Birth story - Part II - Labor

Read Part I here...

We started from home by 3.15 AM and went to the hospital by 3:35 AM. I was feeling very uncomfortable, but no contractions yet. I don’t know if it was because of the loss of fluid, the car travel felt awful, I couldn’t sit and was feeling strong jabs even when Nikki was not moving and when he moved it was like a sharp-edged rock racing through my belly. Towards the end of the drive, pain symptoms started kicking in - menstrual pain like pain, mild enough to just make me wince every now & then.

DH took the car to the parking garage while my Mom & I walked up to the emergency admission, leaving trail of the fluid everywhere. I informed the front-desk lady and apologized to her, but she did not seem to care about it, probably they see it every other day. I was about to complete the forms, just when DH came in and took over. We finished and DH was wondering which way we should go (we had 2 tours of the hospital in our antenatal classes – the instructor had given step by step instructions for everything, elevator, floor, pre-registration, etc.), I was really angry with him that he did not remember anything from the classes. Earlier during the drive, I had to even tell him the exit he had to take for the hospital, this in spite of traveling to the hospital at least 10 –12 times before. I gave him a glare and started walking to the West elevator(5th floor). The intensity of the pain got a bit stronger(normal menstrual pain) as we waited for the antenatal evaluation. The nurse heard the heart beat, put me on NST and checked my cervix. They do this evaluation to make sure the woman is really in labor before admitting them to a labor suite. Since I was 3+ cms dilated and my water had broken already, I was given ok to proceed to the labor ward. Before that, the nurse started me on penicillin IV because I had tested +ve for Strep B in the tests taken during 36th week. I had De Quervain’s syndrome and already my wrists were paining like hell, I was asking the nurse if she can find a different place to stick the needle. She said wrist is the best place, tried my right one first and then settled for the left. I can still remember how the penicillin felt, like somebody was injecting acid through my veins. The nurse agreed to reduce the flow of penicillin telling me that she would increase it later, once my body gets used to it(?!).

Four labor suites were free at that time and I was happy there was one with Jacuzzi. After a few minutes of wait, around 4:30 AM we were ushered into the labor suite. I asked the nurse for the birthing ball and told her I will be using the tub as well. She gave me the birthing ball and proceeded to fill the tub with warm water. There was no pattern to the pain(5-1-1 was etched into my brain from my antenatal classes), it was like me having late periods – bad pain minus the bleeding. The nurse walked us through the labor suite explaining everything . I was in no mood to listen to her, when she was talking about the usage of the tub, I asked her if I can eat something, she gave me a strange look and said she will check with the doctor and let me know. I came out of the bathroom to the bed thinking I will try sleeping for some time. I just couldn’t get my eyes to close, I was all excited and extremely worried at the same time, so I just lay there thinking how things would enfold from then on. The nurse came and set up the fetal monitor and said she would monitor the baby for 10 – 15 minutes every 30 minutes, since I had lost lot of fluid. Just when Dr. A came in, did the internal exam and told me I am 4 cms dilated. She felt my belly and said that the baby was really big and we better get going with the dilation sooner than later. As though dilation was in my hands, like I could reach up to my cervix and just stretch it. She probably meant in a good way, I was getting irritated with everyone/everything. Anyways, I was happy that I moved from 3 to 4. Dr. A told she will be back in another 2 – 3 hours to check me again. She also told me I cannot eat anything other than ice chips and popsicles. By that time, I was in no mood to eat anything, I was feeling nauseous.

The pain intensity was picking up gradually, still there was no pattern. I was using the tub, birthing ball, heating pad, doing some squats, walking, everything on my own, mom started dozing off sitting in the chair, DH was munching cookies and talking to me. I brushed my teeth and that made me even more nauseous. I vomited(the first time in my entire pregnancy) the poori and potato masal dinner I had had the previous night around 8:30 PM. Close to 12 hours and it was not digested at all, I could see chunks of poori and masal?!!! My body was preparing itself for labor even before I knew it !!!! (when your body prepares for labor or when you are in labor, all the energy in the body will be channelised towards labor and other bodily functions will be ignored, that is why many people vomit or have a bout of diarrhea just before labor or during labor). Was feeling damn tired after the vomiting, so had some water and stretched myself on the bed for some rest. Badly needed some energy, so sent DH for getting popsicles from the fridge. [People who are not for unpleasant graphic details, please refrain from reading the rest of the paragraph]. I felt something prodding around my rectal area and was wondering whether I had pooped without even knowing it. Or have I dilated to 10 cms and this is an indication that I should start pushing? I did not feel the pressure yet, so what was it? Rushed to the bathroom and wiped to find nothing, but the urge to poop was there till I delivered. It was only after delivery I discovered what was causing it. I kept visiting the bathroom every now and then to make sure I don’t create a mess on the bed or elsewhere. Sheesh, that was one embarrassing thing that I never wanted to happen during labor.

When I was having the popsicles, around 8:30 AM, Dr.A made her second visit, checked me again and announced I was 7 – 8 cms dilated. The nurse spoke very highly of me to her, that I was on my own trying out different things without anybody’s help and that too without any crying/shouting/shrieking. (I actually went to the verge of crying many times, somehow did not, don’t know why, I am a person who cries very easily). Dr.A seemed happy with the progress, she patted me, told me I was a strong woman and she would come and check me again in a couple of hours. New nurse came in(shift change) and started me on a new dose of penicillin.

DH went down to the cafeteria to get breakfast for him and my mom. The pain was picking up, without any pattern still, so the nurse put me on NST again to check the contractions. The contractions were very random in the chart, I did not feel them like contractions, it was still like extremely bad menstruation pain for me. It was becoming unbearable, the pressure was building up because of the tummy weight and thighs started aching too. The fluid was leaking lightly all the while, it was colorless till then and it was slowly becoming brown.

DH came in and the smell of the breakfast made me very unbearably nauseous all over again. I asked him not to open it inside the room, but he proceeded to open it telling me he will be done in 5 minutes. I could not take it for one more second, got furious and shouted at him & mom to get out of the room and leave me alone. They went out, had the food and came back in 15 minutes. The pain was spreading to the back and was hurting the sciatic nerves. Went to the tub, some how felt very uncomfortable in it and came back to the bed, heating pads also did not work, pain sometimes made me breathless, but I was in no mood to try the breathing exercises. Dr.A came in around 10 AM, checked me again and told me I was 9 cms dilated. Boy! It was such a relief, I asked her if I can start pushing when I feel the urge, she asked me to wait until she checked me again. She encouraged me to take the epidural, but I refused. She said she will check me again in another 1 hour, if I was not completely dilated by then she would contemplate c-section because there was not much fluid left and what was leaking was brownish red. I was stressed, the pain was excruciating at times, I was not as mobile as I used to be a couple of hours earlier. I was feeling extremely tired, popsicles were not helping me and I was drinking so much of water. I was mumbling “I am not able to bear the pain” every now and then, the nurse was advising me to take the epidural, she said it will relax me and make things easier. I told her I haven’t reached my pain threshold yet, I would like to go natural as much as it is possible for me. The main reason why I wanted to avoid epidural was I wanted to be mobile till the end, “walking-epidural” was not available and I would hate it if I ended up with a c-section because of the epidural.

Dr.A came in again around 11 AM, I was hoping I can push, but she told me I am 9+ cms and we have to wait until it becomes 10 cms. (I wonder how people give birth without the help of doctors, nobody checks the dilation, they push when they feel the urge and out comes the baby). She also told me that she can feel the head of the baby and it is big. By that time, I was tired of hearing the word “BIG”. She once again asked me to go in for epidural because I looked so stressed out and without any diet I wouldn’t have any energy to push. “Epidural will help your pelvic muscles relax and help your baby’s descent, you are stressed and that is what is holding up the full dilation. Take epidural, have some rest and then you can push” – it sounded so tempting. I told her I would wait for another 30 mins to see if I dilate fully and then think about epidural. I was praying frantically and was trying to do some squats during the pain-free intervals. Was checked again at 11.45 AM, no progress. I was reaching my pain threshold and just couldn’t take it anymore. It would have been better if I was allowed to eat, food is a stress-reliever for me. I was bone tired and badly in want of rest, but I still wasn’t sure if I wanted to go for epidural. I asked DH and he was like if you want to, go ahead (I need not have asked him this question, I knew what the answer will be). Going for epidural when I was 9+ cms seemed ridiculous, it was completely against all the instructions given to us in the antenatal classes. But here is my doctor who is encouraging me to go for it and she knows my birth plan very well. Moving (squatting particularly) will help the baby maneuver the birth canal easily than me just lying down. With the epidural the only type of movement that I was allowed was turning sides. There came another contraction that made me absolutely breathless, which made me think about the 2-3 hours of pushing that lay ahead of me, I decided no way I can endure this pain for another 3 hours. Reluctantly I said yes for the epidural. Even now, I do not know if it was the right decision to make, at that time since I was not dilating further, I had to go with the doctor’s advice. The pain I think I could have taken for some more time.

Around 12 PM the anesthesiologist gave me the epidural and instructed me on how to adjust the flow in case the pain increased/decreased. Along with the epidural, they gave me some pitocin to help contractions come faster, so that I will dilate sooner. I was relieved of the pain in 20 minutes, but in half-an-hour, the joys of epidural started kicking in one by one. It started itching like crazy all over my body (side effect of epidural), my legs became numb and I had to get help from DH and nurse to even turn sides, they had the monitor tied to my belly all the time, the nurse was using the catheter to take the urine out of my bladder (all those popsicles, ice chips, water and saline from the IV). I HATED it. I was also started on the 3rd dose of penicillin. There was nothing that I learnt from the antenatal classes that I could try. All that I was doing was turning sides now and then and looking at my pattern of contractions and Nikki’s heartbeat. I started feeling cold, asked the nurse for couple of warm blankets and went to sleep for close to 45 mins.

Dr. A came in again at 2 PM, checked me, no progress. She was worried about the baby, she told me categorically that if I am not going to dilate within the next 1 hour, I will be in for c-section. I was devastated. It was taking me too long to dilate the last .5 cms. There was a nurse change at 2 PM (Ginni went and Michelle came in). I liked Michelle instantly. (Ginni also was good, she was a bit old and matter-of-the-fact-like). I told her I badly wanted to have a vaginal delivery, c-section was something that I was not prepared at all. She nodded to me pleasantly and told me she will do what she can. She looked at my contraction charts, they sometimes were 10 – 15 mins apart, sometimes only 1 min apart, completely random. She told me she is going to reduce and switch off the pitocin and let my body take care of the contractions. Increasing the pitocin dosage earlier had not helped with dilation. She asked me to relax increasing the epidural dosage a little bit. Till that time, I was not completely pain-free, I was adjusting my epidural so that pain was within my endurance limits.

It was 3 PM, Dr.A came in, checked me and “I WAS FULLY DILATED”. Switching off pitocin did the trick (I don’t know if increasing epidural dosage had anything to do with this). I would have kissed Michelle if I could have. At that point, I was completely pain-free, so they wanted me to come off the epidural so I can feel the pressure/pain to push.