On Thursday, September 2, 2010 at 11:28 pm, Pud arrived, very much against his will. If my 21.5 inches long, 9 lb, 5.5 oz baby boy had had his way, he’d still be inside me at the time of this writing, nearly 2 weeks later.
Wednesday, September 1 started off with an ultrasound to figure out an approximate size for little Pud, because some of his last fundal measurements had been on the large side. The ultrasound indicated an approximate birth weight of 9 lbs, 8 oz. There was a mix-up in scheduling and the office staff had scheduled me to see Dr. H instead of Dr. S, so I insisted on being rescheduled to see her at the other location later in the day. I’m awfully glad that I did. The ultrasound technician prepared me for the reality that Dr. S would probably recommend inducing labor in the next couple of days, just because Pud’s head circumference was also measuring on the large side, and everyone involved wanted to help me avoid a c-section. I had just enough time to go home and call B to come home and go to the doctor with me.
I had dilated about 1/2-1 cm when Dr. S checked me. With all the information that we had at the time, we decided to begin inducing that night. B and I went home to really, finally, for-real-now pack to go to the hospital and have time for a last meal and to drop off our pups at Aunt Liz’s farm. I was pretty scared and more than a little upset because we had to induce to get him out, and that meant there would be more interventions than I’d wanted. While at Subway, we met the nicest mama who had just given birth to her baby girl at our local hospital the week before, and she was full of encouragement and nice things to say about them. I was grateful for this angel in disguise, because her words calmed my fears and dreadings a bit.
This wasn’t at all what I had envisioned for our birth, and already– the birth plan was practically moot on many points: because of the cervadil, I had to be on continuous monitoring and laying in bed, except to go to the bathroom. No freedom of movement. No chance of waiting to have a heparin lock put in, though I’m beyond grateful to the four nurses it took to find a vein in one of my hands to make it work, instead of insisting on a traditional I.V. There was definitely some mourning going on in the midst of all the anxiety and feelings of being so completely out of control. I had to keep reminding myself that it was far less important HOW he came out than the fact that we both survived it intact and that I would finally have my baby in my arms.
Because of my emotional state, I really, really missed my Callie girl that night. It wasn’t a particularly restful night, either. Little One was no happier about the continuous monitoring than I was, because he kept shifting out of the monitor’s range. Again and again and again. I don’t even know how many times the nurses came in to readjust it, or even remember how many different people tried to get him to stay within range. With those interruptions, my own anxieties, the constant need to pee because he was squarely on my bladder still, and the 5 AM removal of the Cervadil patch, I didn’t really sleep well or very much.
At 5 AM, the nurse removed the Cervadil and gave me permission to spend the next hour moving around freely before I had to get back on a monitor. I got a shower… 15 minutes. I dried off from the shower and felt a gush of water. Yup. My water broke. That put me back to being in bed or on the ball next to the bed and on the continuous monitor again. The doctor came, announced that I’d dilated to 1-1 1/2 cm, broke my waters a bit more and put Pud on an internal continuous monitor before having the nursing staff begin giving me a Pitocin drip. Precisely what I’d hoped to avoid, and even with the nipple stimulation with the use of a breast pump, as recommended by my nurse, precisely what I couldn’t. Pud didn’t want to come out. He and I needed for him to come out for both of our health and safety. What choice did we have? Still, I mourned a bit and worried even more that I would end up in surgery for that dreaded emergency c-section.
At about 6, the Pitocin started, and an internal fetal monitor was attached to my Pud’s head. The contractions weren’t so bad at first. I could breathe through them and was doing a great job with the help of my labor buddy, B and our doula, Lane, and my mama. Lane and Mama came over sometime around 7, I think. It’s all a blur now. Anyway, the dosage kept getting upped and upped and upped. After a couple of hours, the contractions were coming so fast and so strong that I couldn’t use my breathing and “happy place” or any of my coping strategies very effectively anymore. I’d been on my feet dancing/swaying through contractions for several hours, going in and out of “twilight sleep” (while on my feet) in between contractions, and I couldn’t sit or lie down because the pressure of Pud’s descent into my pelvis was so intense that any position which required me to bend hurt more than the contractions themselves.
At some point, I said to B, “I can’t do this… I need pain medicine. It hurts.” He was comforting and he listened to what I said, knowing full well that I didn’t want medicine and that if he provided more emotional and morale support, maybe I’d still manage to work through it. The contractions got more intense and so close together I could hardly catch my breath in between them. Again, I said, “I need help. I can’t do this anymore.” B and Lane suggested that I ask for the doctor to come check my progress and then we could make a decision about getting an epidural. Dr. S came and checked… I was merely 6 cm… so far left to go. B or Lane commented that I had asked several times for medication, and that we had agreed to ask her opinion before we made that decision. She looked at me and said, “Honestly, I’d have the epidural. You look so exhausted and you are going to need more energy to get this baby out. I would get the epidural and I want you to sleep so that you can have the energy you need to push him out.”
So I had an epidural. I slept. I completely lost track of time. I woke up and it was dark outside.
After about 2 more hours, I was checked again and was finally 10 cm dilated. For the next 2.5 hours, I pushed on every contraction. Somewhere in the end, Pud wasn’t moving past my pelvic bones and I was worn out. The epidural was wearing off and I was much more in control of my legs, so I asked if I could change positions to squat and see if that helped him move any. There was a LOT of hesitation, because I’d had the epidural and most people really can’t feel their legs enough to trust them to be upright and safe. The doctor relented when the nurse and Lane both verified that I was using more strength from my legs in my pushing, anyway. Squatting is what we needed to get Pud moving. I wanted to squat to help push him out, because I knew that gravity would help tremendously- so I guess God granted that request, with the help of muscle memory. I only spent the last 4 months of my pregnancy squatting and sitting on a birthing ball, after all, preparing for Delivery Day. I think I squatted for about half an hour, with the help of the birthing bar they attached to the bed, but I really have no idea of the timing. Birth is one of those things in which time loses its traditional meaning and feel.
When Pud crowned, I was quickly put back in the bed and the bed reassembled to the traditional lithotomy position, so that Dr. S could help work him past my perineum. She did an episiotomy, and I still tore quite a bit. No wonder- the child’s head was 1/2 an inch bigger than the opening he was being pushed through. She did a marvelous job sewing me up, while B watched over Pud’s first exams by the neonatal nurse. I was so grateful when Dr. S said to me that she was very glad that I had managed to push him out, because with all my allergies to narcotics, she wasn’t sure what they would have done if I’d had to have a c-section. That made me feel better about deciding to get an epidural and some rest. God is good.
How long was this labor? Depends when you start counting. If from the first contractions, which started on Saturday, then a REALLY LONG time. If from the moment the Cervadil was applied, then it was 26.5 hours. If from the moment my water broke (and labor was much more active), then it took about 18 hours.
In the final pushing stage, when my darling would NOT come down the birth canal, I said to B more than once that I’m not against adopting the next one. A joke, since we’ve always planned to adopt some of our kiddos, anyway. It’s nearly 2 weeks later, and I remember it hurt. A LOT. But I would do it again. Not immediately (thank goodness the earliest it could happen again is approximately 9 months… isn’t God smart?)… but I’d do it again. The prize at the end of the race is worth every pain along the way.