The Sunday to Forever: The Hospital

The Sunday to Forever table of contents:

1. Acknowledgments
2. At Home
3. The Hospital
4. Dylan
5. Musings

Before anything much could happen at the hospital, I was asked a gazillion questions. They were all easy to answer, but I felt like I was moving really slowly and everything took great effort. I was asked what my choice was for pain relief. I laughed and said I’d meant to give birth at home. She marked “unknown”. I remember thinking I didn’t even know what the options were for pain relief.

Contractions were extremely painful. I was going crazy every time one would peak. I took gasping breaths. My face was tingling and my vision was blurry, which they said was from hyperventilating. I would just stare at a fixed spot on the ceiling during a contraction and try to hang on to my sanity. Someone asked if I wanted an epidural and I gave a thumbs up. I think Joshua was surprised. He checked in with me to see if that’s what I really wanted. I really would have agreed to anything that made the pain less at that point.

Eventually I was moved to an L&D room, although I don’t remember exactly when that happened.

The woman who would actually be my doctor came in. She came face to face with me at the side of the bed. She had a gentle voice. She said she had an awkward question that had to be asked – had I been trying to have a freebirth? All the questions and people up until that point had been routine, bland, and just part of the whirlwind of hospital inevitability. When she said freebirth, though, something spread open pleasantly in my mind. I think it was just her choice of that word freebirth, which is the word that I use, instead of unassisted birth, which has always sounded so cold to me. Also, her voice was so gentle, with no snark in it at all, and you just can’t say a word like freebirth out loud with no snark unless you mean it. I knew I would be telling this woman the truth about anything she asked, and I was glad to have her by my side. I said yes. She said that she knew everyone came in from different perspectives and she knew that this wasn’t what I had wanted. She said that growing the baby was the hard part, and the birth was just one moment in time. She said some other stuff, I’m sure, but the message that I got was that she understood me, she was on my side, she would help me, and everything was going to be fine.

My doctor confirmed the earlier cervical check – I had been 4 cm dilated when I came in, and the baby was at -1 station. I felt a little vindicated at learning that. I KNEW I was no where near the end, and there was no way I could continue contractions like this for that much longer. The -1 station also confirmed another thought I’d had through the labor, which was that it was odd that the baby was still sitting so high. For most of the labor, I could still feel the baby as high in my uterus as it had been during all of late pregnancy – high and to the right (from my view). The baby was head down – which I’d also known – but not dropping as expected.

I loved the epidural guy, too. I was so happy that something was going to make the pain go away. I really felt like I was barely hanging on by a thread. I appreciated his communication style, which was really enthusiastic, but I also thought he seriously handled the risk conversation. He sat down so he was eye to eye with me and talked to me in such a way that seemed like he was assessing my ability to really hear him. While he didn’t mention any particularly nasty risks, I got from his tone of voice that this choice was not without serious risk, and I appreciated that that was part of the presentation. Administering the epidural was fairly straightforward. I had one or two contractions during the process, which were hard since I was trying to communicate and also be still. The next couple of contractions ramped down in intensity and length. Then I couldn’t really feel them at all. I could vaguely feel a tightening but no pain at all. At this point, I started to fade out completely. I dozed. I don’t know for how long. I was dilated 7 cm, still -1 station going into the epidural.

Eventually, the doctor came back in. It seemed like it had been awhile, but I’m not sure how long because I was out to the world. She said I was still at 7 or 8 cm and that the baby’s heart rates were dropping during some contractions. She wanted to hook up an internal monitor, which they did. It was really dramatic to me to hear the baby’s heart rate with that monitor. Before, with the EFM, the heart rate was going up during contractions, which is what it should do. Now it was dropping during contractions, which I could clearly hear. Without needing to know the exact numbers I could tell that it was low. Being able to hear this dramatic dip so clearly probably affected my decisions.

The doctor talked to me about the heart rates and my progress. She spoke softly but directly, and I did not feel pressured or led a certain direction. She was concerned about the heart rate and concerned about the station. She said that with pitocin, she could get anyone to fully dilate, no question. She said getting the baby to drop was another issue, but we could see what we could do about that once I was dilated. I can’t remember if she mentioned the other options as to what we could do, but I got the impression that she was saying that there were various things we could try. I was really surprised that she didn’t say anything about a c-section. I guess it was obvious that at the end of the road, somewhere, was the option of a c-section. She seemed to be treading a little carefully around that idea, though, maybe because I was a freebirth transfer, and she didn’t mention it at all. This actually seemed strange to me, because a c-section seemed kind of like a sure thing in this case, whereas the other options were trial and error. I said that at this point, the heart rates were basically recovering between contractions (to about 120 at least, which was still lower than the regular 140). It seemed to me that it was time to move on to a c-section now while things were basically good, rather than waiting around trying out other things that might not work and possibly letting the situation get worse. The doctor seemed kind of relieved that I was suggesting a c-section, and Joshua jumped in to agree and seemed relieved, too. I thought it was strange that they had these reactions but hadn’t brought up a c-section themselves. In retrospect, though, I’m really, really happy for that. Being the person who actually suggested the c-section contributed to my feeling that I was in charge of the decision. I didn’t feel pressured at all – no one else even mentioned a c-section. Having to go so far as to suggest it myself really makes it feel like it was my idea and what I really wanted in the situation.

I joked some with the doctor about how I’m the kind of person who’d watch the c-section if I could. She said she’d be the one to do it, which made me happy. Someone talked to me about what to expect – they would do something different with my epidural so that I was really, really numb. I might feel pressure but shouldn’t feel any pain. Joshua was going to be in there, too.

Going into the OR was surreal. It was like passing across a magical barrier. The lights were different, the air temperature was different, the air flow was different, it smelled differently. It was like crossing a magic line into another world entirely. At that point I started to lose it a bit mentally. I started shivering, teeth chattering like crazy, and crying.

They set up the shield, so that my head was separate from whatever they were doing and tied down my arms. The anesthesiologist (a different one) kept talking to me, and I thought of him (and me) as disembodied heads. My head was separate from the rest of my body, and I could hear him talking and sometimes see his head but not the rest of him.

As the c-section started, I could feel some pulling and “stuff happening” to my abdomen, but not any pain. At one point, I started to feel the “pressure” they mentioned near my chest, and that had some pain. I said, “ow, ow, ow, ow, ow.” It was kind of weird to feel anything similar to pain when everything was so numb. At one point, the doctor and assistant were chatting about something really normal and not at all about what was happening to me. I started to be annoyed about that, but then I realized that it was just evidence that what they were doing was totally commonplace for them, which was comforting to me. I think I felt the part where they pulled Dylan out. It felt like my insides were being turned inside out.

The doctor exclaimed, “Wow, that’s a lot of fibroids!” or something like that. Then I heard her telling me that I had a lot of large fibroid tumors in my uterus. I remember thinking it was really odd that she brought this up now. Saying the word “tumors” to a patient who’s tied down and hidden behind a sheet seemed kind of rude. I think her original statement was an accidental outburst of surprise, though, and then once she said that, she kind of had to elaborate. We talked a couple of days later more in depth about the fibroids, and of course, I’ve googled them. They aren’t really all that uncommon, but apparently I had a lot of large ones. They had distended the size of my uterus, may have caused excessive labor pain, and may have been the cause of Dylan not dropping. If I had been under OB care throughout my pregnancy, it’s almost certain that my OB would have wanted to schedule a c-section because of the fibroids.

The Sunday to Forever table of contents:

1. Acknowledgments
2. At Home
3. The Hospital
4. Dylan
5. Musings

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