Part II; Freedom is Control in Your Own Life
Over our final dinner as a family of two, my husband made the suggestion/joke that we should go rouge. I considered it. The underlying fear of what happens if I become the “bad” patient and don’t go in as scheduled won out over my desire to just wait it out.
We arrived at the hospital, and after a bit of a wait, were checked into a room. Then out came the attachments; I had a blood pressure band on my right arm, IV in my left arm, and both a contraction monitor and an electronic fetal monitor wrapped around my belly. My intention was to still have as natural of a labor as possible, but it was going to be a challenge to move around with all these machines and wires.
When I first made the provider switch, part of what made the move appealing was the hospital. It was known as a natural birth friendly hospital, offering things like tubs to labor in, mobile IV unit, and squat bars. Before the induction began, I asked one of my nurses if I’d still be able to get in the tub to labor. She laughed and said “those things never get cleaned”. Great. Gross. Then she tells me that no, the baby has to be continuously monitored with the EFM, so I was not going to be able to get in the tub during labor.
Next, I asked about the walking IV unit (I’m sure there’s an official name for it, I just have no idea what it is), so that I could walk around the room or the hallways if I wanted. We were then informed that the entire Labor and Delivery unit only had one mobile IV unit, and it was broken. Lucky for me, the hubby is extremely handy and he got in there and figured out how to fix the unit. Yes, my husband fixed the hospital’s equipment. While I was impressed with him, I was not impressed with my chosen birth location thus far.
My induction began that night with the insertion of Cervidil, in hopes my cervix would soften and begin to dilate. It would be in for 12 hours, they would check in the morning to see if it had worked. Best case scenario, I would begin labor with just the Cervidil and worst case, it would do nothing and we’d move on to the next steps.
That first night in the hospital was tough. Sleeping was hard with so many wires, and beeping. If the EFM wasn’t picking up baby’s heartbeat, I was told to move and sleep in a different position. My brain was on overload of what was happening, and how uncomfortable I was with it.
The morning came, and so did the nurses and my midwife to do a cervical check and see if the Cervidil accomplished anything. It hadn’t, I was 1cm and no more effaced than when I was admitted. The next step was to use the Foley Bulb, which is a small rubber tube that gets inserted into the cervix and then filled with saline. The pressure is supposed to cause the cervix to dilate, approximately 3 to 4 cm. Ideally, this would encourage contractions to begin.
In my case, the foley bulb did cause dilation, to about 4cm, but I was never going to find out if contractions began on their own. Right after have the foley put in I was started on Pitocin. I was told that I would receive 2cc every 30 minutes, administered by my nurse.
Oh my nurse. This was a kind woman, that had been doing this a long time. I’m sure she was a very capable woman, but unfortunately we didn’t have that experience with her. She spent so much time talking, she would forget to give my next dosage increase (we got to hear all about the issues her daughter was having with toe fungus). On the flip side, she would get distracted (probably by her own story telling) and it would be a good 45 minutes before she came back to up the pitocin. I don’t know that there was any point during that day that she successfully came in every 30 minutes. My type-A personality did not appreciate her very lackadaisical approach. My stress level was high just being at the hospital, but feeling like the induction plan wasn’t being executed to a T just made me angry. If you’ve ever had a baby before, you know that stress and anger are not conducive to birth.
The hours passed and I was feeling mild contractions, but nothing too serious. The hubby put on music for me, figuring that dancing and moving could help get things going. After he fixed the mobile IV unit, we went and started walking around the floor. Nothing was working. I was getting tired and hungry, and was well beyond cranky (side note: hubby was sneaking me some food; graham crackers dipped in hospital pudding from the vending machine, now known as “hospital smores”).
During a cervical check that evening, my waters broke. I was officially on the clock because of fear of infection (but how about, keep your hands and contraptions out of my vagina, and I won’t get an infection). We made it until about 10p that night before the midwife started laying out what they wanted to do.
The statement started with “the OB thinks we should”, and needless to say I wasn’t interested in what the OB thought. If I was, I would have stayed with an OB practice. I wanted a midwife’s opinion. I wanted a perspective of someone that that believed in natural birth, not interventions. She told me they wanted to put an internal contraction monitor in, and let me labor a few more hours. If there was no progression after that, I’d have to consider my options, which would include a cesarean.
I was really tired, and the thought of continuing until midnight was just too much. I knew even if contractions got stronger, there was still a long road ahead and attempting to labor thru the night wasn’t going work. We didn’t really know what to do. I knew I didn’t like their option, but I wasn’t sure how to navigate the system. This is when we called our birth class instructor. We knew that she had the knowledge to guide us, but would she be available to help? It was almost 11p at this point, so we weren’t sure if she would answer or call back. We also knew she was a doula and could potentially be with someone giving birth. Lucky for us, she called us right back and talked us through the whole thing.
When the midwife came back we had a plan to propose. I wanted to be disconnected from all of the monitors. No wires, no beeping, no pitocin. I wanted to be left alone for the night so I could sleep and get my energy back. We could start everything again first thing in the morning, but for the night, I wanted to be left alone.
The midwife was hesitant at first, but we negotiated and I got most of what I asked for. The only exception was that they wanted to wake me up in 3 hours so they could check the baby’s heart rate. Fine, just keep the lights down and don’t ask me any questions.
The next morning, 7am, and we went right back on all the monitors. That day though, we knew what to expect and we started making some requests. Even though I had to be hooked up to monitors, we turned down the volume on all of them. My pitocin got going again, and instead of the incremental increase, they cranked me up to the maximum dose. I had an internal monitor to keep track of the contractions and how strong they were. We turned down the lights, put on my music and I told myself over and over, “I’m going to birth this baby out of my vagina”. I knew my attitude was going to make or break me, so it was up to me to be positive.
It didn’t take very long for the contractions to get going, long and strong. I was experiencing a lot of pain in my lower back, and that was incredibly challenging to work through. We did have a doula, so she offered some relief options by way of positioning and counter pressure from the hubby. Since I did have so many wires connecting me to monitors, I spent a lot of time on my birth ball. It was really the best option to keep moving without actually going anywhere.
Everything becomes pretty blurry through the day. Something about intense pain coming on every other minute for hours on end will make your brain want to forget. What I can remember is my midwife sat with us through most of the day. She appreciated my birth playlist and the fact that it wasn’t zen yoga music, but all Britney, Rihanna and Madonna. I remember when my water broke again, thinking it was super gross. I remember every time I had to go to the bathroom (once an hour was the rule!), I made my husband or doula follow behind me cleaning the floor from whatever was dripping out. I remember nurses coming in to check on me, and feeling like they believed I could do this. I also remember that E! was airing a Sex and the City marathon, and I’d always catch the intro music, but could never keep time with how many episodes had played.
What I remember most clearly, is when the contractions were coming right after the next. There were no more minutes or even seconds in between them. It was just a constant contraction that just never seemed to let up. I was hoping that meant I was getting closer. I was becoming extremely fatigued, and still rejecting the idea of an epidural. After checking the records of the internal monitor my midwife decided I had been having strong enough contractions for a long enough time that I should have experienced some progression in dilating.
I laid back down in the hospital bed and my midwife did the cervical exam. In my head I was so tired, but I knew if I had even a single centimeter improvement, I could and would keep going. She finished her check, and told us the news; nothing had changed. There was no progress. Not a single centimeter. I was labeled FTP, failure to progress, and I started sobbing.