Squeakles is three weeks old today and I am three weeks recovered. I've been wanting to write and photograph this whole experience, but I've just been too wiped out. But today, finally, I'm starting to feel like I can do a little bit more than sit in this arm chair, either sleeping, eating, or (the majority of the time, it seems) attempting to feed the baby. I thought I'd start by writing out the story of Squeakles' birth. [A little warning: I can imagine that reading other people's labor stories may not be everyone's thing, and if so, you may not want to read this post.]
So. Unfortunately, Squeakles was not dropped off by a basket-toting stork. I was left to do the actual delivery myself.
It started at 9:20 am on Tuesday morning, February 26. I'd slept in a little bit late that morning on the couch in the living room, having moved there in the early morning after another night of back pain. My back still hurt when I woke up and I attributed it to the couch's lack of support, though the reason I'd moved to the couch in the first place is that I thought maybe the firm mattress on our bed was bothering it. I got up and walked to the bathroom with thoughts of work on my mind. I'd had plans to go to my boss' house to work on a grant proposal, but at the last minute, she told me just to stay home because of my back pain and we would just communicate by email. We were planning to touch base at 10:00 to get started.
I used the toilet, thinking about taking another Tylenol to get me through the work day. But after I'd finished peeing, I noticed something odd... I felt like I was leaking, almost like I was still peeing. Weird. When it stopped after just a few seconds, I got up to get a maxi pad, which I'd taken to wearing in the past few days just in case my water broke. But even going the couple of steps to reach the pad, I felt more leaking and so I went back to the toilet. Hmm. It wasn't a big gush of water, but there was definitely leaking. Was my water breaking? After a brief pause in the leaking, I got myself together and headed to the bedroom to wake up J. As I was waking him up, I felt more leaking and now I was convinced that my water was breaking.
J advised me to call my doctor's office to find out what I should do (since I only felt some leaking and not a gush of water), and one of the doctors told me that whether or not my water had actually broken, I should probably go to the hospital. I asked if I could take a shower before going and the doctor advised me not to because I might wash away the fluids that they would want to see and/or it could introduce possible infection if my water had actually broken. But I told J he could take a shower if he wanted, while I put things together in a bag. (I'm so glad I'd pulled together all the miscellaneous things I'd planned to bring to the hospital - all I had left to do was to put them in a bag and add my clothes and toothbrush/hairbrush/cosmetics.) But before J could get in the shower, I started feeling contractions. They were exactly like what I'd felt a few days earlier - like menstrual cramps low in my abdomen - but these were stronger and I knew. They say you'll know when they're real, and I guess it's true, at least in my case where they come on hard and fast. These came on probably every three to five minutes and I found myself unable to pack my bag myself. During moments of respite, I felt completely fine and I was sure I could pack, but I'd pick something up and couldn't even make it over to the bag. It became clear that J did not have time for a shower! Instead we got our things together, I sent a quick email to my boss to let her know that I might be going into labor, J pulled the car around, and we drove to the hospital.
We'd been instructed to head to the ER first and that they would then direct us to the Labor and Delivery floor, but when we got to the hospital the ER door was closed. J asked a security guard about getting into the ER, and the guard took one look at me, half hunched over with contractions and suggested that we just head up to Labor and Delivery ourselves. (I'm really not sure the point of going to the ER first. Maybe they give you a wheelchair to get you upstairs? Maybe they just want to make sure people don't get lost trying to find the labor and delivery floor themselves?)
Upstairs they quickly sent me to a room with a nurse, while J took my insurance card and ID from me and got me registered. A nurse asked me to strip down and then put on a hospital gown and a stretchy belly band; under the band they squeezed two monitors which would allow them to see when I was having contractions and what the baby's heart rate was. None of this was a surprise to me after hearing about it in my childbirth class, but what did surprise me was that I found wearing these things to be irritating. The gown seemed unnecessary, and I asked whether it was for my benefit or theirs. When they told me I didn't have to wear it, I took it off because I was moving around too much to want to deal with trying to stay covered with what is essentially a large wearable piece of paper. I also found the belly band annoying because in order for the monitors to be work, you're not supposed to move around much and, in particular, they wanted me to lean back in a sitting up position. But I was getting uncomfortable and really wanted to be leaning forward on my hands and knees. So the battle of wills began between me wanting to move around and the nurses constantly readjusting my monitors and trying to get me to lay back.
When J got back to the room, he tried to help me with breathing through the pain, but I felt like the slow breathing I'd learned didn't do anything for me. One of the nurses reminded me about the faster "hee hee who" breathing, so I tried it and wow, it totally helped. I felt silly doing it for about a second, but then was panting it loudly enough that I'm sure other people in nearby rooms could hear. As for J's help, I had previous imagined that what would get me through labor would be his calming touch and looking into his eyes to keep me grounded. Instead, I discovered that I didn't want to be touched, didn't really want him to talk to me, and I couldn't look in his eyes because it was too much ... something. I'm not really sure what it was; I just felt like looking in his eyes was too complex for me at that time. Instead I focused on some simple object about four to five feet away from me and when the contractions came, I glared at this object while I used the breathing to get through the pain.
I also felt like the only people I wanted to talk to were women, preferrably women who'd given birth before. In fact, I asked J to call our friend JCM (who had a baby last July) to find out whether she'd had an epidural and if it had helped her with the contractions. I hadn't planned to have an epidural, but now that I was experiencing the contractions, I wanted to understand - would the pain get worse? would an epidural make a big difference? could I get through this? Well, JCM wasn't of much help: she told me she'd been induced and that she hadn't even felt her contractions until she was eight cm dilated. Eight! And here I was at four cm and already reconsidering my previous opposition to having an epidural.
At some point, the hospital called my doctor's office to get my doctor, since she would be the one delivering the baby, but apparently they couldn't get in touch with her right away. I wasn't really in the mood to wait around, so I instructed J to get my doctor's beeper number out of my purse and he called her. I think that it was actually our beep that alerted her and not the message from the hospital, but either way, she called the hospital back and told them that she would be over around 5 pm. The nurses told me this, and I thought, is my doctor crazy?! It was maybe 11 am at that point and I really felt that I would be having this baby before the end of the work day.
Eventually another doctor from my doctor's office came over. The details are getting a little fuzzy already, but I remember thinking that he seemed nice and that if he had to deliver our baby that I would be ok with that. I think he asked whether I wanted an epidural and I said that although I hadn't planned to have one that maybe I did want it after all. I figured that when the anesthesiologist showed up, I could always refuse it, but since I had heard it can take a while for them to come by I figured it wouldn't hurt to get everything in line just in case. Also, I was thinking that if it was true that I was going to be feeling this way for hours, then maybe a little pain relief might not be such a bad thing.
He also asked if we planned to have the baby circumsized, something J and I had been discussing a lot but hadn't completely decided. This is probably the most amusing part of the day - there I was essentially naked on the hospital bed, on hands and knees and hardly looking up at them, telling J to ask this doctor for his opinion because, you know, he's a man. I'm sure it was an awkward moment for both of them, but they obliged and had a brief conversation about it. :)
In the meantime, the contractions kept coming and the monitors kept falling out of place with all of my moving around and I was soon dilated to 6 cm and then my doctor showed up (the hospital had called her to say that I was dilating fast and that this delivery probably would be happening soon). However, as things were progressing, I was also learning that the contractions weren't really getting worse. And the best part, as J pointed out, was that every contraction ended. So it's not like they were getting longer or more painful. They were just getting closer together, but with the breathing, I was able to get through them. Already I thinking that I probably would end up refusing the epidural.
After what felt like much too long, they finally found a room to move me to so I could get around to giving birth. It was a really nice room with wood paneling and a gorgeous view of the Philly skyline. It was a dreary and overcast day, which perfectly suited how I felt - I think a bright and sunny day would have irritated me.
It's hard to describe how I was feeling at this point. I know that I occasionally told J that I didn't really want to do this any more, as if I could just make it stop. But I also knew that things were moving forward and I just had to go with it. As the contractions got closer together, I felt the urge to push. I remember being surprised at how obvious the feeling was and how I didn't even question that that is what I was feeling. If contractions feel like the most intense menstrual cramps, then the urge to push feels like the most intense constipation. When they finally told me I could push, it honestly felt like a bowel movement. I'm not surprised many women poop on the delivery table - there would be no way to know the difference or control it. (I suspect this wasn't an issue in my case because I hadn't eaten in over twelve hours anyway.)
When I was pushing there were only four other people in the room - J, my doctor, a nurse, and a student nurse. J was trying his best to be helpful and I was trying my best to ignore him, to not even make eye contact. I feel bad about it now, but I just couldn't handle it. The other three gave me various instructions and suggestions, and I felt the most connected to the student nurse. I don't know what it was, but there was something so comforting about her. But overall, I really felt like I was going to get through this and that everyone was working together with me to make that happen. It was all the more encouraging when I heard that they could see the top of the baby's head!
However, as things were progressing, I started getting massive cramps in my outer thigh muscles. They were so painful that I think I was yelling more after pushing than I was during it because my legs hurt so much. After each bout of pushing, my legs seared and I had to change positions and try to work out the pain before I could go on. I tried several positions to see if any of them helped - on my back, on my side, on my hands and knees, standing up by the side of the bed - and nothing worked. The baby was not descending any more, and I think, if anything, he was receding as I kept moving around. Also, because of all the moving around, the monitors became unreliable, so my doctor attached a monitor to the top of the baby's head. At least, this is how I remember it. At the time, I felt like I didn't have a good grasp of time or the sequence of things, I just knew that my legs hurt like crazy. I really wanted to just push the baby out and get past this, but I couldn't.
Finally, my doctor suggested that I consider an epidural. I'd decided that I could handle the pain of the contractions so I hadn't even been thinking about an epidural, but she suggested that an epidural might be the only thing that would alleviate my leg pain and allow me to get through the pushing. I hardly hesitated in saying yes because I knew that I really wanted the baby out. So she went off to find the anesthesiologist and to ask other doctors for their opinions about what to do - and they agreed that the epidural was the best idea.
Here is where the details become especially fuzzy for me. I remember that the anesthesiologist came in with some other people and he was really nice. He instructed me to lie on my side and to curl up. The hardest part of it was to avoid pushing when I felt like I needed to (I'm not sure I successfully stopped pushing - it felt like my body was just doing it on its own), but the epidural itself was hardly painful. I think they actually administered an epidural and a spinal block at the same time, and within moments I was feeling so much better. My legs felt buzzy and a little numb, but I was no longer in pain. I was ready to go!
But then, everyone in the room started to get concerned about the baby's heart rate. Apparently it had dropped and wasn't going back up, which is a sign that the baby is in distress. However, I didn't really understand this, and I just felt annoyed that they weren't helping me to just push the baby out. I mean, if the baby needed to come out, I was ready to do that! I tried to ask the doctors why they were making me do various things, like turn over on all fours so they could reach in and try to stimulate the baby's head (they'd done this once before earlier in labor and it had worked), and my previously cheerful doctor got very serious and told me that she would explain everything later but that right now I just had to do what she said. J repeated that to me, and grudgingly, I tried to just go along with it. Then I heard my doctor say that more people were coming in the room and suddenly there were 10 to 15 people in the room, all wearing various versions of scrubs and masks.
They told me that they were going to take me to the OR, where they would try to continue with labor but that I might need a c-section. This is when I finally realized the seriousness of what was going on and I was wheeled away from J. J was given a full body suit and hat to wear and then he had to wait while I was prepped.
In the OR, just a few rooms down from where I'd been, it was clear that no one planned to try any more natural delivery. They asked me to move from the table I was on to another table that was an inch or two higher. I looked at the table and I looked at my legs and tried to move and nothing happened. I think they must have already upped the anesthesia and they ended up having to pick me up and move me themselves. Everyone in the room was buzzing around, and every few seconds there was a new person who would stick their face right up in mine and introduce themselves and explain what they were doing. I have no memory of most of them; I just remember thinking, please people, I don't need to know your names! Am I supposed to remember them? Do I care what you're doing? Do I have a choice? Well, actually that last part is something I was obsessing over. I kept saying it was all my fault and that I shouldn't have had the epidural. At one point a very nice doctor with a huge plastic face mask appeared in front of me and very kindly told me that it was not at all my fault and that these things happen and now they were doing what they had to do to make sure everything would be ok. I asked her if I had a choice about the c-section, and she looked at me sympathetically and just said no. She then told me what exactly they would be doing and that they would be cutting through various layers of tissue and so there were some risks but that if anything happened that they would fix it.
Soon after this a big blue sheet was placed at my neck, going up toward the ceiling. I felt so claustrophobic with that sheet there and with my arms pinned out to the sides. My jaw clenched up and it was all I could think about - why couldn't I unclench my jaw? Shortly after this J showed up and he started trying to massage my jaw, which helped a bit. And then he left and that nice student nurse showed up again and she took over the jaw massage. I didn't know at the time, but Squeakles was born at 4:31 pm and J had gone off to cut the umbilical cord and see the baby. I hadn't felt a thing (no tugging or pulling) or even realized they'd started surgery until I heard the surreal sounds of a baby gurgling.
J then brought the baby around and asked if I wanted to see, but I could hardly turn my head and almost didn't even want to look because I was so tired. But then I caught a glimpse of him out of the corner of my eye and I was simply amazed - he was beautiful. I just said, "He's so cute." I mean, it was truly amazing. I was expecting something sort of horrendous looking - covered in goo, wrinkled, ugly - but no, here was the most perfect baby I'd ever seen. I guess some women feel ambivalent or even detached when they first see their baby, while others fall in love instantly - for me it was definitely love at first sight.
Then the nice doctor with the big plastic face mask appeared in my face again and she told me that everything had gone perfectly and there was no damage and that they would be stitching me back up. After this, I got moved to another room and soon enough I was sitting comfortably (but very, very numb) in a bed. My doctor was there and suggested that I try breastfeeding, but I was too numb and shaky to do it myself. (In fact, I kept accidentally hitting myself in the face.) So the doctor maneuvered the baby onto my breast and he did something like sucking - it was hard to know because I couldn't feel anything. Just then my parents arrived (we'd called them when we were leaving the house to go to the hospital, but I don't think they were prepared to leave the house that second, so they spent time packing and canceling various commitments they had for the upcoming week and then got on the road).
As for what went wrong, we were told that there might have been a couple of things. First, it's possible that the epidural/spinal block caused the drop in his heart rate. Apparently they each carry a slight risk of this happening. I hadn't known before agreeing to get the epidural, but even if I had, the risk is low enough that I'm not sure I would have done anything differently. But worse, instead of the baby being face down (best) or face up (painful, but doable), he was face sideways (occiput transverse). This is possibly the reason for my leg pain - he might have gone as far as he could go and I was still struggling to push him farther. I don't know whether they could have moved him if they'd known he was positioned like this (probably not), but once his heart rate dropped, they just made sure to get him out before he suffered from anything else.
Lying there with my baby when it was all over (only seven hours from when it had begun that morning), and with J and my parents there, I suddenly felt silly for being so upset about needing the c-section. I'd really felt like I'd made a huge mistake by allowing myself to get the epidural, but now that everyone was fine and the baby was perfect I couldn't bring myself to care about how it happened. He was born and now we have the rest of his life in front of us. I was just so happy.