What I Wish I Had Known about Labor

If you all have been following along, you know I like to be prepared. I feel like we were pretty prepared as a couple.  After all, the books, classes, research and blogging should have made up for the bulk of my lack of experience right?

Up to a point.  Here's where I play the game "I Wish I Knew."

I wish I knew that the labor clock starts when you tell them your water broke.  My water broke at 8pm and I thought I had 24 hours from the time I was admitted before they would push a C-Section.  I would have told them my water broke shortly before I arrived at the hospital at 11pm to give myself more time to try for a vaginal delivery if I knew my baby was a size that I could actually birth.

I wish I knew that babies can go into distress based on which side of your body you lay on.  Ben's fetal heart rate dropped when I laid on my right side. I don't know how often he did that when I was pregnant but when I was admitted and they hooked me up to fetal monitoring and I moved from my left to my right side for comfort, he had a steep heartrate drop.  I would have avoided laying on my right side during the pregnancy had I known there was a risk of compromising baby's bloodflow.

I wish I had known that once I was admitted, there would likely be some reason to require being hooked up to monitoring and as a result, I would not be able to freely go to the bathroom.  I actually should have known this but the childbirth classes led me to believe that most people have a free range of motion to labor as they wish.  I packed a birth ball for goodness sake.  All for nothing. I would have made sure I went to the bathroom before going to to hospital to empty my bladder and bowels so I would be comfortable and not need to go to the bathroom and not be allowed to.  

I wish I had known that contractions compound the feeling of needing to void one's bowels but nothing will come out.  When my contractions started, I thought I just really needed to go the bathroom.  I wasn't allowed to because of the whole fetal distress monitoring but when I was finally allowed to go, I wasn't physically able to void.  It was so uncomfortable.  During the pushing period of my labor, the nurse manually excreted my bowels to make more room for the baby to pass through what was already a too narrow passageway.  I would have had an enema before going to the hospital to make sure my bowels were empty and not have to deal with any of that mess.

I wish I had known that I wouldn't be able to eat or drink at all starting from when I was admitted to hours after surgery.  I was allowed ice chips and that was it. I was dying of thirst.  I don't know what I would have done differently in this case, as I did vomit water during the end of my labor, but I just wish I had known to prepare myself mentally. 

I wish I had known how distant and violent a c-section would feel like.  Where the labor process felt animalistic and primitive down to the core, like being nothing more than an instinctual experience, the c-section felt clinical and detached.  It was almost futuristic in comparison to all the reading I had done.  The drugs made me woozy so I couldn't hold my baby comfortably for hours after birth.  It underscored my confidence as a mother.  I wouldn't have done anything differently because I was able to experience both sides of the coin but I would have liked to understand that those feelings were a natural part of c-section instead of feeling insecure in myself post birth. 

But mainly, I wish I had known that everything I had stressed about, the time I spent on my birth plan, everything that was disappointing or surprising wouldn't matter in the end.  It all feels like a past life. I became a mother.  I would have read less books about childbirth and more books about parenting. 

Because this is seriously a wild ride.

Birth Story: The Short Version

When people who haven't had children ask me now how my labor was, I give them this story:

DH asked me to not give birth until my due date, September 9th. He had a project he worked on all year long and people flying in from all over the country at work to bring it all together on September 9th.  As long as I could hold on until then, he could leave on Paternity in good shape.

I told him, "That really isn't up to me sweetie." 

But apparently our child is a considerate little bean because he waited until the evening of September 9th, when Daddy had met his deadline and felt at ease, to break my water. 

But my water breaking, I mean a confusing trickle.  It didn't happen like in the movies.  When it happened, DH looked at me and asked what was wrong because of the look on my face and not a puddle on the floor.  I said, "I think my water just broke?"

And when we got to the hospital at 11pm, I still wasn't 100% sure my water had broken.  We waited to get the fluid tested.  And then it was 25 hours of labor. Everything we expected, nothing we planned for.  That Birth Plan I spent so long on was as good as toilet paper. 

But we knew that Little Bean might be too big for me to vaginally birth and that a C-section was highly likely.  They thought he would be in the high 7 lb to low 8 lb range. I did want to try to have him without surgery though.

So, after hours of labor without an epidural, the next day I had them juice me up.  And it was amazing.  I was finally able to sleep through contractions.  I even had visitors.  My labor wasn't progressing naturally and there's a 24 hour clock that starts when the water breaks to when the baby should be born to avoid high risk of infection. They administered Pitocin to induce productive labor. At hour 23, we started pushing for the next 2 hours only for Baby Buckshot to end up stuck in my pelvis.  

The experience of a c-section is surreal.  Completely drugged up which being shoved and yanked, what I finally remember is hearing him cry when he was removed from my body and the doctor saying "He's bigger than we expected."  Yeah, 8 lbs 12 oz to be exact.  There was no way I was going to birth him out of my 5'2 frame.   Apparently he was very long and had big feet for a new baby too. 

But Mommy drugs are a weird thing.  I don't remember any of the unpleasantness of my labor experience, the same way I don't remember how uncomfortable I was during pregnancy.  This might be my sleep induced haze talking or my breastfeeding frustrated mind talking but it just wasn't that bad.

Birth Story: Part 3 - C-Section and the Technicolor Dream

I can't describe the disappointment I felt when the OB told me that the baby hadn't descended and that my only reasonable option was to have a C-Section.  I'm sure I could have said no and insisted on continuing to push but by the time the 25 hour mark came up, I was so tired and all the pushing felt so futile.

I relented and now have no regrets.

During the pushing, the nurse had removed my catheter to make more space for the baby to pass.  As a result, they had to reinsert the catheter before surgery which proved to be a difficult task because the baby's head had been pushed far enough to block access to the bladder. I'm not really sure how they handled this issue because I was exhausted and ready to sleep.

They wheeled me into the operating room and after a nifty bed switch with what felt like an inflatable raft, the anesthesiologist administered a local anesthetic which allowed me to stay awake during the C-Section without me feeling any of the pain.

Did I mention that before receiving my epidural I had an extreme case of involuntary shaking that continued after I had the epidural?  It scared the living daylights out of me at first because I thought I was seizing.  Turns out it was just my body's way of dealing with pain.  I started shaking uncontrollably again in the OR.

Now, a C-section is an odd experience.  They put up a barrier preventing any glimpse of anything below the shoulders.  The anesthesiologist talks and directs the staff like you aren't even there on the other side of a flimsy cloth wall.  I felt no pain but pressure but did feel violent pushing and yanking of my insides while my body shivered and shook.

Had I not already gone through a whole day of labor, experienced vomiting and someone manually voiding my bowels during pushing already, my birth story would be of this C-section alone where I was completely disconnected from my body and the moment.  Where labor and pushing were visceral, the C-section was totally clinical with an unreal dream like haze. When my baby was yanked from my body, the only way I knew that it was him and not some organ was that I heard his cry.  The only way I knew it was my baby was because I felt the yank vaguely in the lower parts of my body.

I heard the doctor say, "He's much bigger than I expected.  If I had known, I would have made a bigger incision."

I heard the someone else say, "Those are really big feet."

I heard my husband say, "8 pounds, 12 ounces?!"

I hear another voice say, "22 inches."

And I heard someone ask me if I wanted to hold him and I had to say "No."  I couldn't hold my baby. I felt weak and out of control from the anesthesia, my shaking had me worried that I would drop him. Instead, my husband held my little boy next to me and I was able to kiss him before he was taken away to recovery for my husband to do skin-to-skin with him and I stayed to be stitched up.

Then I passed out.

Birth Story: Part 2 - Epidural, Pitocin and Pushing

When we arrived at the hospital, as I got out of the car and walked to Labor & Delivery, I felt fluid trickle down my leg.  About 90% sure it was amniotic fluid at this point, I waited in Triage to have the fluid checked.

Instead of immediately checking the fluid, they hooked me up to a machine that tracks the baby's heartbeat and my contractions, which at that point, had not started, and relegated me to a hospital bed while being monitored.  About an hour into waiting for the fluid to be tested, the baby's fetal heart rate dropped rapidly.

A nurse came in and hooked me up to an IV immediately in order to create a larger fluid cushion around the umbilical cord, and just like that, all my hopes of applying the birthing techniques from my Childbirth Preparation class, walking in the courtyard to bring on labor and using a birthing ball went out the window.  I couldn't even get up to go to the restroom because they were concerned about the baby's heart rate dropping again.

A Midwife came in, checked the fluid and confirmed it was amniotic fluid and checked my chart and explained that if I didn't start labor by 2am, it's hospital policy to start induction with Pitocin.  I wanted to avoid induction because of the strong and unnatural contractions. I explained to the midwife that I would rather not induce and she explained that the risk of infection dramatically increases 24 hours after the bag of waters breaks. She then told me to think about it and we would talk again at 2am.

We were moved to a Labor and Delivery room and I was kept on continuous monitoring. At 2am, the midwife came back and said it was time for the Pitocin.  I told her I'd like to wait until 4 or 5am.  She asked, "What do you think will happen between now and then?" I told her that I just hoped to get a nap before starting labor which she thought was reasonable and agreed.  The truth was, I hoped I would start laboring on my own without needing the Pitocin.

By 4:30am, when the midwife returned, I had started contractions.  She seemed satisfied and stopped insisting on induction, performed a cervical check and said she would come back in a couple of hours to see how my labor progresses.

Now, I understand that contractions feel differently for everyone.  For me, it was like a combination of menstrual cramps and the extreme need to void my bowels.  The pressure on my bowels was the most overwhelming.  I was desperate to go to the restroom based on that feeling and they allowed me to disconnect my monitoring temporarily since the baby's heart rate remained steady to go to the bathroom.  When I finally got onto the toilet, I didn't have the need to void any longer.  Apparently, it was just the contractions.

DH did what he could to relieve my pain.  Tennis balls and back massagers didn't work.  What did work was him kneading a knot out of my shoulder.  The pain from releasing the knot took my focus off the pain from the contractions enough to get through each one.

By 9am, I had not progressed and my contractions were still irregular and not productive.  The contractions were painful enough that I was willing to get an epidural which allowed me to finally get some sleep.

Throughout my pregnancy and up until that moment in labor, I had been worried about the pain of a needle going into my back for the epidural.  I was so scared of needles that I figured I could forgo the epidural because the pain of contractions couldn't possibly compare to the pain of a needle going into my spine.  Turns out, when the contractions got painful enough, that fear went out the window.

The anesthesiologist administered a local anesthetic that numbed the area he would work on to insert the epidural.  I felt the needle go in with a wince of pain and then a cold feeling spread from the injection point.  It didn't take away all the pain associated with the placement of the epidural tube but it made the pain bearable enough for him to work without me writhing around.  When the happy juice started flowing, I was given a button to self administer if I needed additional relief and immediately felt the need to pass out from the exhaustion of being up all night dealing with contractions.

When I woke up, the new Midwife on staff brought up the possibility of needing a C-Section if I failed to progress by the time the 24 hour mark came up at 8pm.  She recommended that I receive Pitocin to create a productive contraction cycle to which I agreed in hopes that a vaginal labor was still a possibility.

In an effort to get my contractions in the right symmetrical single hump pattern every three minutes (my pattern up to that point was two to three humps varying between three to seven minute apart), the nurse played with the Pitocin levels.  That result in fetal distress and a gang of hospital employees came in, worked quickly and the OB on staff had the nurse take me off the Pitocin until the baby's heart rate was regulated again. An hour later, the nurse was allowed to administer low levels of Pitocin again to try to progress labor.

At 7pm, I felt the need to push and after another cervical check it turned out I was fully dilated but the baby was not well descended.  It was pushing time!  I vomited water from all the ice chips I had eaten.  I hadn't been allowed any food or drink since I was admitted and the IV was keeping me hydrated.  Pushing, it turns out, is a lot like pooping.  And I'm a very effective pooper.  I didn't involuntarily void on the table but the nurse did manually express my bowels in hopes that it would make more room for the baby to pass.

After over an hour of pushing, the baby had not descended far enough to be birthed vaginally, nor did the OB or Midwife believe I would be able to push him through my pelvic area.  It was time for the C-Section.

Birth Story: Part 1 - Pelvic Problems, Due Dates and a Bag of Waters

At my 36 week appointment, my OB, a previously gung-ho believer in me being able to have a vaginal birth despite what looked like a narrow birth canal, started to change her tune.  She had hoped that as the weeks progressed, my pronounced pubic bone would shift or that the baby would have enough space behind my pubic bone to descend.

I went proactively looking for a solution to my skeletal problem through walking, sitting on a birthing ball daily, doing hip circles, pelvic stretches, you name it.  I googled, binged and read everything I could on spinningbabies.com.  I was determined.

By week 39, my cervix hadn't changed, my pubic bone was still in the way and my OB suggested that even if I wanted a vaginal labor, if when I went to the hospital and I had labored for a few hours without result, I should ask for a C-section.  There was no need to labor needlessly if the baby wasn't going to be able to descend; it would end in surgery anyway.

My due date, September 9, also happened to be a major work deadline for my Dear Husband, who asked that if there was anything I could do to put off labor until after September 9, he would really appreciate it.  As though I had any control over the situation.  But given that I was a first time mom, I assumed I would go over my due date by about a week.

And my due date came quietly and uneventfully.  DH went to work and came home.  We had dinner and went through our typical nightly routine.  At around 8pm, I felt a trickle of water on my leg and went to the bathroom.  Urinary incontinence?  That's odd, I've been doing my kegels.  So I hopped in an epsom bath to clean myself off and to stave off some the pregnancy swelling and felt a few more leaks. "Hmmm... maybe this isn't urine?" I thought to myself.

As I dried off from the bath, I went to DH and said, "We might need to take a trip to the hospital tonight.  I think I'm leaking amniotic fluid."

"Did you want to call ahead to the hospital?" he asked.

"I'm just going to sit down for an hour and wait and see if the fluid pools up and comes out in more of a gush before I call," I explained after placing a pad to catch the fluid, while I sat down for a game of League of Legends to wait.

An hour later, I stood up quickly and there was no gush.  "False alarm I guess," I told DH as I headed to the bathroom.  I sat on the toilet and urinated and then felt a gush of water come out in the toilet.  I wiped and checked the pad and saw tinges of pink and decided it was time to call the hospital. They confirmed I should go head into the hospital.

DH went to go load the car as I went to take another shower, do my make-up and hair and pack up some last minute items. We loaded Charlotte Bark the Corgi in the car, called my mom and went to go drop Charlotte off at her house.  By the time we got to the hospital, it was 11pm.