(Three years late, this is the story of the unmedicated hospital birth of my oldest daughter in October 2007. Three of the six hours of my labor took place at a small hospital in northern CA. In retrospect, a lot of my associations with the experience (i.e. hospital staff) are negative, but my labor wasn't super painful and I avoided the "cascade of interventions" and ended up with a "natural" vaginal delivery.)
I began having contractions shortly after 5:00 p.m. on the 13th; initially I only felt them in the lower half of my uterus and they felt more like menstrual cramps. I also began to lose my mucus plug, clear KY jelly-like pink streaked snot. Pretty quickly the contractions began to become more regular and to encompass my entire uterus. Mark began timing them and they were ten minutes apart. Around 7:00 p.m. Mark called my OB, Dr. M., in order to let him know that I was having regular contractions and that we’d probably be in sometime that night/the next day. Dr. M. told Mark to call him back in an hour with an update on how close together they were; Mark ended up calling him back from the hospital. I planned/expected to remain at home for several more hours; the contractions were still completely manageable. At this point I really liked sitting on my exercise ball. I took a shower and abruptly began to feel really nauseous. I spent the next fifteen minutes on the toilet, alternately pooping and puking into the dogs’ litter box. My contractions were now eight minutes apart, but getting closer together and I still felt really nauseous, so Mark cleaned up my mess, put the puppies in their playpen, and we drove to the hospital.
We arrived at the hospital around 8:00 p.m. By the time we had checked into labor and delivery, my contractions were about five minutes apart and becoming harder to talk through; my cervix was dilated 4 cm and was completely effaced. I became fairly hostile toward the nurse assigned to me rather quickly. I agreed to an initial twenty minutes of external fetal monitoring during which I had to sit in a hospital bed; staying still for this was probably one of the few actually “painful” parts of labor, exacerbated by the fact that she had the television on and tuned to Fox News (when Mark realized this, he turned it off). The nurse told me that I would have to have external fetal monitoring for 20 minutes every hour and continue to wear the hospital gown she had had me put on upon arriving. I was about to get in a fight with her when Dr. M. arrived. He informed me that I could wear my own nightgown (which I had planned on) or walk around the hospital naked for all he cared; he suggested walking around outside (which never happened). He wrote in my chart that I didn’t have to have any further fetal monitoring, wrote for both spinal and regular narcotics (“in case you change your mind”), and went home to get a few hours of sleep, predicting that I wouldn’t deliver until 2 or 3 that morning.
Mark brought our things up from the car and we were shown to our room. He blew up my exercise ball, but I ended up hating it for the rest of the night. I had thrown up once in the bathroom of the triage room and once we were shown to our room I barricaded myself in the bathroom and resumed the pooping/puking routine; I also decided that there was no point in wearing either my nightgown or a hospital gown. The nurse insisted upon taking a medical history from me at this point, 99% of the questions which Mark ended up answering for me since I couldn’t have left the bathroom at this point if I wanted to. The nurse asked Mark to confirm that I was bipolar. He refused claiming that I was “just depressed.” The nurse then asked me the question directly--in the middle of a contraction--and I screamed at her that I was neither, that I didn’t know, and to leave me alone. (I’m guessing that she wrote “yes” based on the argument I got into the following day with another nurse about why I would not resume taking ssris.) At some point--it may have been now, it may have been later--one of the nurses approached Mark about inserting an IV; he convinced her that it was not in her best interest to bring the subject up with me and that I would be refusing.
(The rest of this may be somewhat out of order; already I’ve waited too long to finish writing this down).
After he was done giving my medical history, Mark suggested that I try using the exercise ball. I tried sitting on it, but it (and any nearly any non-standing position) made the contractions hurt. I found that for most of labor if I went with whatever position “felt” right that the contractions didn’t actually hurt, but that the second I placed my body in a position that I “thought” might help they became painful. The nausea began to become less constant so I decided that I wanted to take a hot shower. After I was in the shower for a minute, I decided that I’d rather take a bath. The second that Mark turned the shower off in order to run the bath water, however, I became so cold that I insisted that he turn the shower back on while the tub filled. As the tub was filling I began to realize that there was no way that the water would ever be hot enough and Mark left to get towels from the nurses. At this point I was really cold/uncomfortable and kept alternating between sitting on the shower floor in the few inches of water that had accrued and standing shivering under the spray. Unfortunately it was also at this point that someone from the lab decided that they wanted to draw my blood because although my chart from my OB contained my blood type, and Mark was positive as to what my blood type was, I had no idea and couldn’t confirm it. The lab tech barged into the bathroom literally demanding my blood and wanting to know where I was (crouched on the shower floor). I don’t recall exactly what I said to her, but I refused to get out of the shower and began screaming at her to leave me alone. (Mark and the nurses could hear me from the hall.) She left with the threat that “you’re going to have to do it before you deliver.” (I actually didn’t end up having my blood drawn until the following morning by a much nicer girl who admired my baby.) Once I was out of the shower and dry some of the nausea returned (but nowhere near as bad as it had been earlier) and I noticed that I was not only still losing my mucus plug (which was much bloodier) but also leaking amniotic fluid. Mark asked if I wanted anything to eat or drink other than water--which I had been drinking the entire time--and I decided that I wanted a Coke. He went to the nurses station and came back with a can of Pepsi but offered to go down to the cafeteria and buy a Coke. I was so focused on my contractions, however, and hostile toward the nurses that I decided that I would rather have him stay and that I’d drink the Pepsi; this is only “significant” because normally I would never agree to drink Pepsi when a Coke machine was so close by. Mark encouraged me to walk around the room--and I did somewhat--but I kept wanting to return to the bathroom and sit on the toilet every time a contraction began. At some point during this time the nurse assigned to me asked really nicely if she could listen to the baby with the doppler after my next contraction and then during a contraction; I agreed and it wasn’t too horrible, although it was bizarre to have a strange woman holding the doppler against my stomach while I sat on the toilet.
I have no idea for how long/how many contractions I stayed in the bathroom. The contractions were really bothering me at this point. It wasn’t so much that they were super painful, but that they kept coming and I had no control over them. It was really hard to remember to breathe and I found that if I moaned and/or chanted “ow, ow, f--k, ow” it helped me to get through them. I seriously began to consider getting some kind of pain medication, reasoning that it could take the contractions away and give me my body back; between contractions, however, I would remember all of the side effects and complications caused by pain medications and decide that I didn’t want anything after all. Mark suggested that I really should try to stand up and walk around because it would help the baby move lower and come more quickly. I began to walk around the room but had to stop and cling to Mark every time a contraction came. They were really close together and I began to panic/become irrational, wondering why I couldn’t have an elective c-section or do something to make this be over. I told Mark that I maybe wanted pain medication and asked him if it would make labor go faster. He replied that it would slow labor down, and it was my choice but that I had said that I didn’t want it. I asked him to get a nurse to come do a cervical check and told him that I wanted to push. I decided that there was no way I could stand it anymore if I hadn’t dilated very far, although I expected to hear that I hadn’t. I really was feeling the urge to push and actually bearing down with each contraction, but I told myself that I was imagining it because I was so anxious to have it be over. Mark came back with the nurse who had me lie on the bed and decided to attach the fetal monitor as long as she had me agreeing to stay still. Mark reminded her that I wanted to be able to walk around and that Dr. M. had said that I didn’t have to have any monitoring. She then informed him that I was “not going anywhere” and “going to have this baby soon.”
The room abruptly filled with people and everything became very “busy.” Dr. M. was called and (according to Mark) arrived in less than fifteen minutes. A nurse I hadn’t met before, but whom I liked slightly more because she hadn’t had a chance to argue with me, stood on one side and began encouraging me to breathe through the contractions. Mark stood on the other side and I can’t remember what he was saying, but his voice was really calm and soothing. The contractions were definitely painful at this point, probably because I was reclining on the bed, but I felt really tired/overwhelmed and didn’t want to move, especially after someone placed heated blankets over me which felt so good. In addition to reminding me to breathe, the nurse began instructing me not to push and to blow through the contractions instead. Mark said later that he thinks the nurses were worried that I would deliver before Dr. M. could arrive and were trying to slow things down; I have no idea when he actually arrived, but at some point I noticed that he was there. According to Mark, who could see the monitor, my contractions were really strong and the baby’s heart rate began dropping during them; because of this, I was given oxygen which seemed to help. I don’t know if the oxygen was actually “necessary,” but it made it much easier to breathe through the contractions. I was pushing somewhat during every contraction now, but not as much as I wanted to and I was still being told not to. (Mark later explained that the reason they were telling me not to push was because she was coming so fast on her own that it wasn’t necessary and because they were trying to keep me from tearing.) I heard one of the nurses comment on how much hair she had and I thought “wow, the thing about heartburn and hair really is true.” Finally, someone said that I could do little pushes. I felt a burning sensation, began to push harder, and then she was out.
Mark explained to me that because she came out so fast there was still some amniotic fluid in her lungs and so they were going to take her across the room for a second to suction it out. Dr. M. informed me that I had a small tear (“no worse than if I had given you a small episiotomy”) and that he was going to have to “patch [me] up.” He also informed me that he and another OB had had a bet on whether he would “end up sectioning” me and that I had “proven everyone wrong” in addition to having just won him a dollar by delivering her vaginally. I heard someone say that her Apgars were 8 and 9 and then she was given to me. Mark heard one of the nurses tell the other to go get something IM (intramuscular) because I didn’t have an IV in and so he asked, “what do you want to give her IM?” I completely missed this part of the conversation, but I very clearly heard her reply, “pitocin for the placenta.” I started loudly and adamantly refusing and one of the nurses replied that it was to keep me from hemorrhaging. I appealed to Dr. M. and asked him why I couldn’t try to deliver it on my own. He informed them that the pitocin could wait and that I had proven them wrong about everything else so far. My body then expelled the placenta very shortly after that (I think I pushed it out a little) and he asked if I wanted to see it. I informed him that I did not, but Mark later told me that it looked good. I asked Dr. M. if we were done now and he said that he still had to give me some “numb-er” and “a few stitches.” I think that this part hurt more (at least in the way I think of “pain”) than everything prior, that or I was just a lot more lucid; I complained loudly the entire time he was sewing the stitches, but even that was more uncomfortable than anything else.
Everything immediately after the delivery is pretty much a blur. I remember my conversations with Dr. M. and Mark’s reassurances that he was staying with Alice and that she was fine, but it’s all really vague and disjointed. I know that I spent a lot of time holding her and looking at her while Mark held her, but--other than the pitocin--I was mostly just content to let other people make decisions. The nurses delayed weighing her and giving her the vitamin K and eye cream and she did not receive a hepatitis B vaccine. Mark didn’t take her to the nursery to get a bath until the nurse took me into the bathroom to help me pee, clean up, and go over the care of my stitches. Alice also breast fed for the first time less than an hour after birth (a little after 12:00 a.m. and she was born at 11:17 p.m.).