Wednesday, March 5, 2014

A Birth Story



I generally pride myself on having very few concrete expectations, but for some reason my expectations about birth were different. They actually existed. The crunchy-granola hippie took over and I imagined that I would have a completely natural birth. No pain killers, no drugs, birthing while laying on the floor or squatting, plenty of kisses and intense, painful intimacy with my husband. I imagined that burning sensation when our son began to crown, and then the relief of having him slip out of me, wet and crying. I thought it would hurt, of course, but I thought it would be a manageable pain, growing gradually. It was nothing like that.

During my last few months of pregnancy I began looking for information about how birth actually feels. Sadly, there were not a lot of answers. Almost everything had a standard description of indescribable, the worst pain ever, like period cramps etc. I wanted to actually describe the experience and I went so far as starting my blog entry. It was entitled, A"How Birth Is Like An Acid Trip." I began by writing about the few days before birth and the anticipation of a trip... the waiting, the intense awareness that SOMETHING is happening. But after experiencing it, I realize it was nothing like an acid trip. Well, except that just like an acid trip no one really wants to hear about your personal experience giving birth. They might ask a casual question or two... how did it go, are you ready for another? But ultimately it's personal. It's private. It really is indescribable.

All of that being said, here is what happened to me.

I was 'due' on February 13, 2014. I considered the due date a loose estimate. With my long and infrequent periods it was likely that I would go over. Towards the end of pregnancy I imagine I felt how most women felt. I felt heavy and was in pain. My joints ached from the extra relaxin I was producing. My wrists in particular were screaming every time I tried to prop myself up on them. My hips ached from laying on my sides, and there was no possibility of laying on my back. I was beginning to have swelling, which I had avoided all pregnancy, and my blood pressure was steadily rising. My energy levels were the lowest they had been all pregnancy, and I could not even complete an hour of yoga without aching and feeling exhausted. In short, I was miserable. However, I was determined to wait things out and start birth naturally. I imagined feeling the contractions start and laboring at home with Nikola for the first 8 hours, before I even thought about heading to the hospital. I figured that when our baby was ready to be born he would start things. Really, I was terrified of the rolling ball of interventions that is said to begin with an induction.

On February 17 I had a checkup with my doctor. Before going in I discussed with Nikola how we were going to avoid an induction. What we would say if she offered one. Whether we would accept a membrane sweep. But she did not offer an induction. She recommended one. After checking my uterus she hooked me up to a monitor and determined that I was loosing water and my placenta was beginning to disintegrate. The baby's heartbeat, which sounded slow and rhythmic to me, was apparently too calm and she suggested an induction be started at 6am the next morning. Everything Nikola and I had discussed went out the window. I made a weak attempt at, "well, what would happen if we waited a few more days..." to which my doctor strongly recommended against it. We didn't ask for a second opinion, which I now regret, but really, would a different doctor working at the same hospital have told us anything different?

That evening I went home and cried. I didn't want an induction. I was terrified of it. Perhaps part of me was terrified of the actual birth process, but having it loom so solidly- 6am the next morning- it suddenly felt more real. At home Nikola and I took a nap, shaved me, and I took an oral enema to avoid having a physical enema at the hospital. Around 9pm we left for the hospital.

At check-in I was asked to put on a nightgown and slippers. The doctor on duty made an offhand comment that the baby was small to be induced and I had a glimmer of hope that I would be sent home to wait another week. But he said nothing more. A nurse came to do scratch tests on my skin and I shied away from the needles, asking to not have an IV catheter inserted due to my fear of needles. As usual, the doctor seemed annoyed by the request and asked what would happen when I needed one. I said that hopefully I wouldn't, but if I did I would allow it then.

We were then shown to our private room where Nikola and I cuddled, played cribbage, and watched half a movie while I tried to put off the anxiety and begin to feel sleepy. Eventually our efforts worked and around midnight I fell asleep.

At six in the morning the doctor on duty came to insert a capsule of progesterone. Nikola and I fell back to sleep. Around 8:30 I woke up and began to feel antsy. I suggested we finish watching our movie while we waited but as I sat up I felt a forceful POP in my abdomen. It was not uncomfortable, just a bit of a sound felt physically. I then stood up to use the restroom and the contractions started.

I had prepared myself for moderate contractions in the beginning, with a good fifteen minutes to rest between them as I adjusted to being in labor. The induction allowed no such thing. At first they were moderate and coming every two minutes. Nikola called the nurse on duty and told her my pains had started. He was informed that it was to be expected. But twenty minutes later I was sure that the pains were coming too quickly and too strongly so he called again. They checked and I was dilated to 2cm. I had a long way to go. That was about 9am.

At that point I was unable to find a comfortable position. I kneeled in front of Nikola. I had him kneel in front of me. I had him press my back. I tried deep, calming breaths. Nothing was helping. The pain was coming faster and harder. The nurses came and moved us into the active birthing room. However, by that time I had no interest in "active" birthing. I found that sitting on the bed with Nikola kneeling in front of me worked best. As each wave of pain came I bit into his shoulder and pounded his back with my fist. I felt like I was being torn apart inside and there was no break. I think I lasted about an hour of those contractions, one on top of the other with less than a minute between them, before I caved.

"I want an epidural," I told Nikola.

He did what he was supposed to do, "They said it gets easier when you are to 6 cm. Let's get to 6cm and then we'll see."

"Yes," I agreed. Then the next contraction hit and I found myself near tears.

"I want an epidural, now," I said, calmly, forcefully, without room to argue.

He picked up the phone and told the nurses. The anesthesiologist was in our room within three more contractions.

I didn't really LIKE the anesthesiologist. She made Nikola leave the room, which terrified me. But she spoke English, which was helpful. She had a nurse help me into a balled position and tried to find my spine, muttering about how much weight I had gained during pregnancy and how it made her job difficult. She kept telling me that I just had a low threshold of pain and the contractions could not be that strong yet, and mistook my screaming for fear of her needle as opposed to the constant contractions, which were now one on top of the other.

Finally, after what seemed like forever, the catheter was in and she had me roll onto my back. She slowly injected the anesthesia into the catheter and the pain melted away. Not completely, but significantly. At that point my doctor came in, checked my progress, and informed me that I would have to be moved to a medical birthing room as opposed to the active birth room because she wanted to be near the operating room, just in case.

From 11-12 things were rather calm. Nurses went in and out of the room while I sucked on oxygen and one nurse monitored my baby's heart rate. It slowed dangerously during each contraction and I was told to breathe the oxygen more deeply. The oxygen was making me nauseas and every time I breathed it I thought that I would throw up, but if I stopped my baby was in distress. At least the pain had subsided. I was scared, but finally able to catch my breath.

Around noon I hit 9cm and my nurse began to explain the pushing phase to me. By that time the epidural was wearing off. At that hospital they allow the epidural to completely wear off for the pushing phase so that the mother can feel when to push, for which I was grateful and upset. By 12.15 I heard a woman in the room next to me start her pushing phase. I still couldn't tell whether or not I had an urge to push.

There. Was that an urge with that contraction? Or was that just confusion from the, "Давай, давай, давай," I heard being chanted in the next room? Either way, by 12.30 I couldn't take it anymore and decided that it was time to push.

Perhaps it was too early.

I pushed with my contractions, which had slowed to every 2-3 minutes, for about twenty minutes. During that time the woman in the next room gave birth and her baby was being washed. At the end of twenty minutes my doctor decided my contractions were not efficient enough and gave me a dose of oxytocin. Immediately the contractions ramped up in speed and pain. I no longer had any time to rest between contractions. I was pushing constantly. As I pushed I pulled on Nikola's hair, and a nurse helped to push my leg up to my chest. But nothing was happening. I stood and pushed. I threw up twice. It was an electric green bile that burned as it came up and offered no relief. I squatted and pushed. The nurses chided me for moaning when I pushed, telling me to direct my energy down into my ass as I pushed.

I was vaguely aware that in the next room another woman was getting ready to birth. It was the Russian who had checked in before me the previous night. For twenty minutes they encouraged her to push and then she was done. I wondered what was wrong with me. Why did this baby not want to come out?

At one point the contractions were too close and I was loosing strength. I was about to give up. I wondered if I passed out if they would just do a c-section and the whole thing would be over with. I looked up to Nikola and felt my eyes roll back, sweet surrender coming over me. But then another push was demanded and a slight encouragement was given- he was finally moving down. It wasn't quite as encouraging as, "I see the head!" but it was enough to keep me going.

Finally the time had come. Whether or not my pushing was strong enough, whether or not the contractions were efficient enough, the baby had to come out or I would be too week to continue. As the baby made his way down the birth canal the nurse gave me an episiotomy. Nikola saw the big scissors and told me that it would hurt, go ahead and squeeze. The nurse snipped once and apparently there was a big spurt of blood. The cut wasn't deep enough and she snipped again. I felt nothing either time. I was too concerned with pushing, which still wasn't working. My doctor got on top of me, pushing down on my uterus with her full weight. Not knowing what was happening, I tried to throw her off. She demanded I not push her off and once again attacked my abdomen. Finally... 1.30, an hour after the pushing had begun, and three other women had given birth, our baby was born.

There was immediate relief, and more anxiety. They laid him on my stomach, for just a moment. His head was grossly elongated and he wasn't crying. They took him away and for five minutes I waited anxiously, repeatedly asking Nikola what was happening, until I heard the sweetest, little cry from him. He was okay. During that time they delivered my placenta and the anesthesiologist came back to give me a full dose in my epidural. They stitched me up and for the next two hours, while Peatuk lay in an incubator next to me, I lay there, drifting in and out of sleep, feeling a blissful nothing.

It wasn't the birth experience I wanted. It was too rushed. It was too painful. But in the end I am healthy and Peatuk is healthy, and I suppose that is what really matters. I remember while I lay in that dazed state I thought, "Yeah, men can have their wars." I am not really sure what birth and war have to do with each other, but I felt somehow distanced from men in that moment. I also remember thinking that I do not ever want to do this again. But it is a tricky business, birth, within a week the stitches come out, you can walk and talk, and you have a fussy, cooing baby to love and adore... and you forget what it felt like. You forget to the point that it becomes indescribable, and then it becomes a faint memory and then it is a mental memory that your body has forgotten altogether... and then you find yourself thinking, well... the next one... 

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