Dominic Alec Whitcomb Valdez – a Very Long Labor
Wednesday Feb 9 at my 41week midwife checkup, my midwife confirmed I was dilated to 3 cm and 90% effaced. Woohoo – it was time to get the party started and I was excited.. She expected to hear from us later that evening. We did call her about dinner time, and she came over to check me – by then I was 5cm dilated, and we officially started the labor clock. (Keep in mind, I’d been having contractions off and on for well over a few weeks). I went ahead and officially started my maternity leave. Laura (our midwife) went to dinner and said she’d come back in a few hours to check on me. Rod filled the birth pool and I got in to spend some time laboring in water – it was wonderful. Then I pruned up, and got out. I was having some back pain, so was doing a lot of bending over the birthing ball, laboring on all fours, and bending into the chair with my knees on pillows on the floor. Laura got back about 11pm, we checked me and I was dilated to 7cm. She started to set up all her supplies for the homebirth, and I continued to labor. My back by that point was hurting so much (and so constantly) that I couldn’t find a single flat spot in my entire house to either sit or lay comfortably. We should’ve called it back labor then…. I spent most of Wednesday night contracting every 10 or so minutes with either Laura or Rod applying counter pressure to my lumbar. Around 4am (and around 20 degrees outside) Laura and I decided that maybe I should try sitting in the hottub (which is outside) and letting the lumbar jets massage my back. 20 minutes of that did help, and we came back inside so she could thaw out. We repeated the hottub process about 7am. Laura checked me again and I was still just 7cm. After consulting with her midwifery partner, Robin, Laura decided to leave us alone to labor for a few hours, and gave instructions to call when we felt we needed her there again. Before she left, she gave me a good dose of cottonroot tincture which should’ve kicked me into high labor. I threw it back up almost immediately.
I was back to laboring on the birth ball, on all fours, etc, but with my back so sore I had to have Rod apply some pretty hard counter pressure for each contraction, and I started to realize that my lumbar area was feeling actually bruised from all the counterpressure. By about noon, I was a mess, and called Laura to tell her that I didn’t know how much longer I could do this and wasn’t there some magical way to make the back pain stop. She decided to send over Jessica, one of the intern midwives, who is also a massage therapist to check me and see about loosening up my back. We also decided to send Rod out to get me a fleet enema to see if maybe I was just a little constipated since I hadn’t been able to use the bathroom for a few days. Jessica got over around 2:30 Thursday afternoon. She checked me, and called me still a 7, but thought she felt bulging water bag. She massaged my lower back and managed to loosen it up beautifully for me. I stood up, had a single contraction, had her feel it, and then felt my back lock up entirely. She is the one who confirmed the back labor. The reason I wasn’t able to time the contractions I was having very well was because the pain in my back was overriding the pain nerves in my cervix, so I was constantly feeling the back pain, and not able to feel the true contraction. We went ahead and did the enema, and it did clear me out nicely, and I started to have contractions every 7 or so minutes. Jessica called Laura, and it was decided that she would stay with me until Laura arrived to recheck me.
Laura arrived about 4pm. Confirmed I was still dilated to a 7, but wasn’t sure that what Jessica thought was my water bag really was, she said it felt more like a cervical lip. I got back in the hottub and Rod started to refill and heat the water in the birthing pool, as we had decided water was the best place for me now. After getting the birthing pool up to temperature, I got in. I stayed for well over 4 hours. I actually really enjoyed laboring in the pool. It was an awesome experience to surrender to the contractions, float on my back, relax in my little womb world. It would’ve been even more awesome to deliver the baby there, but it wasn’t meant to happen that way. Around 9pm, Sara, the other senior midwife I’d seen through my prenatal appointments made it over. We joked that I’d held onto having the baby until she made it there (she had been out of town briefly). Laura by now was able to feel the water bag, and went ahead and broke my water – which should’ve kicked me into high labor – it also put us on a clock because it increased the risk of infection. When she broke my water, there was mild meconium staining in the water.. By now Rod and I were both really tired, so he tried to get some sleep while the midwives watched over me laboring. At some point during my 4 hours in the tub, I started getting a bit pukey, and ended up throwing up into a metal bowl several times. The midwives checked the babys hearttones easily every 15 minutes, and every time they were beautiful. I was still loving water labor, and had them boiling water on the stove to keep the pool nice and warm. We tried to get my labor going a bit better with nipple stimulation – and even a good hour of that didn’t make much of a difference. At about 11pm, Laura asked me to get out of the water and do some dry land contracting. I was by this point dilated to 9cm with a bith of a lip. She was very concerned that I had not developed a regular, hard, labor pattern. She had Sara and Jessica stay with me and went upstairs to get a bit of a nap (she’d had less sleep than I had at that point). I got on the birth stool with a chux pad underneath me and waited for a contraction. Nothing. Hardly at all. The contractions came grating to a halt on dry land, which was very bizarre. So, I got back in the water and the midwives consulted. Rod was still trying to get some sleep. Around 1am Friday, Laura, Sara, Jessica and I made the decision to transport me to the hospital, because even if I was able to get a good labor pattern going, I was far to tired after laboring already 32 hours to push the baby out, and the baby was getting tired too.
We woke up Rod, madly ran around packing a bag, printed my contingency birth plan (SO glad I wrote one), called our friends who had said they’d take the dog for us if needed, and got moving. Laura called the hospital to tell them we were coming, and drove me into the hospital, with Rod following in our car. Sara also came to the hospital with us. This is where it starts to get very fuzzy for me. When we arrived at the hospital, they were waiting for us in the labor and delivery ward. We had a great nurse who got me all set up, and the on call person in the ward that night was a lovely Certified Nurse Midwife who agreed to honor my birth plan, we got me hooked up to moniters, an IV drip (very important because I’d gotten a bit dehydrated during labor) and checked. At that check up my cervix had gone back down to 6cm. The hospital staff was awesome to my midwives, and both Sara and Laura stayed with us the night in the hospital. We all expected me to deliver by 7am. I agreed to fentanyl (no idea on spelling, it’s a short lived narcotic) to take the edge off my back pain so I could sleep. That was fabulous, I got a couple of hours of sleep, and dilated back up to a 9. When the shift changed, and I got my new nurse (Nisa – fabulous woman), my dilation was back down to 6. The CNM was beside herself. (We were by now making jokes about my misbehaving cervix). The new doctor wasn’t nearly as nice as the CNM, and had a very abrupt bedside manner. They started me on an epidural (my request), and pitocin to try to get a decent labor pattern going. The problem was my cervix was asynclitic (again, no idea on spelling) which means it was dilating at different rates – the front would get to a 10, the back still be stuck at a 7. Nisa turned out to be amazingly patient – she tilted the bed so I was basically upside down and had me rolling from left side to right side every few minutes to try to get the baby to back out of my pelvis, turn around, and come down directly on my cervix. Because of the meconium in my water, they did a procedure by which they added saline to my water to try to dilute it so that the baby would not aspirate meconium during delivery. Note to self – being upside down, while in labor, while having heartburn, is bad. I threw up multiple times. The backpain was thankfully gone with the epidural. The doctor came and checked me around 10, and started to make noises about a c-section if I didn’t progress faster. We kept trying to get me dilated to 10cm so I could push, and by 12 noon, the doctor laid a line down – I was only at 9cm and if I didn’t get to 10 by 1:30, we were having a c-section. Also, at 12 noon, I was almost 16 hours past my water being broken, so we had to add antibiotics in case of an infection to my IV.
Well, the threat of a c-section didn’t set well with me. I put the oxygen mask on, started doing deep breathing to make sure the baby had plenty of oxygen, and got creative. We flipped me up on my hands and knee’s – not easy when you’re numb from the waist down, and sort of draped me over the bed (it was propped up) in a supported squat. I within 15 minutes of being in this position started to feel a bit of an urge to push. We got the doctor back in there, he said I was complete and could try pushing, but didn’t look too thrilled – come to find out he was already working on c-section paperwork. I was determined to not have surgery. We put Rod on one foot, Laura on the other, Nisa doing hot compresses and guiding my pushing, and Sara being a cheerleader, and I pushed for everything I was worth. Everyone there who’d been around laboring mom’s said I pushed like a second timer. In about 30 minutes the baby was crowning, so they made me stop (yeah right, try to stop a freight train – I could NOT not push), got the doctor in, he had enough time to gown up, and catch the baby. I pushed Dominic out in a total of 41 minutes from the time I was told I could try to push. When Dominic came out, he spewed blood and meconium everywhere. Rod jumped back, and the doctor got splattered. The doctor didn’t let me deliver the placenta before he wanted to cut the cord, but he did let Rod cut the cord, so we were happy about that. He delivered my placenta into a bowl, palpated my stomach for clots, stitched up a small perineal tear, and went on to the next laboring mom. I did get permission to keep the placenta, and we will bury in the spring in the garden.
Dominic came out great – no meconium aspiration, 7lbs 15 oz, 21 inches long, born at 2:09pm on Friday Feb 11. 44 hours after Labor officially started. Laura and Nisa got him latched on and he nursed in the delivery room. We got about an hour before we transferred up to the recovery area, and then Rod stayed with Dominic while he got his bath, his tests, etc, and I went to lay down and get some rest.
We were treated beautifully in the recovery ward, and released almost exactly 24 hours after his birth. We are home now, trying to really learn breastfeeding and focusing on resting. Even though I didn't get to deliver him at home, I am so happy with how we were treated by the hospital. So it wasn't a bad tranport experience.