I've finally gotten my act together between feedings and changings and loads of laundry and visitors and naps and crying jags and gotten my birth story down. Overall, I have to say I feel very happy and lucky with my birth experience. I didn't really have any expectations going in, but I was definitely starting to get a little scared towards the end about how things were going to go. Hopefully this will be helpful to anyone facing a possible induction.
Prologue: The Final OB Visit
We had our final OB visit on Tuesday, December 22nd -- six days past the chicklette's due date, and also my birthday. We were expecting to talk induction with the doctor, since she had told us she'd be willing to induce at 41 weeks, and would probably encourage it if I was already starting to dilate.
Right before our appointment, my husband took me out for a fabulous Italian lunch. We lingered over our food, talking about how excited and nervous we were for what was coming, and remembering some of our favorite times together pre-baby. It was really special. Thinking about what came next, it seems even more so!
At 2:15, we got to the doctor's office and learned that she was back after being out a week with swine flu. Maybe that's why the chicklette waited? Anyway, she checked my cervix, and I was 1 cm dilated and "moderately" effaced. She asked how we felt about induction, we told her we were ready, and she said that she thought I'd probably head into labor soon so we might as well get her out before Christmas. Her plan was to check us into the hospital that evening, give me some meds to ripen my cervix, and start Pitocin in the morning.
Act 1: Cytotec, A Pain in the Ass
After our appointment, we ran home to get our things together and get ready to check into the hospital. Promptly at 6:00 p.m., we checked in to Labor & Delivery and got settled in our very large and somewhat fancy room.
What I didn't really think about or anticipate was that they'd be hooking me up to an IV and monitors RIGHT AWAY. I mean, I guess I should have known that, but I thought they'd give me the ripening agent and kind of leave me alone for the night. Not so much. I got set up with the IV (which was put in by a 12-year-old nurse who didn't really seem to know what she was doing). Next came the monitors for the baby and for contractions, which were strapped around my waist. Then came the fun part -- my doctor and her oh-so-delicate hands came and shoved a Cytotec pill up my hoo-hoo. She left with a "well, we'll see if that puts you into labor -- otherwise, see you bright and early in the morning!"
My mom came by after that, and hung out for a couple of hours. I started to have some mild contractions, just like I'd had at home for the past week or so. My mom kept watching the contraction monitor and giving me the play-by-play, which was kind of annoying. The nurse came back and gave me an Ambien at about 9:30, and I drifted off to sleep. The Mr. and my mom left -- it was weird being alone, but it made sense for my husband to get some rest in case the next day was a long one.
At 1 a.m. or so, another nurse came in to check my cervix and give another dose of Cytotec. I was still only about 1 cm dilated, which was kind of disappointing. I fell back asleep.
At about 2:00, I woke up with some lower abdominal cramping. When the nurse came by to check on me, I asked her about it and she said it was normal with the Cytotec. I drifted back off to sleep.
Act 2: Active Labor?
Whew!! Sorry for the novel. And for the hazy parts post-epidural. I don't mean to be a drug pusher or anything, but OMIGOD that epidural was the bomb. The post-partum Vicodin wasn't bad either.
Shortly after 3:00, I woke up yet again, this time with some back pain added to the lower abdominal cramping. It felt an awful lot like period cramps, but like 10 times more intense. The pain seemed to come and go every couple of minutes. I checked the contraction monitor, but didn't see anything too interesting. I made a few trips to the bathroom to try to distract myself, but the pains continued to get more intense. I tried breathing through them, which helped somewhat. It took about 6 breaths to get through each pain, which calmed me down. Just 6 breaths. I can do this, right?
By 4:00, I was REALLY uncomfortable. When the nurse came back in to check on me, I reported that the pains were progressing, and asked if there was any way I could be in labor. She looked at the monitor and said "no" -- and kind of laughed at me a little bit. I started to get annoyed. I mean, I'm not a pain champion or anything, but I think I would know when something felt different, right?
By 5:00, I was on my side, gripping the bed rails with each contraction. They were now lasting 10-11 breaths each. Another nurse came in and I asked again about labor, and about any pain relief. She said that since I wasn't dilated, they couldn't start an epidural but could give me a narcotic called Stadol to "take the edge off." I thought about how Pitocin was scheduled to start in a couple of hours, and how it could take a couple more hours after that to dilate to where my doctor would let me have the epidural, and I said "yes, please."
Now, if I had been thinking clearly, I would have made the connection that they hadn't checked my cervix in over 4 hours. But I wasn't thinking clearly. I was getting sick of having to fight with the nurses, though, so I called the Mr. and asked him to come in early. I needed an advocate for pain management, and I was, well, in too much pain to do it for myself.
Act 3: HOLY SHIT THIS HURTS!!
In the time between when I called the Mr. and when he showed up, I got my Stadol. It made me loopy and delirious and slightly hallucinatory, but did nothing for the pain. By the time the Mr. arrived, I was in full clench with my bed rails, and taking 17 breaths during each contraction. (I had tried some other positions to try and work through the pain, but they just were not cutting it. I don't know if this is a back labor thing, or I'm just a big pussy.)
We decided a shower might help (and plus, I figured this would be my last chance to take one for a while), so he walked me over. I don't remember much, except having to sit on the little shower stool and moan a lot. Oh, and there was some bloody show.
Act 4: Sweet, sweet relief
At some point around 7 or 8, one of the nurses got ahold of my doctor, and the doctor gave the go ahead for an epidural. I don't remember specifially asking for it, but I think either the Mr. or my mom (who had arrived by this point) took care of letting someone know that I really really wanted it. The anesthesiologist arrived and was great -- they sat me up on the bed and rigged me up to this massage chair-type contraption. He talked me through everything, and while the needles didn't tickle, they were nothing compared to the contractions.
It took about 10 minutes, but I started to feel some relief. I was still feeling a LOT of pressure, so the doctor topped me off with a little more juice. And let's just say at this point that I became a Very Happy Person. I mean, really happy.
Oh, and guess what? They checked my cervix right after the epidural, and turns out I had already dilated to 4.5 centimeters. Guess I was in active labor after all. Idiots.
At some point my OB arrived and said -- "let's have this baby by lunchtime!" I think it was at this point that she broke my waters, but the timeline is a little fuzzy. It didn't hurt at all, but it did feel really funny to have all that stuff gushing out. Oh, and they started Pitocin somewhere in here, although I don't remember that at all.
Act 5: Push it real good!
I spent the next hour or two in a very happy place. I dozed a bit, which was nice. My blood pressure apparently dropped, because they gave me some oxygen. But it's all a little hazy at this point. I could feel the baby's head moving lower and lower, but not in an unpleasant way. I was laying on my side, and it sort of felt like I could just lift a leg and she would come out. I'm not sure if this is what they call the "urge to push," but getting her out didn't seem like such a bad idea.
At around 10, someone checked my cervix and pronounced me 9 centimeters. They called my doctor, and we waited. A bunch of people came into the room and started moving things around. When they started switching on the baby warmer, we realized that things were getting seriously moving!
At around 10:30, my doctor arrived, checked me again, and declared that the baby was "right there." They whipped out the crazy full-leg stirrups, rigged me up, and one of the nurses gave me a quick tutorial on pushing. Basically, pull my legs in, lift my head and bring my chin to my chest, hold my breath and push for 10 seconds. We were supposed to try and get 3 pushes in with each contraction.
And then we started! It was pretty neat -- I had the doctor and the nurses down below, and the Mr. right next to my head, holding my hand and quietly urging me on. My mom was still in the room, but back a ways by the window. I could feel the each contraction come, and would alert the doctor and nurses, and they would coach me through the pushes. It was very surreal, because there would be these breaks in between pushes where we would just chat and wait for the next one. We did about 5 rounds of pushes when the doctor said that she could see the head, and that it wouldn't be long.
(By the way, just a note on how great the epidural was -- at one point during the pushing, the doctor somewhat loudly asked one of the nurses to prep sutures for her, because I was going to tear, and I DIDN'T FREAK OUT.)
At this point, I could definitely feel her head, but not in a painful way. It just felt very stretchy. I started one more round of pushing, and then all of the sudden she was out! She cried right away. They wiped her off a little bit, wrapped her up, and put her on my chest. That moment was everything I had hoped it would be -- my husband right next to me, and my beautiful miracle of a baby looking at me. The Mr. cut the cord, and we just enjoyed life for a minute.
Of course, then they snatched her away to weigh her and do her Apgars and all of the other crazy crap they do to newborns. At some point I delivered the placenta, but seriously, I don't even remember. My doctor stitched up my second-degree tear (Public Service Announcement: If your doctor wears glasses, you will see WAY MORE THAN YOU WANT TO if you make eye contact during this process), and I continued to enjoy my epidural.
We got booted pretty quickly from Labor & Delivery to our much smaller post-partum room. I got to push the little button on the way that plays the lullaby chimes all through the hospital. At some point I started bleeding a LOT, and freaked out a bunch of the nurses, and had to have my bedding and gown changed several times. Yuck. The epidural took a while to wear off, so I ended up with a catheter for 24 hours, which was actually awesome. I mean, when was the last time you got to drink 37 cups of water and not have to leave your bed to go to the bathroom?
Overall, I feel very happy about my delivery. I'm happy that the induction was quick, happy that the epidural worked, happy that I didn't tear horribly, and most of all happy that the chicklette came out in one beautiful piece. I'll post a bit more about recovery later (and our lovely readmission to the hospital about 4 hours after our discharge), but long story short is that two weeks out, I physically feel pretty darn good. Emotionally, I'm a bit of a mess, but I think that's more sleep deprivation than anything else.
And on that note, I shall sign off. Time to go pump and watch some more Gilmore Girls.