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VBAC
Week by Week

Eric

It was an easy pregnancy-aside from some queasiness and heartburn, no morning sickness (I never threw up once), no excessive bloating or out-of-control weight gain. I went running several times a week through five months. A masters student, I was glad for the lack of complications, and only hoped that the baby would come some time during the month-long Christmas break. I planned to return the next semester, and while I could take a couple weeks off of teaching, I rather preferred not to have my water break during class. My doctor had originally given me the due date of January 10, only to have the ultrasound fix it for the 20th, the first day of classes. My doctor turned out to have more foresight than the technical equipment (though the ultrasound accurately pinpointed gestational age). I went into labor on January 10, and Eric Parley Green was born January 11, 1998. Contractions began about 5:30 in the evening.

I had been having lots of Braxton Hicks contractions for a month and had ceased to pay attention to them, but these were different-they hurt a bit, like menstrual cramps. I had lost my mucous plug a week ago, so I was hoping these would be real. I lay on the couch, wondering if I should say something to my husband, when suddenly at 6:00 I sensed what seemed like two brisk knocks down low inside. Then I noticed that I was leaking something, something that began to flow heavier and heavier and which turned out to be amniotic fluid. I had been timing contractions and when I mentioned the leakage and regular contractions to Jonathan, he suggested calling the hospital. We finished dinner (which I'm glad I ate!) and called. They said to shower and come in, so we did. By that time, the contractions had become so intense that I could only moan during them and was very irritated by anything competing for my attention. (My husband adds that "Women having contractions have NO sense of humor, so save it for the epidural-or better yet, til after delivery.") We arrived around 8:30 or 9:00, only to be told, "There's no room in the inn." A low pressure system combined with the proper moon phase (and too many babies who had picked up on the subliminal nativity messages they heard in the womb over Christmas) had caused a rush on the hospital, and there were no empty rooms. My doctor was not there, either. She was out of town for the weekend. I would have to take whoever was on duty that night. After waiting for a while in a wheelchair in the hall, I was at last shown into a temporary room where I was given a hospital gown and asked to supply a urine sample (which I couldn't). I was checked and found to be dilated 3-4 cm and completely effaced, and my water had indeed broken. They went over my paperwork, asked if I was interested in an epidural (which I accepted with a resounding "YES!" between contractions), and wheeled me off to a delivery room which had become vacant. I had planned to see how things went and then decide if/when I wanted painkiller. Now there didn't seem to be an option. Still, I wasn't dilated enough to have an epidural just yet, despite the intense contractions. They gave me nubaine to make things bearable, and by breathing and focusing on relaxation skills, I was able to control the discomfort. As we sat in the room, waiting for things to get going, we felt mocked by the screen saver on the computer. "Walking speeds labor," it said. I wanted to walk, but things had progressed to an intense level far quicker than I had thought.

I couldn't talk during contractions, let alone get up and stroll around the floor. The pressure on my lower back was very strong, and Jonathan undoubtedly left dark bruises on my skin from applying counterpressure, but I needed all he could give me. An internal exam revealed that the baby was in a posterior position-he was head down, but facing the wrong way. Finally, when the breathing and relaxation techniques I had been doing no longer worked, I was ready for the epidural. Relief, at last. I could feel my uterus hardening in a contraction, but it was not much worse than Braxton Hicks. I could still feel pain on my right side, but for a time, it was working. We chatted with the nurse, who told us about the midwife on duty. She said he had formerly been a nurse, also, but had recently become a licensed midwife. She admired his skill and told us about the 10 lb. 4 oz. baby next door who he had delivered-without even an episiotomy. I had never considered going to a midwife before, but when Ray (the midwife) came in (wearing two buttons-"Listen to women" and "I support the perineum"), I told him I wanted him and no one else to do the delivery. The one thing I wanted to avoid was an episiotomy. To describe that night is difficult. I had somehow thought that I would be bored waiting, and had brought things to read. Instead, I found myself struggling to survive contractions when not medicated and asking the nurse questions when I was. It helped distract me while getting poked for an IV and an epidural. Jonathan and I watched the computer screen monitoring contractions with interest. They became more painful, and I realized that the effects of the epidural were wearing off. The nurse called the anesthesiologist; he came and gave me another dosage. This was not the end of the medications, however. About twelve hours after my water had broken, my temperature was rising and the baby's heart rate was a little racy. Hoping to prevent infection, the medical staff gave me a dose of antibiotics. Soon conditions returned to normal. The night went on, and contractions were slowing, probably due to the baby's position (although by this time, they thought he was turning). The epidural wasn't helping, either. They suggested trying pitocin if the contractions didn't pick up. Despite the intensity when they did occur, I was only dilated to 5 or 6 cm after many hours. Finally, I agreed, although I had hoped my body would do the work on its own. "We'll just feed it in on a secondary line with the IV," the nurse said. "That way we won't have to poke you again." I noticed that the tube attached down close to my skin, and asked about it. "That's so we can take you off the pitocin immediately should we need to," the nurse said. "So, what happens if you get too much?" I asked. "You just explode or something?" I was kidding. She wasn't. "Yes," she said. "It's a very serious condition. See the reading on that machine? We don't ever go above a level of 16." I decided that maybe it was time to stop asking questions. I tried to rest, but found that the epidural was again wearing off.

Suddenly, I was needing to breathe harder than I had yet, and was unable to concentrate, to relax, to control the pain. I was given a third dose of the epidural. I hoped it would work this time. They also inserted an internal monitor, not attached to the baby, but just loose inside the uterus to measure the intensity of contractions. Finally, at some point of this unending night (actually, it was about 9:00 am), I was completely dilated. I could push! The first few pushes were easy. I felt pressure but that was all. The contractions were irregular and slow, however, and they turned up the pitocin. And soon I began to feel a familiar pain returning. The epidural had once again worn off, and this time, I could receive no more. The next hour and a half or so was not very productive.

They had realized that even though they couldn't feel the fontanels, the baby hadn't turned, after all-his head was just tilted in a strange way. They tried a variety of positions for pushing. I wanted to sit up; it felt more natural, and gave me something to push against; but for some reason they did not want me to. The hospital is a research hospital and they encourage all the things birth books and birth plans say one should demand, so there must have been a reason why they tried having me push on my back. Perhaps it had something to do with turning the baby, or stretching the perineum. I could have told them it wouldn't work, though. They also had me try lying on my side. Not much better. Then they tried the towel method-I grabbed the middle of a towel and pulled while a nurse held the ends. It worked-it provided something I could work against. In the meantime, medical people kept turning up the pitocin. Jonathan, who had put a hospital gown on over his clothes and was assisting by holding one of my legs, saw them take the tarp off the table that was off to one side of the cheerfully-wallpapered room. It was covered with all the necessary implements for doing whatever was necessary to get the baby out. I won't elaborate. It's better if you don't think about that sort of thing. People kept coming in the room, but by this point I was mostly keeping my eyes closed. I noticed the doctor on duty. She was standing there watching. I was glad she had not decided to take over at that point. The midwife was slathering all sorts of goo on my perineum and was doing just fine. At least, that's what I thought later. In the moment, all I knew was that this hurt far worse than anything I could imagine. Strangely, the contractions didn't hurt as much as the time between contractions. The midwife tried holding the baby in position while I was resting so he wouldn't slide back, and the nurse kept pushing a monitor on my abdomen to check the baby's heart rate, and it just hurt a lot. At least while I was pushing, I could do something about it, try to end the pain. Jonathan kept encouraging me, telling me that he could see the head, but it seemed to me that I wasn't making any progress. I knew that once the head was past the bone, it couldn't slip back any more, but I couldn't tell if people were just being nice or if he really was moving. I remember thinking that there was no way I could go on any longer and do this any more. The pain was just too much. But then I realized that if I gave up, my body would still keep on doing this, only not so fast, and in the end, I might end up in a cesarean. So, I kept at it. Finally, I felt a stretching feeling and heard happy commotion in the room. I heard the midwife tell me to slow down for the shoulders, but by the time that registered, the baby had slipped out. Eric Parley Green was born. Six pounds, twelve ounces, and totally unconcerned about everything that had gone on. He even stuck his tongue out at us the whole time they were cleaning and measuring him.

After it was all over, the midwife told us that in the 700-800 births he'd participated in, he'd only seen one other baby with Eric's presentation who didn't produce a cesarean. As it was, I had no episiotomy and only minor tearing-one stitch. Despite a terrible labor, recovery has been pretty easy, and now I'm completely sold on midwives! I do hope next time is easier, though.