This is the story of a girl
In honor of Mother's Day, here is the story of Lottie's entrance into the world. :)
The universe has a dependable, if fundamentally perverse, sense of timing.
You see, April 19th was the fourth grade musical at my school. It's a big deal- they're the only grade level that does an evening performance, there are props and costumes, solos, hoards of parents- we even auction off reserved seating and parking as a fundraiser. It is, in general, the big ol' rock on the rubber sheet of my spring semester.
Which may explain why, when I felt a little liquid start leaking at 15 minutes to show time, my response was to say aloud "that had goddamn well better be pee".
It was a slow enough leak that i wasn't entirely convinced, though that may have been denial. (Denial is apparently the first stage of labor, in my world. Two for two, so far.) After calling Adam and texting Trey- who notes that getting a message with “please don't panic” in it is one of the shortest paths to panic possible- I rather hastily cribbed together a cue sheet and went looking for my principal. When I handed it to her, she looked at me and said, "you're going into labor, aren't you?", I said "I think I'm going into labor, yes," and she burst out laughing, trying the whole while to apologize and reassure me that she wasn't actually laughing at me, just the timing. I told her it was okay, I understood the impulse- the whole situation was so ludicrous that laughing at it was pretty much the only response left. We found a chair that it didn't matter if I dribbled on, and I went on with the show. (Yes, I'm dumb. What can I say? It was a really slow leak.) Instead of sticking around to restack chairs and haul instruments back to my classroom (I'm not that dumb) I called my OB and headed home.
Fortunately, my doctor was actually the one on call, so I got to talk to someone who had actually met me. (I was going to meet the rest of them the next week...) She told me to come on into the hospital to get checked. And she reminded me that I had done everything I could to keep this from happening, and hoped knowing that helped how I felt. That was nice to hear. After throwing some clothes, my med kit, and some supplies into a bag, Adam and I gave Tim some hugs and kisses, saluted my sister, then headed for the ferry.
During the ferry ride we walked around the deck, and noted ways that this was better than last time. We were in the same state. We weren't trying to sell a house. And so on. Plus one other one: I was actually having contractions on my own. See, with Tim's birth, they put me on pitocin to start labor; I never started it on my own. (Never did any of it on my own, really.) As completely unthrilled as I was to be on the clock heading for a premature birth again, I took the contractions (as mild and irregular as they might be) as a sign that I might still be able to salvage some of my hopes for this birth and go as intervention-free as possible.
(A note for those who haven't been through this particular funhouse: once water breaks, there's a time limit- usually about 24 hours- before they really want you to be in labor. The risk of infection increases greatly from there. Plus there's more danger of a compressed cord, since there's no fluid padding everything.)
We got to the hospital at around ten, checked in at triage- which we could actually locate, since we'd gotten smart and scheduled the hospital tour damn early- and met up with my OB. She verified that yep, that was amniotic fluid, got me a saline lock for antibiotics, and checked to see where Lottie was. Happily, the answer was head down. Slightly less happily, she was wiggling like nobody's business, which made keeping her heartbeat on the monitor rather tricky. (This would be the theme of the next thirty hours or so.) The doctor mentioned pitocin. I pointed out that I'd done that the last time around, thank you very much, hadn't liked it, and since I was actually having contractions and was a whole 1 cm dilated, it would be nice to give my body some time to see if it could figure out what to do. And besides, half my support team was still en route and I would rather like him to be here. She... well, I wouldn't call it “agreeing”, but did at least back off and say she didn't want me to feel like she was pushing us into deciding to use the pitocin, but did want me to keep it in mind as a possibility.
So with that I got set up in a birthing suite. Adam got the window bed arranged more-or-less to his liking, and I dozed through the night. I would have aimed for a more solid sleep, but the damn EFM system kept losing Lottie's heartbeat and the nurse would have to come back in and scoot it around until we found her again. I was less than thrilled, since my plan had been to handle labor with movement and walking and time in the tub. Having the monitor conk out unless I was semi-sitting up in bed was going to put a serious crimp in that plan. Luckily, the L&D nurses were all really supportive of my wishes to do this as naturally as possible, and did things like unhook me from the monitor completely so I could take a long bath, follow me around the room adjusting the blasted thing as I paced, and generally making sure I could get as much freedom as possible. (There was one point on Wednesday night that I had two nurses in the room trying to find the right angle. I said that I wanted to be on my side, but couldn't because they'd lose the heartbeat again, and practically in tandem they said “You find a spot that's comfortable for labor. That's your job. Worrying about the monitor is our job, let us do that part.”) But for that first night, Tuesday, I just stayed in bed and snoozed as much as I could.
Oh- one nice discovery that night: I had no food restrictions whatsoever. I had thought, because that's what they had said on the tour, that I would be limited to the “laboring menu” of clear liquids, broths, gummy bears, and popsicles. But the nurse checked, and said “You can eat whatever you want. I'll find you a real menu. Just expect to see at least some of it again later on...” (Throwing up in transition is not at all uncommon.) I really think that being able to eat what I wanted when I wanted it made this labor a lot easier to handle than the last where I was allowed IV fluids and that's it.
Wednesday morning rolled around, and with it Trey (huzzah!), as well as a new nurse and my OB, who was worried about the fact that my contractions weren't actually progressing at all; they were still irregular and not really increasing in intensity. She again mentioned pitocin. I asked if there was anything else to try first. (In case it's not clear, I didn't like having pitocin last time.) So we went with a medicine that causes the cervix to ripen, a strange phrase meaning to efface (thin out) and dilate (open). The first dose of it, which I got at 8:00 am, seemed to be working, as my contractions finally began to get harder and closer together. But they hit a point where they stopped progressing. After some walking around and a turn in the jacuzzi (which I was threatening to stay in the entire time and just let someone scoop the baby out of the water) we went with another dose at around 4:00. We gave it a good six hours, but it didn't do much.
I should back up and mention a couple of things here. One is that my OB had gone off shift and the next doctor in the practice, who happened to be her husband, was on duty. He had come by and introduced himself mid-morning. The other thing is that we were really limiting cervical checks. I had had a grand total of one by this point, when I was admitted. The reason for this was twofold. First, once the water breaks, you do not want to increase the chance of infection by introducing things (like fingers) from the outside unnecessarily. This is especially true when the mother s group B strep positive, like I am. And second, I learned from Timothy's birth that cervical checks hurt like hell. And really, they don't do anything but increase the pressure on the mom to accept interventions.
So the OB came in at about 9:30 and teasingly said, “Did the baby come yet? Did I miss it?” I laughed and said “Nah, but if she falls out on the floor we'll let you know.” He grinned, then said since at this point I'd taken as much of the ripening agent as I could, he'd like to do a cervical check and see how things were going. I pointed out I was about to get back in the tub. He said that he could come back, or do it now, but the advantage of doing it now was that we'd know what was going on and I could decide what to do after my bath. “If you're progressing well, then we'll know that we don't need to do anything, but if not, then maybe it's time to start thinking...” at which point I interrupted and said, “No, at this point if nothing is happening we should probably move to pitocin.” So he checked, and I had in the last 24 hours gone from one centimeter dilated to... wait for it... two centimeters. Yay. It was a frustrating thing to find out, but at least I knew that this time I had given it a try, and that it was actually going to be needed, instead of just being hooked up to a drip as soon as I walked into the hospital. (Well, that's a bit of an exaggeration... but basically the only reason that didn't happen with Tim is that I told them flat-out that they had to wait until Adam was at least on the ground in CA.) I got into the tub and relaxed there (for which read “fell asleep”) until about quarter till midnight. Adam and Trey were asleep on the window bed (an amusing sight) getting some rest for when things got going. So it was a little after midnight when the pitocin drip started... and things got interesting.
See, being on pitocin means two things: the contractions get a lot more intense and they really, really, really want to be able to hear that kid's heartbeat more-or-less constantly. So we had the lovely combination of me wanting to move around more and more and the monitor that was the textbook example of honoring one's commitments more in the breach than the observance. This is where the poor night nurse really earned the stars in her crown; I'm sure she didn't realize when she came on shift that she was going to spend the entire time following me around trying to find the perfect angle that meant we could hear Lottie's heartbeat again. (I ended up with the silliest getups- washcloth folded under the belt, a tape roll wedged to attempt to keep the perfect angle, etc.- to try to keep babygirl on the paper. Nothing doing.) To her immense credit, she never said word one about it, just encouraged me as I dealt with the contractions, reminded me I could get back in the tub if I wanted, and kept fiddling with the dang receivers as needed. The only time she told me not to do something was when I was sitting up on the edge of the bed, leaning on Adam, through a contraction, and that was because Lottie's heartbeat had a tendency to drop when I did that. (Pity; it was one of the more comfortable positions I found.)
It was at about three in the morning when I realized I needed support to help me cope with the contractions. I had been considering it earlier, but every time I looked over to where they were sleeping I'd find myself thinking something like “oh, but they need to get some rest... I shouldn't bother them...” Fortunately some last shred of rational thought cut through the conditioning to not make a fuss and demanded to know why, precisely, I had brought them along if not for this? and I had the nurse wake Adam up.
Now this is the point where timings and details get a little hazy, because everything was getting much more intense. The pitocin was most assuredly doing its thing, and I think my body was beginning to get the hint as well. I remember a lot of leaning on Adam and doing my best to stay relaxed by vocalizing (a deep hum or sort-of moan) through the contractions. At one point I'm pretty sure I was doing so in triads (so-mi-do, on an “oh” sound). What was left of my brain- that part that is always, always watching was still a tiny bit functional- viewed all the noise rather wryly, as I had been certain when watching the videos and taking the classes that I wasn't going to be making noise at all. I usually don't, when in pain. I get quiet, then silent, then turn completely inward. But this was different. Part of it, I think, is that it wasn't pain to be conquered, or pushed away; it would go on its own and then come back, and all I needed to do was ride with it until a break came and I could catch my breath. I know I got back into the tub, but it was too hot, so after maybe 15 or 20 minutes I got back out. And then realized I was nauseated. Rather badly. Luckily Trey was awake by then, so he was able to get a basin and cool washcloths and such while Adam performed the very essential (and no, I'm not being sarcastic) task of being clung to. This was the only point at which I remember using profanity, by the way. Adam says there was a “goddamn it” at some point in the later contractions, but the only one I recall was raising my head back up and declaring “fuck but I hate throwing up”.
Remember the malfunctioning monitor? As things got more and more intense, it became a bigger and bigger factor. Between being on the pitocin drip and the variable decelerations in Lottie's heartbeat, they were getting awfully antsy about not being able to see that heartbeat constantly. In fact, at 4:00 they had turned the pitocin off rather than keep going without full tracking. (Couldn't have proven it by me, for the record. I think at this point my body was figuring this was happening one way or another so it might as well get with the program.) Their recommendation, which the nurse was trying to explain to me until I got hit by a big contraction and interrupted with “Can't listen right now!” was to switch to an internal scalp monitor. Those wig me out, I must admit. But I could also see their point. With no amniotic sac, there was nothing to keep the cord from being compressed by a heavy contraction (which is kinda the definition of pit contractions) and no way to tell it was happening without some sort of heartbeat tracking. I said fine, the OB showed up to put it in, and lo and behold there was a heartbeat. He also told me that I'd made progress from 2 cm to 5-6 cm in the last four hours, and I was completely effaced, so once I dilated the rest of the way I should be good to go. I asked-between contractions!- if it was really necessary to turn the pitocin back on. Wisely, he said no.
At this point it was somewhere between 4 am and 4:15, I think. I had made the textbook 1 cm per hour progress and had, I figured, somewhere between four and five more hours to go. I hung in there for another fifteen minutes, dealing the best I could with contractions that were getting harder and harder to handle. And then my body completely redefined the idea of “hard to handle”. I was hot, I was cold, there was no place comfortable, no position that worked through an entire contraction. And the contractions themselves were piling on top of each other, with no space in between to recover and get set for the next one. And, most worryingly, I was losing it. I could hear it in the sounds I was making- high pitched and disorganized- and in the fast, erratic way I was breathing. I could feel it in the way I was tensing against the contractions instead of relaxing into them, and in my inability to find any focus anywhere.
Now, I can hear you thinking at me: “You were in transition!” And I was. You could have used me as a checklist of symptoms. But I didn't know that at the time, and apparently it didn't didn't occur to anyone else in the room, either. After all, I had been only halfway dilated less than half an hour ago. From my perspective, I had hit sheer and utter hell and had multiple hours of it left to endure. There was just no way. I codeworded out. Adam asked the nurse to get me an epidural, and she left the room to get the anesthesiologist. I gritted my teeth and... yelled? Cried out? It wasn't a moan anymore, too high-pitched- made noise through a few more contractions and the anesthesiologist came into the room, about five minutes later.
I sat up on the edge of the bed, halfway down the side, knowing I was going to have to somehow hold still long enough to get a big needle into my back. The anesthesiologist checked my spine and was rubbing down the site with iodine when a nagging sensation that I needed to use the bathroom all of a sudden changed on me. “I think I feel like pushing,” I said with serious surprise, and flopped over onto my side on the bed. That got the nurse's attention really fast, and she came back to my side in a hurry and said, “Before you push let me check on how you're doing.” She did so, as the anesthesiologist said with some reproof “I can't do anything at that angle” and I ignored him. The nurse looked up at me and said, “The reason you feel like pushing is because you're fully dilated,” and went to the hallway to call for something, more people I guess. I sat up again (thinking for some reason that I'd still need the epidural) and the urge to push hit for real.
This was the first time I'd felt it- with Tim I got an epidural fairly early on- and calling it an “urge” is completely inaccurate. You get an urge to eat some chocolate. You might really want some, be desperate to get some, be so hungry for it that your mouth is watering down your chin, but even then you decide to eat it, consciously pick it up and put it in your mouth. There was no conscious decision here. As inelegant a comparison as it is, the sensation that's most similar is needing to vomit; your body is going to get this thing out of your body and the most you can do is try to pick where you'll be when it happens. There is no stopping and no controlling. Baby was on her way OUT. I had some vague idea about getting onto my hands and knees on the bed- a position I had thought, when in classes, that would be comfortable for me, but there was no time. I fell back onto my side, grabbed my leg to get it out of the way, yelled “PUSHING NOW!”, then reached down to feel Lottie's head. (Adam says seeing me do that was his “Oh shit” moment- that's when he realized how damn fast things were moving.) The nurse was running back into the room with reinforcements, saying, “Hang on, don't push!” I called back, “No choice!”- and out Lottie came, all at once, landing on the bed. She cried nice and loud, I laughed and said, “Hi, baby!” and chaos generally ensued. Someone eventually picked her up and handed her to me- I would have done it, but I couldn't see where on the bed she was so I didn't want to but my foot down to reach for her- and the OB arrived to deliver the placenta. I couldn't help giving him a hard time; when he came in the room I pointed and said “You missed it! The baby fell out!” :D
The universe has a dependable, if fundamentally perverse, sense of timing.
You see, April 19th was the fourth grade musical at my school. It's a big deal- they're the only grade level that does an evening performance, there are props and costumes, solos, hoards of parents- we even auction off reserved seating and parking as a fundraiser. It is, in general, the big ol' rock on the rubber sheet of my spring semester.
Which may explain why, when I felt a little liquid start leaking at 15 minutes to show time, my response was to say aloud "that had goddamn well better be pee".
It was a slow enough leak that i wasn't entirely convinced, though that may have been denial. (Denial is apparently the first stage of labor, in my world. Two for two, so far.) After calling Adam and texting Trey- who notes that getting a message with “please don't panic” in it is one of the shortest paths to panic possible- I rather hastily cribbed together a cue sheet and went looking for my principal. When I handed it to her, she looked at me and said, "you're going into labor, aren't you?", I said "I think I'm going into labor, yes," and she burst out laughing, trying the whole while to apologize and reassure me that she wasn't actually laughing at me, just the timing. I told her it was okay, I understood the impulse- the whole situation was so ludicrous that laughing at it was pretty much the only response left. We found a chair that it didn't matter if I dribbled on, and I went on with the show. (Yes, I'm dumb. What can I say? It was a really slow leak.) Instead of sticking around to restack chairs and haul instruments back to my classroom (I'm not that dumb) I called my OB and headed home.
Fortunately, my doctor was actually the one on call, so I got to talk to someone who had actually met me. (I was going to meet the rest of them the next week...) She told me to come on into the hospital to get checked. And she reminded me that I had done everything I could to keep this from happening, and hoped knowing that helped how I felt. That was nice to hear. After throwing some clothes, my med kit, and some supplies into a bag, Adam and I gave Tim some hugs and kisses, saluted my sister, then headed for the ferry.
During the ferry ride we walked around the deck, and noted ways that this was better than last time. We were in the same state. We weren't trying to sell a house. And so on. Plus one other one: I was actually having contractions on my own. See, with Tim's birth, they put me on pitocin to start labor; I never started it on my own. (Never did any of it on my own, really.) As completely unthrilled as I was to be on the clock heading for a premature birth again, I took the contractions (as mild and irregular as they might be) as a sign that I might still be able to salvage some of my hopes for this birth and go as intervention-free as possible.
(A note for those who haven't been through this particular funhouse: once water breaks, there's a time limit- usually about 24 hours- before they really want you to be in labor. The risk of infection increases greatly from there. Plus there's more danger of a compressed cord, since there's no fluid padding everything.)
We got to the hospital at around ten, checked in at triage- which we could actually locate, since we'd gotten smart and scheduled the hospital tour damn early- and met up with my OB. She verified that yep, that was amniotic fluid, got me a saline lock for antibiotics, and checked to see where Lottie was. Happily, the answer was head down. Slightly less happily, she was wiggling like nobody's business, which made keeping her heartbeat on the monitor rather tricky. (This would be the theme of the next thirty hours or so.) The doctor mentioned pitocin. I pointed out that I'd done that the last time around, thank you very much, hadn't liked it, and since I was actually having contractions and was a whole 1 cm dilated, it would be nice to give my body some time to see if it could figure out what to do. And besides, half my support team was still en route and I would rather like him to be here. She... well, I wouldn't call it “agreeing”, but did at least back off and say she didn't want me to feel like she was pushing us into deciding to use the pitocin, but did want me to keep it in mind as a possibility.
So with that I got set up in a birthing suite. Adam got the window bed arranged more-or-less to his liking, and I dozed through the night. I would have aimed for a more solid sleep, but the damn EFM system kept losing Lottie's heartbeat and the nurse would have to come back in and scoot it around until we found her again. I was less than thrilled, since my plan had been to handle labor with movement and walking and time in the tub. Having the monitor conk out unless I was semi-sitting up in bed was going to put a serious crimp in that plan. Luckily, the L&D nurses were all really supportive of my wishes to do this as naturally as possible, and did things like unhook me from the monitor completely so I could take a long bath, follow me around the room adjusting the blasted thing as I paced, and generally making sure I could get as much freedom as possible. (There was one point on Wednesday night that I had two nurses in the room trying to find the right angle. I said that I wanted to be on my side, but couldn't because they'd lose the heartbeat again, and practically in tandem they said “You find a spot that's comfortable for labor. That's your job. Worrying about the monitor is our job, let us do that part.”) But for that first night, Tuesday, I just stayed in bed and snoozed as much as I could.
Oh- one nice discovery that night: I had no food restrictions whatsoever. I had thought, because that's what they had said on the tour, that I would be limited to the “laboring menu” of clear liquids, broths, gummy bears, and popsicles. But the nurse checked, and said “You can eat whatever you want. I'll find you a real menu. Just expect to see at least some of it again later on...” (Throwing up in transition is not at all uncommon.) I really think that being able to eat what I wanted when I wanted it made this labor a lot easier to handle than the last where I was allowed IV fluids and that's it.
Wednesday morning rolled around, and with it Trey (huzzah!), as well as a new nurse and my OB, who was worried about the fact that my contractions weren't actually progressing at all; they were still irregular and not really increasing in intensity. She again mentioned pitocin. I asked if there was anything else to try first. (In case it's not clear, I didn't like having pitocin last time.) So we went with a medicine that causes the cervix to ripen, a strange phrase meaning to efface (thin out) and dilate (open). The first dose of it, which I got at 8:00 am, seemed to be working, as my contractions finally began to get harder and closer together. But they hit a point where they stopped progressing. After some walking around and a turn in the jacuzzi (which I was threatening to stay in the entire time and just let someone scoop the baby out of the water) we went with another dose at around 4:00. We gave it a good six hours, but it didn't do much.
I should back up and mention a couple of things here. One is that my OB had gone off shift and the next doctor in the practice, who happened to be her husband, was on duty. He had come by and introduced himself mid-morning. The other thing is that we were really limiting cervical checks. I had had a grand total of one by this point, when I was admitted. The reason for this was twofold. First, once the water breaks, you do not want to increase the chance of infection by introducing things (like fingers) from the outside unnecessarily. This is especially true when the mother s group B strep positive, like I am. And second, I learned from Timothy's birth that cervical checks hurt like hell. And really, they don't do anything but increase the pressure on the mom to accept interventions.
So the OB came in at about 9:30 and teasingly said, “Did the baby come yet? Did I miss it?” I laughed and said “Nah, but if she falls out on the floor we'll let you know.” He grinned, then said since at this point I'd taken as much of the ripening agent as I could, he'd like to do a cervical check and see how things were going. I pointed out I was about to get back in the tub. He said that he could come back, or do it now, but the advantage of doing it now was that we'd know what was going on and I could decide what to do after my bath. “If you're progressing well, then we'll know that we don't need to do anything, but if not, then maybe it's time to start thinking...” at which point I interrupted and said, “No, at this point if nothing is happening we should probably move to pitocin.” So he checked, and I had in the last 24 hours gone from one centimeter dilated to... wait for it... two centimeters. Yay. It was a frustrating thing to find out, but at least I knew that this time I had given it a try, and that it was actually going to be needed, instead of just being hooked up to a drip as soon as I walked into the hospital. (Well, that's a bit of an exaggeration... but basically the only reason that didn't happen with Tim is that I told them flat-out that they had to wait until Adam was at least on the ground in CA.) I got into the tub and relaxed there (for which read “fell asleep”) until about quarter till midnight. Adam and Trey were asleep on the window bed (an amusing sight) getting some rest for when things got going. So it was a little after midnight when the pitocin drip started... and things got interesting.
See, being on pitocin means two things: the contractions get a lot more intense and they really, really, really want to be able to hear that kid's heartbeat more-or-less constantly. So we had the lovely combination of me wanting to move around more and more and the monitor that was the textbook example of honoring one's commitments more in the breach than the observance. This is where the poor night nurse really earned the stars in her crown; I'm sure she didn't realize when she came on shift that she was going to spend the entire time following me around trying to find the perfect angle that meant we could hear Lottie's heartbeat again. (I ended up with the silliest getups- washcloth folded under the belt, a tape roll wedged to attempt to keep the perfect angle, etc.- to try to keep babygirl on the paper. Nothing doing.) To her immense credit, she never said word one about it, just encouraged me as I dealt with the contractions, reminded me I could get back in the tub if I wanted, and kept fiddling with the dang receivers as needed. The only time she told me not to do something was when I was sitting up on the edge of the bed, leaning on Adam, through a contraction, and that was because Lottie's heartbeat had a tendency to drop when I did that. (Pity; it was one of the more comfortable positions I found.)
It was at about three in the morning when I realized I needed support to help me cope with the contractions. I had been considering it earlier, but every time I looked over to where they were sleeping I'd find myself thinking something like “oh, but they need to get some rest... I shouldn't bother them...” Fortunately some last shred of rational thought cut through the conditioning to not make a fuss and demanded to know why, precisely, I had brought them along if not for this? and I had the nurse wake Adam up.
Now this is the point where timings and details get a little hazy, because everything was getting much more intense. The pitocin was most assuredly doing its thing, and I think my body was beginning to get the hint as well. I remember a lot of leaning on Adam and doing my best to stay relaxed by vocalizing (a deep hum or sort-of moan) through the contractions. At one point I'm pretty sure I was doing so in triads (so-mi-do, on an “oh” sound). What was left of my brain- that part that is always, always watching was still a tiny bit functional- viewed all the noise rather wryly, as I had been certain when watching the videos and taking the classes that I wasn't going to be making noise at all. I usually don't, when in pain. I get quiet, then silent, then turn completely inward. But this was different. Part of it, I think, is that it wasn't pain to be conquered, or pushed away; it would go on its own and then come back, and all I needed to do was ride with it until a break came and I could catch my breath. I know I got back into the tub, but it was too hot, so after maybe 15 or 20 minutes I got back out. And then realized I was nauseated. Rather badly. Luckily Trey was awake by then, so he was able to get a basin and cool washcloths and such while Adam performed the very essential (and no, I'm not being sarcastic) task of being clung to. This was the only point at which I remember using profanity, by the way. Adam says there was a “goddamn it” at some point in the later contractions, but the only one I recall was raising my head back up and declaring “fuck but I hate throwing up”.
Remember the malfunctioning monitor? As things got more and more intense, it became a bigger and bigger factor. Between being on the pitocin drip and the variable decelerations in Lottie's heartbeat, they were getting awfully antsy about not being able to see that heartbeat constantly. In fact, at 4:00 they had turned the pitocin off rather than keep going without full tracking. (Couldn't have proven it by me, for the record. I think at this point my body was figuring this was happening one way or another so it might as well get with the program.) Their recommendation, which the nurse was trying to explain to me until I got hit by a big contraction and interrupted with “Can't listen right now!” was to switch to an internal scalp monitor. Those wig me out, I must admit. But I could also see their point. With no amniotic sac, there was nothing to keep the cord from being compressed by a heavy contraction (which is kinda the definition of pit contractions) and no way to tell it was happening without some sort of heartbeat tracking. I said fine, the OB showed up to put it in, and lo and behold there was a heartbeat. He also told me that I'd made progress from 2 cm to 5-6 cm in the last four hours, and I was completely effaced, so once I dilated the rest of the way I should be good to go. I asked-between contractions!- if it was really necessary to turn the pitocin back on. Wisely, he said no.
At this point it was somewhere between 4 am and 4:15, I think. I had made the textbook 1 cm per hour progress and had, I figured, somewhere between four and five more hours to go. I hung in there for another fifteen minutes, dealing the best I could with contractions that were getting harder and harder to handle. And then my body completely redefined the idea of “hard to handle”. I was hot, I was cold, there was no place comfortable, no position that worked through an entire contraction. And the contractions themselves were piling on top of each other, with no space in between to recover and get set for the next one. And, most worryingly, I was losing it. I could hear it in the sounds I was making- high pitched and disorganized- and in the fast, erratic way I was breathing. I could feel it in the way I was tensing against the contractions instead of relaxing into them, and in my inability to find any focus anywhere.
Now, I can hear you thinking at me: “You were in transition!” And I was. You could have used me as a checklist of symptoms. But I didn't know that at the time, and apparently it didn't didn't occur to anyone else in the room, either. After all, I had been only halfway dilated less than half an hour ago. From my perspective, I had hit sheer and utter hell and had multiple hours of it left to endure. There was just no way. I codeworded out. Adam asked the nurse to get me an epidural, and she left the room to get the anesthesiologist. I gritted my teeth and... yelled? Cried out? It wasn't a moan anymore, too high-pitched- made noise through a few more contractions and the anesthesiologist came into the room, about five minutes later.
I sat up on the edge of the bed, halfway down the side, knowing I was going to have to somehow hold still long enough to get a big needle into my back. The anesthesiologist checked my spine and was rubbing down the site with iodine when a nagging sensation that I needed to use the bathroom all of a sudden changed on me. “I think I feel like pushing,” I said with serious surprise, and flopped over onto my side on the bed. That got the nurse's attention really fast, and she came back to my side in a hurry and said, “Before you push let me check on how you're doing.” She did so, as the anesthesiologist said with some reproof “I can't do anything at that angle” and I ignored him. The nurse looked up at me and said, “The reason you feel like pushing is because you're fully dilated,” and went to the hallway to call for something, more people I guess. I sat up again (thinking for some reason that I'd still need the epidural) and the urge to push hit for real.
This was the first time I'd felt it- with Tim I got an epidural fairly early on- and calling it an “urge” is completely inaccurate. You get an urge to eat some chocolate. You might really want some, be desperate to get some, be so hungry for it that your mouth is watering down your chin, but even then you decide to eat it, consciously pick it up and put it in your mouth. There was no conscious decision here. As inelegant a comparison as it is, the sensation that's most similar is needing to vomit; your body is going to get this thing out of your body and the most you can do is try to pick where you'll be when it happens. There is no stopping and no controlling. Baby was on her way OUT. I had some vague idea about getting onto my hands and knees on the bed- a position I had thought, when in classes, that would be comfortable for me, but there was no time. I fell back onto my side, grabbed my leg to get it out of the way, yelled “PUSHING NOW!”, then reached down to feel Lottie's head. (Adam says seeing me do that was his “Oh shit” moment- that's when he realized how damn fast things were moving.) The nurse was running back into the room with reinforcements, saying, “Hang on, don't push!” I called back, “No choice!”- and out Lottie came, all at once, landing on the bed. She cried nice and loud, I laughed and said, “Hi, baby!” and chaos generally ensued. Someone eventually picked her up and handed her to me- I would have done it, but I couldn't see where on the bed she was so I didn't want to but my foot down to reach for her- and the OB arrived to deliver the placenta. I couldn't help giving him a hard time; when he came in the room I pointed and said “You missed it! The baby fell out!” :D