Part One here.
You know how good a hot tub feels? And how it feels even more wonderful when you're sore and tired? That feeling doesn't even come close to the incredible relief of a tub of hot water in active labor. Instantly I stop feeling lingering pain between contractions; I am able to relax my body around my contracting uterus, to move around without feeling as though I would break. Yes, contractions still hurt, but they become infinitely more tolerable. I sink into the water up to my chin, and in between contractions, I lie back against the edge of the pool, or rest my chin on the rim.
(The pool itself I recommend highly; it's just an inflatable children's pool, available for about thirty dollars at big box stores, and it fills in about fifteen minutes with an air pump of the type you'd use on an air mattress. Once filled, it's so stable that you could sit on the inflated rim; I was able to hang on it, push on it with all my weight, and yet it was comfortable to lie against or drape my arms over.
Some things went very right: our water heater filled the thing in one go, with plenty of hot water left over for refills; after we'd gone to the hospital, my sister knocked the filling hose out of its place in the sink (we'd been planning to drain it using a Python pump), and placed the end of the hose in the bathtub, where gravity drained the pool down to the bottom few inches. No leaks, no splashing, no floorboards breaking.)
While I am in the pool, we se some signs of progress: bits of bloody show appear floating around in the water, and Nicole scoops them out with a fishnet. Labor is growing more and more painful, and I am so tired, though the water lets me rest; I can relax fully and actually feel good in between contractions, and even fall asleep for a minute. Sean is next to me constantly, reassuring me when I get edgy during a contraction, talking me through it when I need it, and supporting me quietly the rest of the time. I think I keep my eyes closed most of the time; I remember being conscious of how wonderful that hot water felt, but not of what was going on in the room. I hurt enough that I have to focus intently on every contraction while it happens, and afterward on the lack of pain. There's no room for anything else. But it's doable; I'm doing it. I am also making more noise, now, loud groans with every contraction, like mooing, like lowing. I wonder, briefly, if the neighbors can hear. I don't care.
Nicole suggests I get out of the water for a while, try being upright. I make a halfhearted attempt, but as I'm about to step over the edge of the pool a contraction hits and I jump right back in. Just the edge of pain at the start of the contraction, without the comfort of water, is alarming. I offer a compromise: I will stay in the pool, but I'll squat, holding the edge of the tub. Sometimes I even stand up in the water; from the pool I can reach the old mantel in the bedroom, which is strong enough to support me. I lean on it, hang from it, but keep my legs in the water, as though hedging my bets. I don't want to get too far away from the only source of relief. I don't think NIcole finds this sufficient, but she doesn't say anything, or if she does it doesn't register. In my pain I am belligerent, at least internally.
I am also sick.
All along Sean and Gretchen and Nicole have been giving me sips of ice water, white grape juice, electrolyte mix; now anything other than plain water tastes cloying and leaves me nauseated. "I wish I could throw up," I say, again and again. I should point out that I still have not felt the effects of the five ounces of castor oil I've had today; earlier in labor I was concerned, wondering if diarrhea would hit while I was having contractions or in the water, but at this point I don't care, and anyway my bowels seem to have shut down. I don't see any sign of the castor oil until the next morning, when Sophia is several hours old, and by then I am grateful: it makes the first postpartum poop infinitely tolerable. Anyway, I am increasingly queasy, and finally insist on a bowl. If I do throw up, I'll feel a lot better, and sometimes the act of having a receptacle makes nausea dissipate.
Nicole gets the enormous metal mixing bowl we've set aside for the placenta, and holds it at the ready. And I do indeed barf, copiously. And it is a great relief, until it happens again. I bark orders, have Gretchen mix me up some unsweetened electrolyte drink, because now I'm sure I'm getting dehydrated, but I can't bear to have anything sweet. Even watered-down juice is too much. My energy is low, but I don't want to keep throwing up. I do anyway.
It's dark outside, it's gotten a lot later. Louise comes in, sees me still in the water. She is a lot more forceful than Nicole, and talks me out of the pool over my whiny objections. "We've got to get you upright so you can have your baby," she tells me. I reconsider the advisability of having a baby at all, but at this point it still seems doable. Out of the pool I am miserable, lowing as loud as I can to take the edge off the peak of the contractions; I am so tired, though, that I keep falling asleep between contractions. I discover that making a slight grunting noise at the top of each moan, like you'd expect from a woman getting ready to push, helps a lot with the pain.
"Do you feel like pushing?" Louise asks. "Are you pushing?"
"No," I say. But I want them to check me. Each exam is intensely painful, the kind of pain that renders any coping technique laughable. During cervical checks I whine, whimper, almost scream; I crawl backward on the bed, crablike. I want to know, though, so I submit.
I'm almost seven centimeters dilated at this point. It's full dark outside, late; I have no idea what time it is. "Let's try a push, to see what happens with your cervix," Louise suggests. Nicole gets the Doppler, finds the baby's heartbeat. In my state I am not thinking about how Louise will need to have her fingers in me during this push, and so I am taken by surprise at the pain. I scream for her to stop; it is the most horrendous feeling, impossible to describe; she expects this, and speaks gently but firmly, talks me through it so she can do what she needs to. I bear down, and she works with her fingers, stretching my cervix a bit, feeling how my body responds. And suddenly I feel a tremendous change of energy in the room. At this point I've lost any sense of the passage of time, so I can't tell you how many seconds or minutes it took for the midwives to see what was going on, exchange looks or even words, make decisions. But I feel something is not right, in the room, and then Louise's face is next to mine, telling me, loud and firm, to get on my hands and knees, face down on the bed, bottom in the air, and Nicole is getting the oxygen tank and giving me the mask.
"There's some meconium in the fluid, and I saw more blood than I like to see," she says. "We're going to give you oxygen, and then we are going to the hospital. Your baby is okay, we just need to be somewhere with better monitoring and more oxygen."
The oxygen clarifies me, makes me feel weirdly calm, and I think about Fight Club, how Tyler Durden says the oxygen on planes will do that. I don't know what's going on, where the blood is coming from; I say out loud, to myself: "Stop bleeding. Stop it." I stop contracting, too.
Later I learn that it was more than "some" meconium -- the meconium was thick, and the blood was more than you'd expect to see, and at the same time I pushed the baby's heart rate stopped responding, remaining steady. The blood, Louise explains later, is from a marginal separation of the placenta, a result of the the good yank on the cord provided by that practice push. That yank and separation caused the baby's distress, too, hence the nonreactive heart rate and the meconium.
"Which is the closest hospital?" Louise asks Sean. It's ten minutes up the road, a straight shot, and their L&D is triaged by midwives; it's a good hospital for birth, though my midwives don't have privileges. At this point it seems to be a case of any port in a storm, so Sean gives the mercifully simple directions. "Okay, I'm calling the ambulance, and you" -- here she gestures at Nicole and Gretchen -- "can follow in the car." Nicole hurries to pack up their necessary supplies, and Sean finds my hospital bag. Every few minutes Nicole returns with the Doppler to check fetal heart tones, which are fine, now that I have the oxygen. Louise dials 911. From my ass-in-the-air spot on the bed, I hear the phone ring, once, twice, five times. Ten. Twenty.
Thirty.
Thirty rings, and no one picks up at 911. Louise swears, and says, "Okay, we're going ourselves. Nicole, ride in the back with Jo, with the oxygen tank. Sean, sit in the front. Gretchen, take care of things here and meet us there." More swearing, entirely justified. "Joanna, I need you to put some clothes on. We're going to drive to the hospital. Your baby is okay." What about me, I wonder. I don't know where the blood is coming from. I throw on a t-shirt and some shorts, wondering how fast I'll bleed through them. With Nicole right behind me, holding the tank, I hustle down our steep, narrow stairs. The adrenaline has shut down my labor completely, and I am unreasonably grateful for the respite from pain, considering the circumstances.
Louise, meanwhile, has her cell phone, and is calling the local precinct, trying to get an ambulance if there's one in the area, or a police escort, or at least trying to warn them that there will be a speeding car, so we don't get stopped. The person on the other end of the line is both baffled and, I am delighted to report, incredibly stupid, unable to grasp the situation that Louise explains in short, declarative sentences that make sense even to me. We are in the car now, speeding down the road; thankfully it is a few minutes after midnight on a Monday, and no one else is on the road. In frustration Louise hangs up on the idiot at the precinct, and calls the hospital itself to let them know we're coming.
We pull up to the emergency entrance and pile out of the car. It's a small, quiet hospital, though with a first-rate NICU; no one else is in the emergency room, and a lone guard stands by the door. Louise explains to him, and to the receptionist we're approaching, what's going on; I am standing there, oxygen mask clutched to my face, bloodstain spreading across the back of my shorts. No one seems to know what to do, there at the hospital, so Louise takes charge, demanding a wheelchair and directions to Labor & Delivery. "We'll need an L&D room, an external monitor, more oxygen, and possibly an OR," she tells the receptionist, who appears now to grasp the gravity of the situation. She insists Sean stay back to fill out forms.
"I'm not leaving her," he says. He is terrified. After a few minutes of deliberation we determine that Sean can stay to give insurance information and will meet us upstairs. I feel well taken care of, being pushed at a clip down the empty corridors of the hospital by Louise. We follow the receptionist's directions, which land us in Maternity rather than L&D, where they have no idea what we're doing here; eventually we get directions to the right place, and they are expecting us.
I take off my glasses, since I can't get them to sit right on the oxygen mask, and from this point on I have only a dim awareness of anything more than four feet from my face, and that's blurry as well. A couple of nurses introduce themselves to me, explain what they're doing, swap out the midwives' oxygen tank for their own setup, attach a pulse oximeter, put in a hep lock and start IV fluids. Louise helps them set up the external monitor belt. At some point I shed my clothes and am dressed in a gown, which feels wonderful, cool and clean. Forms are presented to me, which I fill out as requested in a messy scrawl. I list Louise as my labor support person, since I don't know if they'll let her stay otherwise.
The CNM on call, whose name is also Nicole but who I will call Nicole C. to prevent confusion, introduces herself to me. Louise talks with her, and they discover they have some professional association, have taken classes together. Somehow it is decided that Louise, though she doesn't have privileges, will stay, and even assist. For this I am grateful to Nicole C., and even more so later, as you'll see.
The first thing I say to Nicole C. is,
"What can you give me for the pain?" There in the car, during that
break from contractions, I have decided I do not want to do this anymore, and hey, maybe I'll need a cesarean and I won't have to do this, oh thank God, because this fucking sucks. I want morphine, I want an epidural, I want not to be doing this any more.
"We can talk about options for pain relief," she says in a friendly
voice, and Louise inserts herself. At the time I am irritated,
petulant. She points out, first, that my baby's health is somewhat
compromised at this point, which makes most drugs an unacceptable
option, and that if I get an epidural, I will almost certainly need a
c-section, and that I want to avoid that if I can, since a vaginal
delivery will be better for me and my baby. You can do this, she tells
me. I know you can. I wouldn't ask you to if I didn't know for sure
that you can do this. Here is where, Louise says later, the
relationship a client and a midwife have is extremely important; if it
weren't for five years of history, I doubt I'd have listened to her,
and she would not have felt able to say that sort of thing to me. In
the end, I was so thankful she did; at the time, however, I am annoyed.
"We've got to get you contracting again," Louise says. And at some
point the adrenaline wears off a bit, and the hydration from the IV
perks me up a bit, and the contractions come back, only this time I'm
stuck in the hospital bed, with an external monitor that tends to slide
around when I move, and one hand with a hep lock in it, and the other
with a pulse oximeter, so I really only have one hand to hang onto the
bedrail with, and only four of the fingers on that hand. I'm lying back
at about a 45 degree angle, which is supremely uncomfortable; with each
contraction I cling to the bedrail, holler complaints. I have given up
trying to maintain a positive attitude, and find myself secretly hoping
that some issue will present itself that will spare me from having to
continue -- something that will force a c-section. In fact, I believe
this is what I am screaming about: just give me the c-section, give me
drugs, I shriek, like something off a sitcom. Sean is next to me the
whole time; Gretchen is nearby, and Louise and NIcole come and go.
Nursing staff and Nicole C. hover at the edges, but I'm not conscious
of them, since I can't see that far anyway, a fact I have to point out
to someone who speaks to me from the foot of the bed.
Since I'm no longer in a tub of water, and since I've suddenly been
rehydrated, getting to the bathroom becomes an issue. A nurse says I
can take off the monitor for a minute, and the pulse ox, and Sean can
carry the IV bag. I pee a surprising amount, and then feel sick; I ask
for a bucket. A woefully inadequate emesis basin is provided (why are
they always so tiny?), and someone, Nicole or Sean, holds it in front
of me. I vomit water and bile, and hope that the force of the upchuck
helps me dilate, at least.
"You'll have to keep the oxygen mask on next time," a nurse says.
"That baby flatlined when you went to the bathroom." Thankfully I know
she means the heart rate stopped changing, rather than went away
entirely; Sean does not know this, and is unduly frightened, though he
is reassured later by the obvious vigor of the baby on the monitor.
Back in the bed, I throw up again and again. Sean gets ice chips to
feed me between contractions. I have no sense of time, lost in misery;
my reserves are gone, I think. I can't do this anymore. But Sean is
always there, reassuring me, telling me he loves me; Louise is telling
me we're almost there, almost there, she knows I can do this. Nicole
reminds me to do just one contraction at a time. I am dimly aware that
there are a lot of people in the room; no one else is on the ward
tonight, so all the staff are following my story, coming in and out of
the room. I don't mind at all. I am too busy telling myself, between
contractions, that this sucks, I don't want to do it anymore, maybe I'll just quit! I'll quit and stop having contractions! I don't know how much of this I say out loud, and how much I just whimper.
Nicole C. checks my cervix, which is maybe an eight? I don't remember. There's a cervical lip though. The exam is unimaginably painful, and I scream at her to stop, I plead, I beg. It must sound horrible, and she must hear it all the time. I don't care. I have no dignity left, and no ability to filter what comes out of my mouth.
I read a lot of birth stories, in preparation for my own labor, and what they all failed to convey was the absolute impossibility of the pain, how unimaginable it can be at times. I don't think that's a function of amnesia hormones; I think it's a failure of the English language. There's only so much you can say about pain after a while, so what we end up with is, "It hurts." Which is true. But which is also completely inadequate.
Labor at home was painful but tolerable; in the hospital, I was in transition and somewhat immobilized, which was horribly painful, and not tolerable exactly, which is why I am not the only one to contemplate quitting at that point. Which is hilarious, because at that point, you can't quit, of course. So when I talk about the way I screamed for drugs, cried, begged for a c-section, happily abandoned all principles (and was thankfully reined in by my infinitely wise midwife, which is what I really wanted) I hope that it conveys the extent of the pain at that point.
It got worse, of course.
Thank God I know this ends OK! I'm about to cry before the end of the first page of part 2.
Posted by: mary | Tuesday, September 27, 2005 at 08:34 AM
Wow, you tell your story so well. I am also so glad to know that Sophia is ok. These babies are so strong aren't they? And so are you.
Posted by: Annie | Tuesday, September 27, 2005 at 08:38 AM
Dear gods, woman, you went through the mill! My own labour (because who can resist sharing) was not at all the same, but I am convinced, equally painful. From two to ten centimetres in an hour (thank you, pitocin!), intense pushing, lots of monitors, one bitchy midwife who helpfully advised me during the peak of a hefty contraction "don't grab the bedside cabinet, dear. NO! You're not to do that. Tsk tsk." I still feel my venom rise over a year later when I think of her. What a cow. Anyway, at some point, I gladly proffered my flank for a hit of morphine. Tears, forceps, and one giant-headed baby later...
But this is your story. Write more!
Sangita.
Ps - write more SOON.
Posted by: Sangita | Tuesday, September 27, 2005 at 08:42 AM
God, this just ended and I looked up and realized I am at work. I had completely forgotten. You really are an extraordinary writer, my dear.
Posted by: Alexa | Tuesday, September 27, 2005 at 08:45 AM
I forgot about work too--
I'm late for a meeting with my boss!
Gaaah -- I want to hear the rest!
Posted by: DoctorMama | Tuesday, September 27, 2005 at 08:58 AM
Wow--I feel like I'm there.
Can't wait to hear the rest of the story--more, more, more (please)!
Posted by: Dee | Tuesday, September 27, 2005 at 09:03 AM
You are an amazing writer - I don't know how you can remember all of this...amazing. Thank goodness you didn't blog this live because we'd all have died of anticipation and worry.
Posted by: VHMPrincess | Tuesday, September 27, 2005 at 09:20 AM
Wow. I thought you brave before, and I'm sure you didn't feel brave at the time, but you are even more my hero now than before. I honestly do not think I could've done what you did (my pain threshold is extremely low). I can't wait to read the ending.
Posted by: Natalee | Tuesday, September 27, 2005 at 10:21 AM
This story is amazing, I can't wait to hear the rest.
Like everyone else said, it's good to know that baby is fine, otherwise it would be really scary!
Great job at describing your birth story, I have read a lot of them, and it is one of my favorite.
Take care,
Stella
Posted by: Stella | Tuesday, September 27, 2005 at 10:32 AM
I am such a horrible teacher. I was so eager to hear the rest of the story that I was trying to read this while my 3rd and 4th grade students were doing their spelling.
I think reading this would make me go crazy if I didn't know it turned out fine in the end. You are so strong and brave and such an excellent story-teller.
Posted by: Amy | Tuesday, September 27, 2005 at 10:33 AM
*on edge of seat shoving popcorn in mouth*
MORE!! MORE!!
Posted by: Faerie | Tuesday, September 27, 2005 at 10:40 AM
thank you for sharing your amazing journey with us, jo. i really am grateful.
Posted by: marianita | Tuesday, September 27, 2005 at 11:17 AM
Oh. Oh. Thank you for what you've shared so far.
Posted by: Kira | Tuesday, September 27, 2005 at 11:25 AM
See? Stories like yours Jo it the only thing that made my he pain and subsequent infection of m,y planned cesarean seem tolerable....a good choice even. And to think I was a bit jealous of those who had a vag birth and got all the drama that went along with it... HA!! Home birth? Bwahahaaa!!! never, no way, no how. nuh-uh. Not for me. Now I am kinda glad I will always have to have a cesarean.
By the way your action/drama writing style is awesome and I look forward to seeing your birth story on the big screen sometime soon.
Posted by: Aitch | Tuesday, September 27, 2005 at 11:31 AM
Yikes. {I'm freaking out a little over here.} I just found out that I'm pregnant and I was already thinking that I might not be cut out for this labor stuff...
I'm eagerly awaiting the Part III where everything ends up okay and it was all worth it and you say you'd do it again in a heartbeat:)
Posted by: AinH | Tuesday, September 27, 2005 at 11:37 AM
Agh. Ur. Other unintelligible sounds.
I am so glad that I, too, know there is a happy ending. This gets scarier and scarier. You are a brave, strong, eloquent and honest woman!
:note to self: Do NOT read this again anywhere near anticipated delivery!
Posted by: Jen (yup, another one) | Tuesday, September 27, 2005 at 11:45 AM
Okay, now I'm crying, and maybe rethinking my plans for natural birth. Write the ending soon!
Posted by: TB | Tuesday, September 27, 2005 at 12:10 PM
Utterly amazing, again. I, too, am glad I know this turns out well. Girlfriend, you went through hell and back! But, like they say, it's the best pain because the reward is so great. Yet, it sure doesn't feel that way in the middle of it! Keep it coming!
Posted by: Erin | Tuesday, September 27, 2005 at 12:10 PM
Wow.
I'm also choking up at my desk. This is so powerfully written. Thank you so much for letting us all know that things are fine BEFORE posting this story, otherwise there's be a mass of gibbering women all over the internet.
Posted by: Rosemary Grace | Tuesday, September 27, 2005 at 12:11 PM
You know, I've read this part twice now:
"I'm not leaving her," he says. He is terrified.
and it still makes me cry.
Posted by: Susan | Tuesday, September 27, 2005 at 01:38 PM
I'm breathless. I'm crying. I'm in awe of you. What a great job you are doing so far of conveying what it's like, what it's really like, even if you are prepared, even if you are ready. Astonishing.
Posted by: Brandee | Tuesday, September 27, 2005 at 02:19 PM
thank you, thank you. I mean, I'm not glad you had to go through this. At all. But reading this is theraputic for me. For more than two years now I've felt like I was an absolute failure because when my doctor said it would be better to have a c-section, I agreed. And I agreed because I was tired and in pain and I didn't think I could push him out. I didn't think I could do it anymore and so I said yes. I didn't have anyone telling me I could do it, that we should wait a little more...my husband and my mother just trusted the doctor. And the nurses were a bunch of bitches.
Anyway to read that you, who were much more knowledgeable than I was, and much more committed to your course of action than I was, got to the point where you wanted to give up too...I don't feel like such a lazy failure. I hope that isn't insulting to you because I certainly don't mean it that way.
Posted by: mare_imbrium | Tuesday, September 27, 2005 at 03:07 PM
Holy crap. You are so awesome.
Posted by: Nicole | Tuesday, September 27, 2005 at 04:18 PM
I agree with the above, that while reading this, I was completely out-of-body. I clicked back to a chat window partway through and thought, 'wha?'
It's reassuring to be able to look out the window after reading this, notice it is a beautiful fall day (here in Vancouver at least), and that Sophia and you and Sean are all okay, healthy, and present on the internet!
And Susan, now you made me start to cry, too, from contemplating that line!
Ahh, how moving!
Posted by: heather | Tuesday, September 27, 2005 at 04:25 PM
Not at all, mare_imbrium. More on that in the wrap-up.
I can tell you right now, you ain't no lazy failure.
Posted by: Jo | Tuesday, September 27, 2005 at 04:26 PM