A Birth (Part Three)

Note: There is some talk of discomfort and bodily functions in this post. If you don’t like reading about pain and pushing out a baby, move on along!

7. Push It Real Good (and Hold for a Count of Ten)

The room was quiet. Nurses wandered in and out, checking the bleep-bloop machines. Janet asked intelligent-sounding questions and sent nurses to go get things. She taught childbirth classes at this hospital and had an air of calm authority. If I roused and needed to roll over, she and John helped me roll over.

We had a huge picture window in our room overlooking the Manhattan rooftops. There is a special kind of cloudless, amber light in Manhattan during the winter, especially when it is very very cold. As dusk settled the sky turned periwinkle and then midnight blue. Lights glowed inside the buildings far away.

At one point I started to feel stressed and overwhelmed. I started to cry, missing my mother. Before leaving the apartment I had packed her pink silk scarf in my purse. It’s been over a year since packing it, and I’m still carrying it.

Also, giving birth at this hospital was a tough choice, for I had been present for a traumatic event here. Eight years prior my boyfriend collapsed of a massive heart attack while we were out for a walk. He died as the ambulance was pulling into the emergency room. And now the baby was coming at the same hospital, on the anniversary of that event. I couldn’t believe this was actually happening.

By late afternoon Dr. B had gone home; her partner, Dr. S, came to take over. After my first miscarriage Dr. S was the one who had performed the D&C in the hospital. Back then I had sobbed uncontrollably as she had promised, “I’ll see you again, to deliver your baby!” And here she was.

I had dilated a bit while sleeping, but not fully. However, we were now more than 24 hours past my water breaking, and that was their timetable for getting the baby out. Also, I was developing a fever.

“We are going to start you pushing now,” Dr. S told me. She said it with a grim determination, as if we were about to try to pull a truck full of live chickens out of a muddy ditch.

The troops assembled: Janet, John, a nurse, the doctor. I received instructions. Janet cradled one of my knees and John took the other, bringing them up to my chin. I curled up and bore down. We did strings of three pushes, each push a full ten-count.

I had done semi-ridiculous physical training for years prior to getting pregnant — contorting in various positions with kettlebells, punching people in the face and body, being punched — but nothing had prepared me for pushing. After the first round of these pushes, I had a very clear thought: “this is bullshit.” I didn’t feel in control. It put pressure on my back and neck. I wished I could hover over the bed, or squat.

To late for that. No retreat, no surrender. We did a few rounds. The machine indicated when I was contracting. I watched the faces at the foot of the bed as all eyes turned up to the monitor, then down to my vagina. I started to be able to feel the contractions, so I got into the habit of rounding up the crew ahead of time to assume their positions.

Time went by. The doctor had to duck out now and then to check on her other patients in labor, and came back when I needed to push. She started placing two fingers inside me and pressing down hard on my perineum. “Push toward my fingers!” she said. Her fingers burned. I started to hate her.

I may or may not have complained about not being able to get leverage, but they brought in a metal bar that attached to either side of the bed — not unlike the bar-lever that comes down over your head when you go on a ride at an amusement park. John and Janet propped my feet up against the bar. More sensation was drifting back. I was able to lean in more deeply as I pushed.

Someone came up with the bright idea of having me push for four rounds at a time instead of three. Later I was told that my third push was always the best one, and they wanted to ride that wave for at least five counts if not ten. For me, the third push was always fueled by annoyance at those persistent burning fingers and (what I perceived to be) being yelled at. The fourth push became one of abject spite.

And what about the baby in all of this? He was hanging tough, no signs of distress. His head started coming down. And then went back up. And down. He was playing peek-a-boo with us.

This went on for a long time. Surging pain in my back; burning fingers in my vagina; painful neck and upper body as I curled and bore down; three pushes and then the dreaded fourth half-push; a bunch of puzzled faces as the baby slipped away, back up the canal.

I felt a vibe of impatience in the room. Or it might have been my own impatience. Either way, I was exhausted.

“I don’t think this is happening,” I said. “I’m calling it. Time for a c-section.”

Later I learned that I had been pushing for three and a half hours.

They started getting me ready for a c-section. That meant getting the anesthesiologist back. It was probably between 9 and 10pm.

Everyone else took a break. They turned down the lights and I was more or less alone lying on my side on the bed. The contractions had come surging back in full force. I closed my eyes and swam in them.

Unlike the pitocin contractions — which resembled how I imagine it might feel to get hit in the lower back with a spiked club — the natural contractions had an arc, a breathlessly painful climax, and a bottoming out. My mind’s eye imagined a dark forest. I lay on a bed of decaying leaves.

When I remember the labor, this is the shimmering moment. Just the baby and me. I wondered if it would be possible just to push him out now, in secret.

8. Let Me Roll It (to the OR)

Lying in the dark, I called out to John. I asked him where the anesthesiologist was. Finally, she came. They rolled me to the OR very quickly after that.

It was very bright and there was a whole team assembled. This reminded me of the D&Cs after the miscarriages, and the later (and ultimately successful) egg retrieval — you suddenly meet a squad of friendly people whose job is to cut you. The curtain went up in front of my face. Having seen numerous birth stories on TV, I knew this was normal. Nonetheless, I completely lost my shit and started screaming for a halt.

I asked the anesthesiologist for something to take the edge off. She said she could, but I wouldn’t remember anything.

Everyone says you will “feel pressure” as the baby is being delivered, but I experienced it as violence, being thrown by a wave and spit back up out of the sea, only to be thrown again.

And then we heard a cry.

Demo: In Late July

Going through the audio archives, I found a tasty morsel from the demos for Snowblind. Enjoy!

In Late July (mp3 download). Mac users can download by clicking on the “play” button with the “control” key pressed.

 

A Birth (Part Two)

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Note: There is some uncomfortable stuff in this post. If you are squeamish about pain or female anatomy, move on along!

4. This Used to Be My Triage

We made our way up to triage, which was empty. Slowly people started filling in: a short and hugely pregnant ponytailed girl slow-dancing hands-on-shoulders with another woman while a man filled out paperwork; a tall girl with an enormous shock of black, curly hair and very large calves and ankles who moaned, leaning on a man and pretty much dwarfing him under her hair and girth. I felt fine and felt slightly guilty for that. Loolooloo, nothing to see here.

We settled into a bed in a triage cubby. I peed in a cup, changed into the hospital gown and fantastic mesh underwear, and got hooked up to the blood pressure cuff and fetal monitor. This last part was not unduly anxiety provoking, as I had been at the hospital for weekly monitoring at least five times prior to this, and was more or less used to it. The monitor went WOWWOWWOWWOWWOW and I tried to relax and think of the ocean. I got checked and was 1 cm dilated. John and I chatted and he periodically checked in on his phone to see how the Pats were doing. A lot of time went by.

The baby was fine but my bp was a little high, which I figured was normal under the circumstances. After my urine was checked the nurse said I was dehydrated, and threatened an IV if I didn’t drink up. John filled up my water bottle; Janet advised (via text) that the high bp could be a byproduct of the dehydration, that there was a vending machine with Gatorade on the first floor, and we should definitely try the Gatorade. John went downstairs to get it and I commenced to chug water. This all made sense, as I never drank anything after that nap. I desperately wanted to avoid an IV, feeling that once you started getting poked, that was basically opening the door to lots more poking.

Around this time the woman in the suite next to me, who had been moaning and yelping off and on, suddenly ramped it up. Her noises started at a soprano warble and quickly escalated to a full-on scream. I started texting Janet anxiously — “the lady next to me is in transition, ha ha ha” — and soon enough, the shrieking was so bad I could no longer think straight enough to write clever missives.  “Don’t push!” I heard someone say.

The nurse came in and told us that my blood pressure readings were still looking high. Huh, REALLY? Could it be related to that fact that a woman has been shrieking, five feet away from my head, for the last HOUR? The nurse was going to test my blood and urine again to rule out preeclampsia, and run my numbers past my doctor, who was on call overnight.

Finally they wheeled the screaming woman off to have her baby. It was 8pm and the nursing shift changed. Things quieted down. A new nurse came in and checked my readings. “Hm, they were using a small cuff on you,” she said. She took my blood pressure again using a larger cuff and the readings looked more normal. Within the hour, the preeclampsia tests came back (negative). John and I were getting excited to go home and have some good cuddles! And I could take a hot shower and roll on the pilates ball and do cat/cow and commune with our animals.

I was overjoyed to see my doctor, Dr. B, poke her face through the break in the curtain!  She was calm and smiling and looked tired. She sat down on the edge of my bed and explained that, because my water had broken, they really wanted to deliver the baby within 24 hours to avoid potential infection/complications. Even though my bp readings were looking better, they still were not great, so she decided to admit me. She wanted to start induction: dilating me on cervidil, and if labor hadn’t kicked in overnight, start pitocin in the morning.

5. Cocktails Burgers for Two (crash, bang)

My heart sank. Induction meant that we’d be in regular labor and delivery rather than the birthing suite. Also, my fear of pitocin was as strong as ever. I wouldn’t mind if my son becomes a headbanger, but would prefer that he be on the outside first.

I wanted to stay calm so it helped remembering my motto: Trust the baby; trust your body; trust the doctor. I accepted Dr. B’s plan. The blood pressure issues scared me a little. Also, at least the doc was giving us until morning before piping in the heavy drugs. She was giving me some space, and I appreciated that. We could camp out in our room and have a late dinner. It could even be romantic.

John brought back cheeseburgers and fries just in time for us to move to our room. We dug in. The burgers were incredible, big and juicy with just enough char. The fries were crispy even after being carried through the cold.

At some point the nurse came in to place the cervidil. I might have already had the hep lock at that point and she gave me an IV. But when she checked me, I was at 3cm! The nurse had already opened the packet of medicine, so she set it aside and left to consult with the doctor. Soon enough it was determined that since I was dilating on my own, they weren’t going to place the cervidil. We’d see how much I’d dilated by morning and pick up the pitocin then, if needed. Booyah!

It was pretty late at that point and John and I sat in the darkened room. I watched anonymous bad TV and John was poking around on his phone. I got hooked up additionally to a blood pressure cuff; they placed a fetal monitor by having me step into an enormous tube top and shimmy it up to wear around my belly, holding sensors in place. I lay down. At that point I couldn’t really move much, even if I wanted to.  “Try to get some sleep,” the nurse said to me. Um, yeah, okay. John’s chair pushed back into a sleep recliner; he lay back and slept off and on.

Awake in the dark, I listened anxiously as the machines bleeped, blooped, and emanated a faint wowwowwowwow. It seemed that anytime I moved, the baby’s heatbeat would disappear. I’d frantically move the sensors to get it back, and if that didn’t work, call the nurse. At one point she came in with an oxygen mask for me to put on. That was torture; I felt as if I were suffocating. I tried holding the mask an inch or two from my face, but the nurse came in and busted me on that. If you are counting, I was now hooked up to four machines. My hips and lower back were aching and I was having contractions in my back. Flipping from side to side was difficult with all the hookups. I dozed off and on.

During one of the bajillion times I called the nurse to adjust my monitor, she let me know that the doctor would be coming in at four o’ clock and would probably remove all of my hookups for a time. So I was pleased as punch when my smiley, tired doctor finally appeared at the foot of my bed! She congratulated me for dodging the cervidil, checked my cervix (still at 3 cm), and started unplugging me from the machines. King Kong unchained! She said she was going to come back at 6 with the pitocin and at that time I should call my doula. In the meantime, I could shower, walk the halls, roll on the ball, do cartwheels — whatever I need to do to get comfortable and try to get the labor going. Game on!

6. The Endless Plain of Ow

I waved bye to Dr. B and lurched into action, sending John out to the car for our bags and the big yellow ball. I was thinking, THIS IS IT! THIS IS YOUR CHANCE TO MAKE THIS DEAL GO DOWN.

I really wanted to get some heat on my lower back to relax it. I waddled to the bathroom and turned on the shower. The water was on the tepid side so I cranked it. I walked away, walked back . . . still tepid. This sucked. I really wanted hot, hot water on my lower back.  But you know the saying — you go to war with the shower you have, not the shower you wish you had. I stepped in.

The pressure of the water was decent but the temperature made me sad. Soon enough I was wet and shivering. So I got out, dried off, and put on two fresh gowns (the first with the break in the back, the second with the break in the front). I peeked into the hallway and started trundling slowly up and down. All I needed was a heavy chain to drag. Marley’s Enormous Ghost.

John came back with all the stuff. It had gotten bitterly cold outside and he was hauling a lot of gear, including the inflated pilates ball. He rolled the ball up to the side of the bed and I sat down on it and threw my arms across the bed. Roll roll roll. A few contractions came and went. I cat/cowed on the bed for awhile. The sun was rising. Somebody brought breakfast and said the doctor would be in soon. We ate cereal. We called the doula.

Janet arrived like Tinkerbell, floating in a halo of light. I remember she and John talked about California. As I sat and rolled on the ball Janet stood behind me  and started pressing on my lower back. She had brought a hot water bottle and sent John to fill it up, as the hot water obviously was not doing well in this room. John was gone for a long time. Later I found out that the nurses steered him to the pantry; the water there wasn’t hot, either, so he was microwaving tiny Dixie cups of water and pouring them into the rubber bottle. The nurses checked my cervix (not much change), hooked me back up to tubes and gadgets, and started the pitocin in my IV.

The contractions started coming with new vigor. I could feel one far away on the horizon; pain would roll in and slowly overtake my lower back. I asked Janet to place the hot water bottle right on my lumbar and lean in as the pain surged. At one point in-between contractions she helped me climb up on the bed on all fours. She got up behind me, rocked and swayed with me, and kept pressing the water bottle. “The heat pulls the pain out,” I said over and over. After a time I started getting shaky and uncomfortable and we climbed down.

Every so often someone would come in and dial up the pitocin. Janet watched carefully.

After two slow and steady hours of the pitocin being dialed up, a contraction came and Planet Alderaan exploded. I was immobilized. The thought of sustaining this level of contraction for hours, or pushing while feeling this way, seemed ridiculous. I asked for an epidural.

Soon enough, a perky girl showed up with a special cart. Coffee, tea, or anesthesia?

When she placed the line, I felt a jolt of lightning in my back. My bottom half slowly went numb and I slept for the rest of the afternoon.