Questions about my labor - 4 month hindsight - Mothering Forums

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Old 08-30-2010, 10:48 PM - Thread Starter
 
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So all in all, I had a really great experience, not quite what I planned for, but the end result was great and I did not feel violated, so I consider myself fairly lucky. But I'm having some questions as I think about my labor now. I'll try to keep this relatively short.

On Friday afternoon, I was 41 and 5, 3cm, and not in labor. I woke at 2:30 AM that night with VERY intense contractions. They were exactly 7 minutes apart but they lasted over a minute and a half EVERY time. I figured they would get closer together soon, and I did my best to rest in between them. I was unable to sleep so around 5, I finally got up for good. DH and I walked, I took a bath, I sat on my birth ball, but mostly, I just got on my hands and knees for every contraction. They were super intense, but did not get any closer than 7 minutes apart. We were in contact with our midwife, and were planning the one hour trek to the birth center pretty much as soon as the contractions got closer. At 6:30 PM (16 hours of this) my water broke while I was on the toilet. Immediately, my contractions were 3-4 minutes apart, and they continued to last about 90 seconds or so. We left for the birth center at 7PM and arrived at 8PM. I was 5cm - so disappointing, since I had labored for EIGHTEEN HOURS and only progressed two centimeters!

I then labored in the tub, the shower, the bed, the birthing stool, the birthing ball, and on the toilet. The contractions continued 3-4 min apart and at least 90 seconds long, not a lot of time to recover. My biggest complaint during this time is that my midwife had a student who we had previously authorized to be present, but I had changed my mind, but didn't know how to say so. So I never said anything and just suffered through her presence. I wish I hadn't. My second biggest complaint was that it seemed as though they wanted to do internal checks ALL THE TIME. And they effing hurt. BAD. And they also seemed to trigger massive horrid contractions while I was flat on my back, and then I would be debilitated by the pain and it would be so hard to get on my hands and knees to make it through the contraction.

I felt like the baby was coming out of my rectum for HOURS. And the pain in my back was almost unbearable, the water didn't help at all, only counter pressure really seemed to do anything. Weird thing was that everyone kept saying the baby was not posterior, so I'm not sure if that changed or if I just had intense back labor for no reason or what. The other problems were that the contractions just lasted FOREVER, and that I had only slept about 2 hours in two days.

At 3:30 AM, the midwife and her student started talking about a transfer since I was still only 8 cm. Ough. 5 cm in 26 hours, and the contractions were frighteningly intense and unrelenting. I talked to DH and told him I wasn't ready to give up our birth center birth yet, and that I would change my strategy. I went to the toilet and told everyone not to speak to, or touch me. I labored silently directing all of my energy inward trying to will my cervix to open those last two centimeters. After one hour of that, I was still 8cm. I had nothing left and I totally lost it. I started crying and screaming and carrying on like a wounded animal. I consented to the transfer since I just couldn't imagine going on any longer without sleep and a break from the pain.

We made it to the hospital, which was literally across the street, and I was in a hospital bed in about half an hour. So somewhere around 5AM or so, while I was getting into the bed, I felt the urge to push and just started. My midwife immediately identified my sounds as pushing noises, and wanted to check to see if I was finally complete. I was fully dilated with a "swollen cervix." I was told that if I kept pushing I could make my cervix so swollen that it would be unable to fit a baby. I then got the epidural. I'm not going to lie, it was heaven. The pain was magically GONE!!!! I was awake long enough to learn that my contractions were "coupling," which indicated a dysfunctional labor, and explained my incredibly long contractions and also the lack of progression. Then I slept for about 6 hours. I woke close to noon, and started pushing. I really wanted to be vertical, and the midwives humored me, but eventually convinced me to just go flat on my back with my legs in the air. The exact position I DREADED. But whatever, I didn't really care at that point, I just wanted the baby OUT!!! Then the student midwife insisted on having her hands inside my vagina to see whether the pushes were effective. I begged her not to, but eventually just suffered through it. After 2 hours of pushing, she was delivered. Totally healthy and perfect 8 lbs, 19 3/4 long. She spent the next 1 1/2 hours on my chest while they stitched up extensive starburst first and second degree tearing.

Sorry that was so long, here are my questions and the things I can't get out of my head:
1. Why was my labor so long and unproductive, while also being so incredibly intense? Did it really have anything to do with the coupling?
2. Why did my midwives need to check me so frequently when I made it clear that it caused me a tremendous amount of discomfort?
3. When I was clearly in transition and saying I couldn't do it any more, would it have helped if my midwife had just given me some more encouragement? Could I have possibly had my birth center birth after all?
4. Once I got to the hospital and was completely dilated, what would have happened if I had just pushed then? Would it really have caused my cervix to swell to badly as to preclude a vaginal birth? If I had pushed at that point, could I have had a med free birth?
5. Once I had the epidural, was it possible to deliver in any way other than on my back?
6. When I was pushing, why oh why did anyone's hands need to be on my cervix?
7. Why did I tear so badly, and is there something anyone could have done to prevent it? The midwives used oil, but not much else, except telling me to stop pushing, which I did, but my uterus had other ideas.

I think that's it. Thank you anyone who made it this far. I am not really tormented by this, but I can't help wondering about these things, and I could really use some feedback. As I said, I consider myself lucky, and I truly believe that had I been in another practice, I would have been delivered via cesearean long before I ever had the chance to push. I feel like I still have a lot of unanswered questions though. Thanks for reading.

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Old 08-30-2010, 11:18 PM
 
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1. Why was my labor so long and unproductive, while also being so incredibly intense? Did it really have anything to do with the coupling?

I don't know. Maybe your baby needed a long labor to get ready for life outside of the womb, and maybe your baby was in a weird position.

2. Why did my midwives need to check me so frequently when I made it clear that it caused me a tremendous amount of discomfort?

They were probably hoping that you had "progressed" cervical checks are usually not necessary, unless you are thinking about induction/augmentation or if a c-section is being talked about(don't want to section for fetal distress if you're 10cm 100%effaced!) They should have listened to you though.

3. When I was clearly in transition and saying I couldn't do it any more, would it have helped if my midwife had just given me some more encouragement? Could I have possibly had my birth center birth after all?

When I was in transition, thats what I needed(encouragement), and will keep that in mind for next time.

I don't know if you would have been able to have your birth center birth or not.


4. Once I got to the hospital and was completely dilated, what would have happened if I had just pushed then? Would it really have caused my cervix to swell to badly as to preclude a vaginal birth? If I had pushed at that point, could I have had a med free birth?

I would think that it could have caused swelling to the point of a necessary C. But i'm not a medical professional(though thats probably what they would tell you)

If you were my client(and I've had a client before like this, who got an epidural at 10cm) I would tell you(meanwhile, whole-heartedly believing it) that an epidural was a good choice for you, because it helped you relax. Maybe you could have found something else to help you relax, some herb or something(I don't know my herbs very well) it sounds like it was a very long and difficult labor, and i'm sure you needed to rest a bit!


5. Once I had the epidural, was it possible to deliver in any way other than on my back?

yes, but in which position depends on your personal circumstances. You may have been able to deliver in a squat if you had enough control of your legs(and perhaps the assistance of a squat bar or a DH or doula or nurse or friend or whoever) and you may have been able to deliver in hands and knees. you probably would have been able to deliver laying on your side, or at least in a semi sitting position(still on your back)

6. When I was pushing, why oh why did anyone's hands need to be on my cervix?

Because the student midwife was a UAV. (it didn't)

7. Why did I tear so badly, and is there something anyone could have done to prevent it? The midwives used oil, but not much else, except telling me to stop pushing, which I did, but my uterus had other ideas.

maybe because of the position you were in, or because the midwife's hand was in your vagina, or maybe they were pulling on it(i.e. massage) or maybe you were dehydrated, or maybe you were overhydrated, or maybe thats just the way your skin is down there, or maybe thats how your baby was. epidurals can also make tearing more likely, but i'm not sure if its due to the medication or due to the iv fluid.
It sounds like you did amazing, given the circumstances

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