launching the meeple, part 2

[psocoptera]

Things got really, really hard.

As early as the car ride to the hospital I had started to sometimes feel the need to vocalize - there's this idea that you're supposed to keep your sounds strong and low, if possible, because if they're high and tight you'll freak yourself out, so I decided to try a sort of low, descending "oh" on the tenth breath, which was nice. It gave me something to look forward to if seven, eight, and nine were particularly hard, and then a sense of being "over the hump" on eleven, twelve, etc. Sometime in the exam room (I think) I was starting to sometimes not be able to make it to breath ten, and was deploying my noise on five and ten; by the time I had rejected the tub (I think - my sense of exactly how my subjective memories line up with external events is pretty fuzzy, and while we have fabulous detailed timeline notes taken by Chaos, they don't include my subjective impressions, for obvious reasons) this was sometimes five through or somewhat beyond ten, and my good strong I-am-the-boss-of-this-contraction "oh" was sometimes turning into a whinier are-you-all-aware-this-really-hurts "ow".

Over the next two hours the "ow"s got louder and louder. The bathroom of the labor and delivery room was by then even more horribly and hideously far away than the bathroom down the hall had been from the exam room, and on my trips there and back I was losing my breathing entirely, just bracing myself against the wall and yelling. Around 6 pm, the midwife on duty said that on the basis of the timing and intensity of my contractions, she thought I might be entering transition (and dilated to around 8 cm), and it was feeling like what it seemed to me transition might feel like - intense, scary, more and more and more painful. I started getting the full-body shakes again because I was just so tense, even with all of Josh's "deep breath, deeep breath", I could only very occasionally manage to relax between contractions. Increasingly, I wasn't managing to keep a count going any more, and was just sort of riding my way through trying to breathe sometimes - one of my very few regrets about my labor was not getting someone else to start doing a count for me. I'm not even sure it was ever apparent to anyone else that I had been counting - I had been doing it in my head, with my breathing - but losing the count definitely made me feel that much more overwhelmed and out of control. The "ow"s were getting even higher pitched, sometimes turning into full-blown shrieks. But I was hanging on to the idea that transition was the shortest stage of labor, that it probably wouldn't go longer than 90 minutes, or maybe two hours, that it might be even shorter, that this would all be over soon, and when I did manage to drop my shoulders and unclench some of the places I kept bracing against the pain, that's what I was thinking, that I was getting through, that this was the hardest part.

Then the day shift went off and the night shift came on and the new midwife wanted to do an internal exam, as none had been done since I had been admitted. At first I just couldn't see how I could possibly comply - I knew that the second I put weight on my legs to move the required few feet up the bed I was going to be hit by a terrible contraction, and then I was going to have to endure at least one and probably several while on my back, and even though I was being hit by bad contractions anyways, this somehow seemed unbearable beyond contemplation. I can't remember what Josh said to encourage me, but eventually I conceded that I could undertake the journey, and made it up to the head of the bed in a series of small scooting increments punctuated by a couple of contractions, where I realized that I really actually could not figure out how to lift my legs onto the bed and it wasn't just fear this time. Fortunately the midwife agreed that she and Josh could lift them and swing them over for me.

Finally settled into exam position, the midwife checked me, and announced that I was at 6 to 7 cm.

I remember being furious. Here this terrible woman had taken over from my nice afternoon midwife, made me leave the one place that was at all comfortable, go through this exam, and now she was taking away all of my hard-earned progress and sending me back to 6 cm. 6 cm! I had been working so hard, fighting to not fight, to keep accepting the contrations and sink down into them and let them work, and it hurt *so* much, for *one centimeter*? And *four more* still to go? And this wasn't transition yet? Real transition was much *worse* than this?

She said I had three choices. I could try laboring in the tub, I could get an epidural, or they could break my water and see if that would speed things up. (In Chaos's notes, the first choice was "try another two hours" rather than "try the tub" - this is likely correct, but I remember it very clearly as the tub, so go figure.) In my next break between contractions (having been helped back down to the corner for the small but very precious amount of relief it gave me), I snapped at her that after my next contraction she was going to leave the room and I would decide with Josh what to do. She was gracious and reasonable about this.

I'm pretty sure I opened the conversation with Josh by saying "I don't know, I don't know", but in fact I sort of did know: I wanted the epidural. There was no way I was going back to that tub, and I felt like I was already running out of ability to cope just as things were - I was starting to get a muscle cramp in one calf, from tensing my leg, and another in one thigh, another in my back - I didn't feel like I had any physical resources that could handle things getting even more intense with the breaking of my water. And the setback in how much progress I thought I was making had just been too big - my belief that I could get through what was left was crushed under the thought of hours and hours left to go. Finally, it sounds sort of stupid to say I opted for an epidural so I wouldn't have to pee, but I was terrified of that next bathroom trip, and I couldn't help but think that if I chose the epidural, they'd give me a catheter and I wouldn't have to get up from the bed anymore.

Josh said all the right things - first, that I was strong and *could* do it, and then that I didn't *have* to, that I was making a good choice for myself, that the epidural didn't mean that everything else (pushing, breastfeeding) would necessarily fail.

What followed was something like an hour of hell. I swear, when we announced our decision, that they said something about one bag of IV fluids and fifteen minutes, although when the anaesthesiologist finally did show up, I said something about being glad he finally showed up and he said he came as soon as he was paged, so it's not entirely clear to me whether I had misunderstood something, or what. In any case, having made the decision to employ pain relief, I felt *entirely ready* to be done with the whole business of excruciating contractions (which had of course been going on this entire time.) After that first fifteen minutes, after each one, I would think that maybe that was it, and I would get my epidural soon, and then it just kept going and going... I had entirely lost the thread of my breathing and was just freefalling from contraction to contraction, screaming and begging and barely aware of anything except the idea that relief was supposed to be coming. (Later on, the nurse who was placing my IV, etc, told me it was a good thing I had gotten the epidural so that I would stop bothering the people next door by being loud, or words to that effect. Pissed me off then and still does a bit - to paraphrase Avenue Q, I totally think you can be as loud as the hell you want when you're having a baby, and if the hospital thinks that's a problem they can invest in soundproofing between the rooms. I'm not saying I particularly *wanted* to be screaming but it seems ridiculous to me to think that I was supposed to be thinking about being considerate of my neighbors at that point!)

Adding to my difficulties, I had one last epic trek to make: because of the layout of the room and locations of some of the equipment, I had to be sitting on the other side of the bed to get the epidural. When I heard this, they might as well have been telling me I had to get to the far side of the moon, for how possible it seemed. And in fact I have no idea how I did get over there - I feel like I remember a fair bit about most of the rest of my labor, but I have no memories of making that move, just the general blur of unhappiness. I recall that getting my IV was surprisingly painful; my next clear memory is of being bent over prematurely by the nurse (you have to curl tightly forward to get the epidural) and of pleading to be allowed to straighten up in the current contraction until they were actually going to start doing something, which the nurse refused and then anaesthesiologist, thankfully, let me do. It wasn't quite so bad to be bent once I knew it was actually *necessary*, and the actual getting of the epidural was not a big deal, on the scale of bodily events at the time (although that was never an aspect of the epidural that was an issue for me, except for the risk of side effects.)

Finally, finally, it started to kick in, and I got my catheter and various monitors. (Ironically, I ended up feeling my contractions as bladder pressure, so I was not entirely relieved of the "feeling the need to pee" issue, but it was indescribably better than feeling them as contractions.) Someone mentioned that the baby's heartbeat looked good and I realized that it was the first time I had thought about the baby in hours - oh, yeah, the baby! The anaesthesiologist came back after a bit to check on things and said he hoped I wasn't having epidural remorse, that sometimes women felt guilty about it once it was going. I had, and have, no remorse: I made a choice based on the specific reality of the situation. In my ideal labor, the situation might have been different, but, honestly, I was, and am, very aware of how incredibly lucky I am that my body was able to make and grow a baby with a minimum of technical assistance. If it was going to not be so great at something, "labor" rather than "pregnancy" was totally my preference anyways. I'm not sorry I waited as long as I did to get the epidural either, though - I absolutely would have regretted "tagging out" before finding out whether I really needed to or not, and I'm glad to have had the experience of unmedicated labor that I did.

The one thing I feel bad about is people being impressed or sympathetic about my 27 hours of labor. Once I got the epidural, I spent the next seven hours resting in bed, warm and safe and calm, sometimes sleeping and sometimes just resting. It feels fraudulent to take credit for those hours as "labor". The person who really deserves to be congratulated or pitied is Josh, who was not able to sleep, with all the many things in my room going "bzzt" or "whirr", and who was thus awake for 24 straight hours of those 27, right there talking me through every. single. contraction. (I think Chaos might have gotten him to eat something once I had the epidural in; I'm sort of hoping he'll post some comments about his own experience through all of this, once I finally get this very long birth story posted. Chaos was herself there for a good 15 hours or so and I think for awhile during the epidural part she didn't even have a reclining chair - I think I was the most comfortable of us during that part, even with the various itching from the epidural, weirdly numb skin on my left leg, etc.)

The other reason I feel validated in my decision to opt for the epidural is that, as I just mentioned, I was in labor for *seven more hours* before even reaching the pushing stage - the epidural did slow down my contractions, but even if you assume it, say, halved my rate of progress, I still had a lot of labor left to go. I was at 9 cm after about five hours and the midwife did end up breaking my water at that point - it was bulging down pretty far but was refusing to break on its own, and it seemed like a pretty reasonable intervention, given that I was at the point where it was supposed to have broken anyways and I was hoping to actually get on towards having the baby at some point.

The water breaking was around 2:45; I was pronounced ready to push around 4 in the morning. (This is where Chaos's timing notes are the most necessary, because I never would have guessed that I was pushing for over two hours.) I think I'm going to leave that, and the actual birth, for a third part to this series, since I've been working on this one for a week and a half now and it would be nice to get something actually posted. So, uh, stay tuned for the conclusion, although I think it's more or less clear at this point how it all turns out. ::grin::

Comments

[gannet.livejournal.com]

Some hospital staff can be such jerks. (I'll never forget how, while I was miscarrying my first pregnancy, I drove by myself to the nearest emergency room, bleeding and in some of the worst pain I've ever felt (physical and emotional), only to have the guy who was taking my information tell me I should have driven twenty minutes further to the hospital where my doctor practiced!)

Fortunately, other hospital staff can be really supportive.