Friday, September 22, 2017

My birth story : Part 2 : Labor and Delivery

I'm not particularly excited to write about this part. As I said in my first post, I wanted to have a positive attitude about my labor. I wanted to focus on what my body was capable of. I wanted to entertain the possibility that everything would happen as I envisioned. That positive attitude about the possibility of a straight forward, easy labor, was bullshit.

I knew things were not going to go well right from the start. I was past my due date, which was fine. I was in that waiting period where nothing is happening and the doctor wants to induce. But I was just waiting for my body to get shit going, and so on Friday, I decided to go for a short walk at a local park. Not too long into my walk, my water broke. I didn't know for sure that's what it was. I was fairly certain though, as liquid continued to leak out of me, because the only other alternative was that I had become suddenly incontinent. (A possibility, but unlikely.)

Premature rupture of membranes is one complication that often leads to a c-section, so my anxiety started as soon as my labor started.

I went home and went to the bathroom where I found that my mucus plug had finally decided to come out. I was able to confirm that my water broke, because the fluid was definitely not urine. I texted my doula and called the nurse hotline and I was working hard not to feel discouraged. Premature rupture of the membranes is a pretty uncommon complication...though it's what the movies love to show as the way labor happens. The reality is that the amniotic sac should stay in place for most of the labor, it's the cushion against the contractions. Because it's uncommon, I didn't even consider it a possibility and never talked to my doctor about it. The problem is that once your water breaks, and the longer it's broken during labor, the higher the risk of infection. How much? I wouldn't know, because I didn't research it. So I knew when I called the nurse hotline that they would tell me to go to the hospital. I didn't want to go this early.

Going to the hospital before transition (dilation of 6cm) is another complication that tends to lead to a c-section.

So when I called the nurse hotline and they told me to come in, I wasn't surprised.

I decided to wait a few hours, but I knew I'd have to go in. I wanted to wait longer, but again, I had no idea how my doctor felt about it and had not discussed this possibility. I felt dumb about that, but honestly, there is only so much a person can anticipate, you know? So I packed up and went in and was super annoyed about the whole situation. They did a quick pelvic exam (something I had wanted to avoid but couldn't justify refusing) and found out that I was leaking amniotic fluid and I was only 3cm dilated. Much to my dismay, I had to be checked in.

From then, my labor just descended into everything I didn't want. I stalled at 3cm, for HOURS, and so the doctors told me I had to have pitocin...of course, first they ignored me for five hours, not examining me or discussing what was happening. They claimed it's because my birth preferences said no pitocin. But honestly, that's some bullshit. What a patient wants and what a patient needs are two different things. It's the doctor's job to communicate to the patient in order to bridge the gap between those two things. These doctors didn't care though and just ignored me. When the doctor finally came in, he didn't even touch me. He didn't examine me. He just told me I needed pitocin and that they had waited HOURS beyond when they would normally administer it.

So, pitocin it was...yet another complication that often leads to a c-section.

The pitocin made my contractions bearable but VERY painful. It also made my anxiety go through the roof. I had been holding my anxiety at bay, trying to maintain a positive attitude while being stuck in the hospital for hours, enduring the commentary of the nurses who wondered why I'd come to the hospital at 3cm. As if I'm an idiot who WANTED to be there and didn't have a fucking chart they could read that told them why I was there. I knew that I could mitigate either the painful contractions OR my anxiety, but not both.

And so, I decided to have an epidural...yet another complication that often leads to a c-section.

By the time I had the epidural, I had been in labor for over twelve hours. The epidural was AWFUL. It caused a precipitous drop in my blood pressure, a DANGEROUS blood pressure was something crazy like 55/64 (I know the top number was 55, can't remember the bottom). The room felt weird, they had to lay my bed flat and start pumping me with fluids and some other medicine. It took them over an hour to get my blood pressure to a reasonable level. The doctors LOVE to ask if a patient has a history of high blood pressure or a family history of it, but they never ask about low blood pressure. They wouldn't have been able to prevent it, but still, it'd be nice if they were thorough in their questioning. The epidural required a catheter, but at least I couldn't feel it. They ran the epidural pretty fucking high, so one of my legs became totally immobile and I couldn't feel the baby move. Eventually, I asked them to turn it down. With the epidural in, all I could do was lie in bed, immobile, and just hope that my contractions were doing their job. Also, I was now on constant monitoring of everything, but still totally ignored by all the doctors.

Day One with Smashface

Six hours after the epidural, I was stalled at 5cm. I was not really progressing. Also, by this time, my water had been broken for almost 24 hours, so it was time to start IV antibiotics. I continued to wait. My labor progressed very slowly, each centimeter taking hours. After more than 30 hours in labor, I had only progressed to 8cm. Also, by this time, my OB had become the house doctor, which was great for me. He didn't ignore me AND he was nice and not bossy and didn't fail to communicate with me until the very last minute. He kept me abreast of everything that wasn't happening and he was totally respectful of watching me go through a labor that was the exact opposite of everything I wanted.

I made it to 8cm and stalled for four hours. At this point, my doctor was talking c-section. He had explained to me that labor was all about progression and progression had a specific time table. I knew this and I knew I wasn't progressing. At this time, he mentioned that Smashface was positioned "asynclitic," this means he wasn't positioned going straight into my pelvis and instead was coming in at an angle.

Asynclitic is not a great position for a baby, but it's not necessarily hopeless. With a willing midwife (or doctor), a woman has options for trying to reposition the fetus. Usually, this means holding a position for 40 minutes that is meant to use the contractions to pull the fetus out of the pelvis so that it might straighten out and head in properly. Of course, by the time I knew this, it was too late. I had an epidural which meant I couldn't move, even if I wanted. Maybe if any doctor had bothered to examine me and communicate with me, I could've done SOMETHING...but instead, I was ignored. So my doctor mentioned Smashface's positioning and also that I had been stalled for four hours at 8cm. I asked him for one last chance and he allowed me to position myself so that my bottom half was twisted over and one leg was in a stirrup. Apparently, this sometimes works, but not for me.

After six hours of labor at 8cm, he wanted to talk c-section. At this time, it wasn't an emergency. I was fine, Smashface was fine, and I probably could've pushed to stay in labor...and maybe I could've tried to move around. But by this time, I was tired. I had been in labor for 40 hours. While most of it was not particularly painful, it was still exhausting. The nurses were nice but the sensory overload was constant. I couldn't move. All I could do was lie in bed, watch movies, and contemplate the inevitable. I had no hope of a natural birth by this point and I just didn't want to be stuck anymore. Also, my doctor would only be there until 9a, and then who knows what asshole I'd have to deal with.

I didn't want to see any other doctors, so I agreed to a c-section.

Day 2 with Smashface

The operation was terrifying and one of the worst things I have ever experienced. Everyone in the operating room was happy as motherfucking clams. They were loud as fuck and there were too many of them. The operating room was the brightest room I've ever been in, all white and sterile and fucking awful. They strapped me down like fucking Jesus, with my arms outstretched, and they numbed the shit out of my lower half, so much that I couldn't feel anything and had a hard time breathing. Despite the numbing, I could still feel their hands inside my abdominal cavity. It was a nightmare and all I wanted was for it to be over. So I kept my eyes shut the entire time and tried to pretend I was somewhere else.

At 5:40a, Dr. Ballas pulled Smashface from my abdominal cavity and everyone in the operating room, except me, was super fucking exciting about it. They all wanted to know the sex of the baby, but I just wanted to know what hair color it had. It turns out Smashface is a boy and his hair is red (no surprise). The doctor told me he had my ears and offered me to hold him, but I didn't want to. I didn't want to experience any part of my child in that awful fucking operating room. I just wanted to get the fuck out of there. So they sewed me up and wheeled me into the postpartum room...a tiny piece of hell chock full of too much fucking furniture and one window. That's where I held my son for the first time.

It turns out that what everyone said was true; my labor was nothing like I wanted and absolutely everything went wrong. However, given how much I was completely ignored by the doctors at the hospital, and how no one bothered to give me a physical exam to determine the position of Smashface, I have to wonder if it could've gone differently. I managed to keep calm and to keep my cool throughout the entire process, though every single thing went wrong. I wanted to try to have a positive experience despite all the negative aspects of the experience, and I did manage to stay relatively happy the entire time. Eventually, I had to succumb to the inevitable conclusion that I would not have a baby vaginally...and while I'm supposed to be ok with this, especially since me and the baby were healthy and survived fine...the truth is, I'm not ok with it at all.

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