Betsy's labor journal: Part four
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Back home with baby!
WE'RE HOME!!!
I made it to the "other side." Yay!! It's amazing how one's outlook on life
can be changed by one event. I am feeling GREAT! Wow, what a difference
from a section recovery; I deserve it, though, dammit; that was one
hard-earned VBAC!! I feel like a She-Woman now!! I will write/post the
birth story later -- so much to say and not enough time to say it. I want
to get it down though before I forget anything.
The birth story...
Although it is still rather painful to sit in front of the computer for any
length of time, I at least want to get the process of writing Hannah's
birth story started while I'm still in this state of euphoria! Given the
ambivalence I felt about VBAC vs. repeat c-section at the beginning of this
pregnancy, I am in complete awe of my capacity and endurance for the pain
and rigors of childbirth. When I first found out I was pregnant last
September, I didn't even know if I wanted to consider a VBAC and my doctor
seemed willing to schedule a section for me if I wanted. Thanks in large
part to the support and resources I found on-line, I found myself more and
more committed to a vaginal birth and avoidance of the routine intervention
pitfalls that could prevent this from happening.
I am still a little dazed that I made it through this. My doula told me I
had the hardest labor she had ever seen in her experience. God knows, I'd
rather NOT have a labor like that. I'm certainly not out to prove anything,
but to be stuck with it and come through it makes me feel like I've run
(and won) a marathon. I feel like I can do anything, ANYTHING, if I can do
that. Despite the empowerment I feel, I got lucky, too. I never never never
could have done it without a doula. She really kept me focused and was a
great source of validation of the pain I was in. Also, the L&D was *very*
busy that day and didn't have time to suggest options or otherwise
(mis)manage my labor.
A look back
Labor for me really started very slowly. Beginning on May 12, I had
intermittent contractions of varying frequency, duration and intensity and
was fooled into thinking "this was it" many different times. On Thursday,
May 15, I had contractions all day that got progressively more intense and
frequent as the evening wore on. We met my doula, Julie, and went to the
hospital at 3:30 am Friday morning when the contractions were 2-3 minutes
apart and 45 secs long. Upon arrival I was 2 cm dilated; 80% effaced. After
two hours of monitoring, we were sent home, thank goodness. I had not had a
good night's sleep in days and I was exhausted. The contractions waned and
I was able to get some fitful sleep for about four hours. At 10:30 am, the
contractions woke me again and I had them all day again. These were bad
enough that I had to focus on breathing through them, but even though they
got closer and closer I knew it wasn't "real." Much to my frustration, they
stopped completely at 5:00 pm! I was in tears. I felt that I couldn't trust
my body's signals and was starting to think I'd be in labor forever. Pretty
scary state of mind for someone only in early, early, early labor.
Finally, I went to bed depressed and, of course, the contractions started
up again as soon as I laid down. This was 10:00 pm. I got up at 10:30 to go
to the bathroom and swear I *felt* the baby engage. From that moment the
intensity of the contractions changed. I felt a grinding pain in my pelvis
with each one and I KNEW this was it. We only hung out for another hour or
so and I called my doula and we headed off to meet at the hospital.
The Hospital
Upon arrival this time I was dilated to 4 cm and 90% effaced. Progress! At
last! We were excited. Active labor went very smoothly, if a little slowly.
My contrax settled down to 5 minutes apart, but I was progressing at this
rate so no interventions were recommended. It helped that the L&D was SO
busy. My water still had not broken and the doctor on call was making
noises about amniotomy, but since I was progressing and he had more
pressing matters, I was left alone. At the beginning of transition I
started losing my concentration. I was exhausted and couldn't stay focused.
My doula and I discussed it and she agreed that I would probably be better
able to handle the end of labor better if I could rest beforehand so I
requested Stadol to dull the edges a little and was able get some rest.
Because the baby was so low in my pelvis (evoking a comment at every exam:
"Wow, that baby is right THERE!"), I was very uncomfortable in the
squatting or even sitting positions I'd used effectively in early labor.
Even the birthing ball was uncomfortable. I was most comfortable on my
side, which of course, did not facilitate a speedier labor. But I did
manage some dozing.
With the Stadol and a lot of gutteral moaning I was able to get through transition without an epidural. At 11:00 am, I was at nearly 10 cm and had been for over an hour. The doctor suggested amniotomy then to get me fully dilated and hopefully increase the frequency of my contractions (only 3-5 min. apart throughout transition, but VERY long and intense) without pitocin. I complied, but unfortunately this made no impact on the effectiveness of the contractions. What it DID do, I didn't even know could happen! I heard the nurse say uh-oh as she examined my cervix after the AROM and then she said, "you have 'go-back;' you're back at 7 cm." Those were the most devastating words I could possibly have heard. She felt so sorry for me. She said that the baby was so low that she knew that intensified the pain and she couldn't believe how strong and stoic I was for doing this without an epidural. I didn't feel very strong; I felt trapped. Believe me, I was not grace personified.
I howled, "NOOOO!" At this point I'd had less than four hours sleep in the
past 72 hours, had labored all the way through with minimal pain relief and
now was being told I had to transition AGAIN??!! I was at the end of my
rope both physically and mentally. The nurse told me I should be back at 10
cm in less than an hour, so I gritted my teeth, determined not to give up
(as if I had a choice). At this point, an epidural wouldn't even have time
to work, so I asked for more Stadol, received a 1/2 dose that did NOTHING
to relieve the pain and ground my way through THREE MORE HOURS. It was
ugly. I think I would have snapped without Julie there. She couldn't really
do anything for me, but she moaned and yelled through the contractions with
me helping me maintain a rhythm. Between contractions I retreated into my
own world. I don't know if it was just my mental state at the time, or the
Stadol (or both), but I would be in this netherworld and when a contraction
hit I was amazed each time that I was still in labor. I shouted my way
through it each time, convinced I would not live to see the next one. Once
again I got to 9 cm and held there. Contractions were 4 minutes apart; not
close enough for effective pushing. The doctor came in and suggested pit.
to increase the freqency and IV fluids anyway because I was getting so
dehydrated. After another hour, I was at the point that I could barely
resist bearing down. At this point, the L&D nurse told me to puff, not
yell, because the yelling meant I was pushing. I yelled "No! the only
reason I'm *not* pushing is because I'm yelling." Once again, I was so
thankful for Julie. When the nurse left she told me she never heard
anything so ridiculous and to keep yelling if I wanted to. So I did. What I
would have done without that validation I don't know.
Pushing phase
About 10 minutes later, I sent Tony to tell the nurse that I HAD to push
with the next contraction. He came back and said I couldn't. I said to go
back out there and tell them I'm not joking around that I WOULD push with
the next contraction. The nurse came rushing in and examined me and said I
had just a lip left and a full bladder, so she inserted a cath and drained
my bladder and said I could push next time if I wanted to. By this point,
my contractions were a minute apart. She called the doctor and told him the
baby was crowning. For the first two contractions I pushed in a side-lying
position, then everything was set up, the room was crowded and the bed was
broken down. At last! Everyone was telling me what a good job I was doing.
I was in such an irritable frame of mind at this point that I was convinced
they were lying to me just to make me keep working. They got the mirror
adjusted so I could see how close she was. What an amazing sight to see
your baby pushed out like that. It took four contractions and the most
physically challenging work I've ever done in my life, but I was incredibly
motivated to get it over with. I had a small episiotomy, which was
definitely necessary. Julie commented that even with the massage, my
perineum was stretched as far as it would go and with my state of
exhaustion they wanted to speed it up and so did I.
Hannah MacKenzie Judd was born at 3:25 pm on Saturday, May 17, 1997. She weighed 7 lbs 14.5 ozs and was 20 inches long.
I happened to notice when I looked at her chart that while her weight and
length were 75th and 50th percentile respectively, her head circumference
was in the 25th percentile. Praise be! Could I have even pushed that baby
out otherwise??!
After the birth
As emotional as I am, I thought I would cry when my baby was born, but I
simply stared at the ceiling for a moment; relieved to be free of the pain.
I didn't feel strong or stoic or brave or anything else they kept saying. I
felt like I'd survived a war and that I was lucky to be alive. The nurse at
my shoulder said she was so impressed by my strength, but next time I ought
to try an epidural. I am horrified that she said that. Did she think I did
this "naturally" just to say I could? Me????!!! The ultimate pain wimp? As
slow as this labor was, I'd hate to think how much an epidural would have
slowed it down (the Stadol probably did a little of that anyway), then I'd
have needed more pit, earlier, been at higher risk for uterine rupture,
fetal distress....etc etc etc.....I didn't say anything to the nurse. My
doula and I talked about it the next day, though, and she was as appalled
as I was. Even at this stage there is someone there to undermine your
decisions, even if it is done in ignorance.
Completion of a dream
Anyway, as I had dreamed it, my baby girl was immediately laid on my
stomach and was latched on to my breast within a minute. Tony got to cut
her cord and she was never out of my sight. I will always treasure the
memory of Bailey's birth, even though it was not something I "did" in the
sense that I birthed Hannah, but THIS fulfilled me in a way I really needed
and never knew. Certainly it was not the labor of my dreams. But I am
exhilarated that I MADE IT THROUGH!!! And not only did I make it through; I
did it based on decisions and commitments I made and I STUCK with them even
in the midst of the most mindnumbing pain I've ever experienced. I never
dreamed I could withstand something like that. Although I didn't feel
strong or empowered immediately after Hannah's birth (mostly just
relieved), beginning with that night and ever since I feel a surge of
adrenaline every time I think of what I did. I feel pretty amazed and
impressed with myself. And it's so funny, because it's not like I'm the
first person who ever did this. It's an everyday, common occurrence. THAT
is amazing and miraculous to me.

