We listened to Ben Folds on our drive to the hospital.
We love the piano on Songs For Silverman and I tried to sing along instead of moaning uselessly during contractions.
So we drove to the hospital with me groaning, “I’ve got YOU… to THANK… for THIS…” and hoping that PH didn’t think I was extrapolating the lyrics to suggest that I was blaming him for my current discomfort.
“The problem is,” I told PH, “that the contractions are so overwhelming that for a while I feel like everything in the universe is hurting me. So when the contraction starts it feels like the piano is hurting me and I’m like “DAMN YOU, BEN FOLDS,” and then when the contraction eases I feel like the piano is making it feel better and I’m like “THANK YOU, BEN FOLDS.”
I also noted that when my contractions came closer together they were less intense, but that if the space between them stretched to three or even four minutes then it meant that a real doozy was on the way.
I actually preferred the doozies, because at least I got three or four minutes of relief first, rather than barely time to catch my breath before another one hit. I think that was what made my labour seem so awful last time – the fact that sometimes contractions were coming one on top of another with no real relief.
We pulled into the emergency parking lot of the hospital, expecting that PH might have to drop me off and go find parking, but unusually the parking lot was almost empty. Apparently early morning on a Monday is not the most popular time for emergencies.
It took me three contractions to get into the hospital. I had to finish one before I could get out of the car and then another one came on almost immediately and I had to stop in the middle of the lot. This one squeezed so hard that for a moment I felt a straining sensation, like you get when you have to poop REALLY badly and you’re struggling to hold it in.
That was weird.
I didn’t mention it to PH. I told him to go pay for parking while I slowly made my way inside. Even between contractions it felt very uncomfortable to walk but I made it in and calmly told the lady at admitting that I was in labour, then had another contraction.
She asked me how far apart the contractions were, was this my first, etc etc and pulled me up in the computer. PH arrived as she was printing out my arm band.
“Do you want a wheelchair?” she asked me. I said no, I could walk. Another contraction hit and she watched me carefully.
“Why don’t you take a wheelchair?” she said again. “There’s one right there, and it’s a bit of a walk to maternity.”
PH grabbed the chair and got me to sit down and then wheeled me over to the elevator and up to maternity.
The maternity ward was silent and seemed empty. A nurse greeted us and led us right to a labor room, which was a very nice change from last time. She handed me a gown and suggested I get into it, which I did. The room had a little bathroom with a shower for labouring in and a toilet. I thought I might try the shower in a bit.
The nurse asked to see my Depends so she could check the amniotic fluid.
“A bit of bloody show,” she said, “but that’s normal. Okay, I’ll be back in a bit to check you.”
I sat on the bed for a while but I found the contractions worse when I was confined to the bed so I wandered around a bit. I think it was around seven in the morning by this time.
“That looks familiar,” I said, pointing at the waiting warming table.
“I’m pretty sure this is the exact same room we had Owl in,” PH said. He popped his head out and checked the location. “Yeah, I’m pretty sure.”
I feel like it took a surprisingly long time for a nurse to actually check my dilation. I think there was a shift change so they were busy doing rounds and stuff. They did make me sit on the bed and they strapped a fetal monitor to me.
“Just for 15 minutes or so and then you can move around again,” said the nurse. “You have gestational diabetes? Did you take your blood sugar this morning?”
I answered her questions about my blood sugar, the last time I had insulin, how much and so on and then she left.
“I guess they aren’t going to send me home?” I said to PH.
“Your contractions are really close,” he said.
“They were last time, too, and they still sent me home.”
Finally a nurse came in and checked my dilation.
“Have you had any urges to push?” she asked, pulling on a glove.
“Once, in the parking lot,” I admitted. “Not since, though.”
“Well, you’re only at three centimeters,” she said, “not as far along as we thought you would be.”
“I’m just glad it’s that much,” I said. “I needed pitocin to get that far last time.”
“It may be a while yet, but you’re a second timer so you’ll probably go faster than last time,” she said. “Do you need any pain control? Will you be wanting an epidural?”
“I’ll probably end up wanting an epidural,” I admitted, “but I don’t want to slow down my labour so I’ll wait as long as possible… I don’t want any morphine, I didn’t like that, but I would like to give nitrous another chance.”
One of the books I read recently was called Birth Day and was written by a pediatrician. As a doctor of babies rather than women he had some interesting perspectives on child birth. You could tell that he thought women deserved pain control if they wanted it, but he really hated the available options. He said epidurals were great for stopping the pain but often stopped the contractions, too. They resulted in longer labours and therefore a higher risk of complications. He said he was called in for epidural births much more often than non-epidural births. And morphine affects the fetus, too, so the baby is more drugged up when born.
He said that nitrous oxide, while offered in Canada and much of Europe, is rarely offered in American hospitals and he couldn’t understand why not. While the pain control was nowhere near as effective as an epidural it was about on par with morphine and had basically no effect on the fetus at all.
I had tried nitrous when in labour with Owl and hadn’t noticed any pain control at all, but this guy had sold me on giving it another try. Besides, the women on Call The Midwife seem to love it.
“Be sure to use it through the whole contraction,” said the nurse, handing it to me. “It wears off fast so some women stop when it starts to feel better but then the pain comes back.”
So at the next contraction I put the thingy in my mouth and started to huff and puff. As the contraction grew I noticed no difference but I kept breathing it in, and I began to feel a mild dizziness and the contraction seemed to ebb a bit. I kept breathing until I was sure it was gone, and then took it out of my mouth.
“Did it work?” PH asked.
“Well, my lips feel a little numb, but I’m not sure,” I said. As the nurse had said, the feeling wore off quickly, but I soon felt another contraction coming on and I put the valve in my mouth again.
After two or three we thought it probably was working. PH could see my contractions on the fetal monitor, which was turned away from the bed so that I couldn’t actually see it. He reported several times that my contraction was continuing when it felt like it was ebbing to me.
My fetal monitor kept coming off, though, because when I would hunch and writhe during a contraction, the straps would come loose. The nurse came to reattach it and I asked if we could just take the thing off, and she said yes. That was a relief because lying on my back was really uncomfortable.
I wasn’t using my timer any more so I don’t know how far apart the contractions were now. They were quite painful by now so all of my mental energy was devoted to getting through each one and preparing for the next one. I was sort of turned inward and losing track of the things going on around me. The nitrous probably contributed to that since it made everything seem slightly unreal, although it wore off after just a few breaths of regular air.
At 7:45 am the nurse checked me again.
“Well, you’re four centimeters now,” she said cheerfully. I groaned with disappointment.
“I’ll let the anesthetist know and he’ll probably be in at around 8:00 for your epidural,” she said.
I was going to say that if I was only four centimeters I would try to hold on for a little longer, but another contraction came on and even with the nitrous it was so strong that I found myself thinking that I didn’t want even one more of these terrible aches.
Of course once the contraction has ebbed I didn’t feel like that any more, but I decided to keep my mouth shut. Fifteen more minutes. Maybe that really was about as long as I would be able to wait, anyway.
That’s the last time I remember looking at the clock. The next contraction seemed even worse, and the one after that squeezed my moaning into a higher register. I felt that same feeling that I had had in the parking lot – a feeling like I REALLY had to poop.
“I’m having an urge to push,” I gasped to PH, who quickly notified the nurse. She checked me again.
“Still only four centimeters,” she said, “don’t push, it isn’t time yet!”
“Why am I having an urge to push if I’m only 4 centimeters?” I asked, but if she answered me, I don’t remember, because another contraction hit and another terrible feeling of squeezing pressure.
(By the way, if anyone out there DOES know why my body was trying to push at only 4 cm please let me know, because I still don’t. Google has been unhelpful to me).
“Wave or something if you’re having urges to push,” PH told me. I couldn’t wave because one hand clutched the nitrous valve and the other hand was squeezing his hand, so I just sort of jiggled his hand with mine as the contraction built up to unbearable levels and tried to turn me inside out. But he knew what I was trying to say.
“She’s having another urge to push,” PH communicated quickly to the nurses while I sucked on nitrous.
“Don’t push! Don’t push!”
“I can’t help it,” I gasped as the contraction finished. It seemed baffling to tell someone not to do something that was completely involuntary. “Why am I having urges to push when it’s not time to push?” I whined to PH. “What’s wrong with my body?”
PH and the nurses were nattering to each other over me as I fought through another contraction which again ended in my frantically wiggling PH’s hand and my moan being squeezed into a higher key.
“When you push, love, it can actually slow down your dilation,” PH tried to explain to me.
“But they’re uncontrollable…” I felt entirely unable to do anything about it. I wasn’t pushing, the contractions were pushing. They were trying to squeeze the baby right out and there was nothing I could do about it. I could no more stop the pushing than I could stop the contractions themselves.
“I know…” PH said quickly.
My chronology for this period of time is poor. I think they tried strapping the fetal monitor to me again but that it continued to pop off as I twisted round. I didn’t want to lie on my back. I wanted to turn over.
I don’t remember any space between contractions. I only remember contractions. There must have been space between them, because I don’t think they came one on top of the other the way they had when I was put on pitocin last time. But I can’t tell you what I was doing during those spaces. Getting updates from PH, I guess, because during the contractions I was completely unable to participate in the world around me. When a contraction was on I became sucked into a tiny world that encompassed only the deep visceral squeezing in my lower abdomen, the feel of the nitrous valve as I desperately sucked it, trying to distance myself from the pain, and the low moan that kept being squeezed into a higher register as my body tried to push the pain right out of me.
Where was the epidural? I was definitely ready for it now. Even as I thought that, though, I felt bad for giving in. When the contractions wore off I would wonder if I could keep going, but when another started I would know that I didn’t want to.
I heard someone say that I was now at 8 cm. I heard someone say that the anesthesiologist would never get here in time. I heard PH talking to the nurses.
“Love,” he said, holding my hand tight, “I have some bad news…”
“Don’t tell me…” I begged. I don’t know why I didn’t want him to say it. It doesn’t make any sense. After all, I had heard the nurse tell him, but the nurses weren’t really real. The only real things were the pain and the hand that held mine. Maybe if I heard him say it that would make it real? I don’t know. Duress makes us do weird things.
“There isn’t going to be time for an epidural,” PH persisted. He had to be sure that I understood. “You’re going REALLY fast.”
“I don’t want to hear it,” I think I said, but it turned into a moan as the pain came back.
Part of me was almost relieved about the epidural: the part of me that was a thinking, rational person, who wanted a different birth from last time, the part that was curious about what a REAL birth felt like, the part that wanted to give my baby the best start possible. If I had an epidural I would be giving up all of that. The decision had been made for me and I suspected that I wouldn’t regret that.
But that part of me was heavily overshadowed by the part of me that was going “OH HOLY SHIT MAKE THE PAIN STOP”.
I was past the point of rationality. I couldn’t sit there and rationally think that the pain would be over as soon as the baby was born, and that was probably going to be relatively soon. I don’t think my frontal lobes were in any way active. I was more like an animal, caught in the moment, all higher thinking temporarily shut down.
It reminds me of when I was a child and a speck of dirt got in my eye and my mother had to get it out. And even though I KNEW she was trying to help me, and I knew that the dirt had to come out in order for my eye to feel better, I still screamed and struggled and she ended up having to physically pin me down and fight me into submission before she could do it. What was the rationale there? No idea. But I couldn’t help it.
This was sort of the same.
Human beings really can’t give birth on their own, can they? I mean, I know women do every now and then, but it’s when they have to. Most animals give birth in complete privacy. Some animals, like elephants and dolphins, have family around them but don’t really NEED the family. But humans need help. I was in no way capable of helping myself at that point. I was barely aware of the world around me.
“10 centimeters!” someone said. “She can push now.”
“Good news, love,” PH translated, “you’re at ten centimeters. It’s almost done.”
“I don’t believe you,” I whimpered. Don’t ask me why I said that. PH asked me afterwards and I didn’t have a good answer. I have no frigging clue why I said that I didn’t believe him. After all, I had heard the person announce it – although I needed PH to repeat anything before I could register it consciously – and I did believe it, really.
Maybe it was just hard to believe that there could ever be an end to these contractions?
I don’t have a clue.
I remember them trying to get my feet up on stirrups or bars or something so I could push, but I still resisted any attempt to make me lie on my back.
“Okay, she can lie on her side,” someone said and I felt hands trying to move my feet onto bars again but I twisted more until I was hunched on knees and belly. PH says that I was spouting protestations about studies showing that this was more efficient for labour. Anyway, they eventually let me be.
They were nattering at PH some more and then he told me that they needed to take away the nitrous because I was breathing into it instead of pushing during my contractions.
Pushing! I had been pushing completely against my will since 4 centimeters, and now they were saying that I wasn’t pushing?
Hands tried to take the nitrous away but I clutched it close to me. I have no idea if it was doing a damn thing any more, but if I breathed into it long enough I started to lose consciousness. Except you can’t lose consciousness on nitrous oxide because then I’d start to breathe through my nose and the nitrous would instantly wear off.
It may not have been helping but it was the only thing I had which could possibly help. Besides, what if it WAS helping and I gave it up and the pain got EVEN WORSE?
“Love, you need to give us the nitrous,” my husband’s voice said. “You can’t push and breathe at the same time.”
“I’ll push, I’ll push,” I whimpered, but I wouldn’t let it go.
“Just let her hold it,” my husband told the nurses. “I think it has become her security blanket.”
“Okay,” he said to me, “You can hold it but next contraction you need to give a really good push, okay?”
I sucked on the nitrous frantically before the contraction could really take hold. I felt hands trying to take it away again so when the contraction got strong I took my mouth off of it and when the contraction hit the straining squeezing point I tried to contribute something to the effort. But it felt torturous. It was bad enough that my body was trying to turn me inside out with each contraction. To actually try to make that feeling even worse seemed wrong.
Like, I think part of me was expecting my butt to just EXPLODE or something.
I pushed through the next couple of contractions, feeling like I wasn’t actually contributing much. I huffed nitrous in between, until I began to feel that inside-out squeeze, which was when I put down the valve and tried to push.
After some pushing I could feel the stinging around the baby’s head which books refer to as the “ring of fire”. I registered this new discomfort nervously. It didn’t feel like fire yet, just a stinging sensation, but maybe that would get worse. I didn’t want worse. No more worse.
I forgot about it with the next contraction though and didn’t really pay attention to it after that.
Everyone else was getting excited about seeing the baby’s head, and exhorting me to greater efforts. I tried to add to the pushing that my body was doing with or without me but it took a lot of will power.
I think I grabbed the top of the bed – which had been tilted up at the back- and pulled on it during on contractions. I can’t really explain why. It’s almost like the contractions and the pushing were such an intense downward force that I needed something to pull against to hold ME up or I really would be turned inside out.
There is no dignity to birth. Anyone who says birth is beautiful is lying. Just like death. I’ve supervised a lot of euthanasias, and I’ve seen some peaceful deaths, but never dignified or beautiful ones. They still void their bowels and urinate on themselves. Birth is the same. Even my relatively peaceful epidural birth still involved me being naked while a team of people stared at my bulging gooch.
This nearly-unmedicated (I’m not sure if the nitrous counts) birth was even less dignified. There was moaning and whimpering and writhing and grabbing and (since the pushing urges were identical to those you feel when you’re going to the bathroom except times a million), pooping. The nurse would delicately wipe away my poop with a warm little wet wipe each time.
I refuse to admit any beauty or dignity in a process that involves someone having to wipe my butt.
“You’re almost done,” PH urged me at one point. “Just a couple pushes and you’ll be done.”
Somehow that filtered through and I realized that I could escape the pain if I just did this one thing. I tried to think of the baby. A little more pain, and then I would have a baby.
And NO MORE INSIDE OUTS.
I don’t actually remember pushing the baby’s head out. With Owl I remember the moment quite clearly, but I don’t really have that memory this time around. I remember AFTER I pushed out the head, when everything suddenly erupted frantically.
I heard them say something about the shoulder, and my brain opened up its file on shoulder dystocia for me to ponder.
“She needs to turn around,” someone said, but it took PH’s voice to make me turn.
“The shoulder is stuck, love, they need you to turn over. Come on…”
Whimpering, I managed to roll myself onto my back with a supreme effort of will. My memory was telling me that shoulder dystocia is a common complication in gestational diabetes cases because the baby is large, and that it is more common in overdue babies for the same reason. If the shoulder is really stuck it can be an emergency situation because the umbilical cord can become crushed in the narrow space…
Don’t ask me how I was able to dredge up all this information at a time when I could barely process or react rationally to the world around me. It was of no use to me since I still had very little control over my own actions. But I managed to painfully get myself onto my back, and they slipped the baby loose in a second.
I didn’t see her come out. I didn’t even see her. I saw a crowd of people around the warming table at the far end of the room.
“Where’s the baby?” I whimpered. “They should bring her here.”
“They’ll bring her in a minute. She’s not crying.” PH said with admirable patience giving the circumstances.
I noticed the silence. “Is she OKAY?” I asked, trying to sit up.
But even as I asked I could hear a thin, cranky baby cry beginning.
“She’ll be fine,” I was told by someone.
“They just need to get her pinker,” said PH, “remember how blue Owl was when he was born?”
A man with a turban, a beard, and a beaming smile introduced himself to me. He was the OB who had just delivered my baby, and this was the first time I had seen his face or even noticed his presence. I shook his hand.
Then another contraction hit and I endured ache one more time to deliver the damn placenta.
I kept asking for the baby.
“Taking her away even for a minute makes her less likely to latch at the breast,” I complained to PH. I’m surprised no one bitch slapped me and said “we’re TRYING to make your baby HEALTHY.”
But all I could think of was that I had been through all that and I STILL DIDN’T HAVE A BABY, and my brain kept providing completely unhelpful information, like paragraphs from articles about gestational diabetes quoting the importance of getting colostrum into the baby to prevent low blood sugar.
While I waited for the baby, though, I slowly became increasingly aware of my surroundings. I looked at the time. It wasn’t even 9 am yet.
“You went from 4 centimetres to 10 in, like, forty minutes,” said PH.
“When was she born?” I asked.
“Did I tear?” I asked the OB as he studied my vulva with professional interest.
“Just a tiny bit,” he said. “I’m debating whether or not to even both stitching it. I guess one stitch.”
But I don’t remember him putting in the stitch, because they finally brought over the baby.