For over two weeks, I had been having strong, recurrent
bouts of contractions. They weren’t painful, but they were strong enough to
make me stop and wonder, then look for other signs of labor. And then they’d
stop. Starting at 36 weeks, at each appointment with my nurse-midwife, she’d
check my cervix (per my request), and each week, I had opened another centimeter. Each week, we
were both certain that I’d give birth before the next appointment. But I was
there, still pregnant, at 37 weeks… 38 weeks… By my 39-week appointment, I was
3cm dilated and 80% effaced, and still no labor. I was getting antsy. Very
antsy. But I knew baby would come when he was ready, and I sincerely wanted to
let nature take its course. I was determined to have a spontaneous labor and
successful second VBAC.
It was the Sunday of Labor Day weekend. I was due the
following Wednesday. I had convinced myself that I couldn’t possibly have this
baby before 40 weeks, because otherwise I was going to lose my mind. On that
Sunday, we went to the park with the boys and had a picnic, then to a community
barbecue. The whole afternoon, I’d have occasional strong contractions, much
like before, but they didn’t come to an end. I started to toy with the idea
that maybe, just maybe, they meant something this time. But, by that point, I’d
had so many, “Maybe this is it!” moments that I was not ready to commit.
Around 10:30 that night, I decided the contractions were
actually getting stronger, and I started timing. Five minutes apart. Well,
that’s the tell-tale sign, right? But, they didn’t hurt as much as I thought
they should, and I could walk and talk during each one, so I still wasn’t
totally convinced. I decided to take a bath and see if I could relax them away,
then try to get some sleep. If I was going into labor soon, I should try to get
a few hours of sleep first.
I took a bath, and they didn’t stop. I got ready for bed,
laid down, and WHAM, I had a really strong contraction. My thought was, "Well, I won't be able to sleep through these!" Five minutes later, another
one. Okay, I said. This is it. I put clothes back on and told my husband I
thought it was for real this time. We called someone to come stay with the kids
and called the hospital to make sure it was okay to come in (it was). By the time
everything was arranged, the hospital bag was double-checked, and we were ready to go,
it was about 12:30am, Labor Day. We took off for the hospital. We didn’t want
to wait at home too long, because the hospital was 40 miles away, and I didn’t
want to take the chance that we would be “too late,” as it were. I also didn’t
want to be too early and hang around in the hospital for more hours than
necessary, or to get there and find out it was false labor again, but I was
pretty certain. I was completely certain about halfway there when I realized I
was no longer able to carry on a conversation during a contraction. Whew.
My husband drove… er… rather fast, and I think we got to the
hospital in about half an hour, around 1:00 in the morning. To my delight, the
nurse-midwife on call that evening was none other than the one I’d been seeing
for my prenatal appointments. We were mutually excited, since that rarely
happens at Kaiser. They triaged me and checked my dilation, and I had gained
another centimeter and was having regular contractions. Time for baby!
My nurse-midwife told me I could have the epidural whenever
I wanted. I wasn’t sure that I wanted one at all, and I said I knew I could
have it, and that I’d ask for it if I wanted it. I definitely didn’t feel that
I “needed” it yet. The contractions were definitely growing in intensity, but the
five minute break in between was enough for me to catch my breath. My husband
knew I was hesitant to have any medications during labor, and I’m really glad
we talked about that beforehand, because the idea of the epidural becomes very,
very tempting at 3:00 in the morning in active labor, let me tell you.
Sidebar: I wanted to avoid epidural and Pitocin during this
labor, if possible, because I was intent on having another VBAC and because I
knew that any interventions could lead to further interventions, which might
eventually lead to c-section. Additionally, I had Pitocin with each of my
previous deliveries, and in each of the previous deliveries, I had postpartum
hemorrhage, and both boys had jaundice. Pitocin is a risk factor for both
postpartum hemorrhage and jaundice in the baby. I did NOT want Pitocin, and, by
extension, I did not want an epidural, in case it created a “need” for Pitocin.
They kept offering to break my water to move labor along,
but I kept refusing. The amniotic sac protects the baby from the brunt of the
contractions, and it also lessens the intensity of the pain. Once the water is
broken, everything gets ramped up. I didn’t want that. I wanted my water to
break naturally. I think they really wanted to do it, but I didn’t. I really
really didn’t. So I kept refusing. Besides, labor seemed to be moving along
quite quickly!
I had dilated to about 6cm when labor went crazy. I was
managing the every-five-minutes contractions reasonably well, but all of a sudden
they went from every five to every 1.5 to 3 minutes! There was no break in
between to breathe or relax. One ended and the next began. The nurse, who was
wonderfully attentive, strong, and worked with me very well, was coaching me to
blow and breathe, which is NOT EASY. At the end of each breath, I desperately
wanted to push, but I couldn’t, because it wasn’t time. I started to
hyperventilate a bit, and they gave me oxygen. I’m not sure if it helped. I had
to breathe so fast to stay ahead of that “push” feeling, I barely had time to
exhale before I had to inhale again.
And that’s when I said, “I want the epidural!”
The nurse and my husband both knew that I wasn’t so sure
about it. I knew I wasn’t so sure about it. They asked if I really wanted it, and all
the fears about what might happen if I got one surfaced, and I backed down. And
then said I wanted it. And then backed down. I just couldn't make a decision.
Between them, my husband and my nurse were very good about putting me off
without making it seem like they were. I did want it, in that moment, but then
I didn’t. I was so tired. I think my feeling was that if I could just rest a
little, I’d be okay to continue, and an epidural would let me rest.
The other nurse-midwife on call came in, because mine was taking
a break until I was ready to deliver (she was staying around because she wanted
to deliver me, but I think she was technically supposed to be off). She
suggested that I try the shower. So I got in the shower for a bit, and the hot
water felt really good, but the contractions were just coming and coming and
coming, and I was so tired. I hadn’t expected it to hurt quite so much, and I
hadn’t expected the contractions to be so close together or so intense. How
much longer did I have to endure these? Hours? I couldn't do hours. I just
couldn't. I got out of the shower and returned to the bed, somehow hoping that sitting or lying down would help. Maybe I was just tired of standing.
I think the nurse realized that I must be close, because she
said to me, “Jessica, listen. I want to tell you something about the epidural.
I’m happy to get you one if you want it. But by the time we get the anesthesiologist
up here, and we sit you up and do it, it will still be 20 minutes before it
kicks in. By then, you might be ready to push, and you won’t even get to enjoy
the epidural.”
That convinced me to keep going, and, sure enough, I was
almost fully dilated. At 4:40am, my water broke with a pop. The nurse checked
and found that I had just a lip of cervix left. She said I was absolutely NOT
to push until she got my nurse-midwife up there. I distinctly remember saying,
“Tell her to RUN!” She got there quickly, checked me, and said the words I’d
been longing to hear, “Go ahead and push!”
I pushed. Boy did I push. I wanted this labor OVER WITH. I
wanted that baby OUT. Besides, it hurt a lot less when I was pushing then when
I wasn’t. I heard the nurse-midwife call for a local. She said my perineum just
wasn’t stretching quite enough. She made a little cut, I made another few
pushes, and I felt that baby slide out. I had never felt that before. My
previous VBAC had been with an epidural, and I’d had a c-section before that,
so I had no idea that you could actually FEEL the baby slide out. Wow. He was
born at 4:57am, just 17 minutes after my water broke!
They put him right on my stomach, whereupon my first words
were, I believe, “I made a baby!”. They dried him off, but otherwise waited,
per our request, for a couple minutes to cut the cord, and then we brought him
right to my chest to nurse. At the same time, there was a flurry of activity
around me, administering medications by injection in each leg, Pitocin to contract my uterus - I had actually YANKED my IV out of my hand while pushing, so first they
were frantically trying to put a new one in while I was trying to hug my new
baby - and stitching up the episiotomy. They were working
furiously to prevent a hemorrhage, and, you know what? I had blood loss within
normal limits! Spectacular!
They waited until I felt he was taking a break from nursing
before weighing him. He came in at a healthy 8lbs., 3.5oz. Pink and
strong. They gave him right back to me.
Just before we were ready to head up to the postpartum ward,
they made me go pee. I had never been ambulatory right after giving birth
before. This was all so new to me. I sat in a wheelchair (rather than lying on
a bed) to go up to my room, and I got to hold the baby while we went up there. So
cool.
My stay at the hospital was really good. The breastfeeding
support was phenomenal. I was actually told that I should sleep with him
skin-to-skin on my chest! I will be writing a separate blog post in more detail about the hospital, so I won't get into it too much here.
We went home the next day at noon. The baby did become
jaundiced, but his numbers came down on their own, rather than his needing
phototherapy like my first two had. I don’t know if the method of birth had
anything to do with the jaundice or not.
The second day home was very hard. We were in the middle of
a heatwave. It was 90 degrees, and I had no milk yet, just colostrum. The poor
baby was so thirsty. I couldn’t unlatch him for two minutes without him
screaming. My nipples were sore beyond belief. I was having horrible hot
flashes, crying jags, the postpartum hormone surges. It was pretty awful. But
I’m already feeling better. My milk came in Wednesday afternoon, and the change
in the baby was incredible. He became so content!
Overall, I feel that the birth went just about as well as you
could ask for. Only 4 hours of labor in the hospital? Wow! Natural birth (even if it was kind of by
accident), immediate and constant skin-to-skin. I got pretty much everything I
wanted out of this birth. If we have another child in the future, G-d willing,
another birth like this one would be just fine!
awesome! So happy for you and your family! baby #3 is due one week from this Friday! Hoping to have as beautiful a birth as u did! Congrats!
ReplyDeleteI'm so happy to hear things went so well! Sounds like it was still a lot to handle, though.
ReplyDelete