My Thoughts on Labor and Childbirth
With the irresponsible encouragement of wisewoman Laurie, I've decided to write down what's been running in my head since I had my baby a few weeks ago. So, what are my thoughts on labor? What... are... they? Mother Nature's pretty smart--the birth is increasingly foggy to me. I remember all the details, but it's more intellectual than visceral now. For instance, I remember that there was a lot of pain at the transition to the last stage of labor, but it's more like a fact memorized from a history book than a traumatic event. But here are my remaining thoughts, despite advancing motherhood-induced dementia:
This time, I tried to learn from my first birth and do two main things differently: First, not spend the night unnecessarily in the hospital before being induced, and second, not spend the recovery sharing a room with a crazy woman I would have to comfort as she accused my baby of making hers cry. I succeeded on both counts. With both births my water broke and I was induced around 24 hours later. This time, on doctor's orders we went to the hospital but as I was smarter I was able to convince them to let me go back home after they'd checked to see if I was in active labor and the baby was moving OK. That was a great decision.
I really wanted to experience my body going into labor on its own this time, and I do think eventually things would have picked up (but perhaps not have been so intense). When contractions started the next morning, the doctor on call said, "Well, since you're naturally in labor, why don't you naturally come on over to the hospital and we'll naturally be waiting for you." Then he hung up. I couldn't tell if he was being sarcastic or not. My mom, by phone, said, "Don't worry about him--if I need to talk to him about his attitude, I will." I appreciated that.
When we got to the hospital early in the morning, the nurse on call started talking about everything I didn't want to have happen. She told me I'd be induced shortly--this was not part of the plan yet. She told me I couldn't eat anything, and when I argued I had last time she said perhaps I'd had some kind of medieval stopper in me--of course I hadn't! She told me she'd put a hep-lock in my arm, even though I didn't need antibiotics or other meds. And she told me I couldn't move as I'd be on a fetal monitor, even though I told her that last time I'd walked around a lot with my IV pole while being induced. This was not going well. I had to soften her up. I genially explained that if I didn't believe in medical intervention I wouldn't be in a hospital; I recalled how great my last childbirth had gone, and how skilled the nursing staff was. Eventually she started to warm to me, and once the doctor's orders came in she realized that I was not a high-risk case. Her shift ended and the nurse who ultimately delivered the baby came in.
This nurse was excellent. She'd birthed her own child at home with a midwife and said she'd "invited too many people." One thing I've learned from both births was the importance of emphasizing up front that you don't want an epidural. I had lots of support with my mother and husband there, but the nurses are trained to help you and to alleviate pain, so they need to know that's your intention before you're in the thick of things. For several hours, I walked around, visiting the roof garden and looking at the babies in the nursery, and then periodically got back on the monitors to see if things were progressing. While my contractions were getting stronger, they still were not so painful I had to breathe through them. Secretly, I hoped this meant I was so strong and inured to pain that this birth would actually be comfortable. Yeah, right. It was blessedly fast, but not comfortable.
At noon, it was arbitrarily time to decide whether to induce or not. Two emotions, fear and disappointment, were holding me back. I didn't want the pain to start in earnest--who does? I also really wanted to feel nature taking its course. Ultimately, I remembered something I'd read about how mothers who waited several days after their water broke weren't as happy with the outcome as those who'd been induced (due to the risk of infection) if labor hadn't started in 24 hours. So I agreed to the Pitocin drip.
Now my focus started to turn inward. I had my music playing. My "coaches" were a bit rowdy this time, and certainly the presence of my 5-year-old son had something to do with that. So while they made lots of noise yelling baby names, I stood swaying to the CD player with my eyes closed. The nurse chased my mom and son out of the room after a while. I was past breathing and into a sort of moaning/humming to get through each contraction. Draped over a birthing ball, I enjoyed a period of my husband rubbing my back with heavy downward strokes and the nurse giving me a foot massage. Eventually, that didn't work anymore. I remembered how the first birth was manageable because of the breaks between contractions. This time, the breaks kept getting shorter and less distinguishable from the contractions. It was time for the shower (I couldn't do a tub, again, because of my water having broken).
"God bless the shower," I said as the hot water hit my back. I'd used the shower last time too. The nurse left me alone and I continued to hum (I seemed to stay on one note) through the contractions, bent over and clinging to the hand rails. I tried getting on hands and knees on the floor of the shower but the water was too far away--unfortunately I had to endure a contraction in that position. As soon as I could I got back up. The nurse finally checked me and when she said I was only 5 centimeters dilated I felt lost. "I still think you're going to have this baby before I leave," she said. "Your cervix is really stretchy." A few more contractions came and went and the shower was losing its effectiveness. "I'm thinking about all kinds of things right now," I told her in desperation. "I need Fentanyl," I said a few contractions later--no asking for half doses this time. "I'll get it set up for you," she said. Another few contractions: "Is it too late for an epidural?" I asked her. "It's never too late," she lied. More contractions, and no breaks between them, or so it felt. This was hell. "Which is better, the shower or Fentanyl?" I asked the nurse the next time I could speak. "Let's get you dried off and see." She left to prepare the bed for me.
Suddenly, I was in transition, my whole body shuddering like an earthquake. "I feel like pushing," I yelled. She came back to the shower with a towel. "Look how low your baby is now!" she said. Sure enough, the entire bulge of my tummy had migrated downward several inches. Another contraction started as she toweled me off. "Just breathe through it, you can do it. Now it's over, breathe and relax," she coached. We scuttled over to the bed and as soon as I lay down I felt a tremendous urge to push. "Do what your body tells you to do," she said. This was not like my first child's birth, where pushing was very premeditated and a lot of work. Meanwhile, my husband told me later, he had run out of the room after the nurse asked him to get the doctor. The next thing I knew, all my muscles in concert exerted a tremendous push--I don't think I could have stopped it from happening--and there was the head. One more push and there was the baby's body, swooped up and on to my chest with a towel. I looked at my baby boy and then at the clock. "Oh my God, that was so fast!" I cried. "Didn't we start at noon? Is it only 2:30? Oh my God!"
The doctor came in a few minutes later and took care of the final business of birthing. The nurse showed me the placenta. "Do you want to cook that up?" I joked to my mom. The nurse gave us an explanation of the tree of life and how the umbilical cord is slippery and can't get stuck in a knot. Then she hugged me. "I can't believe you were asking for an epidural while you were in transition. That's the hardest part. That's where women get desperate," she laughed.
There it was. I had made it through without any pain meds (last time I'd had a half dose of Fentanyl, which is how I knew it's not particularly effective). I had (probably) sped my progress by staying upright and moving around a lot--which was the point of not taking too many meds. My baby had never left my side. And I had taken care of myself by staying the next day and a half in the hospital in a private room (thankfully they no longer have shared rooms). I felt so much better than I had after my first child.
According to my husband, the amazing thing about the birth was this: As soon as I popped the baby out my demeanor changed completely--it's like you snap back into the real world. The internal focus is gone, the sense of humor is back, the pain is over, the baby is at your breast. It's all worth it. It's life.
