

Walking the room – can you tell I was really discouraged?

It seemed to take a full eternity; looking back, I think my nurse might have moved slowly in order to buy me as much time as she could.  While I walked the room attempting to get my contractions to regulate and strengthen she made phone calls.  Eventually, I noticed an annotation running across my digital chart on the computer screen monitor – “Dr. W okay with patient switching to midwife-managed care.”  Then a few moments later – “CJ (midwife) agrees to assume care of patient.”  I immediately relaxed, and within 25 minutes was in full-blown labor, 6.5 centimeters dilated and begging for some sort of pain management.

Going into Gabe’s labor I was certain I didn’t want an epidural and hoped to avoid any narcotics, also.  (In the end I did skip the epidural but had some Nubain in my iv.)  With Isla, however, I felt much more open.  I intended to use Hypnobabies as much as possible but was open to the idea of narcotics or an epidural if I wanted either in the moment.  When my labor suddenly and strongly kicked into gear?  I wanted!  I was so desperate for relief that I sent Tahd from the room to find the nurse – the call button wasn’t fast enough. I wanted him to find her and bring her back with him, instantaneously, if possible!  It didn’t take her long and she came with supplies to start the iv as well as fluids and some Nubain to hold me over.

Again, bless her!  I loved that nurse!

The Nubain took enough of the edge off that I briefly considered skipping the epidural, but knowing it would only get worse I decided to go ahead and have the epidural anyway.  Several hours later when my midwife was actually reaching inside me to manually remove the placenta, she said I should be very happy I had gone ahead with it.  Apparently manual removal of the placenta is extremely painful, a fact to which I can’t attest since I was happily drugged and oblivious to anything but my babe at that point.

I didn’t know it at the moment, but apparently Tahd was extremely nervous while the anesthesiologist administered the epidural.  Lacking a soft touch, he listed off the potential side effects and complications rapid-fire, and these really troubled Tahd.  I, however, was almost unaware of him speaking, just gritting my teeth and waiting for him to GIVE ME THE DRUGS!  The whole thing was relatively quick and painless, and I welcomed the relief that washed over me.

Some people talk about their epidurals not taking properly, and I had been worried about this.  As it was, I think my epidural worked really well except for one spot that ran down the left side of my belly.  In certain positions it hurt worse than others, and taking full, deep breaths didn’t feel great.  No one knew why it didn’t take there, but I wonder if it had to do with the fibroids I have, or maybe the position of the baby.  Whatever it was, it was annoying – but not bothersome enough to make me regret the medication.

With the epidural in place labor took on a much lighter tone.   My mom and sisters had joined us and I called a dear friend and invited her to visit if she wanted.  Gabe stopped in a few times to see what was happening – he’d spent most of the time sitting in the hospital waiting room with my dad and brother-in-law, and I think he was as nervous as he was excited.  Someone delivered some food for Tahd and we settled in for the duration.