Ryan's Birth, Part II

I gave my nurses a copy of my birth plan, which basically informs them of my preferences during labor, delivery and post-partum. It includes things like wanting Mike to cut the cord, wanting to wait on any routine medications until we've had time to hold him, etc. Of course, it's just a plan, and sometimes labor doesn't go according to plans, so it's really more of a rough guideline.

In my plan, I asked that I not be offered pain medication. I knew what my options were, and I would ask for it if/when I needed it. I wanted to have a natural birth, and I knew that if I was constantly offered medication, I would cave and take it before I really needed it. I didn't know what kind of pain I was in for, so I made a deal with myself that I would try to go without medication. But if I couldn't do it, that was ok. I'm no hero. But I did want to get as far into labor as I possibly could before getting an epidural because they can often stall or slow labor down. I wanted to get some good progress in, at least to 5 cm dilated, before I took anything that might slow me down.

At first, the pain was totally manageable. The nurses brought me in a birthing ball and a rocking chair, and I rotated using those two things, pacing the room and laying in bed. I tried to relax as much as I could, picturing myself in Cabo or on the beach in Ocean City.

Between contractions, I text messaged with friends. For about the first four hours, I did pretty well staying calm and relaxed and working my way through the contractions. But they were getting progressively more painful. By 5 p.m., I didn't want to even look at my phone and the imaginary beaches in my head weren't bringing me any peace.

By 5:30 p.m., I was in serious pain. I laid down on the bed and couldn't get back up. The pain is something you can't really describe to someone who has never been in labor. It's just unlike anything else. It was, by far, the most pain I'd ever experienced in my life. I can only say that it wasn't just in my stomach. I mean, technically it was, but it felt like the pain radiated through my whole body, filling my head up completely. I told myself to breath, that the contraction would end, that relaxing was the best way to handle it. Mike says you would never know by looking at me that I was in that much pain. He says I was the opposite of the crazy, screaming, "you did this to me!!" stereotype of a woman in labor. He says I laid there looking totally calm and like it was completely manageable. This is sort of surprising to me because there was so much chaos inside my head. Each contraction was coming harder and faster. I asked the day nurse, Cassie, how long it would take to get an epidural. She told me that the actual epidural only takes about 10 minutes, but that I needed to be hooked up to an IV first and needed to get a bag of fluid in me before they could administer the meds. All told, it would take about an hour. At that point, Connie, the midwife who was working the day shift, came in to check and see how far I'd progressed. She told me I was at 5-6 cm, and I knew it was time to get the epidural. I wasn't even sure how I would power through the next hour without it, and I'd met my self-imposed mandate of at least 5 cm dilated.

I told Cassie to drug me up, and she got the IV set up and ordered the epidural. The next hour was the most painful of my life; possibly even more painful than what I went through at the end. The epidural was simply amazing. The best part was that I couldn't see what the doctor was doing as he administered it. I was thankful for that because I know the needles are huge and scary (one of the reasons I didn't want one to begin with). Mike told me later that there were actually a couple of different scary looking needles and tools involved. But the medication took the edge off the pain almost immediately and within about 10 minutes, the pain was almost totally gone.

But it wasn't gone completely. I could still feel the contractions a little. It was more like mild cramping, and I could still feel my legs enough to move them a little on my own. I was relieved that I wasn't totally numb and could still feel what was happening with my body. The nurses offered me a higher dose, but I told them I was fine with the level for the time being.

As the next couple of hours wore on, the contractions became stronger and I finally reached a point where it seemed a little ridiculous to have an epidural and be in so much pain. So I asked for a little more medication, and although they only gave me a small amount, it was enough to completely and totally numb my legs and feet. We're talking dead weight. It was weird and a little freaky, but at least the pain was gone.

At this point, they had me laying on one side for a while and then switching to lay on the other side, to allow the epidural to work its way through my body via gravity. I was on my left side for a while, when midwife Anita, who was working the night shift, came in to check and see if I'd made any more progress. She moved me to lay on my back to do the exam. It had been a couple of hours since the 5-6 cm check, so I was hoping to have made some good progress. It turns out that the epidural did slow down my labor, and she was now estimating that I was just at 6-7 cm. I was disappointed, but at least I had moved forward somewhat. Right as she finished the exam, one of my monitors started beeping loudly, and the night nurse, Stephenie, said that Ryan's heartrate was dropping really fast. All of a sudden, several more nurses were in the room and someone called out to page Dr. Carrion, the OB-GYN who was working the hospital that night. I was relieved when I heard her name because I'd gone to her for several appointments during the summer and liked and respected her a lot. If there was going to be any kind of complication, I wanted her to be the one to deal with it.

Stephenie gave me an oxygen mask, which probably would have freaked me out if she hadn't told me earlier that if anyone ever gave me an oxygen mask, it was simply to get a little more oxygen to the baby and not an indication of anything really scary. I told myself to stay calm and breathe and that there were lots of people in the room who knew what they were doing and that everything would be fine. They decided to try to move me on my right side to see if that stabilized the heartbeat, but it only dropped even further. At this point, Anita began telling me that Ryan could only tolerate that environment for so long, and that if they didn't get his heart rate up immediately, they would have to look at other options, i.e., a c-section. They moved me to my back and then to my left side, where I had been before Anita came in to do the exam. As soon as I was back on my left side, his heart rate stabilized. After a few minutes, Dr. Carrion did another exam and declared I was now at 8 cm. Whatever happened during that time seemed to have moved me along a bit, which was good. But now they knew that for whatever reason, Ryan didn't like it when I was on my back or my right side. So they said I would have to remain on my left side indefinitely -- probably for the rest of my labor.

Because the epidural works its way through your body via gravity and I was stuck on my left side, the medication began to wear off on the right side of my body. All of a sudden I could feel the contractions again, but just on the right side of my stomach. They got progressively more and more painful as the hours went by and the medication continued to flow down my left side. At my next internal exam, around 10:30 p.m., Anita said I was 9 and 3/4 cm dilated. I was soooo close, but they wanted him to get a little bit lower before I began pushing, so they told me I should wait it out a little longer. At one point, they tried once more to move me to my back to see if Ryan could tolerate it yet, but his heart rate dropped again. So they said that when I did begin pushing, I would have to do it while laying on my left side.

Mike and I began pondering whether he'd be born on the 20th or the 21st. If I began pushing soon and it went fairly quickly, it might still happen on the 20th. But as it turned out, I didn't begin pushing until just after midnight, so he was destined to be a 21st baby.

Pushing while laying on your side is not easy and it's not very productive. Let's just say you can't get good leverage. Therefore, I pushed for two and a half hours. I was exhausted after about an hour, and the nurses kept trying to get me to take a break. In fact, at one point they insisted that I rest for 30 minutes to get my strength back. But the epidural had worn off on my right side so much that I was pretty much feeling everything. And it HURT. And the only thing that relieved the pain even slightly was the act of pushing. So I couldn't help but push. Even when I was supposed to be resting, I was doing mini-pushes. They discovered this on their monitors and came back in to see if I wanted to resume. I told them I had to keep going, we had to get this baby out. They decided to try one more time to move me to my back to see if Ryan's heart would take it. This time, his heart rate stayed steady, so I got to push on my back for about the last half hour. It was a hundred times easier to push on my back, and I finally could really feel that I was making progress.

They told me they could see his head and that he had a little bit of brown hair. That little nugget of information about my baby boy was all the motivation I needed to power through the contractions and get that little guy born.

Feeling him being born was surreal. I remember actually thinking "Ok, that was his head... shoulders... arms... " And the pain relief was instantaneous. I mean, I still ached in all kinds of ways, but the contractions were gone, thank god.

The white board in my room that kept track of how my labor was progressing.

They put him on my chest, and I looked at his face and felt like I'd always known him. I think I actually could have picked him out of a group of babies as being mine. All that time I wondered what he looked like and hoped that he'd be cute, and when I finally saw him, it was like I knew what he had looked like all along. And was he ever cute...

Next up... Part III: Post-Partum.