Birthing the unknown

The day finally came. After over 280 days of nourishing the growing baby in my belly, the time came for the inception of his passage into the world.

The beginning of my baby’s passage into the world was marked by the trickle of amniotic fluid out of my body and onto my bed. My water broke shortly after 11pm on Monday, March 12. I was not having regular contractions, only weak Braxton Hicks-type contractions.

We called the delivery ward and a nurse invited us to come in to check on the baby’s status. We gathered the bags we packed for the hospital, just in case, and we headed for the hospital. I continued to lose amniotic fluid, but I noticed it was stained with meconium, the baby’s first bowel movement. At one point I stood up in the examination room and a contraction pushed a gush of amniotic fluid out of me and onto my socks and the floor. I pointed out the greenish color and the doctor in the room said we would be staying at the hospital, instead of going home and coming back in the morning, which would have been the case if meconium was not staining the amniotic fluid.

At around 2am, the hospital personnel showed us to our room in the delivery ward. We were exhausted, and yet it was very difficult for us to sleep in a hospital room. I’m a light sleeper. The clock made really loud sounds, the bed was uncomfortable, and then there were the blood-curdling screams coming from a woman in the throes of labor next door. I slept about 20 minutes in total. My partner slept perhaps an hour or two. I was not hooked up to any equipment to monitor the baby. There was essentially no reason for us to be there.

At 7am, the new shift started and several midwives introduced themselves. They checked on the baby’s heart rate and on my contractions. The baby’s heart rate was fine. I was having some contractions, but they were weak and irregular. Sometimes an hour passed between contractions. The midwives encouraged me to get up and walk around to help stimulate more contractions and for the baby’s head to move even further down. So my partner and I walked the halls for seemingly several hours. The midwives came in every 90 minutes or so to check the baby’s heart rate and my contractions. Nothing changed during that time.

In the afternoon, the doctors visited us and proposed a “mechanical” method to induce labor. They would insert a plastic balloon through my cervix into my lower uterus and fill it with water. The weight of the balloon would eventually help dilate my cervix and the balloon would fall out. I agreed to this procedure, as I was hoping to avoid being induced by synthetic oxytocin.

The procedure was extremely painful. The less experienced doctor tried it first, unsuccessfully. Then the more experienced doctor attempted the procedure, with gentler hands, and it worked. I walked around with the balloon in my uterus and two hours later it fell out. My cervix was now dilated about 3cm. But I was still having irregular weak contractions.

At 4pm – 17 hours after my water broke – I agreed to the synthetic oxytocin drip. I knew that the risk of infection was greater in my case, and that it was possible the baby was aspiring his meconium. The drip started slowly and increased incrementally each hour. I had exactly the same irregular weak contractions for the first three hours. And then a tidal wave of contractions hit me.

Before the contractions started up with such potency, I was beginning to think that the synthetic oxytocin would not work on me. But all of a sudden I was having extremely powerful contractions 30 to 60 seconds apart. The strength of the contractions triggered the muscles around my sacroiliac joints to go into constant spasms.

I had suffered from pelvic girdle pain for most of my pregnancy. In the last few weeks of pregnancy, the pain had moved toward the back of my pelvis. I could not lie on my left side for more than two hours without waking up in pain that was radiating from my sacroiliac joints, and during the last weeks of pregnancy I could only sleep on my left side. So during those nights, I would get up, walk around, sit in the lounge chair in our living room and meditate. Then I would try to go back to sleep. I did physical therapy but it only helped so much. I was just glad I could walk.

I had written about the pelvic girdle pain in my birth plan. I had also talked about it with my midwife. She didn’t even include it in her summary about my pregnancy because, as she said, “pelvic girdle pain is so common among pregnant women.” In retrospect, that was something I should have seen as a red flag. The midwives and other hospital personnel seem to think that pelvic girdle pain is just another pregnancy ailment that women just have to suffer with, and that it does not have much real bearing on the labor process.

I was in constant pain. The pain level alternated between 10 out of 10 during the contractions and 9 out of 10 during the 30 to 60 seconds between contractions because of the muscle spasms. My partner pressed his thumbs into the muscles around my sacroiliac joints during the contractions, and the poor guy has double-jointed thumbs, so I’m sure it was painful for him as well.

I did my best to breathe through the contractions and in the seconds between the contractions. I had lots of experience in breathing techniques, so it was not difficult to remember to breathe. I tried to send myself compassion too, for all that I was going through, and to remember that even though the pain felt constant, it was temporary. There was an end in sight.

By 10pm my cervix had dilated about 6cm. But I was exhausted. I had not slept in 40 hours. The constant pain was wearing me down further. And I started puking, without warning. My partner was in the wrong place at the wrong time during one puking episode and his clothes got soaked — poor guy! I had relied on food and juice to keep my energy levels up, but I could no longer hold anything down.

At 11:30pm I asked for an epidural. The contractions were consistently 30 seconds apart, and due to the constant nature of the pain – with no real breaks – I knew I needed some kind of break in order to regain some stamina. The pain relief from the epidural dampened the pain for about 20 to 30 minutes. And then the contractions were just as fierce and the muscle spasms just as marked as before the epidural.

The nurses and midwives did not seem to understand the kind of pain I was in. They thought it was just normal labor pain. It was not normal labor pain. The synthetic oxytocin brought about extremely potent contractions and the spasms from the sacroiliac joint pain were relentless. The only person who understood and was really empathetic was my partner.

I embraced my fear of the unknown as much as I could. In the last weeks of my pregnancy I had listened to many dharma talks about relating to fear. I knew that I could not stop the fear, but I could “be” with it in a way that gave it space to transform. My fears were strong, and yet my awareness of those fears was also strong.

I began to get scared when I went to the bathroom because I was beginning to feel an urge to push, but I knew it was too early to push. The upshot was that it was very difficult for me to urinate and defecate. I was also beginning to shake uncontrollably. One midwife said it was a side effect of the epidural. It may have been a combination of a side effect and a stress response.

I asked the midwives to check on how much I had dilated at 3am. Nothing had changed. I was still 6cm dilated. And now it had been 45 hours since I had any real sleep. I asked to talk with a doctor. At this point, I trusted my intuition more than anything else. I felt that I was not reacting to the synthetic oxytocin in the “expected way.” It was too strong of a reaction, which seemed to overwhelm my sensitive constitution.

The doctor came to talk with me and she presented two options, though it was clear she favored one option over the other. She suggested giving me uterine relaxants and sleep medicine so I could rest for three hours, and then they would start up the synthetic oxytocin again. The other option was a C-section surgery. My head, heart, and gut were united in making this decision. The C-section felt absolutely right in that moment. I did not think that three hours of sleep would make much of a difference at all, especially considering how I was reacting to the synthetic oxytocin and how exhausted I was.

Within the hour, the medical personnel were prepping me for the surgery. One of the first things they did was to give me a uterine relaxant but I continued to have strong contractions every two minutes. They gave me a second dose, and nothing changed.  I continued to have strong frequent contractions until the anesthesiologist administered anesthesia for the surgery. At that point, I was absolutely sure I had made the right decision. If two doses of a powerful uterine relaxant did not stop the contractions, how would I possibly have gotten three hours of sleep?

I was shaking in the operation room. I could not stop shaking my shoulders, hands and arms. There was a wonderful nurse who held my hand and took my blood pressure. She was charged with ensuring that my blood pressure did not get too low or too high. She was so caring. My partner’s presence was also extremely comforting.

The doctors decided to make the incision along the same incision line from my colectomy-appendectomy surgery, though the incision was half the full incision. The C-section literally marked a change in my body, marking my transition from sick patient to healthy mother.

At 5am on Wednesday, March 14th, the doctors announced that I had given birth to a son and tears streamed down my face. I hadn’t even seen our little boy, but I felt overwhelmed by emotion at the news that he had completed his passage into the world. The doctors lifted the baby and brought him to me so I could see him. His skin was stained with meconium and he was covered with blood. He had a full head of hair and big blue eyes. It was surprisingly difficult to take in the moment fully – here was my son, the baby in my belly, in his earthly form. Here was a form so unknown in one moment now present in flesh and blood.

My partner went with the medical personnel who cleaned up the baby, weighed him and conducted various examinations. Our little boy was extremely healthy, and he scored three 10s on the APGAR scale, which is unusual. He weighed 7 lbs 9 oz (3421 grams) and was 20 inches in length (51 cm). Again, I felt confident that my decision to have a C-section was absolutely right on.

My partner came back looking a little bit like a deer caught in the headlights. He was holding our baby so I could reach him. The baby’s hand clutched my finger strongly. It was a tender moment. And then the medical personnel ushered my partner upstairs to our new hospital room, where he got to bond with the baby through skin-to-skin contact for a few hours as I recovered from the surgery. The baby was eager to begin breastfeeding and sucked on my partner’s collarbone so hard that he had a hickey!

The medical personnel wheeled me up to the room around 8am and the baby quickly took to breastfeeding. Holding him for the first time was such an incredible experience. In the days that followed, this little being captivated my heart.

3 Comments (+add yours?)

  1. penelope
    Mar 24, 2012 @ 17:05:43

    HI Erica, thank you so much for generously sharing your story with us. I can feel your self-compassion, your sensitivity and your strength and intelligence through this process. I have heard about many births (and been to 5). I can see how a birth can be empowering, regardless of the actual circumstances, often so different from the birth plan, simply through all the causes and conditions of that person’s life coming together. I am so glad yours was this way and that your little family began in such a loving and attentive way. Kudos to Chris and the lovely nurse, I had one like that in the ICU! Oh and I had one of those ‘hickeys’ (we cal them love bites in Oz) on my bicep. It really hurt!!! The baby was 3 weeks old and her mum went to the dentist!).

    Hugs to you all!
    Penelope

    Reply

  2. pilarkristine
    Mar 24, 2012 @ 23:46:07

    such a beautiful boy… such an incredible account. kudos to you for being able to write it. and for the courage to share it! gratitude for the miracle of life– and the miracle of intuition. love love love to you.

    Reply

  3. Erica
    Mar 28, 2012 @ 13:22:11

    Thanks Penny and Pilar! Intuition is a miracle! And I totally agree that even a c-section can be empowering. Love to both of you!

    Reply

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