I had my fifth prenatal appointment on Wednesday at exactly 36 weeks. My blood pressure was normal. Weight was up 19 pounds. I felt good. We tested for GBS. My midwife was surprise I elected to get tested since I had declined so many of the standard tests to that point. I explained that I wanted a result so that I could make an informed decision if my water broke before I went into labor; I knew that I could decline an induction and walk around for days with my membranes ruptured if I was GBS negative.
Fast forward to Friday. I was exhausted. I didn’t sleep at all the night before. When I got to work I asked my co-workers how long they had worked during their pregnancies; I got various answers and lots of understanding. Another month or more of full-time work was difficult for me to face. I had had an exceptionally easy pregnancy. No vomiting. No backaches. No troubles. It was a very happy time. Up until that day working hadn’t been a problem, then all of a sudden it was too much. Since I was an RN on the midwife unit I planned to deliver on, I looked up my own GBS result. Positive. Damn. Putting my irritation with the test result and my fatigue aside, I got to work.
Halfway through the shift I noticed my scrub pants were wet; I assumed it was the extra discharge that occurs at the end of pregnancy so I changed and thought nothing of it. A little while later I was wet again. Quick trip to the bathroom to clean up and back to work I went. A short time later, same thing. Okay this was distracting me from the labor patient I was trying to assist, I couldn’t continue going to the bathroom every ½ hour; I put a pad on to absorb the fluid and, again, went back to work. The next time it happened I decided to test myself for rupture with nitrazine paper, just for fun. Hmmm…came up positive, but I couldn’t be ruptured. I went back to work. I did this 4 or 5 more times and each time I denied that the nitrazine paper could be correct – I couldn’t really be ruptured, I was too early. At the end of the night I told the midwives what was going on and we decided to do a sterile spec exam just to be on the safe side. I called my husband while I pooled and he said he’d wait up until I called back with the results. I felt silly and slightly embarrassed. What would my co-workers think when it turned out to be a false alarm? It was strange to be lying in a patient bed. I didn’t belong there. On exam, the midwife didn’t see a lot of fluid, but took a sample anyway to test for ferning. I finished my charting from that evening while waiting for the results
. They came back positive, but only in one spot, so we weren’t convinced. We decided to do it again. While waiting for the results the second time I sat out at the nurse’s desk chatting with my co-workers, feeling nervous and oddly excited. When the midwife came out I knew from her expression that it was not the news I was hoping for. She confirmed that my water had broken. I burst into tears. All my nervous energy and anxiety boiled up and came out in a good cry. A co-worker gave me a big hug. I went home to pack.
I knew I would not be having the intervention-free water birth I was hoping for. I would need an IV, antibiotics for the GBS, and an induction since I was not in labor. I couldn’t have a water birth because I was less than 37 weeks pregnant and considered preterm. I mourned my loss, but was determined to make the best of it and go with the flow. I’d joked during the pregnancy that my water would break at work and I would punch out and check myself in as a patient. Wow, it really happened that way. Who could have guessed?
The drive home was surreal. When I got there I hugged my husband. We packed and took pictures of my still-too-small belly. When we got to the hospital I elected to start the induction right away. It had already been about eight hours since my water broke and I was running around working during that time, so I figured that if it was going to happen spontaneously, it already would have. It was now Saturday morning. We got settled into our room. The IV was placed, external monitors were applied and cervidil was placed. I was dilated to .5 cm. I tried to sleep. All of a sudden I got very nauseous and shaky, and had constant abdominal pain and severe pelvic pressure. It was awful. The nurses brought me heated blankets, which helped a little. This went on for some time until finally the cervidil fell out while I was using the bathroom. Once the cervidil was out I got into a warm bath and felt 100% better. It turns out that I had a bad reaction to the cervidil and my uterus was hyperstimulated in the lower segment. Fortunately, the baby’s heartbeat stayed okay. I continued contracting on my own all morning, but by evening they spaced out. Saturday at 6:30PM we started pitocin. I had cordless external monitors on so my movement wasn’t restricted, but I had to drag an IV pole and two heavy IV pumps with me wherever I went and it was very distracting. I was coping well. My husband was there and a friend came to keep me company. I didn’t tell anyone else I was in labor. The pitocin continued until 3:00AM Sunday morning, then it was time for a break. I wish I had asked to have it shut off earlier because I could have used more sleep. During the break I went into the bathroom for some privacy and had a good cry. I was sad that I’d gotten through the entire pregnancy without so much as a Tylenol and now I was getting penicillin every four hours and meds to induce labor. Sigh. I took a nap and was woken at 5:30 to resume the induction. The midwife wanted to try cervidil again, so I agreed. While she placed it she felt a forebag which I agreed to let her rupture in order to help labor progress. I had the same reaction to the cervidil as the day before and it was pulled out right away. Again, my contractions continued, only more intense this time. The bathtub, rocking chair and warm rice packs helped me cope. The pelvic pressure was intense and uncomfortable. Again, though, the contractions spaced. I took a short nap. When I woke my midwife recommended we try pitocin again. I was really scared. The contractions that morning had been difficult and I was afraid I wouldn’t be able to cope with more intense pitocin induced contractions. I cried and my midwife listened as I expressed my fears. I was tired, I wasn’t ready to be in labor, and I was sad that things weren’t going as I had hoped. The midwife ran me a bath and once I was settled in, we restarted the pitocin. It worked. My contractions came back with full force. I could handle the contraction itself, but was having trouble coping with the pelvic pressure. Time passed. Labor got intense. I tried everything to get a handle on the pain. Water, birthing ball, bed, rocking chair, walking, warm rice packs. I couldn’t focus. I paced the room. I needed help. I told my midwife I had to do something. She filled the birthing tub for me; I got in hoping to find the relief I had seen on so many of my patient’s faces during their labors. It didn’t work. At this stage in my labor the water just made me hot, wet, and still in pain. I got out and paced some more. I became desperate. I didn’t know what to do. I was disappointed in myself. The midwife offered Nubain, but I declined knowing it would make me nauseous. I fretted through a few more contractions and finally asked for an epidural. I had them shut the pitocin off while I waited for the anesthesia team to come place it; the staff moved quickly and the epidural was placed without difficulty a short time later. I was instantly pain free. I slept.
2 hours later I woke up and was dilated to 8cm. I called my sister to come to the hospital. I quickly progressed to 10cm. My husband had gone home to exercise the dog while I was sleeping with the epidural and wasn’t back yet. Since I was fairly comfortable, I decided to wait for him before pushing
. My nurse and midwife set the room up for the birth and went to get some dinner while we waited for him. 45 minutes later he arrived, was filled in on what he missed, and it was time to push. I couldn’t feel anything so I requested the epidural be turned down, then off. There was a really good vibe in the room and we laughed and chatted between contractions. 1 ½ hours later I had a beautiful baby girl. I was shocked because I had thought it was a boy my entire pregnancy. It was a lovely birth. She came right to my chest and had no difficulty adjusting to extrauterine life. I was very relieved that I didn’t tear at all. Baby breastfed well and I felt great! After about two hours of skin time and breastfeeding I got up and gave her warm bath. She was perfect. I felt good about the birth, despite things not going according to plan.
Fast forward. It took me about a month to come to terms with the fact that I’d had a baby. I hadn’t been physically or emotionally ready for the birth. I wasn’t ready to be done with the pregnancy. I felt cheated, in a way. The labor, birth, and baby seemed very disconnected from the pregnancy. I wish things could have gone differently. I think I would have coped better if I’d gotten some sleep. I regret I didn’t insist on rest before continuing with pitocin. I never imagined I’d ask for an epidural. It was what I needed at the time…and I’ve always understood when my patients needed one, especially when on pitocin. Penny Simkin said something that has helped me come to terms with my decision at a conference once, “it’s okay for a laboring woman to be in pain, but not for her to suffer.” I was suffering and needed help and am trying not to second-guess myself for asking for it. I do resent that my parents said, “I told you so.” At least my husband was supportive. I’ll always wonder if I dilated so fast because I was relaxed with the epidural, or if I needed the epidural because I was dilating so fast
I mourn the loss of the birth I had imagined for myself, especially when I come here and read these wonderful birth stories. The whole experience has been a lot for me to digest and I still think about it often. Sometimes I wish I could do it over. Such is life. I am thankful beyond expression that we had a good birth outcome and that she is healthy.
Our beautiful baby girl was born on 5-15-2005, weighing 5#9oz.