Sunday, November 6, 2016

Cat's birth story part 2: Nasty, brutish, and short

Obligatory birth story disclaimer: Lots of details about where exactly babies come from. Read at your own risk.

When we left off in part 1, I had just gotten to L&D triage.

I had to start by giving a urine sample but fortunately pregnant people excel at producing urine so that wasn't too difficult. I brought the little cup back into the triage room and asked the staff person if she could take it and do whatever and she said she wasn't allowed and I could take it back out to the people at the triage desk. (I have no idea what actual job title each of these people had; I would have assumed they were all nurses but apparently not!)

At that point I was having another contraction so I just set my pee cup down by the sink in the room and leaned on the bed. Person For Whom Touching Pee Is Above Her Pay Grade left and I changed into the hospital gown and the stretchy wrap thing they use to hold the monitors on. As soon as I finished that I had another contraction strong enough that I found myself moaning through it. That gave me a little adrenaline kick because I was pretty sure "uncontrollable moaning" meant I was about 7 cm and we needed to get this show on the road.

So I poked my head out and said, "Somebody needs to come take my pee and check me because I want a room." One of them said, "What?" and I repeated it and then retreated back into the room. And three of them (I think) came in shortly thereafter. One of them did things to the pee sample and one of them entered data in the computer ("Anything you can't talk about with your husband in the room?" etc.) and one asked me to get on the bed so she could check me. ("There's going to be some pressure." "You know pressure hurts A LOT?")

At that point I was 7-8 cm and 90% effaced so they all started moving a little faster. I hesitated for a second, not wanting to be bossy, but decided to go ahead and tell the one who had checked me, "You should call Dr. B__ and tell him to come NOW because last time I went from 8 cm to baby in 30 minutes." So she did. The one who was entering data in the computer said a little nervously, "And it's supposed to go faster the second time, right?"

"So they tell me," I replied.

At that point I started having another contraction and definitely didn't want to be on my back so I flipped over to hands and knees. (Around this time they brought Scott back in.) Hands and knees didn't feel quite right either so once the contraction ebbed I crawled up and draped my arms over the raised head of the bed so I was still kneeling but with my back at more of a 45* angle to the floor. I was still moaning loudly during all these contractions, incidentally.

One of the nurses mentioned needing to get an IV going and I agreed but said something about how I'm kind of a hard stick so they should keep that in mind. (I can't remember exactly how I phrased it; I had been trying and failing for a while to come up with a way to phrase that that didn't sound like, "Are you sure you know how to do your job?" and I don't improvise well in labor.) And then of course the nurse who was trying to start the IV spent a good minute or two carefully examining my arm and poking all the veins. It never ends well when they have to poke around like that.

I had another contraction or two during the vein exploration and apparently the noises I was making were making the nurses a bit nervous because they decided to interrupt their routine to move me out of triage into a regular room because "we're not set up to deliver the baby here." I stayed kneeling on the bed and somebody covered my butt with a sheet and we went off down the hall like that. I managed to crawl from the triage bed onto the delivery bed and somebody gave me a new sheet to cover my butt when I asked. (I specifically said, "I know I'm not going to care later but..." I have no idea how I wasn't already past the point of caring at 7+ cm but there you have it.)

I think we got to the room around 11:05 but I have no idea how I know that.

Shortly after that a new nurse appeared at the head of the bed so that my eyes were right at name tag level while she started working to get an IV started. (She did it much more quickly and confidently than the nurse who had been trying in triage.) I noticed that she had the same name as Night Nurse from my previous birth story and asked, "Have you worked here since before?" (Super clever phrasing there.) She said yes and I said I think I had her when my son was born 3 years ago and she said, "You do look kind of familiar. Did we have a good birth?" Me, a bit dryly: "Yeah, it was a blast."

Up until that point I think the focus on getting to a room had distracted me from the contractions--or else I had assumed that once I got to a room I would be able to settle down and relax and they wouldn't hurt so much. But it was impossible to get on top of these contractions. They were so much on top of each other that moving or changing positions was pretty much impossible. Scott rubbing my back or using the ice pack didn't help. Moaning loudly didn't help. (I knew I was losing control because when the contractions were peaking the moaning sounds started to slide up the scale until they were more like screaming.) Thinking that it would be over soon also didn't help, because what I wanted was to not be having this particular contraction. Or any contractions.

So I complained a lot, and I feel super dramatic about it now but honestly is that any worse a coping mechanism than moaning and making a lot of noise? I cope how I want, y'all. :p This included muttering while Nurse Who Maybe Was At My Last Birth was placing the IV, "I am never having sex again." I think she thought this was funny.

Then she went off to do something else (or possibly left entirely; there were a lot of nurses and I didn't care enough to keep track). I had a nurse we'll call Nurse K who stayed standing by my head. When I felt a contraction coming on I would say pitifully, "I can't do this..." and she would respond with a relentlessly cheerful, "You ARE doing this." I didn't find it super comforting at the time but in hindsight it was sweet that she tried. (And it certainly wouldn't have helped to be offered an epidural at that juncture--even if I'd wanted one, and I kind of did, there was simply no time at that point. Spoiler.)

Eventually I started responding to "You ARE doing this" with "I don't want to do this." Because I did get that I was doing it but man was it awful. And I complained at least once that I wanted to start pushing because pushing was better and when were we going to get to that part?!

At some point I noticed that my blood pressure cuff was not hooked up to anything and was just sort of flapping uselessly around my elbow. I think I asked aloud, "Do I need this?" but then I didn't actually wait for an answer, just pulled it off and threw it on the floor behind the bed. Best patient ever. :p

At some point after that my IV fell out (HOW? I have the worst luck with IVs...) and Nurse K quickly started a new one just below my elbow rather than in my hand. I am pretty sure this was after I took off the BP cuff because that had been on my left arm and the IV ended up in my left arm. (I eventually got a new BP cuff on my right arm.)

Also somewhere in there: I asked what time it was (because I was convinced I had been stuck in labor twilight zone for HOURS at this point) and it was only 11:15. I found that super discouraging because the amount of pain I'd been through in 10 minutes was already more than I thought I could handle, and no way was this going to be over quickly enough at that rate.

Scott, on the other hand, responded to my asking the time by saying, "Just think! Only a few more hours of this." Me: "Fuck you."

(P.S. Scott I love you but that was not super encouraging. :p )

(P.P.S. It occurs to me as I'm writing this that he wasn't in the room during the part where I was checked at 7-8 cm. So he had no idea how far along I was and was probably assuming that labor would be about 6 hours like last time.)

I decided that I should try breaking the contractions into smaller increments so I didn't have to get through a whole contraction at once. (With Tad's birth I broke transition contractions into 4 Hail Marys apiece.) So I told myself to take a deep breath and moan for as long as I could and see if doing that 3 times in a row was enough to get through the contraction.

As I recall, I got through about 1.5 moans before the sounds suddenly changed to more guttural and grunty ones. (Because I was starting to push, let's be clear on that.) The nurses all jumped to attention at that and one of them said to go fetch a resident just in case. I asked where Dr. B was and Nurse K reassured me that he was on his way, but of course he had been "on his way" last birth too.

The resident was a blond girl--and I say "girl" and not "woman" because she literally looked about 14. I mean, she would have had to be at least 26-27 to be a medical resident, right? How do people my age look like such babies? She introduced herself (no memory of her name) and I said "Yeah, my last baby was delivered by a resident too." And then I never spoke to or saw her again because a minute or two later Dr. B actually arrived, looking very well-dressed in a sport coat.

I seem to recall he watched me through a contraction (during which I complained "This baby is trying to break my spine.") and then once I was done he said calmly, "I'll just get changed." I replied, "Get changed QUICKLY."

After that leaning on the head of the bed stopped feeling right. I asked for a squat bar and somebody put one up and I ended up kneeling at the foot of the bed with my arms draped over the bar. I have no idea why that was better but it felt much more stable at the time.

With Tad I remember pushing being a huge relief but this time around I just went from feeling like my back was going to snap in half to feeling like my pelvis was going to snap in half. I complained about this a lot while I was pushing. ("This is supposed to feel BETTER why doesn't it feel BETTER?" Also more generic pushing-out-a-baby stuff like "It burns" and "Oh God oh God oh God." For real, you guys, I was super dramatic with this labor.)

At one point I reached down between my legs to feel the baby's head (report: much more smooth and slimy than you'd think, sorry baby) and Dr. B asked if I could feel the head. I was still wearing the hospital gown and kneeling so he literally couldn't see anything from where he was sitting at the foot of the bed. That's how you do hands-off, seriously.

I said, "Yes, but that hurts my arm muscles" and went back to being draped over the squat bar. (It really did make my arm hurt. Do you ever get that thing where you sort of hyperextend your arm and it really hurts? This might be just me.)

After this somebody had their hand on my perineum but I didn't notice or care who because I was kind of focused on the whole pelvis-splitting-in-half situation. And the situation where it felt like I was going to tear like crazy. It's kind of hard to balance one sensation telling you to PUSH REALLY HARD AND GET THIS OVER WITH and another sensation telling you NO DON'T PUSH THAT WILL HURT REALLY BAD. I did try to hold back a smidge to give things time to stretch but let me tell you that there was no peaceful breathing the baby out happening in my life.

Anyway, I pushed a time or two and felt the baby's head slide out and another pelvis-splitting sensation that I assume was her shoulders and then I pushed and her whole body slid right out and I said something like "Thank you, Jesus!" Confession: For that one second I was 100% glad that labor was OVER and 0% thinking about the baby.

That only lasted a second, though. Dr. B, who at that point was standing next to the bed instead of sitting at the foot, was commenting chattily on how the baby was a girl and had had the cord wrapped around her foot and goodness knows what else and I demanded bossily that he give her to me.

(Scott reported later that Cat wasn't crying right away and Dr. B had to sweep some stuff out of her mouth so it's possible he was not so much "irrelevant chatting" as he was just filling the silence while prioritizing making sure the baby could breathe.)

Dr. B: "It can be tricky..." (I don't remember how he finished this sentence but it conveyed the idea that kneeling is not the best position for instant baby transfer)

Me: "Put her between my legs. And get this thing off me," And then I yanked open one side of my hospital gown while Dr. B obligingly slid the baby between my legs and then I was scooping her right up and everybody was telling me not to go too far because her cord wasn't very long. (I keep making short-corded babies, apparently.)

She cried and I pointed out to Scott that she does the exact same pouty lip thing that Tad does when he cries. And I talked to her soothingly and offered the breast and I'm not sure what else. At some point Dr. B clamped the cord and helped Scott cut it, and I think around that same time Nurse K was getting a bit nervous about the part of my birth plan where I mentioned the history of hemorrhage, so she had me move my arm a bit so she could access the IV and get a bag of Pitocin going.

Once the IV was going Dr. B had me lie back so he could assess for tears, of which there were none. I commented that I had tried to slow down a bit, though there was only so much one could do. Dr. B said, "You timed that well. You sounded so calm on the phone." (I think "You sounded so calm" is code for "I didn't think you were in active labor." Fortunately he had gone with my gut there!) I told him about how I had gotten to triage and had a contraction I had to moan through, "and I was like, 'Oh this is bad' except it wasn't bad because I was already in the hospital.''

Stay tuned for part 3 in which I was really glad to be in a hospital.

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