|Karin and James
Vaginal Delivery, Epidural
I had an easy pregnancy, except for four weeks of all day long nausea in the first trimester, and a lot of Braxton-Hicks contractions starting at twenty four weeks, which prevented me from doing any exercise. I was living alone at that time, without any relatives or close friends nearby, but it did not bother me too much during my pregnancy. I actually became more introspective during that time, and enjoyed taking care of myself and of the new life growing inside me, as well as organizing everything in my apartment to be ready for baby. My coworkers were very supportive and took great care of me. I used to say that they were my second family. Two weeks before my due date, I remember looking around in my apartment, and feeling so satisfied to see everything clean and ready: the freezer was full of frozen meals, the little bed was made next to mine, the changing table was ready with all the necessary supplies, my dresser had a section full of clean baby clothes, the car seat was installed, daycare had been set up, and I had found a great doula.
Exactly a week before my due date, a Monday, my doctor checked my cervix for the first time, and announced that I was three centimeters dilated and seventy percent dilated. I was shocked, as I knew that this is unusual for a first baby. All these Braxton-Hicks contractions that I had been feeling for three months had definitely done something! The next Thursday, I went to work as usual. I remember I had Japanese food with my coworkers at lunch. In the evening, I felt very tired and went to bed at 9:00pm without eating dinner because I was not feeling hungry. I was slowly falling asleep when I noticed some wetness between my legs. I got up to check what that was, but nothing more was coming out, so I just dismissed it and thought it was sweat. I went back to bed, but as soon as I lay down, I could definitely feel more warm liquid coming out. At that point my heart starting pounding, as I was realizing that my water had probably broken, even if the leak was very slow. It was 10:00pm and I decided to call my doula to let her know what was happening. She told me that if my water had really broken, labor would probably start on its own in a few hours, so she suggested I go back to bed and try to sleep. Easier to say than do... Of course I was not able to sleep, as my heart was beating twice faster than usual. I decided to get up and eat something, even though I was not hungry at all, because I figured that I would need energy later on. I was concerned that I was feeling so tired after a long day of work, and that I had to go through labor in these conditions. If only labor had started a morning, after a good night of rest...
At 12:00am, I started feeling contractions coming ten minutes apart, which were definitely different than Braxton-Hicks. I decided to take a shower, wash my hair, shave my legs, and do my nails. At 2:00am, my contractions were uncomfortable and five minutes apart. I had to use the bathroom many times and had a bloody show. I was not expecting so much blood. My water was continuing to slowly leak out. I decided to call my doula again, to let her know that labor had started. She told me that even though my contractions were five minutes apart, I sounded fine, so that there probably still was a long way to go. She suggested that I try to rest, and to call her when I would not be able to manage labor alone anymore. I must say that I badly wished to have someone with me already at that point, as I was getting a little scared, but I wanted to let her sleep. I soon had to focus on breathing through my contractions, and I did not want to move anymore, just sit on my office chair. At 5:30am, my contractions were 2-3 minutes apart, even though still manageable. I decided to call my doula again and ask her to come. I also called the on-call doctor to ask for advice. He told me that I should head to the hospital to get checked. At 6:30am my doula arrived. I told her that I did not want to stay home anymore because I was afraid, and that I wanted to go straight to the hospital.
At 7:00am we arrived at the hospital. I was asked to change into a hospital gown and the nurse checked me. She announced that I was four centimeters dilated and fully effaced. She strapped me to the monitoring machine and started a fluid IV. I initially thought I would not like to be strapped to a machine and to an IV, but at this point I was very grateful to have my baby monitored and to receive fluids, as I was feeling dehydrated and did not feel like drinking anything. After a while, my doula suggested we go walk around in the corridors to help labor progress. At this point I only wanted to lie down, but I knew that moving is recommended during this stage, so I thought I should give it a try. After about thirty minutes of slow walking while pushing the IV tower, leaning against the walls during each contraction, I started feeling very dizzy and nauseous. I almost passed out in the corridor and had to fight hard in order not to throw up, so we headed back to my room. From then on, I had to concentrate more and more during contractions to cope with them, and I started throwing up each time a contraction was peaking. All my dinner came out, bit by bit, mostly undigested. I should have listened to my body: I definitely was not hungry that night, probably because my body resources were mobilized with early labor.
At 12:00pm, the nurse checked me for the second time, and announced that I was seven centimeters dilated. We were all thrilled with my progress. Labor was hard at this point, and I had to breathe deeply and concentrate hard to get through them. My doula suggested I get on the exercise ball and rock through contractions while leaning on her. I had doubts at first, because any movement felt excruciating, but I thought I should give it a try. Indeed, it felt better! For me, labor was definitely as much mental work as physical work. The best analogy I can find to labor is surfing waves: the wave approaches, I have to start paddling to move along with it, we gain speed, then I have to give all I have to maintain balance as I surf the crest of the wave. If my concentration falters, I will fall and be crushed by the wave. Then the peak of the wave passes, speed decreases and I can lie down on the board again and rest, waiting for the next wave. The more labor progresses, the bigger, the more powerful, and the more frightening the wave becomes.
At 3:00pm the nurse checked me again. To my great disappointment, she said that I had not progressed: I was still at seven centimeters. She said she would ask the doctor for advice. The doctor told me that a pocket of water was cushioning the baby's head, and that this was slowing cervical dilatation. He proposed to break my water, but cautioned me that this would make labor much harder. At that point I was feeling so exhausted and so disappointed by the lack of progress that I started fearing that I would not be able to make it. Actually, it became clear in my mind that I would NOT be able to cope through transition and then pushing, because I had no energy left. Until then, I was determined to go through labor naturally, without drugs or epidural, but at that moment I understood that it was in my best interest to get one. I told the doctor that I agreed to have my water broken, but that I wanted an epidural. Half an hour later, the anaesthesiologist came in. In five minutes he had the epidural catheter inserted, and two minutes later, I was already feeling relief. The next contraction was totally painless, and the nausea and vomiting had subsided. It was bliss! For an hour, I laid on my left side, and just relaxed, not doing or thinking anything. The nurse turned me to my right side, then again, I just rested, only feeling the pressure of the contractions, but no pain. I started feeling more pressure in my rectum and knew it was a good sign.
At 6:00pm, the doctor checked me and announced that I was fully dilated, with the baby's head right against the pelvic floor and perfectly positioned. It was time to push! My doula held one leg, and the nurse the other, while I was pushing for 10 seconds three times through each contraction. I think I had the perfect epidural: I could feel contraction pressure, but no pain, and I could feel the baby's head slowly descending. I could even move my legs and lift my bottom up. The pressure of the head was increasing with each push, then receding each time I stopped pushing. At one point I felt the head pass under the pubic bone, and then the pressure became overwhelming and did not recede anymore. I started feeling crowning and a very intense burning sensation. I told the doctor that I was afraid to push any further, but he urged me to go ahead and that the baby would soon be born. I am not sure whether I was afraid to push for fear of tearing, or if I was afraid to finally meet the baby. In a few minutes, a page would be turned, and my life would be forever different. I gave another push and the doctor announced that the head was out. He asked me to give a last push, and I felt the baby slip out. I even felt his legs kicking by bottom.
James was born at 7:35pm, 3 days before his due date, weighting 8 pounds 13 ounces (4.0 kg) and measuring 21 inches (53 cm). What a big boy! His score was 8/9. The doctor laid him still slippery on my belly and gave me the scissors so I could cut his cord myself. My doula positioned him on my breast and he started nursing right away! The doctor told me that James had already passed the entrance exam to Stanford University (I delivered in Stanford hospital)!
I had a second degree tear that the doctor repaired while the epidural was still active. The placenta was delivered just five minutes after James was born. I was given pitocin and a shot of something in my thigh because I was hemorrhaging, but I did not notice anything because I was so taken by James.