The White Lily (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
thewhitelily) wrote2010-11-15 02:04 pm
thewhitelily) wrote2010-11-15 02:04 pm
Birth: all the details you never wanted to know
All sorts of uncensored stuff under cut, mainly for my personal records, so not necessarily for the faint of heart.
So it all started on Sunday night, Oct 31st. I had my 'bloody show', which is a clump of mucous which has served as the 'plug' at the cervix throughout pregnancy, streaked with blood from the beginning of the cervix dilating. According to my reading, a bloody show means it's bloody show time, and labour is likely to start within 24-48 hours.
I was getting cramps on and off, but nothing really regular - I'd get four within fifteen minutes, then nothing for an hour, then nothing for another two hours, then another three cramps, etc. I also had diarrhoea, which is another sign of impending labour as the digestive tract clears the way to the exit. Not to mention that my bladder seemed to have compressed from the size of a walnut to the size of a twenty-cent piece - and every bit as flat. Honestly, I was lucky to get more than ten drips out of it every time I needed to go - and I was lucky to make it through washing my hands before needing to go again. Not to mention that every time I moved, stood up or sat down, I'd get these awful pains which unfortunately didn't really count as contractions, since they were stimulated by movement.
Except... nothing happened. On Monday, I was hopeful. Hubby and I went for a walk before he went to work to see whether we should plan anything for the day or whether me getting up and moving around would simply mean he had to come straight back from work again to take me to hospital. On Tuesday, after two days of crampy, toilet-tethered, painful nothing much, I was getting depressed. I'm not generally a teary person, but I almost burst into tears a couple of times, not so much from the severity of the pain but just at the thought that there didn't seem to be any end in sight. Was it really possible that I could be in pre-labour for the rest of my life? I was googling like a woman possessed, trying to find statistics that might give me some kind of idea of how long I could expect it to go on.
One bit of anecdotal evidence that kept coming up was that long pre-labour often led to short actual labour, because your body’s doing all the hard work before you actually go into labour, which was at least one bit of good news. Up until Sunday, I'd been perfectly happy to go on being pregnant as long as necessary. There were, of course, various discomforts, but to be honest I wasn't really completely ready (the cot STILL hadn't arrived) and I was happy to wait. By Tuesday, I was willing to do anything - even give birth - to get it all over with, cot or no cot!
Tuesday afternoon was my aqua-aerobics class, the movement of which is well known as an inducer of labour, so after a call to the obstetrician to check that it was safe to go in the water after having lost my mucous plug (which helps seal the cervix and keep out infection) I headed off to that. It wasn't the most fun session I've been through, given the pain I was experiencing with movement, and I got a couple of severe abdominal cramps, but it didn't slow me down in the least. This was at least pain that might cause something to happen. Then I went home and made curry for dinner. :)
Wednesday morning at 2:45am, I got up to go to the toilet. For approximately the twentieth time that night. While I was sitting there waiting for my kidneys to manufacture another few drips to avoid going through the whole procedure ten times more before ten to three, I felt something rupture. It was like a water balloon breaking, completely painless, and out came a gush of fluid. The volume was not a ridiculous amount for a bladder to contain, but it certainly wouldn't have been my bladder that could have contained it at that time. Anyway, I called out to Hubby, told him that I was pretty sure my waters had just broken, asked him to get me a pad, and... well, decided to try and get some more sleep. I got an hour or so more sleep, then realised that I was having more serious contractions, that this was definitely underway, and it was time to apply my TENS machine.
TENS is a favourite of natural childbirth proponents (of which I am not one - I'm just in favour of anything which helps relieve pain) which works by attaching four electrodes to one's back and sending electrical pulses. The buzzing sensation of mild electrocution is carried along the same nerves as the pain and thus completes for both room on the nerve pathways and attention from the brain. It's got a standby mode which sends mild pulses every few seconds and a Magic Button which puts it into Awesome mode, which sends stronger pulses continuously during a contraction. In any case, even for people like me who are all in favour of drugs and lots of them, a TENS machine is portable, safe, and available for hire to keep at home to assist with early labour, before it's appropriate to go to hospital and receive said drugs. Apparently there's also an extra endorphin rush associated with having it on for two hours continuously, so you're meant to put it on as soon as you think you're going into labour, even if the pain isn't too bad yet, to make sure you get them.
Hubby helped apply the TENS (big electrode gel pads are difficult to apply to one's own back) and promptly went back to sleep. I tried for a bit more sleep as well, aided by the soothing sounds of Hubby's snoring and a Terry Pratchett audio book, but didn't manage much more than drowsing - contractions were definitely not fun, and were starting to be something I didn't want to be lying down for. The best thing seemed to be to sit on an exercise ball and circle my hips throughout the contraction, then I'd empty my increasingly small bladder AGAIN and go back and lay down and drowse for another five to fifteen minutes until I felt another contraction beginning, whereupon I had to leap out of bed and get back on the ball or regret it when the pain came to a peak.
There was some concern I might have irregular contractions all the way to the end - the doctor missed the birth of ALL FIVE of my mum's children because no one would believe she was actually in labour until they could see the head. At least one of my sisters had similar problems (although she managed to convince them she was really in labour about ten minutes before it was time to start pushing). My contractions were fairly irregular through the night, but seldom closer than four or five minutes and averaged more like ten, and still reasonably bearable, so I felt all right letting Hubby get some more sleep so that at least one of us could be well-rested to take care of the baby while I caught up on sleep after the birth. :)
At 6am, just as I was finishing up with a contraction, I realised I needed to throw up. I dashed for the toilet, and realised upon reaching it that I was going to go at both ends. Fortunately the nappy bucket was right there next to the toilet (what foresight!) and so a nasty mess was neatly avoided. That woke Hubby up, to. 'Looks like you're clearing house,' was his comment. A little while later, after asking Hubby to gather a few things that had made their way out of the hospital bag and pack stuff into the car, I realised that the contractions had been mostly sub-five-minutes for a little while now. I'd been timing them on an awesome little baby gadget called an ItzBeen, which I'll talk about another time, which was excellent for keeping track of roughly how far apart each contraction was, but only counted minutes rather than seconds. So I thought I'd get Hubby to officially time the duration and separation of five contractions, and we'd ring the hospital to see if we should come in now.
The first three contractions were all around a minute long and three to three and a half minutes apart. (A minute long and five minutes apart is the general rule for come-to-hospital.) The last two were under two minutes. We timed another couple to be sure. Under two minutes. Ack. Hubby rang the hospital. They didn't even *ask* how far apart the contractions were, because I hadn't realised I was supposed to notice if the baby had moved since my waters broke, and couldn't say that he had. So they said come in straight away to be safe.
In the meantime, I was throwing up again, with a feeling of dread in my stomach: my sister had told me that when she started throwing up from the pain in labour, the midwife told her that meant she was in transitional labour, which meant it would be time to start pushing very soon. But surely that couldn't be the case - transitional labour's meant to be the worst pain of the lot, and surely that would hurt more than this? I mean, I'm not saying it wasn't really really bad - it most certainly was! - probably the worst pain I've ever felt apart from when I'd got severe burns to my hand, but... well, I'd psyched myself up for it to be truly unbearable, and it wasn't.
We threw the last couple of things in the car, completely forgetting a few essentials like my mobile phone and wallet - fortunately my bag has been packed with the real essentials for months - and made our way to the hospital. Contractions stayed at two minutes apart, one minute long (which essentially means a minute on, a minute off), all the way there, but fortunately I didn't need to throw up again. I'm not sure whether they got much worse on the way, or whether it was just that I was strapped into a single location and couldn't move or use my fit ball, but while I had hoped to wait until 5cm dilation for an epidural (which minimises the chances of side effects), I was happy to go ahead if I wanted one earlier. We fortunately just beat the peak hour traffic, which was awesome, and arrived at the hospital around 7:45. We turned up at reception and I asked 'which way to the epidural?' They pointed me to the pregnancy assessment unit, which was just around the corner, where I gratefully used the toilet (40 mins driving was a VERY long time to hold anything in at that point). We got sent into a little assessment room there, waited around a few minutes for a midwife to be available, and then went through the checklist with her.
First of all, I asked, I know I want an epidural. Can you call the anaesthetist now?
Okay, she said, we need to assess you first. No worries, said I, then is there anything you can give me for the pain right now? Gas is, apparently, fine even before she'd assessed me. So gas it was.
Gas is... well, it's a blessing and a curse. It apparently builds up over around 20 seconds, so the idea is to start sucking on it as soon as a contraction starts, it should kick in after about 20 seconds and cover you over the peak. You stop sucking on the gas after the pain has peaked, and by the time it runs out the pain should have mostly faded. They told me it'd make me feel slightly drunk, but I only really noticed that after the contraction, rather than during, when I'd lie my head down on the bed (I was sitting in a chair beside the bed and leaning forward with my elbows folded on the bed) and answer the midwife's questions in quiet, breathy, exhausted sighs. It definitely helps with pain, which gives it a lead right out of the starting gate, but on the down side, it occupied my hands which meant that it was harder to keep track of both it and the Magic Button of the TENS machine. And it made everything more complicated: when the contraction started, I needed to start sucking on the gas and click the Magic Button at the same time, then when it peaked stop sucking, and when it stopped click the Magic Button again. Which meant sometimes turning off the magic button got forgotten in the confusion, and when the next contraction started, I'd click the magic button and the TENS would turn off, which would make me panic, and I'd forget to suck on the gas while my pain-addled brain would try to work out what to do and the gas wouldn't be effective during the peak of the pain. Somewhat worse, it made me feel very much like I couldn't talk or moan or anything during contractions, because every sound I made was essentially gas I wasn't getting. And any gas I wasn't getting was a BAD THING. I wanted as much of that stuff as I could possibly get. Talking is not top of the priority list during a contraction, however sometimes there's some words that could be gasped that might be helpful in directing a hapless Hubby as to what it is my frantic hand gestures are asking for. But he soon worked out that the clicky thumb signal meant 'I've dropped my magic button where the FIRETRUCK is it?!' And we sorted out that it helped if he hugged me around the back and underneath my tummy. And I managed to rather emphatically nonverbally point out that although I had thought that more pressure rather than just faint contact would be good, when it came to the contraction it REALLY wasn't.
In any case, the assessment. I'd felt the baby move in the car in the way in, so that was good. The midwife watched a few contractions. She listened to the baby's heartbeat. She did an internal exam, which wasn't nearly as bad as I'd been led to believe it might be. Possibly it helped that I was already six centimetres dilated (out of ten), which had me over the moon. I had made it past 5cm before wanting an epidural! Epic win! At this point, I felt as though with the gas I could have waited for an epidural if I'd been *very* early on, but if I was three or more centimetres dilated, I was going to go full steam ahead.
After a lot of stuffing around and some paperwork, while Hubby shifted and a brief visit from the on-call obstetrician from my practice in which I reiterated my desire for an epidural, the midwife moved me on to a birth suite and helped me change into a hospital gown. When Hubby grabbed the suitcase, unfortunately he'd forgotten he'd unzipped it to get out my medical records for the midwife, and it fell open and spewed its contents everywhere. We left him behind to deal with it, moving at an extremely brisk walk; I was setting the pace and there was no gas en route. I had no desire to have a contraction before we got there.
There I passed into the care of a different midwife, who asked 'Now, I understand you were wanting an epidural, do you want me to go ahead and call for the anaesthetist?' I looked at her like she was crazy. Had the anaesthetist not been called by midwife or obstetrician the moment it was discovered I was far enough along in labour to allow it? Were these people actually that cruel?
In due course, Hubby arrived with the hastily repacked suitcase, and we went back to soldiering on through each damn contraction. At some point, the midwife wanted me on the bed while she listened to the baby's heart. I, just finishing a contraction, said 'did you want to do that now, then?' and she told me it would probably take several contractions - and then I never shifted back to the chair again. (The previous midwife, I realised afterwards in comparison, had knelt on the floor beside me and reached around to hold the microphone on my tummy to avoid disturbing the position that was working for me at the time.) I’m sure I could have shifted back again if I’d cared, but it didn’t occur to me.
In any case, at that point I ended up lying down, sucking on the gas, and waiting, while the midwife checked once more that I understood that an epidural would mean I was unable to walk or move around. Yes, I told her, I know what an epidural is. Get me one! (Do you see what I mean? Has this call seriously STILL not been made?) I had been worried about the couple of hours it might take take the anaesthetist to be called in to the hospital from wherever he was, until I realised it was actually almost working hours, and he'd likely be here by 9am if he wasn't at the hospital already anyway.
At about 8:30, she came back with the news. The anaesthetist was currently in surgery, and would be held up. For how long, I asked, dreading the answer. Probably around 45 minutes - but please don't clock-watch, because that's just an estimate. Okay, that's not too bad. I could do another 45 minutes of this - not that I really had a choice.
Things continued progressing. I kept having contractions. I asked a couple of times if the gas level could be increased, which it duly was. And the midwife was bustling around the room opening up the infant resuscitation shelf and setting up the scales, but repeatedly assuring me that she was just setting it up for 'if' the baby arrived.
IF?! Seriously?!
The room was boiling hot, at least as far as I was concerned, and I was totally dripping with sweat. I asked a couple of times if there was anything to could be done to cool me down, to no particular reaction that I remember, although come to think of it maybe I just thought about asking, since it was worst during the contractions when I couldn't talk for fear of getting less gas. (Hubby tells me that no, as far as he heard, I never asked.)
At 9:15 (I HAD been told not to clock-watch, and in fact had completely failed to note the time on the clock when the midwife said the anaesthetist would be delayed, but obviously my body clock was a reasonable timekeeper) I asked Hubby if he remembered when the anaesthetist was due. He told me that he thought, at this stage, that he gets here when he gets here, which I correctly took as 'he's already late, please don't notice that'. It's sometimes not so comforting knowing someone well enough to read the unspoken with such precision. :)
I think it was about then that I started choking in the middle of drawing in big gulps of gas. It took me until significantly later to work out that this was my body seizing up for me to push rather than any particular difficulty with my oxygen intake. Other women have talked to me about the unbelievable and irresistible urge to push that they got - I never experienced that at any stage. In any case, it turns out you can't breathe in and push at the same time, which wasn't quite so distressing once I worked out what was going on half an hour later, but makes it lucky that gas works on a bit of a delay. My main concern at the time was that it these hitches were limiting the amount of gas I could inhale, which was not okay with me. I asked the midwife if I was getting less oxygen when using the gas exclusively, trying to work out what was going on, and she didn't seem to understand that I was merely asking for technical information, and didn't really answer the question. I took that as a 'no', since surely she would know that was an issue and be prepared to explain I should alternate breaths or something if it was in fact the case.
The midwife kept asking me, while this choking was going on, to let her know if I felt pushy. After a while, more caving under social pressure and the lack of any knowledge what 'pushy' really felt like than anything else, I told her I felt like I could push, and she said to go with it, let my body take over. Which was fine, and all, except then she kept coaching me to push, come on, a big one now, we're seeing lots of movement (she said this a lot, and I didn't really understand what it meant until later), we're going to see baby's head soon, keep-going-keep-it-going-keep-going... and I followed medical advice. You see, this is why I always hated sport, because when an authority figure tells me to put more effort into it, I do (unless, as I began to do very early in PhysEd classes in self defence, I enter completely disengaged and determined to do absolutely as little as I can get away with), and I end up completely exhausted and go home with a two-day migraine. I learned to pace myself more effectively and resist the urge to over-comply when I was getting into Taekwondo, which was the only reason I could physically continue with it let alone enjoy it, but I completely forgot learning those lessons here. And so, when she said push, I pushed with all my might. When she said push harder, I dug deeper and pushed more. And when she said to push harder again, I dug up reserves of strength I didn't know I had to push even harder, since she seemed to expect it. After all, I remember thinking when I was trying to find some extra bit of strength to keep up with the coaching, it’s *labour*. I knew it was going to be excruciatingly hard work. I think I'm actually very lucky I didn't completely exhaust myself at this stage.
After a great deal of coaching and pushing and comments about how much movement the midwife was seeing, she triumphantly announced that she could see the baby's head! I felt pretty triumphant, too, and took the chance between contractions to sweatily lie back on the bed and exchange grins with Hubby. It *really* felt like an acheivement!
For about ten seconds, until there was a knock on the door, and a voice said, 'Did someone call for an epidural?' Yay! thought I, he actually made it! I'd given up hope! Until I realised that the midwife was rushing at the door, making frantic 'shush!' motions and telling him 'I'm so sorry! We've just this minute seen the head!'
If I could have undone the last minute's work and sucked that child back into my body, I would.
'Come in!' I yelled at the door, before the blessed man could go away, and he did indeed come in, most apologetically, and told me that it would take fifteen minutes to set up and then another twenty minutes to work, and by then...
At that point, I had another contraction and went back to focussing on sucking in as much gas as I possibly could. By the time it was over, he'd apologised his way out of the room. Coward. :P In actual fact, even at the time, I wasn't really upset with the anaesthetist, more with myself for not keeping a closer eye on the contraction times back at the beginning - and even more with the midwife, because... she'd been telling me to push and push and I'd been putting WAY more effort into it than I really felt like. And then it sounded like if I'd worked just *slightly* less hard to do precisely what she said, and she hadn't seen the head until the *next* contraction, the anaesthetist might have made it in under the bar. I have to admit it cut my motivation to follow instructions.
'I'm so sorry about that,' the midwife told us in the next break, 'I must admit, I thought it was the doctor.' Unspoken (and I expect she thought I wouldn't notice) was 'at last'. She must have been a little bit frazzled. Until then, I had been thinking to myself that surely the doctor should arrive soon. I'd been picking up the subtext of her subtle but non-threatening commentary as she bustled around preparing for 'if the baby came' (If. I mean really.), but since I'd seen the doctor just half an hour previously, I was assuming that he wasn't far away and would turn up just in time for the critical moment, as I'd been told obstetricians tended to do. Hubby mentioned afterwards that he thought she was pretty surprised and a little alarmed at how fast everything was happening (and obviously, as a side note, how effective my pushing was). I hadn't realised until then that she was seriously worried that the doctor might not make it back in time for the birth.
In actual fact, it was only a few minutes later that the obstetrician arrived. In the meantime, the midwife told me, it was time to start pushing.
START?!
Pushing is... not fun. She explained I was supposed to try for three big pushes with each contraction, but it was a bit confusing because they kept telling me to keep pushing on and on and on and... well, at some point I had to stop and breathe, and really, if I pushed for as long as they wanted me to (or until I got dizzy from lack of oxygen (and gas!)) then I only had time for two pushes before the contraction died away. Oddly enough, I kept wanting to throw my head back to push, and I kept getting told to put my chin to my chest. Afterwards, I remembered reading that throwing your head back is in fact a way of restraining yourself from pushing if you have to while they make a cut or unloop a cord from the baby's neck.
The midwife explained to me that some people took away the gas completely in the pushing phase, so that the mother could concentrate properly to push, but that she was okay with me using it as long as I toned it down a little. Which was annoying, because when I had asked her five minutes earlier if that thing (with a gesture towards the gas machine) was all the way up, she'd told me 'nearly', with obviously no intention of turning it up further, and after a moment's consideration I'd decided not to press the matter because it might be nice to have another level in reserve for when things got *really* bad. Somewhat worse, when the obstetrician arrived, he told me it was time to stop using the gas completely.
That was something up with which I was not going to put. They'd refused to give me an epidural, I begged him, please don't take my gas away. I was clearly going to completely lose it emotionally if he pushed the point. He exchanged a bit of a look with the midwife, and it was agreed that I could keep the gas as long as I could remain focussed. Victory! From then on, every puff of gas was extra sweet. :) I ramped the usage back to two huge breaths of gas when I felt the contraction starting, then occasionally stealing an extra puff in between pushes, and having another breath when the contraction was easing. The stolen breaths in the middle felt extra risky, but seriously getting to my next breath of gas was occasionally the only thing getting me through the next thirty seconds, so I felt like it was worth it. At this point, the Magic Button on TENS had become just too complicated to manage as well as the rest, so I left it in Awesome mode constantly.
For most of the time after I arrived in the birthing suite and the first part of the pushing, during contractions I stayed lying back and either grasped the top of the bed with both hands, or with one hand and gripped Hubby's hand with the other. Not long after the obstetrician arrived he asked me to start looping my elbows around underneath my knees when a contraction came to push. This actually seemed to help a great deal, not least because for the first time I could actually see between my legs as I was pushing. My first sight down there was somewhat alarming; I had kind of expected my vulva to open out to the sides and the baby's head to emerge at the point flush with where my genitals are usually. Instead, the entire region was bulging out in a perfect half sphere of my skin with only a thin sliver of the baby's head visible at the apex. I'm not sure whether my jaw dropped, or whether my entire external focus was on keeping on breathing that gas before I had to give it up to push, but internally my reaction was a serious Woah! That, then, was what the midwife had been meaning about seeing 'lots of movement'. If I'd understood it was the baby's head moving past the point where my body usually stops, I might have been more impressed about the progress I was making.
So yeah, that was weird, but the very oddness made me glad to be in the elbows-under-knees position so that I could see what was happening. Every time I pushed the whole area would bulge further out, revealing a bit more head, and back in again. It was like three steps forward, two steps back, but it was definitely progressing. Which also helped keep my chin on my chest to watch progress. As a side note, the next couple of days the muscles of my arms were incredibly sore, even with the strong painkillers they had me on, which I expect was a result of this position.
Hubby was totally horrified when I, after one contraction and before flopping back onto the bed to recouperate my strength, reached down and gave the top of the baby's head a bit of a stroke. He was moist and sticky, but I could feel hair and the semi-squishiness of his scalp. I'd resisted the urge for a couple of contractions while the visible portion of head grew larger and larger, because I didn't want to touch my own tight-stretched skin in case I hurt myself. That evening, when Hubby and I were talking over the whole process, he was still horrified. Do you remember doing that? he asked me, incredulous, and obviously thinking I had been completely drugged out to have crossed the police line and interfered in something that should have been the obstetrician's territory at that point. But it did help me feel like we were really getting somewhere; that the baby really was coming and soon I'd be able to cuddle the rest of him.
A bit later, I remember saying, in response to the midwife's question of almost an hour previously to let her know if I felt the pressure moving into my bottom (which is meant to happen before it’s time to push), saying 'oh, yeah, I can definitely feel that pressure in my bottom now' at which point given even I could see almost half the baby's head, I suspect she was thinking 'no shit, sherlock'.
Speaking of which, I also remember after one contraction, the midwife folding up one of the sterile mats and taking it away, and thinking 'ah, my bowels have just emptied'. We'd been told they were likely to just before the baby came, because the contents are between the baby and the exit and essentially get squeezed out like toothpaste. We were told we weren't likely to care at the time or possibly not even know, because the midwife would just clean it up without saying anything. I was more amused that I had noticed the moment than embarassed, but then I didn't expect to care beforehand; it was simply a part of the entire undignified procedure that they were used to dealing with, and with that kind of thing you can make a choice beforehand to just go with whatever because it's not embarassing, it's what happens.
I had heard from a number of sources that going slowly through crowning (where the largest point of the baby's head passes the ultra-sensitive tissue at the mouth of the vagina and perineum - also known as the 'ring of fire') was the way to minimise tearing. Since I didn't have an irresistable urge to push, and I wasn't feeling too compliant with the stupid midwife and her stupid telling me to push that had cost me an epidural, and also it stung like crazy hell which made it really hard to overrule the pain-flinch reaction and actually push INTO, I deliberately paced myself even more with this section of pushing. But I also worried that if I didn't show that I was focussing, they'd take my gas away, so I had to at least seem like I was making an extreme effort. Given the worst of it only lasted for about four contractions, and the obstetrician only told me they'd have the baby the next contraction twice, I suspect it just pulled me back from over-compliant-over-acheiver to slow-and-steady.
I have no idea whether going slower or faster would have minimised the tearing I did indeed end up with; it's possible that once I started tearing, the best way out was to get through it as quickly as possible. It's also possible the whole slow/fast thing is bunk, just like upright vs on your back, since I've only ever seen it on the rubbishy 'birthing is a natural process not a potentially fatal medical emergency' sites that seem to overpopulate the internet. Complications of pregnancy and childbirth are STILL the leading cause of death in young women in developing countries - in Africa, it's the cause of death of one in 26 of women of all ages. Not to mention the vastly greater risk to the infant even than the mother. Thank goodness I have access to highly trained medical professionals and the full resources of a hospital, should I require them.
In any case, I didn't actually believe the obstetrician either time he told me the next time they'd have the baby. But halfway through the last contraction when the coaching really ramped up to keep on pushing and the stinging pain was at its worst, I remember thinking bugger it, there's only one way to get this baby out, closing my eyes and going for it with every ounce of strength I had. I still didn't believe that it would be over so instantaneously; the stinging eased and I opened my eyes to see the baby flowing out from between my legs and it felt like from that point on the obstetrician essentially pulled (although whatever they tell you about everything after the head being trivial, the shoulders coming through was DEFINITELY painful, particularly because they were pulled (or at least felt like they were pulled) out past very sore tissue when I wasn't expecting it). I watched in amazement as out he came all at once and they lifted him up onto my chest.
I pulled up my hospital gown as they were lifting him so he could have some skin-to-skin time (that's very big at the moment - both for maternal bonding and apparently it also helps the baby to breathe better in the beginning), and the midwife put a hat on him and smothered him in blankets, because apparently they can lose heat very quickly at the beginning, all wet and not used to maintaining their own body temperature. He made little grunting sounds of effort with every breath out, and because he's so small his breathing rate is closer to once per second, so he sat there going 'uh, uh, uh'. (The midwife later described him as being 'grunty' which means that while he was breathing normally it wasn't entirely freely - I had thought it would be the in breath that would be difficult and require effort and thus would be gaspy rather than the out breath, but maybe that's just where he expressed the difficulty - or maybe gasping would indicate a more serious breathing problem.)
He was much more quiet than I was expecting; I thought he'd be traumatised and freaked out by the entire process and protesting at the top of his lungs, but he didn't cry at all, just looked around with big wide eyes as I held him against my skin and Hubby and I both played with his little hands and stroked his little face.
I'm glad I'd seen photos of very newborns before, as the first time I saw one a few months ago, I was somewhat revolted by the vernix (the white pasty protection for their skin so they don't go all wrinkly in the long-term bath of amniotic fluid). But as I was expecting the baby to be all white and pasty, I wasn't surprised by it, just delighted by him and completely and utterly chilled out by reaching the end of second stage labour (third stage is the placenta). I was also still absolutely boiling hot, particularly given the number of blankets they'd piled on top of him on my chest.
I didn't feel a sudden rush of love or protectiveness or other motherly hormones, which is not to say I wasn't besotted with him, but I'd already felt so close to him while he was in the womb that it wasn't really different to have him out and in front of me, just kind of the next stage. The midwife asked what his name was, and we realised we hadn't actually decided yet. We'd had two names left on the list - we liked them both, possibly William slightly more, but William had also been the most popular name in Qld last year, so we didn't feel awesome about that. We also wanted to leave open the possibility that we might look at him and go... OMG we HAVE to call him Zebulon. But we looked at each other and essentially went: William? William. So William it was.
Then I remembered the camera, and asked Hubby to take some video, then see about some stills. I'd hoped to have some record of labour, even if only for my own records since I expected my memories of labour would get smudgy and blurred, but it all happened so fast that I didn't have the presence of mind to remind Hubby and we didn't get anything past a shot of me flaked out on gas between contractions in the birthing suite before I'd moved to the bed. People had told me I'd find afterwards that I wouldn't want to look at video of the labour - it would be something I wanted to forget ASAP - I would like to categorically deny this. I would love to be able to see some video of what it was actually like outside my head. My memories are as smudgy and sporadic as I expected, perhaps more so, and one of the pivotal reasons that I decided to try for a vaginal birth rather than an elective ceaser was that it was a life experience that I wanted to have. Not necessarily a pleasant one, but what is life if not collecting experiences? In any case, we have plenty of video and stills from then on, which is awesome, even if some of it is a little indecorous of both me and little William. :P
We also have video of me cutting the cord, since that wasn't something Hubby was keen to do. It was quite odd to do this while it was still attached to the placenta which was still inside me. It was at this point that I suddenly remembering that we hadn't remembered to remind them that we wanted to donate the cord blood. The midwife called the collection staff immediately - apparently it needs to be collected within 10-15 minutes of birth or it will be clotted and unusable. It turned out it didn't really matter either way; 15 minutes passed and the collection staff hadn't turned up but I hadn't delivered the placenta at that point anyway, so there wouldn't have been able to collect it in any case.
In the meantime, of course, the obstetrician had been sewing me back up. I didn't notice at the time (possibly it all took place underneath William, so was out of my view, or possibly I was just focussed on other things), but apparently he came out accompanied by what appeared to Hubby to be a significant gush of blood. Apparrently it was by far the bloodiest thing he's ever seen in real life (outside first person shooters and violent movies) with pools of it underneath me. They think I lost about 500ml at this point - which just goes to show how far a moderate amount of blood will go - not much different to a visit to the blood bank, so there was no need for transfusion or even a drip. The obstetrician was still sewing ten minutes later when I asked him how bad the tearing was; second degree, so hurrah for not being third degree (which would be right into the anus), at least, but apparently the edges of the tear were extremely ragged, which was making things very difficult. When he was still sewing another twenty minutes after that, he told me it probably would have been better to cut. Oh well. I guess they can't really tell until after it's all over, and even then it's guessing as to whether I might not have torn even further if they'd cut.
After a while, I remembered to try to feed William, but despite my best ABA-trained attempts to latch him on, he showed no interest whatsoever, so we decided to just go back to cuddling for the moment and try again later. After about half an hour, after checking that he wasn't feeding, the midwife took him to the other side of the room to be weighed and have his Vitamin K and Hep B shots. He was 3.406kg (7lb 8oz) which is spot on average. His head circumference and length were both also spot on average, and his apgar at 1 and 5 minutes was 9, which is the best a newborn can realistically achieve. We actually did hear him cry when he got stuck with his needles, but he calmed down again very quickly even before they put him back on my chest. :)
After we'd had about an hour with William it became clear that not only had the placenta not arrived in the usual amount of time, it was quite determined not to come loose, and I was likely to have to go to theatre to get it removed. I was still having the occasional contraction, the obstetrician was occasionally pushing on my stomach (which REALLY hurt - fortunately I still had my trusty gas tube!) and pulling on the cord in attempts to dislodge it while I tried to push, but to no avail. It was stuck fast. I kept delivering what felt like it would have to be a placenta – seemingly huge blobs of blubbery wobbly stuff - but I was told were just large blood clots. Oddly enough, the placenta made a totally visible lump in my tummy (which wasn't completely pre-pregnancy size, but much closer than I'd expected!), a surprisingly large hard lump off to the right. I kept asking for water or ice or something, but they wouldn't let me have anything in case I had to go to theatre, in which case I should have been fasting - the best they could do was let me rinse my mouth and spit. Yay for realising that I'd gone to aqua-aerobics the night before (which is ironically very dehydrating) then essentially been so distracted by going into labour that I hadn't drunk anything from then on. They let it go for an hour and a half, keeping on trying to get it out, until the placenta started breaking up under the pulling and pushing, then I had to go or risk a dangerous haemorrage.
The midwife inserted a catheter, which was not particularly yay, and told us that Hubby wouldn't be able to come into theatre with me (if I'd still been delivering the baby, he would have, but as it was just a medical procedure, he couldn't). That fitted with our plans in any case; if I or the baby had needed any special attention that required we be separated, we had planned that Hubby was to stay with the baby at all times. The anaesthetist came back and mentioned that we'd met before - I told him that I think I hadn't been very happy with him at that point – asked if I was allergic to anything and about my medical history, then explained they were going to do a spinal block, which is essentially an epidural without leaving the drip in the spine for topping up with more drugs as necessary, but that they might need to give me a general anaesthetic if that didn't work, and that one percent of people had severe headaches and if I needed a GA there were all sorts of potential complications. And the obstetrician came along with a form for me to sign saying that I understood the risks of going into theatre; that I might lose blood and need a transfusion, that I might get a subsequent infection, and if I was haemorraging unstoppably, an emergency hysterectomy to save my life. But, the obstetrician told us dryly, that's not the plan. Oh, good, I said, as I signed on the dotted line.
So, I got my epidural after all. Sigh.
While this was going on, I'd managed to get William feeding without help from the midwife, which was awesome. Unfortunately, I had to detatch him to go to theatre, but he'd been feeding for about half an hour at that point, so I didn't feel too bad about that. The midwife took him over to Hubby and asked him to lay him on his bare chest, so William could get some more skin-to-skin time to remind him to breathe properly, as he was still a bit grunty. Hubby opened his button-up shirt, which he'd specifically worn for this occasion so if the baby needed skin-to-skin it would be easy. The midwife didn't seem impressed, so Hubby complied with the implicit cue and took off his shirt completely, which she then rushed to tell him wasn't right, as she laid William on his chest so he couldn't put it back on again. All in all, I feel that her communication skills were distinctly ordinary. :)
I felt totally floaty and chilled out as they wheeled me out of the room and over to the theatre. Just before I got wheeled in, a nurse came to me holding the clipboard holding the same form I'd just signed, asked me to tell her my name and date of birth, what I was there for. I duly recited what the anaesthetist and obstetrician had told me in my own words, up until we got to the risks, at which point I decided to summarise as 'the usual risks associated with any surgical procedure', which was apparently fine.
We got into theatre and the anaesthetist inserted a cannula into my arm and attached me to a drip. Unlike the delivery room, which only had me, Hubby, the obstetrician and one midwife, the theatre was packed. There was me, the obstetrician, the anaesthetist, and at least four nurses/other assorted staff who were there the whole time, plus several extras who breezed in and out. The anaesthetist told me to roll onto my side and curl up in a ball as much as I possibly could - obviously he's used to dealing with pregnant women who have, you know, a kind of big bulge in the way, because I was only half as curled as I could have been when he went 'woah, that's heaps!' The needle was relatively painless (although admittedly at that point my relativity may have been a little out of whack), and when it was done I rolled back onto my back.
After a few minutes, the anaesthetist came back with an ice cube, which he ran on my arm saying 'This is just an ice cube, you can feel it’s cold.’ I nodded agreement. And damn, but that little bit of coldness was wonderful. ‘Can you feel that coldness when I rub it on your leg?' I couldn't. Just a bit of pressure, which I told him. 'That's fine. Now, tell me when you start to feel the coldness...' and he ran the cube up to about my upper thigh before I felt it. So they waited a few more minutes, and he tried it again - this time the ice cube got all the way to my waist, so he tried it on the other side and it got to my hip. This, he told me, was because I'd been lying on the side while he'd given me the injection, so one side was more affected than the other, which I thought was cool. I thought they'd wait again until it got up past the top of where my uterus had been with baby inside, but that was apparently enough - I certainly didn't feel any pain during the procedure, so obviously they knew what they were doing.
At that point, everything proceeded. They put up a curtain (which was in fact a blanket attached to two IV poles that kept rolling towards the bed and dropping the curtain, and making the nurse dive to pull them out again which gave the whole thing just a tiny bit of a keystone cops feel :P). The nurses piled layer after layer of blankets on me and only desisted in adding more after my most stringent protests about how hot I was. She realised I was having trouble working out what to do with the arm that didn't have the drip - I couldn't put it by my side without going under the curtain, and even crossing it over my chest meant my elbow brushed the curtain, which I didn't feel comfortable with, and it wasn't really comfortable to let it drop down to to the side of the bed. The arm with the drip in it was carefully laid out on a cushioned armrest out to the side, so she extended the armrest to the other side as well, and I lay there like an extremely chilled-out (if somewhat overheated) starfish as they lifted my feet into stirrups and the obstetrician began the process of manual removal. (I didn't choose to enquire closely, but I believe that would be 'manual' as in hand.) By the amount of pressure I felt in previously sensitive places, I was very glad to be numb. It was totally bizarre because I was all numb and tingly, and could feel the pressure and movement, but in combination with the extreme floaty calm it was like I had no voluntary muscle control in my entire body and that was totally fine with me.
I never felt worried or anything other accepting and trusting that I would be looked after (yay for hospitals) and this awesome floaty calm (yay for endorphins). The anaesthetist and one of the nurses stayed by my head (well, wandered about, really, but there was usually at least one of them there casually conversing with me and the obstetrician.
I asked if they could save the placenta so that Hubby and I could have a look at it. (The whole concept of a single-use disposable organ is intriguing to me.) The anaesthetist asked me if I was on Sandomigrin for my migraines, which I’d told him about when he’d asked me about my medical history. I had been on Sandomigrin until I came off to get pregnant and had read on the packet it wouldn't be safe for breastfeeding either, but both the anaesthetist and the obstetrician agreed that it should be totally safe for breastfeeding. Yay. My stomach grumbled, which made them laugh, and I grumbled that the main thing was how thirsty I was - they told me I was totally okay to eat and drink as soon as I was out of theatre. We also established that I was totally entitled to drink a very large glass of red wine that night; it wasn't like anything much in the way of alcohol would come through to little William in the colostrum (the initial milk which is only produced in teaspoonfuls rather than cupfuls). Towards the end of the procedure, the anaesthetist told me that he'd checked my file to see whether I was a doctor because of the interested/informed way I'd been talking about proceedings. I explained that I was a person who dealt with stress by research. :)
Despite them telling Hubby it would be half an hour to 45 minutes, the entire procedure took about an hour, which given the risks they'd talked about, had Hubby... a little concerned, but not freaking out too much. Apparently it had just been a lot more work repairing the stitches again afterwards than the obstetrician had anticipating. Or maybe (given the estimate of how long it would take the anaesthetist to get me my epidural was out by a similar amount) they simply haven't realised that theatre takes an hour rather than 30-45 minutes.
I'll mention here, rather than later, as this seems to be more the place for icky details than anywhere else, that my recovery was somewhat extended by the fact that some of my stitches from the tearing interfered with some of the haemorrhoids the size of school busses which were a consequence of bearing down during labour. This meant, with stitches on top of haemorrhoids the undisputed furthest out point of my lower regions for the next week and a half, they would brush against anything; undies, clothes, and even ice packs to aggravate and inflame the area further. Thus the severe burning ache and swollen feeling that there was a thick-cut porterhouse steak strapped between my legs which was the most prominent unpleasantness for the first few days was gradually overtaken by the acute stabs of white-hot pain, not unlike being stung by a series of wasps, whenever my position moved even slightly to make something shift against the stitches, just as they were wanting me to be stepping down off the strong painkillers. In any case, the first week was hell - I just about burst into tears when it was time to go home from hospital so they let me stay another night and totally drugged me up so I'd forget how bad it was and go home the next day. A week and a half later I started being able to sit for short periods with a rolled up towel underneath each leg and be able to bear picking something up off the floor. Today I can sit reasonably comfortably for extended periods on a couple of rolled up towels, and while I still wouldn't pick something up off the floor by choice, would consider it a viable option if I needed the item in question.
They brought me into recovery, shifted me into a proper bed, and refused to give me my requested water even though the OB had said it would be okay. :| Eventually, Hubby and William arrived, and I got him feeding again, much more easily this time, and by about 1:30 we'd been moved up to our lovely top floor private hospital room with a gorgeous view out over the Brisbane suburbs. (Hurrah for private health insurance.) I started ringing people to let them know about little William. Hubby had rung his dad (also both of our employer) at about 8:30 to let him know he wouldn't be coming into work that morning because we'd just arrived at the hospital. Obviously the grandad-to-be hadn't been able to contain his excitement, because pretty much everyone we rang on Hubby's side of the family knew that I'd only arrived in hospital that morning and was flabbergasted that it was I was all finished and well enough to call them in the early afternoon.
We had just the immediate family as visitors that evening, who cooed and fussed over William and brought a lovely bottle of red for me, which was MAGNIFICENT after a nine month fast. And really, that was about it for the birth. It was awful, but it was a life experience, and to be honest... was not nearly as bad as I had psyched myself up for it to be. I think that's one of the reasons the contractions got so bad before we left for hospital - I could still bear them, so I thought I had to have a huge way to go. I still see no reason to go without an epidural - why suffer pain when you don't have to? But I had to, so I did, and I came out the other side with little William.
And that made it all totally worth it. :)
In summary: I had two extremely unpleasant days of prelabour, then my waters broke at quarter to three in the morning. I should have gone straight to hospital, but anecdotal evidence suggests that people usually go to hospital too early rather than too late, and they told us in antenatal classes to stay home and get what sleep we could for as long as we could, because chances are we would be in for the long haul. So I thought I might as well stay home while I could bear it and let Hubby get some sleep so that he'd have the energy to take the baby and let me sleep that night. Contractions ramped up very quickly in the morning to be 2 mins apart and me throwing up when we decided to leave for hospital. We arrived at the hospital around quarter to eight, and William was born just over two hours later after three quarters of an hour of pushing and bad second degree tearing. The anaesthetist didn't make it in time to give me my planned-from-the-very-first-time-I-knew-what-one-was epidural. Unfortunately, it wasn't over, as an hour and a half later I still hadn't delivered the placenta. So I got the epidural after all and Hubby got to have some one-on-one bonding time with William while I spent an hour in theatre having the placenta manually removed and getting all my stitches redone.
Nonetheless, we have a beautiful healthy boy who passed all his first set of exams with top marks on the ones he was supposed to excel and precisely average ones on the ones he was supposed to be average, almost two weeks later and I can FINALLY start sitting down for extended periods with a couple of rolled up towels under my legs, and I have a new rule for going into labour: get me to hospital RIGHT NOW!
Selected picspam to follow.
So it all started on Sunday night, Oct 31st. I had my 'bloody show', which is a clump of mucous which has served as the 'plug' at the cervix throughout pregnancy, streaked with blood from the beginning of the cervix dilating. According to my reading, a bloody show means it's bloody show time, and labour is likely to start within 24-48 hours.
I was getting cramps on and off, but nothing really regular - I'd get four within fifteen minutes, then nothing for an hour, then nothing for another two hours, then another three cramps, etc. I also had diarrhoea, which is another sign of impending labour as the digestive tract clears the way to the exit. Not to mention that my bladder seemed to have compressed from the size of a walnut to the size of a twenty-cent piece - and every bit as flat. Honestly, I was lucky to get more than ten drips out of it every time I needed to go - and I was lucky to make it through washing my hands before needing to go again. Not to mention that every time I moved, stood up or sat down, I'd get these awful pains which unfortunately didn't really count as contractions, since they were stimulated by movement.
Except... nothing happened. On Monday, I was hopeful. Hubby and I went for a walk before he went to work to see whether we should plan anything for the day or whether me getting up and moving around would simply mean he had to come straight back from work again to take me to hospital. On Tuesday, after two days of crampy, toilet-tethered, painful nothing much, I was getting depressed. I'm not generally a teary person, but I almost burst into tears a couple of times, not so much from the severity of the pain but just at the thought that there didn't seem to be any end in sight. Was it really possible that I could be in pre-labour for the rest of my life? I was googling like a woman possessed, trying to find statistics that might give me some kind of idea of how long I could expect it to go on.
One bit of anecdotal evidence that kept coming up was that long pre-labour often led to short actual labour, because your body’s doing all the hard work before you actually go into labour, which was at least one bit of good news. Up until Sunday, I'd been perfectly happy to go on being pregnant as long as necessary. There were, of course, various discomforts, but to be honest I wasn't really completely ready (the cot STILL hadn't arrived) and I was happy to wait. By Tuesday, I was willing to do anything - even give birth - to get it all over with, cot or no cot!
Tuesday afternoon was my aqua-aerobics class, the movement of which is well known as an inducer of labour, so after a call to the obstetrician to check that it was safe to go in the water after having lost my mucous plug (which helps seal the cervix and keep out infection) I headed off to that. It wasn't the most fun session I've been through, given the pain I was experiencing with movement, and I got a couple of severe abdominal cramps, but it didn't slow me down in the least. This was at least pain that might cause something to happen. Then I went home and made curry for dinner. :)
Wednesday morning at 2:45am, I got up to go to the toilet. For approximately the twentieth time that night. While I was sitting there waiting for my kidneys to manufacture another few drips to avoid going through the whole procedure ten times more before ten to three, I felt something rupture. It was like a water balloon breaking, completely painless, and out came a gush of fluid. The volume was not a ridiculous amount for a bladder to contain, but it certainly wouldn't have been my bladder that could have contained it at that time. Anyway, I called out to Hubby, told him that I was pretty sure my waters had just broken, asked him to get me a pad, and... well, decided to try and get some more sleep. I got an hour or so more sleep, then realised that I was having more serious contractions, that this was definitely underway, and it was time to apply my TENS machine.
TENS is a favourite of natural childbirth proponents (of which I am not one - I'm just in favour of anything which helps relieve pain) which works by attaching four electrodes to one's back and sending electrical pulses. The buzzing sensation of mild electrocution is carried along the same nerves as the pain and thus completes for both room on the nerve pathways and attention from the brain. It's got a standby mode which sends mild pulses every few seconds and a Magic Button which puts it into Awesome mode, which sends stronger pulses continuously during a contraction. In any case, even for people like me who are all in favour of drugs and lots of them, a TENS machine is portable, safe, and available for hire to keep at home to assist with early labour, before it's appropriate to go to hospital and receive said drugs. Apparently there's also an extra endorphin rush associated with having it on for two hours continuously, so you're meant to put it on as soon as you think you're going into labour, even if the pain isn't too bad yet, to make sure you get them.
Hubby helped apply the TENS (big electrode gel pads are difficult to apply to one's own back) and promptly went back to sleep. I tried for a bit more sleep as well, aided by the soothing sounds of Hubby's snoring and a Terry Pratchett audio book, but didn't manage much more than drowsing - contractions were definitely not fun, and were starting to be something I didn't want to be lying down for. The best thing seemed to be to sit on an exercise ball and circle my hips throughout the contraction, then I'd empty my increasingly small bladder AGAIN and go back and lay down and drowse for another five to fifteen minutes until I felt another contraction beginning, whereupon I had to leap out of bed and get back on the ball or regret it when the pain came to a peak.
There was some concern I might have irregular contractions all the way to the end - the doctor missed the birth of ALL FIVE of my mum's children because no one would believe she was actually in labour until they could see the head. At least one of my sisters had similar problems (although she managed to convince them she was really in labour about ten minutes before it was time to start pushing). My contractions were fairly irregular through the night, but seldom closer than four or five minutes and averaged more like ten, and still reasonably bearable, so I felt all right letting Hubby get some more sleep so that at least one of us could be well-rested to take care of the baby while I caught up on sleep after the birth. :)
At 6am, just as I was finishing up with a contraction, I realised I needed to throw up. I dashed for the toilet, and realised upon reaching it that I was going to go at both ends. Fortunately the nappy bucket was right there next to the toilet (what foresight!) and so a nasty mess was neatly avoided. That woke Hubby up, to. 'Looks like you're clearing house,' was his comment. A little while later, after asking Hubby to gather a few things that had made their way out of the hospital bag and pack stuff into the car, I realised that the contractions had been mostly sub-five-minutes for a little while now. I'd been timing them on an awesome little baby gadget called an ItzBeen, which I'll talk about another time, which was excellent for keeping track of roughly how far apart each contraction was, but only counted minutes rather than seconds. So I thought I'd get Hubby to officially time the duration and separation of five contractions, and we'd ring the hospital to see if we should come in now.
The first three contractions were all around a minute long and three to three and a half minutes apart. (A minute long and five minutes apart is the general rule for come-to-hospital.) The last two were under two minutes. We timed another couple to be sure. Under two minutes. Ack. Hubby rang the hospital. They didn't even *ask* how far apart the contractions were, because I hadn't realised I was supposed to notice if the baby had moved since my waters broke, and couldn't say that he had. So they said come in straight away to be safe.
In the meantime, I was throwing up again, with a feeling of dread in my stomach: my sister had told me that when she started throwing up from the pain in labour, the midwife told her that meant she was in transitional labour, which meant it would be time to start pushing very soon. But surely that couldn't be the case - transitional labour's meant to be the worst pain of the lot, and surely that would hurt more than this? I mean, I'm not saying it wasn't really really bad - it most certainly was! - probably the worst pain I've ever felt apart from when I'd got severe burns to my hand, but... well, I'd psyched myself up for it to be truly unbearable, and it wasn't.
We threw the last couple of things in the car, completely forgetting a few essentials like my mobile phone and wallet - fortunately my bag has been packed with the real essentials for months - and made our way to the hospital. Contractions stayed at two minutes apart, one minute long (which essentially means a minute on, a minute off), all the way there, but fortunately I didn't need to throw up again. I'm not sure whether they got much worse on the way, or whether it was just that I was strapped into a single location and couldn't move or use my fit ball, but while I had hoped to wait until 5cm dilation for an epidural (which minimises the chances of side effects), I was happy to go ahead if I wanted one earlier. We fortunately just beat the peak hour traffic, which was awesome, and arrived at the hospital around 7:45. We turned up at reception and I asked 'which way to the epidural?' They pointed me to the pregnancy assessment unit, which was just around the corner, where I gratefully used the toilet (40 mins driving was a VERY long time to hold anything in at that point). We got sent into a little assessment room there, waited around a few minutes for a midwife to be available, and then went through the checklist with her.
First of all, I asked, I know I want an epidural. Can you call the anaesthetist now?
Okay, she said, we need to assess you first. No worries, said I, then is there anything you can give me for the pain right now? Gas is, apparently, fine even before she'd assessed me. So gas it was.
Gas is... well, it's a blessing and a curse. It apparently builds up over around 20 seconds, so the idea is to start sucking on it as soon as a contraction starts, it should kick in after about 20 seconds and cover you over the peak. You stop sucking on the gas after the pain has peaked, and by the time it runs out the pain should have mostly faded. They told me it'd make me feel slightly drunk, but I only really noticed that after the contraction, rather than during, when I'd lie my head down on the bed (I was sitting in a chair beside the bed and leaning forward with my elbows folded on the bed) and answer the midwife's questions in quiet, breathy, exhausted sighs. It definitely helps with pain, which gives it a lead right out of the starting gate, but on the down side, it occupied my hands which meant that it was harder to keep track of both it and the Magic Button of the TENS machine. And it made everything more complicated: when the contraction started, I needed to start sucking on the gas and click the Magic Button at the same time, then when it peaked stop sucking, and when it stopped click the Magic Button again. Which meant sometimes turning off the magic button got forgotten in the confusion, and when the next contraction started, I'd click the magic button and the TENS would turn off, which would make me panic, and I'd forget to suck on the gas while my pain-addled brain would try to work out what to do and the gas wouldn't be effective during the peak of the pain. Somewhat worse, it made me feel very much like I couldn't talk or moan or anything during contractions, because every sound I made was essentially gas I wasn't getting. And any gas I wasn't getting was a BAD THING. I wanted as much of that stuff as I could possibly get. Talking is not top of the priority list during a contraction, however sometimes there's some words that could be gasped that might be helpful in directing a hapless Hubby as to what it is my frantic hand gestures are asking for. But he soon worked out that the clicky thumb signal meant 'I've dropped my magic button where the FIRETRUCK is it?!' And we sorted out that it helped if he hugged me around the back and underneath my tummy. And I managed to rather emphatically nonverbally point out that although I had thought that more pressure rather than just faint contact would be good, when it came to the contraction it REALLY wasn't.
In any case, the assessment. I'd felt the baby move in the car in the way in, so that was good. The midwife watched a few contractions. She listened to the baby's heartbeat. She did an internal exam, which wasn't nearly as bad as I'd been led to believe it might be. Possibly it helped that I was already six centimetres dilated (out of ten), which had me over the moon. I had made it past 5cm before wanting an epidural! Epic win! At this point, I felt as though with the gas I could have waited for an epidural if I'd been *very* early on, but if I was three or more centimetres dilated, I was going to go full steam ahead.
After a lot of stuffing around and some paperwork, while Hubby shifted and a brief visit from the on-call obstetrician from my practice in which I reiterated my desire for an epidural, the midwife moved me on to a birth suite and helped me change into a hospital gown. When Hubby grabbed the suitcase, unfortunately he'd forgotten he'd unzipped it to get out my medical records for the midwife, and it fell open and spewed its contents everywhere. We left him behind to deal with it, moving at an extremely brisk walk; I was setting the pace and there was no gas en route. I had no desire to have a contraction before we got there.
There I passed into the care of a different midwife, who asked 'Now, I understand you were wanting an epidural, do you want me to go ahead and call for the anaesthetist?' I looked at her like she was crazy. Had the anaesthetist not been called by midwife or obstetrician the moment it was discovered I was far enough along in labour to allow it? Were these people actually that cruel?
In due course, Hubby arrived with the hastily repacked suitcase, and we went back to soldiering on through each damn contraction. At some point, the midwife wanted me on the bed while she listened to the baby's heart. I, just finishing a contraction, said 'did you want to do that now, then?' and she told me it would probably take several contractions - and then I never shifted back to the chair again. (The previous midwife, I realised afterwards in comparison, had knelt on the floor beside me and reached around to hold the microphone on my tummy to avoid disturbing the position that was working for me at the time.) I’m sure I could have shifted back again if I’d cared, but it didn’t occur to me.
In any case, at that point I ended up lying down, sucking on the gas, and waiting, while the midwife checked once more that I understood that an epidural would mean I was unable to walk or move around. Yes, I told her, I know what an epidural is. Get me one! (Do you see what I mean? Has this call seriously STILL not been made?) I had been worried about the couple of hours it might take take the anaesthetist to be called in to the hospital from wherever he was, until I realised it was actually almost working hours, and he'd likely be here by 9am if he wasn't at the hospital already anyway.
At about 8:30, she came back with the news. The anaesthetist was currently in surgery, and would be held up. For how long, I asked, dreading the answer. Probably around 45 minutes - but please don't clock-watch, because that's just an estimate. Okay, that's not too bad. I could do another 45 minutes of this - not that I really had a choice.
Things continued progressing. I kept having contractions. I asked a couple of times if the gas level could be increased, which it duly was. And the midwife was bustling around the room opening up the infant resuscitation shelf and setting up the scales, but repeatedly assuring me that she was just setting it up for 'if' the baby arrived.
IF?! Seriously?!
The room was boiling hot, at least as far as I was concerned, and I was totally dripping with sweat. I asked a couple of times if there was anything to could be done to cool me down, to no particular reaction that I remember, although come to think of it maybe I just thought about asking, since it was worst during the contractions when I couldn't talk for fear of getting less gas. (Hubby tells me that no, as far as he heard, I never asked.)
At 9:15 (I HAD been told not to clock-watch, and in fact had completely failed to note the time on the clock when the midwife said the anaesthetist would be delayed, but obviously my body clock was a reasonable timekeeper) I asked Hubby if he remembered when the anaesthetist was due. He told me that he thought, at this stage, that he gets here when he gets here, which I correctly took as 'he's already late, please don't notice that'. It's sometimes not so comforting knowing someone well enough to read the unspoken with such precision. :)
I think it was about then that I started choking in the middle of drawing in big gulps of gas. It took me until significantly later to work out that this was my body seizing up for me to push rather than any particular difficulty with my oxygen intake. Other women have talked to me about the unbelievable and irresistible urge to push that they got - I never experienced that at any stage. In any case, it turns out you can't breathe in and push at the same time, which wasn't quite so distressing once I worked out what was going on half an hour later, but makes it lucky that gas works on a bit of a delay. My main concern at the time was that it these hitches were limiting the amount of gas I could inhale, which was not okay with me. I asked the midwife if I was getting less oxygen when using the gas exclusively, trying to work out what was going on, and she didn't seem to understand that I was merely asking for technical information, and didn't really answer the question. I took that as a 'no', since surely she would know that was an issue and be prepared to explain I should alternate breaths or something if it was in fact the case.
The midwife kept asking me, while this choking was going on, to let her know if I felt pushy. After a while, more caving under social pressure and the lack of any knowledge what 'pushy' really felt like than anything else, I told her I felt like I could push, and she said to go with it, let my body take over. Which was fine, and all, except then she kept coaching me to push, come on, a big one now, we're seeing lots of movement (she said this a lot, and I didn't really understand what it meant until later), we're going to see baby's head soon, keep-going-keep-it-going-keep-going... and I followed medical advice. You see, this is why I always hated sport, because when an authority figure tells me to put more effort into it, I do (unless, as I began to do very early in PhysEd classes in self defence, I enter completely disengaged and determined to do absolutely as little as I can get away with), and I end up completely exhausted and go home with a two-day migraine. I learned to pace myself more effectively and resist the urge to over-comply when I was getting into Taekwondo, which was the only reason I could physically continue with it let alone enjoy it, but I completely forgot learning those lessons here. And so, when she said push, I pushed with all my might. When she said push harder, I dug deeper and pushed more. And when she said to push harder again, I dug up reserves of strength I didn't know I had to push even harder, since she seemed to expect it. After all, I remember thinking when I was trying to find some extra bit of strength to keep up with the coaching, it’s *labour*. I knew it was going to be excruciatingly hard work. I think I'm actually very lucky I didn't completely exhaust myself at this stage.
After a great deal of coaching and pushing and comments about how much movement the midwife was seeing, she triumphantly announced that she could see the baby's head! I felt pretty triumphant, too, and took the chance between contractions to sweatily lie back on the bed and exchange grins with Hubby. It *really* felt like an acheivement!
For about ten seconds, until there was a knock on the door, and a voice said, 'Did someone call for an epidural?' Yay! thought I, he actually made it! I'd given up hope! Until I realised that the midwife was rushing at the door, making frantic 'shush!' motions and telling him 'I'm so sorry! We've just this minute seen the head!'
If I could have undone the last minute's work and sucked that child back into my body, I would.
'Come in!' I yelled at the door, before the blessed man could go away, and he did indeed come in, most apologetically, and told me that it would take fifteen minutes to set up and then another twenty minutes to work, and by then...
At that point, I had another contraction and went back to focussing on sucking in as much gas as I possibly could. By the time it was over, he'd apologised his way out of the room. Coward. :P In actual fact, even at the time, I wasn't really upset with the anaesthetist, more with myself for not keeping a closer eye on the contraction times back at the beginning - and even more with the midwife, because... she'd been telling me to push and push and I'd been putting WAY more effort into it than I really felt like. And then it sounded like if I'd worked just *slightly* less hard to do precisely what she said, and she hadn't seen the head until the *next* contraction, the anaesthetist might have made it in under the bar. I have to admit it cut my motivation to follow instructions.
'I'm so sorry about that,' the midwife told us in the next break, 'I must admit, I thought it was the doctor.' Unspoken (and I expect she thought I wouldn't notice) was 'at last'. She must have been a little bit frazzled. Until then, I had been thinking to myself that surely the doctor should arrive soon. I'd been picking up the subtext of her subtle but non-threatening commentary as she bustled around preparing for 'if the baby came' (If. I mean really.), but since I'd seen the doctor just half an hour previously, I was assuming that he wasn't far away and would turn up just in time for the critical moment, as I'd been told obstetricians tended to do. Hubby mentioned afterwards that he thought she was pretty surprised and a little alarmed at how fast everything was happening (and obviously, as a side note, how effective my pushing was). I hadn't realised until then that she was seriously worried that the doctor might not make it back in time for the birth.
In actual fact, it was only a few minutes later that the obstetrician arrived. In the meantime, the midwife told me, it was time to start pushing.
START?!
Pushing is... not fun. She explained I was supposed to try for three big pushes with each contraction, but it was a bit confusing because they kept telling me to keep pushing on and on and on and... well, at some point I had to stop and breathe, and really, if I pushed for as long as they wanted me to (or until I got dizzy from lack of oxygen (and gas!)) then I only had time for two pushes before the contraction died away. Oddly enough, I kept wanting to throw my head back to push, and I kept getting told to put my chin to my chest. Afterwards, I remembered reading that throwing your head back is in fact a way of restraining yourself from pushing if you have to while they make a cut or unloop a cord from the baby's neck.
The midwife explained to me that some people took away the gas completely in the pushing phase, so that the mother could concentrate properly to push, but that she was okay with me using it as long as I toned it down a little. Which was annoying, because when I had asked her five minutes earlier if that thing (with a gesture towards the gas machine) was all the way up, she'd told me 'nearly', with obviously no intention of turning it up further, and after a moment's consideration I'd decided not to press the matter because it might be nice to have another level in reserve for when things got *really* bad. Somewhat worse, when the obstetrician arrived, he told me it was time to stop using the gas completely.
That was something up with which I was not going to put. They'd refused to give me an epidural, I begged him, please don't take my gas away. I was clearly going to completely lose it emotionally if he pushed the point. He exchanged a bit of a look with the midwife, and it was agreed that I could keep the gas as long as I could remain focussed. Victory! From then on, every puff of gas was extra sweet. :) I ramped the usage back to two huge breaths of gas when I felt the contraction starting, then occasionally stealing an extra puff in between pushes, and having another breath when the contraction was easing. The stolen breaths in the middle felt extra risky, but seriously getting to my next breath of gas was occasionally the only thing getting me through the next thirty seconds, so I felt like it was worth it. At this point, the Magic Button on TENS had become just too complicated to manage as well as the rest, so I left it in Awesome mode constantly.
For most of the time after I arrived in the birthing suite and the first part of the pushing, during contractions I stayed lying back and either grasped the top of the bed with both hands, or with one hand and gripped Hubby's hand with the other. Not long after the obstetrician arrived he asked me to start looping my elbows around underneath my knees when a contraction came to push. This actually seemed to help a great deal, not least because for the first time I could actually see between my legs as I was pushing. My first sight down there was somewhat alarming; I had kind of expected my vulva to open out to the sides and the baby's head to emerge at the point flush with where my genitals are usually. Instead, the entire region was bulging out in a perfect half sphere of my skin with only a thin sliver of the baby's head visible at the apex. I'm not sure whether my jaw dropped, or whether my entire external focus was on keeping on breathing that gas before I had to give it up to push, but internally my reaction was a serious Woah! That, then, was what the midwife had been meaning about seeing 'lots of movement'. If I'd understood it was the baby's head moving past the point where my body usually stops, I might have been more impressed about the progress I was making.
So yeah, that was weird, but the very oddness made me glad to be in the elbows-under-knees position so that I could see what was happening. Every time I pushed the whole area would bulge further out, revealing a bit more head, and back in again. It was like three steps forward, two steps back, but it was definitely progressing. Which also helped keep my chin on my chest to watch progress. As a side note, the next couple of days the muscles of my arms were incredibly sore, even with the strong painkillers they had me on, which I expect was a result of this position.
Hubby was totally horrified when I, after one contraction and before flopping back onto the bed to recouperate my strength, reached down and gave the top of the baby's head a bit of a stroke. He was moist and sticky, but I could feel hair and the semi-squishiness of his scalp. I'd resisted the urge for a couple of contractions while the visible portion of head grew larger and larger, because I didn't want to touch my own tight-stretched skin in case I hurt myself. That evening, when Hubby and I were talking over the whole process, he was still horrified. Do you remember doing that? he asked me, incredulous, and obviously thinking I had been completely drugged out to have crossed the police line and interfered in something that should have been the obstetrician's territory at that point. But it did help me feel like we were really getting somewhere; that the baby really was coming and soon I'd be able to cuddle the rest of him.
A bit later, I remember saying, in response to the midwife's question of almost an hour previously to let her know if I felt the pressure moving into my bottom (which is meant to happen before it’s time to push), saying 'oh, yeah, I can definitely feel that pressure in my bottom now' at which point given even I could see almost half the baby's head, I suspect she was thinking 'no shit, sherlock'.
Speaking of which, I also remember after one contraction, the midwife folding up one of the sterile mats and taking it away, and thinking 'ah, my bowels have just emptied'. We'd been told they were likely to just before the baby came, because the contents are between the baby and the exit and essentially get squeezed out like toothpaste. We were told we weren't likely to care at the time or possibly not even know, because the midwife would just clean it up without saying anything. I was more amused that I had noticed the moment than embarassed, but then I didn't expect to care beforehand; it was simply a part of the entire undignified procedure that they were used to dealing with, and with that kind of thing you can make a choice beforehand to just go with whatever because it's not embarassing, it's what happens.
I had heard from a number of sources that going slowly through crowning (where the largest point of the baby's head passes the ultra-sensitive tissue at the mouth of the vagina and perineum - also known as the 'ring of fire') was the way to minimise tearing. Since I didn't have an irresistable urge to push, and I wasn't feeling too compliant with the stupid midwife and her stupid telling me to push that had cost me an epidural, and also it stung like crazy hell which made it really hard to overrule the pain-flinch reaction and actually push INTO, I deliberately paced myself even more with this section of pushing. But I also worried that if I didn't show that I was focussing, they'd take my gas away, so I had to at least seem like I was making an extreme effort. Given the worst of it only lasted for about four contractions, and the obstetrician only told me they'd have the baby the next contraction twice, I suspect it just pulled me back from over-compliant-over-acheiver to slow-and-steady.
I have no idea whether going slower or faster would have minimised the tearing I did indeed end up with; it's possible that once I started tearing, the best way out was to get through it as quickly as possible. It's also possible the whole slow/fast thing is bunk, just like upright vs on your back, since I've only ever seen it on the rubbishy 'birthing is a natural process not a potentially fatal medical emergency' sites that seem to overpopulate the internet. Complications of pregnancy and childbirth are STILL the leading cause of death in young women in developing countries - in Africa, it's the cause of death of one in 26 of women of all ages. Not to mention the vastly greater risk to the infant even than the mother. Thank goodness I have access to highly trained medical professionals and the full resources of a hospital, should I require them.
In any case, I didn't actually believe the obstetrician either time he told me the next time they'd have the baby. But halfway through the last contraction when the coaching really ramped up to keep on pushing and the stinging pain was at its worst, I remember thinking bugger it, there's only one way to get this baby out, closing my eyes and going for it with every ounce of strength I had. I still didn't believe that it would be over so instantaneously; the stinging eased and I opened my eyes to see the baby flowing out from between my legs and it felt like from that point on the obstetrician essentially pulled (although whatever they tell you about everything after the head being trivial, the shoulders coming through was DEFINITELY painful, particularly because they were pulled (or at least felt like they were pulled) out past very sore tissue when I wasn't expecting it). I watched in amazement as out he came all at once and they lifted him up onto my chest.
I pulled up my hospital gown as they were lifting him so he could have some skin-to-skin time (that's very big at the moment - both for maternal bonding and apparently it also helps the baby to breathe better in the beginning), and the midwife put a hat on him and smothered him in blankets, because apparently they can lose heat very quickly at the beginning, all wet and not used to maintaining their own body temperature. He made little grunting sounds of effort with every breath out, and because he's so small his breathing rate is closer to once per second, so he sat there going 'uh, uh, uh'. (The midwife later described him as being 'grunty' which means that while he was breathing normally it wasn't entirely freely - I had thought it would be the in breath that would be difficult and require effort and thus would be gaspy rather than the out breath, but maybe that's just where he expressed the difficulty - or maybe gasping would indicate a more serious breathing problem.)
He was much more quiet than I was expecting; I thought he'd be traumatised and freaked out by the entire process and protesting at the top of his lungs, but he didn't cry at all, just looked around with big wide eyes as I held him against my skin and Hubby and I both played with his little hands and stroked his little face.
I'm glad I'd seen photos of very newborns before, as the first time I saw one a few months ago, I was somewhat revolted by the vernix (the white pasty protection for their skin so they don't go all wrinkly in the long-term bath of amniotic fluid). But as I was expecting the baby to be all white and pasty, I wasn't surprised by it, just delighted by him and completely and utterly chilled out by reaching the end of second stage labour (third stage is the placenta). I was also still absolutely boiling hot, particularly given the number of blankets they'd piled on top of him on my chest.
I didn't feel a sudden rush of love or protectiveness or other motherly hormones, which is not to say I wasn't besotted with him, but I'd already felt so close to him while he was in the womb that it wasn't really different to have him out and in front of me, just kind of the next stage. The midwife asked what his name was, and we realised we hadn't actually decided yet. We'd had two names left on the list - we liked them both, possibly William slightly more, but William had also been the most popular name in Qld last year, so we didn't feel awesome about that. We also wanted to leave open the possibility that we might look at him and go... OMG we HAVE to call him Zebulon. But we looked at each other and essentially went: William? William. So William it was.
Then I remembered the camera, and asked Hubby to take some video, then see about some stills. I'd hoped to have some record of labour, even if only for my own records since I expected my memories of labour would get smudgy and blurred, but it all happened so fast that I didn't have the presence of mind to remind Hubby and we didn't get anything past a shot of me flaked out on gas between contractions in the birthing suite before I'd moved to the bed. People had told me I'd find afterwards that I wouldn't want to look at video of the labour - it would be something I wanted to forget ASAP - I would like to categorically deny this. I would love to be able to see some video of what it was actually like outside my head. My memories are as smudgy and sporadic as I expected, perhaps more so, and one of the pivotal reasons that I decided to try for a vaginal birth rather than an elective ceaser was that it was a life experience that I wanted to have. Not necessarily a pleasant one, but what is life if not collecting experiences? In any case, we have plenty of video and stills from then on, which is awesome, even if some of it is a little indecorous of both me and little William. :P
We also have video of me cutting the cord, since that wasn't something Hubby was keen to do. It was quite odd to do this while it was still attached to the placenta which was still inside me. It was at this point that I suddenly remembering that we hadn't remembered to remind them that we wanted to donate the cord blood. The midwife called the collection staff immediately - apparently it needs to be collected within 10-15 minutes of birth or it will be clotted and unusable. It turned out it didn't really matter either way; 15 minutes passed and the collection staff hadn't turned up but I hadn't delivered the placenta at that point anyway, so there wouldn't have been able to collect it in any case.
In the meantime, of course, the obstetrician had been sewing me back up. I didn't notice at the time (possibly it all took place underneath William, so was out of my view, or possibly I was just focussed on other things), but apparently he came out accompanied by what appeared to Hubby to be a significant gush of blood. Apparrently it was by far the bloodiest thing he's ever seen in real life (outside first person shooters and violent movies) with pools of it underneath me. They think I lost about 500ml at this point - which just goes to show how far a moderate amount of blood will go - not much different to a visit to the blood bank, so there was no need for transfusion or even a drip. The obstetrician was still sewing ten minutes later when I asked him how bad the tearing was; second degree, so hurrah for not being third degree (which would be right into the anus), at least, but apparently the edges of the tear were extremely ragged, which was making things very difficult. When he was still sewing another twenty minutes after that, he told me it probably would have been better to cut. Oh well. I guess they can't really tell until after it's all over, and even then it's guessing as to whether I might not have torn even further if they'd cut.
After a while, I remembered to try to feed William, but despite my best ABA-trained attempts to latch him on, he showed no interest whatsoever, so we decided to just go back to cuddling for the moment and try again later. After about half an hour, after checking that he wasn't feeding, the midwife took him to the other side of the room to be weighed and have his Vitamin K and Hep B shots. He was 3.406kg (7lb 8oz) which is spot on average. His head circumference and length were both also spot on average, and his apgar at 1 and 5 minutes was 9, which is the best a newborn can realistically achieve. We actually did hear him cry when he got stuck with his needles, but he calmed down again very quickly even before they put him back on my chest. :)
After we'd had about an hour with William it became clear that not only had the placenta not arrived in the usual amount of time, it was quite determined not to come loose, and I was likely to have to go to theatre to get it removed. I was still having the occasional contraction, the obstetrician was occasionally pushing on my stomach (which REALLY hurt - fortunately I still had my trusty gas tube!) and pulling on the cord in attempts to dislodge it while I tried to push, but to no avail. It was stuck fast. I kept delivering what felt like it would have to be a placenta – seemingly huge blobs of blubbery wobbly stuff - but I was told were just large blood clots. Oddly enough, the placenta made a totally visible lump in my tummy (which wasn't completely pre-pregnancy size, but much closer than I'd expected!), a surprisingly large hard lump off to the right. I kept asking for water or ice or something, but they wouldn't let me have anything in case I had to go to theatre, in which case I should have been fasting - the best they could do was let me rinse my mouth and spit. Yay for realising that I'd gone to aqua-aerobics the night before (which is ironically very dehydrating) then essentially been so distracted by going into labour that I hadn't drunk anything from then on. They let it go for an hour and a half, keeping on trying to get it out, until the placenta started breaking up under the pulling and pushing, then I had to go or risk a dangerous haemorrage.
The midwife inserted a catheter, which was not particularly yay, and told us that Hubby wouldn't be able to come into theatre with me (if I'd still been delivering the baby, he would have, but as it was just a medical procedure, he couldn't). That fitted with our plans in any case; if I or the baby had needed any special attention that required we be separated, we had planned that Hubby was to stay with the baby at all times. The anaesthetist came back and mentioned that we'd met before - I told him that I think I hadn't been very happy with him at that point – asked if I was allergic to anything and about my medical history, then explained they were going to do a spinal block, which is essentially an epidural without leaving the drip in the spine for topping up with more drugs as necessary, but that they might need to give me a general anaesthetic if that didn't work, and that one percent of people had severe headaches and if I needed a GA there were all sorts of potential complications. And the obstetrician came along with a form for me to sign saying that I understood the risks of going into theatre; that I might lose blood and need a transfusion, that I might get a subsequent infection, and if I was haemorraging unstoppably, an emergency hysterectomy to save my life. But, the obstetrician told us dryly, that's not the plan. Oh, good, I said, as I signed on the dotted line.
So, I got my epidural after all. Sigh.
While this was going on, I'd managed to get William feeding without help from the midwife, which was awesome. Unfortunately, I had to detatch him to go to theatre, but he'd been feeding for about half an hour at that point, so I didn't feel too bad about that. The midwife took him over to Hubby and asked him to lay him on his bare chest, so William could get some more skin-to-skin time to remind him to breathe properly, as he was still a bit grunty. Hubby opened his button-up shirt, which he'd specifically worn for this occasion so if the baby needed skin-to-skin it would be easy. The midwife didn't seem impressed, so Hubby complied with the implicit cue and took off his shirt completely, which she then rushed to tell him wasn't right, as she laid William on his chest so he couldn't put it back on again. All in all, I feel that her communication skills were distinctly ordinary. :)
I felt totally floaty and chilled out as they wheeled me out of the room and over to the theatre. Just before I got wheeled in, a nurse came to me holding the clipboard holding the same form I'd just signed, asked me to tell her my name and date of birth, what I was there for. I duly recited what the anaesthetist and obstetrician had told me in my own words, up until we got to the risks, at which point I decided to summarise as 'the usual risks associated with any surgical procedure', which was apparently fine.
We got into theatre and the anaesthetist inserted a cannula into my arm and attached me to a drip. Unlike the delivery room, which only had me, Hubby, the obstetrician and one midwife, the theatre was packed. There was me, the obstetrician, the anaesthetist, and at least four nurses/other assorted staff who were there the whole time, plus several extras who breezed in and out. The anaesthetist told me to roll onto my side and curl up in a ball as much as I possibly could - obviously he's used to dealing with pregnant women who have, you know, a kind of big bulge in the way, because I was only half as curled as I could have been when he went 'woah, that's heaps!' The needle was relatively painless (although admittedly at that point my relativity may have been a little out of whack), and when it was done I rolled back onto my back.
After a few minutes, the anaesthetist came back with an ice cube, which he ran on my arm saying 'This is just an ice cube, you can feel it’s cold.’ I nodded agreement. And damn, but that little bit of coldness was wonderful. ‘Can you feel that coldness when I rub it on your leg?' I couldn't. Just a bit of pressure, which I told him. 'That's fine. Now, tell me when you start to feel the coldness...' and he ran the cube up to about my upper thigh before I felt it. So they waited a few more minutes, and he tried it again - this time the ice cube got all the way to my waist, so he tried it on the other side and it got to my hip. This, he told me, was because I'd been lying on the side while he'd given me the injection, so one side was more affected than the other, which I thought was cool. I thought they'd wait again until it got up past the top of where my uterus had been with baby inside, but that was apparently enough - I certainly didn't feel any pain during the procedure, so obviously they knew what they were doing.
At that point, everything proceeded. They put up a curtain (which was in fact a blanket attached to two IV poles that kept rolling towards the bed and dropping the curtain, and making the nurse dive to pull them out again which gave the whole thing just a tiny bit of a keystone cops feel :P). The nurses piled layer after layer of blankets on me and only desisted in adding more after my most stringent protests about how hot I was. She realised I was having trouble working out what to do with the arm that didn't have the drip - I couldn't put it by my side without going under the curtain, and even crossing it over my chest meant my elbow brushed the curtain, which I didn't feel comfortable with, and it wasn't really comfortable to let it drop down to to the side of the bed. The arm with the drip in it was carefully laid out on a cushioned armrest out to the side, so she extended the armrest to the other side as well, and I lay there like an extremely chilled-out (if somewhat overheated) starfish as they lifted my feet into stirrups and the obstetrician began the process of manual removal. (I didn't choose to enquire closely, but I believe that would be 'manual' as in hand.) By the amount of pressure I felt in previously sensitive places, I was very glad to be numb. It was totally bizarre because I was all numb and tingly, and could feel the pressure and movement, but in combination with the extreme floaty calm it was like I had no voluntary muscle control in my entire body and that was totally fine with me.
I never felt worried or anything other accepting and trusting that I would be looked after (yay for hospitals) and this awesome floaty calm (yay for endorphins). The anaesthetist and one of the nurses stayed by my head (well, wandered about, really, but there was usually at least one of them there casually conversing with me and the obstetrician.
I asked if they could save the placenta so that Hubby and I could have a look at it. (The whole concept of a single-use disposable organ is intriguing to me.) The anaesthetist asked me if I was on Sandomigrin for my migraines, which I’d told him about when he’d asked me about my medical history. I had been on Sandomigrin until I came off to get pregnant and had read on the packet it wouldn't be safe for breastfeeding either, but both the anaesthetist and the obstetrician agreed that it should be totally safe for breastfeeding. Yay. My stomach grumbled, which made them laugh, and I grumbled that the main thing was how thirsty I was - they told me I was totally okay to eat and drink as soon as I was out of theatre. We also established that I was totally entitled to drink a very large glass of red wine that night; it wasn't like anything much in the way of alcohol would come through to little William in the colostrum (the initial milk which is only produced in teaspoonfuls rather than cupfuls). Towards the end of the procedure, the anaesthetist told me that he'd checked my file to see whether I was a doctor because of the interested/informed way I'd been talking about proceedings. I explained that I was a person who dealt with stress by research. :)
Despite them telling Hubby it would be half an hour to 45 minutes, the entire procedure took about an hour, which given the risks they'd talked about, had Hubby... a little concerned, but not freaking out too much. Apparently it had just been a lot more work repairing the stitches again afterwards than the obstetrician had anticipating. Or maybe (given the estimate of how long it would take the anaesthetist to get me my epidural was out by a similar amount) they simply haven't realised that theatre takes an hour rather than 30-45 minutes.
I'll mention here, rather than later, as this seems to be more the place for icky details than anywhere else, that my recovery was somewhat extended by the fact that some of my stitches from the tearing interfered with some of the haemorrhoids the size of school busses which were a consequence of bearing down during labour. This meant, with stitches on top of haemorrhoids the undisputed furthest out point of my lower regions for the next week and a half, they would brush against anything; undies, clothes, and even ice packs to aggravate and inflame the area further. Thus the severe burning ache and swollen feeling that there was a thick-cut porterhouse steak strapped between my legs which was the most prominent unpleasantness for the first few days was gradually overtaken by the acute stabs of white-hot pain, not unlike being stung by a series of wasps, whenever my position moved even slightly to make something shift against the stitches, just as they were wanting me to be stepping down off the strong painkillers. In any case, the first week was hell - I just about burst into tears when it was time to go home from hospital so they let me stay another night and totally drugged me up so I'd forget how bad it was and go home the next day. A week and a half later I started being able to sit for short periods with a rolled up towel underneath each leg and be able to bear picking something up off the floor. Today I can sit reasonably comfortably for extended periods on a couple of rolled up towels, and while I still wouldn't pick something up off the floor by choice, would consider it a viable option if I needed the item in question.
They brought me into recovery, shifted me into a proper bed, and refused to give me my requested water even though the OB had said it would be okay. :| Eventually, Hubby and William arrived, and I got him feeding again, much more easily this time, and by about 1:30 we'd been moved up to our lovely top floor private hospital room with a gorgeous view out over the Brisbane suburbs. (Hurrah for private health insurance.) I started ringing people to let them know about little William. Hubby had rung his dad (also both of our employer) at about 8:30 to let him know he wouldn't be coming into work that morning because we'd just arrived at the hospital. Obviously the grandad-to-be hadn't been able to contain his excitement, because pretty much everyone we rang on Hubby's side of the family knew that I'd only arrived in hospital that morning and was flabbergasted that it was I was all finished and well enough to call them in the early afternoon.
We had just the immediate family as visitors that evening, who cooed and fussed over William and brought a lovely bottle of red for me, which was MAGNIFICENT after a nine month fast. And really, that was about it for the birth. It was awful, but it was a life experience, and to be honest... was not nearly as bad as I had psyched myself up for it to be. I think that's one of the reasons the contractions got so bad before we left for hospital - I could still bear them, so I thought I had to have a huge way to go. I still see no reason to go without an epidural - why suffer pain when you don't have to? But I had to, so I did, and I came out the other side with little William.
And that made it all totally worth it. :)
In summary: I had two extremely unpleasant days of prelabour, then my waters broke at quarter to three in the morning. I should have gone straight to hospital, but anecdotal evidence suggests that people usually go to hospital too early rather than too late, and they told us in antenatal classes to stay home and get what sleep we could for as long as we could, because chances are we would be in for the long haul. So I thought I might as well stay home while I could bear it and let Hubby get some sleep so that he'd have the energy to take the baby and let me sleep that night. Contractions ramped up very quickly in the morning to be 2 mins apart and me throwing up when we decided to leave for hospital. We arrived at the hospital around quarter to eight, and William was born just over two hours later after three quarters of an hour of pushing and bad second degree tearing. The anaesthetist didn't make it in time to give me my planned-from-the-very-first-time-I-knew-what-one-was epidural. Unfortunately, it wasn't over, as an hour and a half later I still hadn't delivered the placenta. So I got the epidural after all and Hubby got to have some one-on-one bonding time with William while I spent an hour in theatre having the placenta manually removed and getting all my stitches redone.
Nonetheless, we have a beautiful healthy boy who passed all his first set of exams with top marks on the ones he was supposed to excel and precisely average ones on the ones he was supposed to be average, almost two weeks later and I can FINALLY start sitting down for extended periods with a couple of rolled up towels under my legs, and I have a new rule for going into labour: get me to hospital RIGHT NOW!
Selected picspam to follow.
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I see what you mean!
Congrats to you and well done!
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