Kate (kate_nepveu) wrote,
Kate
kate_nepveu

Labor & delivery post

So I feel the need to put two disclaimers on this post: first, it contains medical unpleasantness that might be considered a bit gory, and second (for those contemplating their first delivery), it is absolutely not a typical chain of events.

The short version is that I had, not the worst of both worlds (since nothing irreparable happened), but the most: a C-section, with some complications, at about the furthest point possible in labor.

Sunday the 6th I woke up around 7:00 in the morning with contractions that were about 8 minutes apart, but (as I noted at the time) when I got up the pattern seemed to vanish, though the contractions were still happening. We eventually asked Chad's folks to come up just in case, and by the time they arrived and we left for the hospital, around 1:30 p.m., I was quite sure I was in labor: my contractions were about two to three minutes apart and about one to two minutes long, though IIRC they were further apart when I was lying down.

At 2:30, I was 3cm dilated. I'd been coping with the contractions by breathing slowly and swaying from side to side, which seemed to help; around this point I believe I moved to sitting on a birth ball rather than standing. A bit later, the nurse noticed that my water had started leaking withough my realizing it, and so the doctor broke it fully to check the color (which can indicate fetal distress). Through this part of the afternoon, I found it harder and harder to cope with the contractions; by 5:00, movement no longer helped and I was fighting hard to control my breathing even a little, and probably not succeeding as my hands, legs, and face were going numb, which apparently was a sign of hyperventilation.

At 5:00 I was 4cm dilated, which was not what I wanted to hear because 4-5cm is generally considered the start of active labor, when dilation speeds up but also contractions get stronger and closer together. I'd been hoping to avoid an epidural just to keep all my options open, but I already felt like I was hanging on by the skin of my teeth (far more so than my first labor, though that may just have been the passage of time dimming the memories), and my doctor said she didn't think it would slow labor, so I decided to get the epidural.

The contractions I had during the epidural's (lengthy, difficult) placement completely justified this decision for me: I was sitting on the bed, bent far forward to round my back out, and during a couple of the contractions, my entire body involuntarily jerked, folding up even further. It can't actually have been that the force of the contractions was pulling the rest of my body down around my uterus, because it didn't happen again after the epidural took effect, but that is absolutely what it felt like.

During the conversation when I'd asked for the epidural, the doctor and nurse mentioned that it wasn't surprising that I was having difficulty, because I was having very long contractions and not much rest between them. After it took effect, we asked the nurse out of curiosity just how long they were. Turns out the monitors record contractions in seconds. Mine?

Were four hundred seconds long.

More than six and a half minutes: no wonder I was having trouble coping. (I was apparently the subject of much wonder at the nurse's station, where the signals from the wireless electronic monitors wrapped against my belly were also being relayed.) I was stunned, because I would have guessed maybe three minutes (we weren't timing them, I didn't want to). I asked Chad if he thought they'd been that long; he said that, well, they felt like an hour and a half, but yes, he could tell that they were going on for a long, long time.

Anyway, a couple hours after the epidural [*] I was another 2-3cm dilated, and by midnight I was fully dilated (10cm). I tried pushing then, but there was still a lip of the cervix in the way.

[*] During this time we watched most of the Patriots-Giants game. I am a Pats fan, Chad is a Giants fan, and I'd actually joked the week before that maybe we'd be in the hospital and so wouldn't have time to worry about whose team was going to win. We did have time, alas for me; it was a pretty lousy game to start, and then my team failed to pull out a comeback, which really seemed like the least I could ask under the circumstances. =>

Around 1:30 a.m., I'd been feeling strong pressure and the urge to push for a while, so the nurse and doctor came in and I pushed. And pushed, and pushed, and pushed. For two hours in total, including a change of position after the doctor initially recommended a C-section and I resisted because I'd come so far, even though I was exhausted (and I can't imagine having the energy to try if I'd spent another several hours fighting that much pain). But the Pip's head wasn't molding (his head circumference was 37cm at birth, which if I'm doing my math right means it was about 11.8cm wide and so needed to squish and change shape to fit) and he wasn't tolerating the second position, squatting supported by a bar, as well (heart rate as shown on the monitors noticeably lower, which I didn't realize at the time because the monitors were behind me). So I agreed to the C-section, despite my disappointment.

They moved quick to get me into surgery, which I appreciated because the pressure was very uncomfortable when I wasn't pushing, though like I said I didn't realize at the time that the Pip was doing a little poorly. He was born at 4:35 a.m. on Monday the 7th, and I could tell that he wasn't as immediately robustly healthy as SteelyKid because Chad didn't get to hold him during the rest of the surgery, but I could hear him crying so I knew he was there. (His breathing wasn't quite what they wanted early on. I don't know what his Apgar score was.)

I didn't realize that the surgery had complications for me until quite late. I was conscious but I was so tired that if someone didn't talk directly to me, it was like Charlie Brown adults: I could tell that people were talking but the noises did not resolve into words. (Also, I was doing the uncontrollable shivering thing again, which was very distracting.) And though I did register hearing more suction than previously, and said "sure, whatever" when the anesthesiologist told me they were starting a second IV "just in case," I completely failed to put those two things together to equal "greater-than-expected blood loss, getting ready to maybe do a transfusion."

Poor Chad, on the other hand, could see three things from where he was sitting: my head, the surgical drape, and the place where the suction was draining, i.e., the blood I was losing. Also he could parse people's words and so heard the doctor mention a "laceration" and call another surgeon down to assist, as well as the anesthesiologist telling someone my blood type on the phone. As I understand it, the Pip's head was sufficiently far down that when they pulled him out, it tore my uterus beyond the surgical incision (I did notice at the time that it didn't feel like SteelyKid, who they literally popped out in one quick motion).

But about an hour after the Pip's birth they sent me off to recovery (telling me directly then about the laceration, though I still wasn't fully processing all the implications of that), and the rest of Monday passed pretty peacefully.

Tuesday is when it started to register that my recovery was going to be more difficult, both because labor had progressed so much further and because of the blood loss. But now I know that I tolerate Percocet well, which is a data point, I guess? The day after, I got two units of whole blood by tranfusion, which helped me a lot, and the Pip got a glowbug light and extra formula for his jaundice, which helped him enough that we were cleared to go home Thursday evening. (I was technically entitled to another day in the hospital, but I wanted my own bed so bad I was literally in tears.) Since then, all has been well: only a brief tiny worry about his jaundice, and no further complications or difficulties for me. (I was off the Percocet before I left the hospital, and didn't even bother filling the prescription for it at home. I had a very good surgeon, and apparently I recover well from major abdominal surgery.)

And so, in conclusion:

  1. Chad and I apparently have babies with big, hard heads;
  2. I have comically long contractions when in labor;
  3. I don't know if, after this, my doctor would let me attempt a vaginal birth again;
  4. But it shouldn't matter, because we were already planning on two and only two kids, and so when I told Chad, first thing when I saw him in the recovery room, "I love you very much and we're never doing this again," it was not actually a new decision prompted by the whole experience;
  5. Even though I meant it (and he agreed);
  6. Look, an adorable baby!
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Tags: pregnancy, the pip
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