Saturday, August 15, 2009

The Labour Story

You know, I had most of this story sitting in my drafts folder for months. I debated whether or not I even wanted to tell the tale or if I'd rather just block it out completely. But then I thought I'd better record it while I can still remember some of the details. When I last updated, it was one day before Maggie's due date, and there was still time for her to pick the day she was born on her own.

Alas, that didn't happen. But she wasn't born on the day the doctors picked either so I suppose that's a victory of some sort. On April 22nd, I reported to the hospital promptly at 6:00pm for a Cervadil treatment. And then I waited - impatiently - for three hours for my scheduled appointment. I said to my husband at about 1:00 in the morning “They’re going to cut me open again. I just know it.” I had a total meltdown because the loss of control and spent the night tossing and turning over it. I was so busy being upset about my baby being forced out before she was ready, I totally lost sight of the fact that I was finally going to meet her.

At 7:30 the next morning, feeling exhausted and totally defeated, I arrived at the hospital to be hooked up to the synthetic oxytocin, aka Pitocin. Labour that is induced or enhanced with Pitocin is known for being very, very hard. Already intense contractions are amplified, and when you're going from a cold start like I was, it's a very difficult process. Oh, and didn't find out until I arrived at the hospital that once the drip was hooked up, I couldn't eat. I was induced because of Gestational Diabetes. I'm not sure what fucking rocket scientist decided it was a GOOD idea to starve the diabetic, but I'd kind of like to kick them in the face. Repeatedly. Anyway...

I was determined to go for as long as I could without medication because I knew that between the Pitocin and the epidural (my only pain option) I was on the fast track to a surgical delivery. I *JUST* had abdominal surgery in November, so I was none too keen on the idea of being cut open for the second time in five months, and during pregnancy to boot. I laboured for 6 hours until the contractions got hard to cope with using natural pain management techniques. I wanted to make sure I was at least at 5cms before screaming for meds to reduce the likelihood that my labour would stall, so when they got pretty intense I asked for a check. A resident came in and said "You're at 6 to 7 centimeters!" Buoyed by this progress, I decided to hold off a little longer hoping to make it to the end without meds, but a couple of hours later I couldn't take it anymore. I asked for the epidural.

The nurse tending to me checked with the same resident who said he wouldn't be surprised if I was fully dilated and ready to start pushing, so perhaps she (the nurse) should check again. Apparently, my cervix has a "tricky presentation". WTF? I was not, in fact, close to ready to go, I was only at 1cm. It was like running a marathon and thinking you’re near the end, only to be told that you were on the wrong track and had to start all over again. Totally took the wind out of my sails. Another resident, this time with anesthesia, came in to administer the pain relief but she freaked me out with her shitty bedside manner. The stress, exhaustion and disappointment came to a head, causing me to have a another meltdown and falling into a fit of tears and hysteria. She was one of those people who talk about patients like they’re not in the room, and that’s just not cool when you’re talking about me and about to stick something into my spinal cord. I kicked her out of the room and was about ready to just unhook all the machinery and go the fuck home. For a second, I really didn’t care what happened to me or the baby. I just wanted to hide.

The nursing staff talked me into letting another anesthesiologist come in to try to place the epidural – not a resident this time. I agreed, it went in, and for two hours I rested. And then the epidural wore off. After much debate, they topped me up with one of the meds in the epidural cocktail. And for two hours, I rested. See where this is going? Yup. Off and on all night, every two hours the epidural wore off and they topped me up. One by one, I maxed out the drugs in the cocktail. The anesthesiologist kept saying she was “confident” that it was placed properly and what I was feeling was the normal pressure that all women feel, even with an epidural. And I kept saying that I wasn’t feeling pressure, I was feeling PAIN. Extraordinary pain. At 5:00 in the morning, I was begging the nurse to page the OB so I could beg her to just cut the kid out of me already because I couldn’t take it anymore. She patted me on the hand and said I was doing well, hung another bag of Pitocin (my third) and ratcheted up the setting. Again. At 7:30, now 24 hours into the ordeal, my OB came in to report that she was going off shift – but hey, I was at 9cms so it wouldn’t be much longer now! I think I said bullshit, but maybe I was just too tired to speak.

I was still in pain, and another anesthesiologist came on duty. He was NOT “confident” that the epidural was placed properly and wanted to re-insert the tube. For obvious reasons, I wasn’t feeling terribly confident about the competency of the whole department by that point and I was supposedly almost at the end anyway so I declined. At 10:00, I felt the urge to push. The same cervical lip (and I’m not sure I want to know what that is) that caused the tricky presentation was in the way so they maneuvered a bit to get me to 10cms and told me to start pushing. THREE HOURS later, there was hardly any movement. She was not even close to crowning. I had now been in induced labour without eating or sleeping for 30 hours. I was done. I had nothing left in the tank. The on-call OB said if I could push her 1cm further down, she could vacuum assist. I gave it one more push and collapsed into tears. I felt like such a failure, but I could not do any more. It was agreed I was going in for a c-section.

Yet another anesthesiologist was waiting in the OR. This guy, I actually kind of liked. He didn’t speak to the nurse as though I was some sort of intellectually delayed child, he spoke to ME, like I was an adult woman, on the verge of being somebody’s mother. He tried injecting various drug cocktails into the epidural and checking with ice cubes or a sharp pin every couple of minutes to see if they had kicked in. The dialogue went like this:

Him: Can you feel this?
Me: Yes.
Him: What do you feel? (Cold, sharp, etc.)
Me: Cold, about two inches to the left of my navel (or wherever it was)
Him: OK then, we’ll try something else.

Wash, rinse, repeat. Five or six times.

I now had a metric fuckton of drugs in my system, and the baby’s heartrate was showing variable decelerations. There was no choice but to put me under a general anesthetic. I didn’t care anymore, I just wanted it over. So there, in the sterility of an OR with her mother unconscious, at 13:13 on Friday, April 24th, 2009 my baby made her grand entrance. I don’t remember the first time I held her. I barely remember her first 24 hours of life. I have finally reached a point where I can separate my love for her from how much I HATED the process of getting her here. I’ve learned things, I have a lot of “If I had it to do over again I would…” But you know, even if I knew I was going to have the exact same experience over again, if I was guaranteed the same outcome, I would do it. For her. In the end, it’s all about her.