september mama

WARNING: this is extremely graphic and may make the weak-of-heart a little queasy. it was not an easy or pleasant experience, in the end, and i spared no details in the telling. it may also bore you if you don't want a play-by-play description of labor and birth.

around 1.30am on 5/15 my water broke. i woke to a small puddle around my nether regions, got up to pee, and went back to bed with a towel under me. when i woke up again around 730am, i was sure it was amniotic fluid and i told matt i was "leaking" (which i later learned he did not full comprehend). throughout the morning it continued in a slow stream, and around 1030 i saw the aptly-named mucus plug, at which point it hit me that i was really going to have the baby, so i called my mom and then the birth center to see what i should do.

i went in for an assessment and learned i was about 1cm dilated. i wasn't having contractions. i lied and said i didn't know what time the water broke; the midwife and i agreed we'd call it 730am since we couldn't be sure (she was kind enough to help me buy some time on the 24-hour clock by doing so). she also stripped the membranes for good measure. she told me to go home, get my stuff, and come back to the birth center, from whence i should take brisk walks as much as possible to help encourage labor to start. i was told if nothing was happening by 7pm that we would need to use castor oil which i did NOT want to do... so i got my stuff, settled in, and walked to maude's for lunch and to see matt, who was very surprised to hear i was technically in labor!

i made it back to the birth center around 3 with my lunch, and after a brief...discussion...with the on-call assistant regarding when castor oil was to be started, we consulted as my mom showed up. the midwife was clearly anxious at this point, because nothing was happening; i still wasn't having contractions. so we decided to try nipple stimulation with the electric breast pump and combine it with black and blue cohosh tincture every 15 minutes for an hour. an hour later, nothing. they checked my dilation and i was still at 1cm... somewhere in there matt arrived and the shift changed so i was now working with the midwife i had always known would be at my labor (she is the one who helped me through the bleeding incident at 12 weeks). she said it was time to take the castor oil, and suggested i go home to do it and try to get some rest before it kicked in, and to call her at 1130pm. matt had a horrible toothache and headed to the doctor for some antibiotics and pain pills. my mom went with me for support.

on my way home i stopped and got a 4oz bottle of the stuff and some ice cream to make a milkshake... let me just say this: castor oil is nasty stuff. and 4oz ain't no small dose, either... it's straight, thick oil. *shudder* i tossed it in the blender with the ice cream, some milk, and a little bit of chocolate, and sucked it down through a straw at the back of my throat as quickly as possible. after that my mom and i went for a walk to kill time and try to get my uterus into gear; and to distract me from the awful nausea my castor-oil-filled belly was feeling (when you burp that stuff, it's like drinking it all over again. i am actually feeling ill just remembering it!). anyway, within an hour i was hit with the explosively powerful digestive-system-emptying qualities of the castor oil, and beginning to get contractions. it's nasty, but it works.

the next few hours are a total blur for me; between cramps from the dose, true contractions, and horrendous diarrhea, i was in another dimension of confusion and discomfort. i remember taking a couple of baths, spilling candle wax on the floor, and eventually listening to very loud tool music (lateralus, mostly) while rocking on my pilates ball, but other than that it's a senseless mass of ick in my mind. by the time 11pm rolled around i was in full-blown labor, vomiting, and dazed. matt called the midwife, my mom showed up (after having left to get some rest herself), and we went back in to the birth center. karen--my dear doula--met us there. sometime during the night my dad showed up as well.

at the birth center they told me i was dilated to 4cm. i labored in every position imaginable; in the tub, on the bed, on the ball, on the toilet, in matt's arms. i labored for an eternity and for no time at all. it's strange how a moment can last forever and hours can fly by all in the same experience. labor contractions are like nothing else in the world; every one pushed me to my utter limits of endurance, and yet with every one i was able to tell myself "it's just one contraction, just get through this one and you'll survive." and the eternal instant would be over. my coping mechanism was to relax as completely as possible through each one, relaxing in spite of the pain, loosening my muscles, and breathing deeply and slowly. i won't say it helped the pain, but it kept me from screaming and from fighting my body. i surprised myself by making labor sounds, too... the deep, round OOOO came naturally. at some point during the night, they told me i was 7cm and it was ok to push if i got the urge. when i did, it was the strangest feeling ever--my body took over and i felt like my insides were involuntarily trying to eject something... there was nothing i could do to stop it, even had i wanted to. so the pushing began.

they tell me i pushed for something like 7 hours total; i have no idea if that's true. all i know is that i pushed, and pushed, and then i yelled, and i got angry... i put every ounce of my being into moving the baby down my birth canal, and nothing happened. consistently. she just wasn't moving down, despite my body's urges and my conscious efforts. coming up to 7am (saturday 5/16) our midwife consulted with her backup OB and we were given permission to try for two more hours before mandatory transfer to the hospital... but the extra time made no difference. the hands in my pelvis, putting painful pressure on the spot i was to push towards, made no difference. getting angry didn't help, and neither did talking to the baby. (lucky for all of us, her heart rate had never faltered through all the stress of the labor, which is the only reason i was allowed to go over the 24-hour limit.) they told me there was a muscle "in the way" in my pelvis that was blocking the passage and they couldn't move it out of way enough to help rowan descend.

finally, 9am, the midwife said it was time to go to the hospital, and i broke down. she said we were looking at an assisted delivery via forceps/vacuum if the baby was down far enough; if not, they'd have no choice but to do a c-section. i knew she wasn't down far enough, and i cried. i was so indescribably dejected--all that effort, all my positive thinking, all my preparations with herbs and whatnot over 9 months, wasted--it was awful. i have never felt so down in my whole life. i failed. we packed up and went to the hospital.

i don't know how i survived the car ride--it was bumpy and i was having non-stop contractions--or walked through the hospital halls, but eventually i was in the labor room and instantly all control, even my sense of having the ability to participate in basic decisions, was gone. the birth of my baby no longer had anything to do with me. i was hooked up to monitors, given an IV, attached to a BP machine, and messed with by no less than 6 strange women who never looked me in the eye or asked my permission to manhandle me. i was, however, allowed to keep pushing in an attempt to birth naturally while we waited for the OB to arrive. my midwife and assistant were graciously allowed to keep working with me under the direction of the hospital's midwife... so the ordeal of pushing continued despite me having absolutely no energy left for it. (they had put me on pitocin also, to make sure i had minimal latency between contractions, which just made me more tired.) after a long while of this the OB came in and said we didn't have her down far enough, and her heart rate was dropping precipitously during pushing which was making him nervous, so he screwed an internal monitor into her head despite my tears and objections. then he said he wanted me prepped for surgery "just in case"--i learned later that he told my family i was going to have a c-section. (i was told it was too late for an epidural and that if i did have a c-section it would probably be under general anesthesia, which was my worst nightmare come true...being unconscious for the birth of my baby.) then he left to give us a few more minutes to push.

by about 1130am i just couldn't do anymore. i was done. the doctor came back and said the baby "might" be low enough, and that we could try the vacuum but it might not work. i signed a release stating the devil could take my soul and anybody else's if the doctor decided it was medically necessary, i was given a foley catheter "just in case," and they started shaving me where the incision would be. i asked what the pain was going to be like with the vacuum, since i couldn't have an epidural for this; he said i was going to get a "pudendal block" (local anesthetic like when you have a tooth worked on) but that i would still have sensation. i should mention that i was crying non-stop at this point, in unceasing pain from contractions, and exhausted beyond my wildest conception of what i could endure. i was told to save my energy so i could push hard when he started to pull on the baby's head. he gave me a big shot of lidocaine or something into my vagina on each side, and my right leg went numb along with (i assumed) my birth canal.

here it gets blurry... my memory recorded only snippets of things... i don't remember pushing, though i must have. i remember hearing other people shouting, and i heard my own voice wailing. i remember vividly the sensation of him pulling her head with the vacuum, like someone plunging a toilet inside of me. it failed to deliver her, but brought her down more, so he switched to the forceps. and ripped her out of me. it felt like she was torn away from my body... it was so fast, and so scary, and so unnatural, to feel it and not feel it at the same time. (the injection--or my wild state of mind--must have dulled any sense of 'pain' but left me fully able to feel the pressure and movement of the delivery.) i felt the tear--or the cut?--of my own tissue as her shoulders came out, i heard her cry, and i cried. she was covered in blood and her head looked awful, but she was out. i was hysterical. not from pain, per se, or even joy, honestly. i was so sad and so tired and so relieved it was over (or so i thought). they put her little body on my chest and she nursed and i just kept crying. her poor little head was so stretched out, it broke my heart. but she was perfect. it turns out the cord was wrapped around her neck (twice?) and holding her back, which is the other part of why she couldn't descend. we didn't get to have the quiet alone time i hoped for, the idyllic bonding moment, mostly because i was so distraught. but she was with me for some amount of time while the hospital staff bustled around, and she nursed, and she looked at me... it kills me that i do not have a clear memory of those first moments with her. if i could do it all over again i would, just to have that time back so that i could pull myself together and truly absorb the moment. but even though she was given the opposite of the gentle waterbirth i wanted to greet her first breath on earth, she never seemed to be affected by the violence of her exit from my body. i am thankful for that above all else.

i thought the worst was over at this point, but i could not have been more wrong. i can't remember if i was still having contractions, but the placenta* came out and after a break of some period of time during which my parents were allowed in and matt helped them wash and weigh rowan, the OB had to stitch me up (yes, they brought in my family while i was left there splayed out, feet in stirrups and half-numb, crying, torn, and bleeding everywhere). i had been given an episiotomy (without being informed or consenting), and still i had something like 8 tears, and at least one was third degree. i want to say that the hour it took him to put me back together was worse than all the hours of labor, and even the delivery. it was horrific. i felt the actual stitching for a great deal of it, and for some reason i was experiencing insanely painful and inexplicable pressure on my anus during the whole thing, such that i was sobbing and wailing the entire time. i had been through far too much trauma and was too weak and delirious to tolerate any more pain. i still feel that way, actually... my emotional pain tolerance has not recovered yet, and any minor pain lately causes me a lot more emotional upset than it normally would.

during the entire time this was happening my mom and matt switched off holding rowan; she never left the room. she was perfect and healthy, amazingly, despite the long difficult labor. she seemed to know her daddy, too, because she quieted down and responded to him immediately when he took her. at least one of us was able to take advantage of her "alert period" after birth.

we stayed three days in the hospital because of some stupid bureaucracy plus a little confusion on the last day. they held us--officially--the second day because we "refused the vitamin k shot and she was born with a vacuum;"** because assisted birth can cause hemorrhage in babies and we didn't give her the clotting agent they wanted us to (considering she probably has a clotting disorder like i do). we were supposed to go home the next morning but we spent all day waiting for a prescription that the midwife forgot to call in. i have never had to sleep in a hospital before, but damn it sucks. in fact i didn't sleep at all... nurses came in almost every hour to hassle me for vitals, wake the baby up for vitals, give me a medication, ask me if i fed her, or whatever other random bullshit they could think of, so it wasn't really easy to get any sleep. plus i was strung out, depressed, and in pain--i now think i was suffering from PTSD for at least the first week after her birth. i slept about 3 hours total over the 5 days following it. anyway, the stay at the hospital was uneventful other than having lots of appreciated visitors.

rowan was more than fine; she was nursing perfectly, healthy, calm, and apparently happy. she had a little bit of jaundice, which is normal for breastfed babies prior to mom's milk coming in, and no other issues. she slept a lot and was attentive and adorable when she woke. before we left they said she had "almost" lost too much weight, but i was told just to feed her like crazy and everything should be fine. i, on the other hand, felt like someone had beaten me with a two by four between my legs--bruised beyond belief, but no pain from the stitches or anything. thankfully the only pain i had during the immediate healing process was a dull bruised sort of ache. i did have nightmares when i finally slept, however, and crying fits for about two weeks. (i'll post another entry detailing my postpartum experience later.)

as i think back on our birth experience one month ago, i still don't know how to feel about it. as many things as i have to be thankful for, there is a balance to be mourned, and i am having a hard time with that. i mourn our loss of the natural birthing experience, of a quiet and peaceful entry into the world, of bonding happily uninterrupted in the moments after birth, of being in a comfortable space and bringing her home to our bed right away. i mourn her trauma; the vacuum that disfigured her head and the forceps that bruised her face, the unloving hands that bathed her and suctioned her mouth and put a monitor in her scalp. and i mourn my own pain and humiliation; physical, mental, and emotional...i have scars on all three planes. i also have guilt: i wonder now if my stubbornness in not acquiescing to a c-section wasn't more dangerous and risky than if i had let it happen--assisted birth (w/ forceps or vacuum) has been known to cause fetal death, brain damage, disfigurement, etc. part of me feels that maybe i risked too much for my own pride in demanding a vaginal birth... i know that is neither here nor there because we both survived without incident... but i do have a sense of slight shame for what may have been irrational egoism in the moment. i am told i was "so strong" and "amazed" everyone with my willpower and endurance, but all i can feel--still--is sorrow for the failure to do it naturally, and now, a sense of having only barely avoided a potential tragedy of my own making. i do not think i will ever be able to feel proud of this birth or to claim it as the victory i am told it was. i hope i am wrong, but it's hard to take pride in knowing that without medical intervention one or both of us probably would have died... it isn't pleasant to be forced into feeling grateful for an establishment i loathe.

in the end though, it was all worth it, of course. i have an incredible little girl who is my reason for living, and if my body and my pride were wounded in the process of producing her, so be it. i suspect that i will always wish it had been closer to my fantasy, but the universe is what it is and that's ok too. someday, before she is too old to answer honestly, i will ask rowan what happened in there and why her birth had to be like that. maybe she will know.



*my placenta was a medical anomaly: it had two lobes (instead of looking like a kidney) and something strange about the veining and the cord which i was too out of it to comprehend at the time. all the medical staff were surrounding it and talking and confused, the midwives were taking pictures, and everyone was saying "i've never seen that before!" so they kept it to send it to pathology but there was nothing wrong with it--apparently it was just really weird. i'm trying to get more information about it but for now all i have is a gross picture and hearsay from matt about what they were saying. (ok, just googled it and learned something: bilobate placenta.)

**we did do the PKU though now i can't help but wonder if i shouldn't have (florida retains newborn DNA for at least 5 years and it's not clear whether they use it for research; i am looking into this to find out how to make them destroy her sample). we didn't do any of the other routine treatments or tests on her.