Tuesday, December 6, 2011
Riddle: How Many Velour Jumpsuits Does It Take to Deliver Baby Z?
But what if…..
By 2:30 I was on my fourth contractions, 10 minutes apart. I was up… and apparently being a bit dramatic because I woke up Danny.
“I think I’m in labor?”
“Really? Should we go to the hospital?”
“No! I’ll just time them and see…”
“Should you call your midwife or Emily?” (Emily was our doula).
“No, just go back to sleep. I’ll just keep track a little longer.” And then I started snapping my fingers because another contraction had started, and I didn’t know what to do with the intensity – or my body. This was like period cramps mutated by Lex Luthor to overtake the world through birthing mothers.
And the ten minute pattern continued…and so apparently did my snapping. And instead of utilizing my hypnotbirthing techniques I had practiced to relax and be at one with my body’s rhythmic waves of feminine splendor (read: pain), I instead made the genius decision to straighten my hair.
So here’s how it went down –
Forty minutes into this comedy of errors, my contractions were eight minutes apart and seemed to be progressing fast. I would work on my hair, and then a contraction would come – I’d drop the hair tool, do a walk around the house, semi-double over in pain and… (you guessed it) snap my fingers really fast and make a weird noise in the back of my throat.
Danny wasn’t sure what to do. He couldn’t sleep because I apparently am a noisy snapper.
Now it’s about 3:15…things are not getting better (unless you consider my hair, and that was coming along fabulously). But the contractions had moved to the 6-minute mark. Oh my gosh this is ridiculous! No wonder people get epidurals. I want one NOW. This is wretched. What have I signed up for? I haven’t even made it to the hospital yet.
Then it dawns on me about the reality of what I was up against:
I. Am. Screwed.
Danny suggests I get in touch with my female-care providers. I send a text message to Emily and my Midwife Lisa explaining a bit of the situation (trying not to be too dramatic) finishing with: “The last ½ hr they are 6-8 min apart now. Sorry to bother you in the middle of the night…..It obviously could be nothing.”
Emily writes back that she’s thrilled; and I ask for a little advice about what to do, she responds:
“I would actually just try to sleep through or at least in-between them…sounds like early labor and at this point you need your rest! No worries on timing them just yet unless they are really strong.”
Sleep through them?
Sleep through them?!?!?
That’s not really possible at this point – and not just because my hair isn’t finished. I pick up the phone, since I’m pretty sure these would be considered ‘strong.’ I don’t have much to compare this too. My body never technically went into labor with Holden. They did feel remarkably similar to the contractions that finally set in with Little Bits after hours of pictocin…
I give Emily a run down and part way into our conversation I drop the phone and hand it to Danny because I need to snap my fingers and I need to snap them BAD.
He's talking to her but “…..the incessant snapping…” is all I get from my husband's conversation.
Emily and I make a plan and she is on her way over.
I try to finish my stupid-dumb-hair, and end up puking in the bathroom from what I understand to be a combination of prostaglandins and pain. (The two “P’s” of childbirth! Huzzah!)
Holden has woke up and made his way into our bed with Danny; so I try and relax in his bedroom (not really happening until Emily shows up.)
She talks to me about relaxing and gives me some techniques to work through the “waves.”
Things are much better and manageable with her help. Danny would later mention on multiple occasions that the decision to have a doula was one of the best decisions we’ve made in our entire marriage. He says it saved him from having to do anything. Which is not true, Danny was actually an amazing support – and, as you’ll see one of the biggest factors in Baby Z’s safe arrival. But having a doula did take pressure off him, and our doula not only helped me with my contractions but was key in giving Danny things to do so he could help –taking away the guesswork. Which a man kind of needs, right?
Anyway, back to the story: with Emily’s arrival and help, I’ve calmed down and think I can actually handle this. We’re still around 6-minutes, progressing to 5 minutes apart.
Another factoid about Emily – she’s also a childhood friend (one of my sister’s best friends from her youth actually). So we have lots to chat about. We do this in 4 ½ minute increments until another contraction comes and I stop mid sentence and she puts pressure on my hips/lower back, I make a weird noise like a humpback whale mating; and we survive and work through one contraction after another.
My midwife has called, and we make the plan to just head to the hospital at the same-Bat-time we had originally planned for the induction.
Except now I wasn’t being induced!!! I was just going to the hospital for labor. We still had a little time, but I did need to get my things ready.
Problem was, the contractions were really too strong, and too-close at this point for me to be packing the remaining items of my ‘go’ bag. I had made a handy list on my iPhone to remind me what I wanted/needed and enlisted Danny’s help.
But he didn’t really know what had made it in the bag – and I certainly couldn’t remember. Thus “velour jumpsuit” became two and then three and I had even packed a cream one. Seriously, cream for birthing or even post-partum? Somehow the fact that I had 10 months worth of menstrual cycles waiting to escape from inside of me post delivery had completely escaped my mind.
Seriously, cream jumpsuit? I am a piece of work. This would be just one of many mental lapses I would experience in the next 20-plus hours.
“You’ve had 10 months to pack this thing,” he said, giving me a hard time.
I reminded him it wasn’t an option to pack the food last night (not that I was up for eating anything after puking already, anyway) AND you can’t very well pack your toothbrush if you’re going to be using it the next day. The amount of jumpsuits somehow escaped my mind.
Somehow the bag got finished, and the food, and everything else…and it appeared I planned on moving into the hospital for a week or two.
Danny’s Mom came over to tend Holden and my Mom came to give me a hug and wish me good luck.
I admitted to Emily I was a bit concerned about the drive to the hospital without her help –especially since the surges were under six minutes apart. We thought it would be a good idea to listen to one of the hypnobirthing ‘scripts’ on my iPod to see if I could relax through the drive. That lasted until the first contraction came and I yanked out my headphones in annoyance. The blessing/curse of the drive was that my contractions slowed down: back to 8 – 10 minutes apart.
Danny pulled into valet parking, I got out walked to the side of the building and took a moment for another surge.
We walked to L&D and I couldn’t help but have this feeling of euphoria that I was checking in, IN LABOR, and was going to have a baby.
42 (almost 43 weeks by my lunar cycle) of pregnancy, my body was doing this. I knew it was possible!
It was after nine in the morning - we'd been at this for seven hours. I made it a point to bring to everyone’s attention when another hour of labor had passed, because I felt like it was some great accomplishment. The irony being that we had no idea how long it was going to last…so counting down the hours was pretty much an exercise in futility, excepting that I thought it was cool.
Lisa eventually checked me (neither of us felt rushed since the contractions weren’t too close together), but I was only at 4 (though 100% effaced)… so she and Emily both knew I was in for a marathon of a labor.
They coached me through more contractions, suggested I try and eat and drink something, and then recommended rest. The problem was, if I was up and moving, my contractions sped up too… but when I rested, they settled back into 10 minutes apart (which is obviously easier to manage, but I didn’t really want to be in labor ALL DAY!)
I took their advice and tried to rest.
We all kept visiting, working through the surges (which still were intense, but seemed to be even more manageable with the support system I had).
The timeline all seems to mesh into an entire afternoon, but my labor had slowed (or ‘stalled’ if you will.) We tried a bunch of things to ‘augment’ my labor: walking, which was helpful, but I was so tired from only getting three hours of sleep the night before and I had no energy because I hadn’t eaten anything – and obviously any nourishment I had consumed the day before had been lost to the great porcelin bowl in the bathroom earlier. Also at some point I had been hooked up for IV liquids because my stomach felt too upset to keep anything down, and they didn’t want me to be dehydrated.
We sent Danny off to Whole Foods to pick up some Cleary Sage essential oil -- it's supposed to accelerate contractions once they've started. Here’s an awesome picture of my giant belly getting some Cleary Sage love rubbed all over it. The marks on my stomach are from the external fetal monitors -- not henna as you may have expected and would've been a much cooler story.
We even tried ‘nipple stimulation’ with a breastpump (poor Danny didn’t even get a chance to volunteer for the job)…ironically, this had the opposite effect, slowing the contractions to 15 minutes apart. Walking seemed to be the only thing that helped… but even that wasn’t cutting it. And I was still so exhausted.
Sometime around one, Lisa had suggested we try the Pitocin -- both she and Emily reminding me that augmenting was different than inducting labor. Emily agreed and Danny and I were on board.
I also agreed to have some lunch (soup, apple juice), and I decided to call my mom to check in since I hadn’t talked to her since the morning. After delivery I found out that Danny had been keeping in touch with some people about what was going on (a few text messages, a couple of phone calls and some facebook updates here and there.)
It turned out my mom and older sister Cassandra were on their way to the hospital to pay me a surprise visit anyway. We would start the picoticn after their visit.
We chatted for a bit. Cassandra made comments about me sounding like a dying whale through the contractions (she also gets induced at 39 weeks and is pro-epidural from the start.. so this whole "trying to go natural" thing did not make sense to her...oh, and she's married to an anesthesiologist.)
Lisa made the executive decision to let me walk around the hospital for a while -- this was actually a pretty big deal because being a VBAC candidate the hospital required that I have continuous fetal monitoring. They gave me a ½ hour to walk with my family without the monitors (otherwise I would’ve been quarantined to the L&D floor which was less than 50 yards of hall space I had access to.)
We were to be back at 3:30.
So we strolled through the hospital; pausing on the sides of the hallway when a contraction would come. I sent Emily off to get lunch since I had the support of my Mom, sister and Danny for the walk. A couple of times hospital staff asked if we needed a wheelchair because I was leaning against a wall apparently looking like I was going to die. Eventually it was time to head back and we made it to the room. I said good bye to my Mom and Cassandra and got ready for the next step in augmenting my labor.
The Problem with Pitocin
Four o’clock-ish… we were on hour 14 of labor (AHHHHH! SERIOUSLY HOUR 14!!!) and it didn’t take much time for the Pitocin to kick in. Fortunately I got one of the rooms with a bathtub so after a little while I stripped down (excepting the external fetal monitors) and spent some time working through contractions in the water. (Thank goodness for those wireless external monitors).
It helped…a little.
The hotter the water, the more relief from the contractions – but my body felt like it was overheating. We took cool washcloths to my face, and I even started wolfing down cups of apple juice on ice.
Danny took some awesome pictures of me in the tub (he is surprised I am sharing them with you). Man I am so good at looking horrible when I am ‘laboring.’ First he snagged this one:
I like how you can really see the agony in my face. Also, that it is obvious I had forgotten how much time I had spent on my hair hours earlier...When I realized he had taken a photo, and saw what was actually caught on camera, I demanded he take another. So we ended up with this:
But as the clocked ticked, something started changing in my contractions… they moved from waves and intense surges to a spiking pain that resonated through my entire body. There seemed to be no peak and resolution, just flat-lined trauma that only intensified when my water broke – yes, in the bathtub (ew.)
My body hit a wall.
The contractions were so intense, I don’t think I physically knew how to deal with the intensity. I started puking. With each contraction, the applejuice returned in all its splendor…and throwing up is so violent that the convulsions seemed to only serve up a stronger contraction more intense than the last. It was a maddening cycle.
I felt hopeless. I couldn’t go on. I was hysterical. More than 16 hours had passed since this birthing marathon (and the contractions) started.
“I don-wanna-do this!” I said, tears streaming down my face. I was sobbing uncontrollably.
I would collapse into Danny’s chest for support and comfort. He was so tender, would just hold me and try to help.
“I c-c-c-c-an’t do this!” My face was stained with a constant stream of tears. I was inconsolable. My midwife and doula each took separate turns staring directly into my eyes, trying to calm me down.
“Sabrena. Sabrena!… you can do this!” they’d say with conviction. I felt like a helpless child that couldn’t be consoled. It was like someone had cut off my arm, and instead of offering a tourniquet and Vicodin, I was expected to breathe through the pain? In the immortal words of Alicia Silverstone: “As if.”
“Danny, I can’t do this. I can’t do this… I don’t want to do this.”
I was cold and practically naked from exiting the tub. I couldn’t focus long enough to even get dressed… This is not the meditative/orgasmic birthing experience I had envisioned.
“Wouldn’t it be better if we were all just calm and could talk?” I said this like everyone was freaking out; not realizing I was the only person acting completely ridiculous. I’ve been told repeatedly that drugs mess with your mind, but Pitocin just messes with everything…
How do you spell relief? A-n-a-s-t-e-e-s-h-i-a, A-n-i-s-t-e-s-h-a…um, “Pain Meds.”
“I’m just waiting for the word,” he explained, “and then we’re calling the Anesthesiologist.” But I was oblivious. As I mentioned, I was too busy vomiting my insides and writhing in pain, like unto that scene in Star Wars, episode VI (?) where it appears that Palpatine is electrocuting Luke with his hands and the power of the dark side.
Now that I mention it, I’m pretty sure Pitocin is what George Lucas had in mind when 'force choking' was invented for Vader (ask your husbands for clarification if you don’t get it. Unless you’re married to a man like my husband, in which case I’d have to explain the joke to him…so if that’s the case, just keep reading and lets just put that whole ‘bit’ behind us.)
Anyway, like a lot of couples on the natural birth track, we had a “safety word.” It’s a word that the Birth Mom can say if it becomes too much for her to handle. The understanding being that of course a woman is going to say, “This hurts,” “I don’t want to do this,” “Get me drugs,” “You did this to me” etc, etc, etc… or any of the many things the actresses on TV would have you believe is all part of the birth experience (and apparently it can be.) But the word is generally something out of the ordinary…or something she wouldn’t say just because it hurts. It has to be something she’d think through to say – making a very conscious decision.
“I want to say the word. Can’t I just say the word?”
I should also mention that while I can’t remember the exact time frame, sometime between the first dose of Pitocin and my meltdown, Danny laid his hands on my head and gave me a blessing of comfort and that I would be able to make decisions in the best interest of myself and the baby.
And at this point, I wanted permission.
I wanted someone to tell me that it was ok to ask for help. That it would be ok to have something to take the edge off. That I wasn’t endangering my baby by getting an epidural (part of my desire to go natural was my fear that the Pitocin, if too strong for me would definitely be too much for baby and cause undue distress).
I wanted support and to hear that I wouldn’t be letting people down. I didn’t want Danny to think I was a wuss – yes, after nearly 17 hours of labor, I was worried I would be perceived as weak. (Still to this day I fell like I have to over explain why I finally “caved.”)
“Sabrena,” Danny said, with a deep intensity in his eyes, that was not forceful, but full of love and concern, “remember I blessed you to make good decisions – for you and the baby.”
He was right. When the thought of a c-section seemed like welcome relief from the agony, I knew this was not a good place for me to be.
“I’m going to say it… I’m going to say the word……Antidisestablishmentarianism.”
Yes, my word was “antidisestablishmentarianism.” Sure I could’ve gone for the longest word in the English language, which I learned in 7th grade at Churchill Junior High was Pneumonoultramicroscopicsilicovolcanoconiosis, but let’s be serious -- that just seemed excessive.
Funny thing about saying the word – it was still another half-hour or so before I got any semblance of pain relief. And having to hold still – hunched over through three rounds of contractions while the anesthesiologist stuck the needle in my back was just one more hurdle in this eventful day.
She also gave me a button to push “up to 40 times” I think she said. Apparently you can self dose your pain meds – and it ranges from “I’d really like to be able to move my toes and feel the contractions” to “make the bottom half of me numb – I’d have chosen ‘Twilight Sleep’ if it were an option.”
I didn’t feel a need to be void of feeling. I actually was grateful the epidural was a minimum dosage. For the rest of labor I could feel (and for the most part move) my legs and feel the surges. Huzzah!
The minutes kept tick-tocking by. We had made it through our first nurse’s shift – and at some point Sarah had said good-bye and was replaced with Kari – who was so interested in ‘the tape’ I wasn’t sure if she was actually a nurse or just an extra assigned to sit at the monitor.
Part of the problem was that Baby Z was showing early signs of distress. I had been given oxygen and internal fetal monitors were placed inside me to more closely watch the baby. They were having me shift positions (much harder since my legs weren’t as functional as I’d normally prefer), but I had kept the epidural dosage light – enabling me to have some movement (also, a lot of will power and determination helped).
Perhaps it was the epidural, or just that the baby had moved positions because I was now at nine centimeters, but the contractions moved from beginning at my uterus to lower and deeper in my body (and yes, I could definitely feel them…they just didn’t make me vomit and I could carry on a conversation. Huzzah!)
Miracles Never Cease
It was right around 9pm – hard to believe we had been at this for 19 hours. Yes, 19 hours. Holy Balls! 19 friggin’ hours!?!?!?!
At 9:07 Danny sent out a text to a few family members and posted to Facebook: “At a 10 time to push.”
Lisa got me ‘positioned’ and said to take really deep breaths and push with the contraction (I was really grateful I could feel the sensations coming since I had only hit that button a few times in the last couple of hours.)
I hadn’t been pushing for very long beforeshe had asked if she could check me… she was concerned the Baby was posterior again. For those unfamiliar with the drill, getting “checked” requires a certain level of intrusion into the female body parts/cavity. Eventually she asked if I was ok having the resident Dr. Calvert check me as well. For some reason, she couldn’t really tell the baby’s position.
Dr. Calvert was technically a resident, who happened to be just two weeks away from no longer being a resident and starting his big-boy-job in some fancy hospital in the Pacific Northwest -- Seattle Grace perhaps? I don’t know how much emotional baggage this doc came with but from the looks of him, he definitely could’ve been a character on Grey’s Anatomy. He walks in -- million dollar smile, amazing eyes (not that I noticed) and at one point was up to his forearm in my lady parts, twisting and turning (what I think was) Baby’s head.
“Sorry,” he said. ”I know this is uncomfortable.”
“That’s ok,” I said nonchalantly. “My husband does it to me all the time.”
The room erupted in gasps and giggles. I’m pretty sure Danny turned a shade of crimson, and Dr. Calvert looked up, aghast and then somehow worked out a smile when he realized I was in fact, joking.
The good news was, he couldn’t categorically tell that baby was posterior. The bad news was, he couldn’t tell if the baby was posterior…and Baby Z continued to show signs of distress.
“I’m going to be honest with you. Those decelerations are concerning to me.” My heart sank a little…ok, a lot. “We’re going to have to start talking about other options to get the baby out.”
And then he mentioned a few things, but of course all I heard was the dreaded C-word.
“What about forceps?” I asked. The thought of having Baby Z delivered by giant salad tongs didn’t sit well with me, but certainly seemed like a better option than a repeat cesarean. He explained that since we couldn’t tell the exact position of the Baby that forceps could actually be more dangerous to the baby.
He was willing to let me try and push a bit longer to see if progress was made, and give Baby Z a little more time… but I knew we were up against the clock.
“We are doing this!” I say to the room. “Everyone needs to believe!” I looked at Dr. Calvert, “Ok?” I ask him. “We are doing this!”
“Ok,” he nodded, and I got the feeling he was agreeing more with my attitude than the actual procedural side of things.
I could not have have another cesarean. This had to happen. Danny had told me it was God's will, I reminded myself (though, that's not exactly what he said, but how I had chosen to interpret it). Beneath the oxygen mask I started mumbling a mantra to myself: “God’s will is my will. My will is God’s will.”
How could I end up in the OR again if what I really wanted more than anything was for us to be safe through a VBAC?
“My will is God’s will. God’s will is my will.”
Dr. Calvert settled in at the base of my bed with Lisa and helped me push. Danny and Emily were to my left with Kari (the paper watcher) to my right. Fortunately for all of us, Kari had suffered a back injury and was not so helpful, so she got replaced by Heidi, to help hold my leg (the fortunate part obviously being that Heidi was great, not so much that Kari’s hurt her back… just wanted to clarify).
I was working so hard. I was using every ounce of strength and all the intention from my past 5-plus years of yoga practice I could muster to take long deep breaths and push until my head would explode. (I would later find out from one of the nurses that my ‘awesome pushing’ was the reason Dr. Calvert let me continue to try and get Z out.)
“Can you feel my two fingers?” Dr. McDreamy asked.
“Yes,” I said, thankful again I had gone easy on the epidural button.
“That’s what you need to push against.” And so I set in again.
I continued pushing for what must have been about another hour. It seemed like we were making progress (at least I was working really hard), but they had turned up the monitors making it impossible not to notice that Baby Z’s heart rate continued to nose-dive, and not just with the contractions – apparently slowing to a critical 80 beats a minute or less.
“We’ve got to get this baby out, soon,” Calvert was stern.
“What’s our time frame? What do you mean?” I was anxious and scared and disappointed but needed something more concrete.
“Twenty to thirty minutes,” he delivered the blow. My heart sank, but my resolve was still in tact.
I looked up at my husband – my face fearful, yet with a pleading faith. Throat choked, eyes welling with crocodile sized tears: ”Danny, you have to TELL ‘em it’s time to come. You have to tell the baby…Now!”
My doula looked at Danny, “She wants you to get down and talk to the baby.”
“I’ve got this…” my husband responded. And while I don’t remember the exact words he used, I do remember what he said. Danny laid his hands on my head for a final time that evening and commanded our baby, by the power of God to come join us.
With a renewed sense of purpose, I dug deep somewhere inside and pushed. Pushed with everything left I had to give, for this baby’s health, for it’s life, for the safety of both of us. The room seemed to move in slow motion-- like in the movies when things go kind of silent and you see people shouting and yelling but there’s only background music.
It was like that.
The room filled with people.
What is it? What is it? I was thinking.
“What is it?” Danny and I said out loud.
Elated she's finally in my arms--didn't know there was a camera, obviously.
Zoë didn’t get full points on the Apgar because of the whole lack of crying thing, but when I took her in my arms, I was surprised to discover she latched immediately. This also surprised the majority of the room, because they thought she seemed less responsive.
Here I did know there was a camera...a little improvement, but not much.
Healthy Baby. Healthy Mama.
Yes, my will apparently was God’s will.
Zoë Suite Mangum
8 lbs 6 oz and 20 precious ounces of perfection