Tuesday, June 5, 2012

the birth story: part V, the hospital birth~labor

The Hospital Birth~Labor

The All Natural Hippie Gets an Epidural

The purpose of going in to the hospital, for me, was to get an epidural in the hopes that it would relax my tense body enough to allow my cervix to continue dilating and allow me to get some sleep. I had been awake for 43 hours and counting by the time I was settled in to the hospital and discussing my wishes with the on-call midwife, Annie*. As I mentioned, this discussion was not going well. Annie was incredibly skeptical of my homebirth midwives and their opinions, and she certainly didn't seem to believe I knew what was best either. She had already been notified before I arrived that I was very anti-medical intervention and that I would not agree to take any narcotics (her plan), but she persisted in her attempt to persuade me. That moment felt every bit like the stereotypical hospital birthing experiences I had read about a thousands times and felt enraged by. So, we went a couple of rounds, and I stood my ground. It was late, I had been beaten down by labor pains, and was sitting in a dark hospital room, not my home, but I was not going to completely give in and abandon my entire belief system when it wasn't medically necessary. 

I watched as Annie mulled over my situation one more time in her head, the light from the fetal monitor bouncing off her glasses. She explained that if I was given an epidural, it would require another medical intervention—either breaking my bag of waters or administering Pitocin. Hearing this only made me panic—a domino effect is exactly what I was afraid of when it came to medical interventions. My homebirth midwives asked Annie if I could make all of these decisions when and if they became necessary. With more looks of skepticism and judgement, Annie backed off and asked me if I had any more questions about the epidural. I responded with, "Yes, can I have one?" Everyone laughed. It seemed like a cheeky comment after the awkward conversation we'd just had, but I really just wanted her to cut the bullshit and tell me what the plan was. I had been in labor for an eternity, I was losing patience. I then heard what I'd been waiting to hear for over an hour, "I'll send the anesthesiologist down."

I couldn't believe how hard I fought for an epidural. I was the one who chose to have a natural homebirth, I chose to put myself in a situation that would not even allow me the option of using pain medication. And though I was able to handle the pain and labor for 36 hours without help, an unforeseen situation eventually arose. It was difficult for me to resign myself to the fact that I needed some sort of medical intervention in order to give birth, but having to go through the experience gave me more perspective on the issue. Although I believe in the innate ability of a woman to give birth naturally, I do acknowledge that there is a time and place for hospitals and doctors. We need hospitals and doctors when complications or emergencies arise (or when a hospital is simply your preference)—this was easy for me to see before giving birth. What I didn't see was that medical interventions, when used as tools, rather than standards of care, are amazing things. I went into my pregnancy with exceptional health, and was lucky to never experience any complications, so I was a prime candidate for giving birth at home. But, given the way my labor unfolded, I ended up becoming a prime candidate for an epidural—so unexpected yet I am so grateful I had that tool available, because it was exactly what I needed. What I didn't need was a cocktail of narcotics (although, perhaps there is a situation when that is the exact right thing as well). I did not want to feel "drugged up" nor did I want my baby to, so I was thankful that I was able to at least avoid that situation.

Back in labor land, I lay in bed awaiting the anesthesiologist. The nurse informed me that I wouldn't be able to eat or drink once the epidural was placed so my husband tore open our snack bag and came at me with some crackers and a Lära bar. The anesthesiologist wheeled his cart of tricks into the room just as I was about to stuff a handful of crackers down my throat. He introduced himself in a thick Polish accent and told me to take the crackers out of my mouth, which I did. I'm not entirely sure why, but this guy seemed so bad ass to me. His head was shaven bald underneath his operating cap, and he reminded me of a character from The Boondock Saints. I was equally impressed and terrified by him. 

The anesthesiologist had me move over to the hospital bed and curl forward so he could scrub my back with antiseptic. I was now faced with the problem with agreeing to an epidural: I had to actually have it placed. Aside from being a natural birth enthusiast, I was also horrified by the thought of having a needle pierce my back and a catheter fed up my spinal cord. I hugged my knees and stared at the linoleum floor. Something about how bad ass this guy seemed to me made me feel less afraid. I felt a tiny prick in between my vertebrae as he shot me full of Novocain before placing the catheter, and that was the last painful feeling I felt for quite a while. 

Just as I was telling the anesthesiologist that I have a history of low blood pressure, the monitor I was hooked up to began to beep. I looked up to see my husband standing in front of me, his face growing distraught—he was not comforted by the image of me in a hospital gown, monitors strapped to my belly, IV in my right arm, blood pressure band and heart monitors on my left arm, catheter in my back. This was quite different than the scene of me dancing barefoot to Phish, dressed in comfy maternity pajamas while I labored at home earlier. As the anesthesiologist leveled out my blood pressure with more medication, my legs began to shake uncontrollably. So far, I was not feeling too good about the epidural. But, after a short while, Mr. Bad Ass got everything under control and I suddenly found myself mouthing the words "I love you" to him. And then he wheeled his cart of tricks out of my room. I could not believe that I was still contracting, because I no longer felt a thing.

The nurse turned the lights out, and my birth team headed down the hall to the lounge area to sleep. My husband climbed into his bed, relieved to be "off duty" for at least a short while. And I was left lying in my own bed, alone with my thoughts. I could breathe again, I could relax. I didn't get much sleep at all that night, but I was at least able to rest, which is exactly what my body needed. One of my homebirth midwives periodically came in to sit with me and we'd chat about labor, and life in general, to pass the time and distract me from my myself. Being taken out of the labor flow meant being able to think again….not the best thing for an anxious gal like me. 

At some point a couple of hours after receiving the epidural, Annie came by to check me. Not only had I made a lot of progress in dilating, but my water broke on its own. I was thrilled to hear this news as it pushed me closer to giving birth on my own. I continued to rest for several hours more until I was woken by the nurse who informed me that the epidural had slowed my contractions down and my labor was now stalled. I had temporarily escaped the need for Pitocin, since my water breaking had the potential to speed up the contractions naturally. But, now I needed more (medical) help. I was not pleased. When the nurse asked for my permission to start the Pitocin, I looked at her and said "epidural plus Pitocin equals C-section!" I was once again thinking about The Business of Being Born. She must have thought I was nuts, but she didn't show it. I then asked the nurse to wake my husband so I could discuss my options with him. After several minutes of shaking him and calling his name, my husband sat up in bed. I told him about the Pitocin and asked his opinion. He looked at me in a daze, and without saying a word, got up and walked into the bathroom. It seemed that 43 hours without sleep had caught up with him—he wasn't going to be much help. I then asked the nurse to get one of my midwives from down the hall. After a short discussion with my midwife, I realized that Pitocin was the only option I had other than lying in my hospital bed not contracting for hours until being wheeled in for a C-section.

Once again, I learned that small doses of medical interventions could work magic. The nurse started me on a low dose of Pitocin and I went back to sleep. Shortly before noon the next morning, Annie came in to see how I was doing and said it'd probably still be a while before I was ready to give birth—really, 48 hours into labor and it'd still be a while?! I asked her to check my cervix, out of curiosity's sake, and when she did she looked up, quite surprised, and asked, "would you like to have a baby now?" I was FINALLY fully dilated, rested, and ready to give birth! Hallelujah! 

**Names have been changed for privacy

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