On Opal's due date, there was no sign she was going to be born any time
soon. She wasn't engaged, and I wasn't effaced or dilated. The doctor wasn't
concerned. A week later, when matters hadn't changed, he was still calm,
but wanted to schedule an induction for the next Thursday, when I'd be 2
weeks + 1 day overdue. We weren't happy about that; inductions don't usually
work well if you're not ready, and everything looked great. He wasn't happy
about waiting, but agreed to 43 weeks with monitoring, as long as we understood
he objected. We did several rounds of non-stress monitoring in his office,
plus ultrasounds to determine the fluid level at the hospital. On the first
ultrasound, everything was perfect, and in fact there was almost too much
amnniotic fluid. But the Monday coming up to 42 weeks, amniotic fluid was
low, and the people at the hospital told us she ought to be induced immediately.
The doctor said not to worry, it was low but OK and to be expected at 42
weeks, but how about going back to his original plan, so we did.
That meant going into the hospital on Wednesday night so they could give
me Cervedil to ripen my cervix, and then starting pitocin Thursday morning.
Paul had a job interview scheduled for Wednesday, which he rescheduled. Everybody
told us that although it was possible that I could start labor just because
of the Cervedil, and they scheduled it in the evening to maximize that possibility,
it wasn't at all likely given how unready I was, the main point was just
to make it more likely that the pitocin would work easily.
We went in Wednesday night at 6 as requested, and then hung out for several hours until a room freed up at 8. Alas, since nobody expected much to happen and it was a routine induction, they assigned us the newest nurse. She was sweet, and earnest, and knew absolutely nothing except the hospital standard procedures, making her really pretty useless. They put in the Cervedil, fussed around no end with monitors, decided that her heart rate was dubious so insisted on putting in a heplock so they could do an IV at a moment's notice (she got the IV on the first stick, but something was wrong with it anyway, as I was badly bruised for 2 weeks afterwards and it made a nasty lump), and then after all this told us to go to sleep as nothing was going to happen. That was much easier said than done, but as soon as Paul fell asleep it became noticeable that the reason I was having trouble was that I was going into labor, which I announced by becoming violently ill and throwing up all over the place. The useless nurse did not offer mouthwash, or a wet washcloth, or even a basin in case I threw up again, but she did offer Phenergan. This made me sleepy, but did not keep me from throwing up every 30 minutes. Fortunately Paul found the basins. Unfortunately all this knocked out the Cervedil eventually and they had to put a new batch in. The nurse then offered more Phenergan, which I declined. I stopped throwing up, and Paul and I went back to sleep, at which point they once again decided the baby's heartrate was problematic.
This caused them to put a blood pressure monitor, an oxygen monitor, and an oxygen mask on me, and hook up the IV with saline, and then to decide they ought to get ready for a C-section and send in an anesthesiologist at 3 am or so. Paul slept through all of this, but woke up promptly when I called him because I was starting to be panicky and truly miserable, and the contractions were getting quite strong. He says that at this point I told him I was never going to have the baby. At about 6, I got out of bed to try other positions to deal with the contractions.
When the shift changed at about 7:30, somebody noticed that my water had broken, as the bed was soaked. My blood pressure was high, so they were back to discussing C-sections, but at this discovery the doctor asked for an internal to see if I was making any progress, before they started the scheduled pitocin. I was nearly 4 centimeters dilated, so they decided to skip both the C-section and the pitocin and see what happened. At about this point, my friend Diana came to help (she hadn't been there the night before, again because everybody said nothing would happen until they started the pitocin in the morning.) I proceeded to dilate to 9 centimeters by noon with very little fuss; in fact, the first thing the experienced morning nurse did was take away three of the monitors and the oxygen. I spent pretty much the entire morning on all fours on the floor leaning over a birthing ball, with Paul rubbing my lower back.. In fact, afterwards I had bruises on my knees, and rubbed patches on my lower back, from Paul providing counter-pressure for a good 18 hours.
At noon, I was at 9 centimeters. At 1, two separate internals were judged
to be just a lip on one side (they were trying to place an internal monitor,
because the external one wasn't being reliable -- they never got the internal
to work even as well as the external). The nurse we had for most of the day
was incredibly supportive, and loved the idea that we were doing it naturally,
and admired how good Paul and Diana were at helping me.
There things stalled. At 6, the shift changed again, and the new nurse insisted
that I try laboring in bed lying down where the external monitor would work
better. At that point, I stopped contracting altogether, and we agreed to
go for the pitocin. Then, the new nurse and the doctor proclaimed that in
fact I didn't just have a lip on one side, I was still at 9 centimeters!
The pitocin succeeded in starting contractions again, eventually, but they
were very painful and after an hour of them nothing had happened. The doctor
wanted to do a C-section, but we settled for doing an epidural and more pitocin.
The epidural was a textbook example; the anesthesiologist arrived within
10 minutes, I felt no pain at all when he did it (much to his surprise, he
thought I was being stoic), it took effect completely and rapidly, I could
still feel and move my legs, and you don't get much later than 9 centimeters.
Everybody intervened to stop him using betadine (he'd missed both the hospital
issued allergy bracelet and our added "iodine allergy, no betadine" sign,
but Paul and Diana were both watching him like a hawk and stopped him as
soon as he pulled out the betadine). Alas, there was some iodine in something
anyway, as I developed a nasty itchy rash all up my back where he taped down
the tubing with the "I don't know about the tape, but this stuff is guaranteed
hypoallergenic" clear adhesive patches. That didn't set in until later though.
There ensued 3 hours of trying 1 last hour in a new position before going
for a C-section. At the end of the last one, when we were resigned to the
C-section but made slightly hopeful because I was getting enough pressure
to need to breathe through contractions even with the epidural, the nurse
came in, checked again, and said no C-section, time to push. And with the
first push, she said "That's why the internal monitors didn't work -- look
at all that hair!"
I pushed for 40 minutes officially, but that's counting the first trial to
see whether it was time to call the doctor. It was only serious for about
20 minutes. I could feel the contractions better than they could see them
on the monitor, and she was moving fast, so they told me to tell them when
I was going to push. I was pushing very hard, but not on every contraction
(even though I was on oxygen again, I was often still out of breath for the
next contraction, as they were very close together.) Although the doctor
did try having me breathe through the last bit and supporting the perineum,
I still had a small 2nd degree tear (he says it's a funny crescent shape,
I haven't checked). She was covered in meconium but still had apgars of 8
and 9, and she is a lovely baby. Everybody kept looking at her weight, and
remarking that late babies are supposed to be big babies, but she was just
right. There is absolutely no doubt that she was late; not only do we know
the last possible date she could have been conceived, she was dated with
an early scan, and she was born all wrinkly with long toenails and fingernails.
Having violated hospital protocol right left and center, the doctor kept
it up by letting them take out the IV immediately and clearing me to go home
12 hours after birth (I ended up staying an extra day to make the pediatricians
happy with the baby, which was OK).
Although on the whole the hospital was very into intervention, they were
great about some things. They got me a sandwich as soon as I got onto the
maternity ward, and they were *fantastic* about helping me breastfeed.