Saturday, November 21, 2009

Jesse's birth story, part 1

These things are always done in parts, it seems, but there's something about recounting the story in as much detail as I can remember. I didn't really record anything about my first son's birth, and really regret it.

When I found out I was pregnant, I could not remember exactly which day my last menstrual cycle had started. I knew it was either Feb. 3 or 4, which meant my due date was either Nov. 10 or 11. I went with the 10th, but the doctors went with the 11th. It didn't much matter to me because I was anticipating an early baby. But, of course, Nov. 10 came and went and still no sign of little JHM.

But on the morning of the 11th, I woke up at about 6 a.m. to find a small puddle under me. I woke my husband and asked him if he thought that was my amniotic water, and he said yes, definitely. But I didn't necessarily agree--I got up and went to the bathroom, and it was a decidedly longer pee than I usually had that late in pregnancy, so I thought my bladder had leaked. I went back to bed and dozed until the alarm went off an hour later.

This time, when I sat up to get out of bed, I felt the gush.

Now, I was already between 2-3 cm. dilated, soft but not effaced. It's not unusual for 2d time moms to dilate first and then efface, but since I wasn't feeling any strong contractions, I decided to hold off on rushing to the hospital. More anxiety-provoking for me was the fact that my midwife's normal day off was Wednesday. I kicked myself for not asking her what to do if my water broke and I wasn't in active labor and she wasn't on call or available. Of all the scenarios, that was not what I pictured: in my family, typically, active labor commences with the water breaking.

First, I got elder son off to school, letting him know that I would not be here when he got home. I waited for the office to open and called; got Scottie the nurse, and she told me to go to the hospital. I asked her about the OB on call--she was new to the practice, and not only had I not met her, I didn't know anything about her. Scottie reassured me. I was still daunted, wishing hard that my midwife would somehow pick up on the psychic resonance of the numerologically auspicious date, but we slowly got everything together and headed to the hospital. Oddly, they had trouble confirming that my water had broken because I couldn't seem to produce another gush for them. I was still 3 cm, and only 50 percent effaced. Part of me wishes that I had just turned round and gone home, because it didn't take long for me to realize I'd just consigned myself to a medical labor and delivery, and I would have to fight tooth and nail to get the natural childbirth I wanted.

It started around 11, when the L&D nurse assigned to me wanted to start an IV because the doctor had _already_ ordered Pitocin for me, as well as nothing by mouth other than ice chips. She had never met me, remember? I refused the IV and the Pitocin and said that the doctor would need to come in and explain to me why there was a medical indication for this intervention. The nurse seemed daunted, and at that point I knew she wouldn't be an ally. She expressed concern about my tiny veins and the difficulty she would have starting an IV if there were an emergency. I insisted I needed to talk to the doctor first, and set about walking around the labor ward to try and get contractions going.

By 12:30 I had a good labor pattern going, even though I wasn't really feeling the contractions any stronger than I had during false labor. They were definitely every 2-3 minutes, though, so I expected there to be some progress. The doctor came in and checked me, and I was still 3 cm, now 70 percent effaced. She again said she'd like to start Pitocin, arguing that since my water had broken there was a chance the baby would go into distress and she'd like him to arrive "during the day while there were still plenty of people here." I think my eyebrows shot off my face. I explained to her that I didn't agree that Pitocin would get him here faster because sending me into hard labor too early might trigger what I call intervention cascade, in which Pitocin contractions are so hard and violent that even the most pain-tolerant mothers beg for relief, usually in the form of an epidural; then, once the epidural is in place, the mother is no longer able to work with the contractions, creating a stressful environment for mother and baby.

She stared at me. "My priority is delivering a healthy baby," she said, implying that my belief in intervention-free natural childbirth stood in the way of this. "My baby _is_ healthy," I replied, gritting my teeth. She and the nurse combed through the print-out of the monitor, looking for evidence that the baby was in distress. "Look, the heart rate dropped here," she said. "He turned away from the monitor," I said. She was quiet. "Yes, you're right, it's only a partial reading, but if it drops again, I _will_ put you on Pitocin."

Then began the fight over the IV, again.

At some break between all this, I wrote on my midwife's Facebook wall: "Missing you right now."

Onward to part 2...

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