It was a dark and stormy night... (part II)

So, I get out of the wheelchair in the labor and delivery room and have the worst contraction yet. I was standing leaning over the bed trying to catch my breath, relax and breathe. The next 30 minutes to an hour are a blur so I'm not sure of the exact timing. What I do remember is wanting things to slow down so I could get in control of the pain and practice relaxation techniques.

The reality was that in a short span of time my contractions started coming fast and hard. I believe they were two minutes apart. At some point the labor and delivery nurse, Devin, checked me, and I think I was 4-5 cm. I tried to relax and and find a comfortable position, but I literally wanted to crawl out of my skin and run away. I became very hot and sweaty and extremely nauseous. The next thing I remember is being in the bathroom, throwing up repeatedly and contracting like crazy (oh yeah...and that amniotic fluid was still flowing and still stressing me out).

At that point, I felt panicked. I knew I needed to relax because tension was causing the pain to be so much worse. I just couldn't. Things were moving way too fast, and I felt as if I had completely lost control of the situation. The nurse was telling me I had to come get in bed and get the monitoring and IV started. (Because I was a VBAC things were "high risk" and my doctor wanted continuous fetal monitoring and IV access). The combination of nausea and intense pain was too much. So, in the bathroom of the labor and delivery room, I made a decision. I was having an epidural. The only issue was that Brian and Elizabeth (per my birth plan instructions) gently tried to convince to ride out a few more contractions and reconsider. I'm not sure what I actually said. I remember thinking, "I know what you're going to tell me. I know that's what I told you to tell me. But I was wrong. Dead wrong. I want that epidural and I want it yesterday."

The nurse hadn't overheard all of this, and popped her head in the bathroom and said something about seeing in my chart that I wanted as natural a childbirth as possible, but she still needed to discuss my options. I stopped her, told her that I had totally changed my mind and I wanted an epidural immediately. She reminded me that I still wasn't hooked up to monitors and that I did not have an IV started. These things needed to happen before the anesthesiologist could come in.

The next hour or so I spent sitting in bed, trying to calm down and breathing through contractions. The contractions were so powerful. I held Brian's hand and continued to sweat profusely. Dr. Fogwell came in checked me and I was at 6 cm. I remember feeling such intense pain and trying to relax between contractions. This was probably the calmest I was during the active labor stage because I just kept telling myself that if I could survive a few more contractions then I would have the epidural. I think I kept asking how long it was going to take to get the bag of IV fluid in so that the anesthesiologist could get his rear in the room and get the job done. I looked at the slow drip a few times and contemplated grabbing the IV bag and giving it a few good squeezes.

The contractions continued to intensify, but the bag was almost empty. Then I heard the nurse call for the anesthesiologist, and I heard the reply over her little radio--"He's just gone into room 7". I was in room 9. This was not good. Internally, I panicked--I could NOT wait any longer. I wanted to run into room 7 and drag the good doctor back to my room. I think externally I stayed fairly calm and zen simply because it was taking all of my energy to survive the contractions. Finally the doctor came in. He said Brian and Elizabeth had to leave while I got the epidural. I didn't want Brian to leave. I was scared and in pain, but I knew that the faster he left the faster I would have sweet relief.

I had a contraction as the epidural went in, and I held onto nurse Devin for dear life. Her little radio kept paging her saying her husband was on the phone saying it was urgent. She seemed a little concerned, but replied that she was busy at the moment (helping a pregnant lady regain her sanity.) Finally the epidural was in--the anesthesiologist said I would probably notice relief after a couple of more contractions. Good grief! Now I was alone in labor and delivery and I had to survive two more contractions. The doctor asked me if I wanted a "light" epidural where I still had some sensation or a "heavy" epidural where I'd be pretty much totally numb. I sucked it up and said "light". Eventually, I started to notice some relief.

Brian and Elizabeth returned and I was starting to relax. Brian's phone kept ringing, and I noticed that he left the room before talking. The next time he came in I asked what was going on. He looked a little concerned, and told me that there was a little "weather situation". I was concerned--my parents were still on the road and Reid was with Brian's mom. What was this weather situation and where was it happening? Brian said, "There's a tornado, and it's on the ground." Again, I feared the worst--like it was heading for our house in Allen and Reid was in its path. So when Brian said, "It actually looks like it's headed for the hospital", I was strangely relieved. Labor and delivery is in the basement of this particular hospital. Brian told me that they had just called a "Code Grey" and that nurses were scurrying around talking about moving patients. Nurse Devin popped her head back in (that urgent phone call from her husband--it was about the weather). She said that with a Code Grey we were safe in L&D. In fact, they were going to start moving other patients into the hallways of L&D.

Once I talked to Brian some more and verified that my parents and Reid were out of harm's way, I thought the situation was sort of humorous. I even asked Elizabeth to turn on the TV so we could watch the coverage. Clearly, the epidural was helping at this point! The tornado broke apart and changed course before reaching the hospital, and I don't think all they did was move patients away from windows upstairs. My parents arrived safely around 6:30, and the nurse checked me again. I was still at a 6.

The hours between 7 and 10 pm were fairly relaxed. I put on my make-up and tried to make the most of my "I-didn't-shower-today" hair. My sister came and stayed awhile. I chatted with Brian, Elizabeth, my parents, sister and our new nurse Julia who had come on at the 7pm shift change. I felt pressure with each contraction and started becoming nauseated again. I threw up some more, and even with the epidural, I sensed that the contractions were fast and strong and that things were changing rapidly with my body.

The nurse checked me around 10 pm, and she looked somewhat surprised and said "Well....". I was so afraid she was going to say that there had been no change in the last 4 hours since I got the epidural. (Side note, I do think that had I not had the epidural, my labor would have continued to progress rapidly, and I would have had the baby in a matter of 2-3 hours, but who knows!) I was excited/terrified when she said I was at 10 cm, and I was ready to start pushing.

I remember the first 30-60 minutes of pushing pretty clearly. I pushed and pushed and was making "a little" progress. My epidural was becoming less effective and I felt so much pressure and some pain. I'm not sure what happened to me mentally during that period of time, but for some reason I started becoming convinced that I could not push this baby out. I was so uncomfortable--not the worst pain, but definitely the worst discomfort of my life. I didn't feel like being on my back was effective so I turned over on my hands and knees (with an epidural--somewhat stressing nurse Julia out) and started pushing.

This is what I remember: I was very tired. I was getting frustrated and feeling desperate. I did not want to be told to push, and I certainly didn't want our perky nurse (who really was wonderful--I just didn't appreciate her at this point in time) counting to 10 repeatedly. I was sort of in my own little world--I could hear everyone else talking, but I just wanted to be left alone. Another weird thing was that, at some point, I got very concerned about Brian being by my side while I was pushing. I never thought I'd be like this, but there was part of me that was self-conscious, and I just started thinking, "this is too much-I cannot let him see me like this, and I can't fully concentrate on pushing for thinking about this". So, Brian ended up spending some time sitting on the other side of the room. I think this helped me slightly from a psychological perspective.

Eventually, after a long time of pushing with not-so-much progress, the nurse told me she had spoken to my doctor and he was coming in to discuss options. When Dr. Fogwell walked in and said, "Let's talk." I was in the middle of a contraction and feeling desperate. I told him I did not want to talk at the moment. The nurse sweetly told me that the doctor had come in just to talk to me, and I needed to talk to him. Luckily, my doctor knows me pretty well by this time, and he said, "no, don't worry, she'll talk to me when she's ready". With that, he sat at the computer and hung out for about 15 minutes (I think-my concept of time at this point is very hazy) until I told him I was ready to talk. He told me my options were:
1. Have a repeat C-section. Which he said, "would be stupid since you're fully dilated, and the baby is fully engaged in your pelvis"
2. Turn your epidural all the off and see if that helps with pushing.
3. Use forceps to assist with delivery.
4. Have the anesthesiologist come in and make your epidural much stronger to see if we can get you comfortable enough to push.

I chose option 4. I was already pushing pretty hard by the time the nurse anesthetist came in. He was an older gentleman named Jack. In the midst of all my crankiness and desperation, Jack walks in and starts cheering me on with all he's got. "Come on sweetheart, just push that baby out!" I almost hit him. I don't know how much longer I pushed after that. I was definitely in the zone with my eyes closed and totally focused. I do have recollections of yelling "please help me", and I'm fairly sure I yelled "get her out" at least once. All in all, I was not the serene laboring goddess that I had hoped to be.

With the last few pushes I heard the nurse and doctor saying that she was moving her head around trying to get herself into position to come out. Just when I thought I couldn't push any harder or take any more, she was out at 12:56 am on Thursday, September 9, 2010. It was the sweetest feeling of relief I have ever experienced! She came out with her umbilical cord wrapped around her neck twice--apparently it was a long cord! They got it unwrapped, and she started crying. Brian cut the cord, and the placed our sweet baby on my chest. She was so purple at first that it scared me, but the nurses assured me that she was okay. I rubbed her face and head and stared at her in amazement.

After a few minutes, the nurses took her to the little warming bed in the room--they were a little concerned that her lungs sounded a little "crackly" and her oxygen saturation was a little low. Eventually they called the NICU team down to do an assessment in our room but kept assuring us that it was nothing too serious. After some deep suctioning and a once over by the NICU team, she was declared perfect and allowed to come back and snuggle with me some more.

I experienced exhaustion like I've never felt before. I pushed for 2 1/2 hours before little Miss Camille made her appearance!

All in all, it wasn't exactly the labor experience I had envisioned. I am thrilled that I accomplished a VBAC. I have a few regrets about getting the epidural, but I also know that with the way things unfolded, it was the best option for me at the time. We want to have more kid(s), and I would definitely opt for a VBAC over a cesarean given the choice. I would even consider attempting a future birth without an epidural. Maybe. Or not. I found the experience empowering and the recovery easier in many ways than with the c-section. We were admitted to labor and delivery around 4:00 on Wednesday, had the baby at 12:56 am on Thursday and went home at 4:00 on Friday. And all my hard work was rewarded with the best prize imaginable!