A Cora is Born

So, 39 weeks pregnant and suffering from a rotten cold, so I spent a week pretty much just laying around like an exhausted sack. And exhausted sack with a huge belly. And violent coughing fits. So at that Monday's doctor's appointment (39.5 weeks) hardly anything had changed--still dilated less than 1 cm. The doctor starts talking about how things will go if I go past my due date.

Over the next couple of days I start feeling much better, and midweek I do a bunch of nesting stuff, but I feel kind of "off"--a little nauseated, kind of vaguely uneasy.

At about 7 pm on Wednesday I clearly start losing my mucous plug. At first it actually seemed a lot like maybe I was leaking amniotic fluid and Geoff and I discussed it and decided to wait and see how things developed before calling anyone, but by bedtime it was clear that it was definitely regular ol' bloody show. Also by bedtime I'm feeling kind of crampy--like menstrual cramps.

Maybe three or four times Wednesday night I am woken up by pain across my lower abdomen, but it always goes away quickly and I fall back asleep.

Thursday morning, my due date, I wake up and feel a pretty constant low-level crampiness across my lower abdomen, and by mid morning it's settling into sort of a rhythm--every four to six minutes, lasting pretty much 50-something seconds each time. That's pretty much the criteria the doctor had given me for phoning in--she said the every-five-minutes-lasting-one-minute was just a guideline and if I was close to that go ahead and call. But . . . I don't know, it just didn't seem as distressing as I expected (though it was a level of pain that definitely made me squirm in my chair) and they weren't settling into quite as regular a rhythm as I expected, and they weren't increasing notably in intensity . . . sure enough, around 2:30 Thursday afternoon they started to kind of peter out, maybe every 20 minutes and not as strong. They never went away, though, and I began to fear that I would spend a long time in too little pain to have a baby, but too much pain to be comfortable. I still thought it was possible it was false labor or some kind of very early labor.

I had been talking to Geoff on the phone every couple of hours throughout the day, and we decided he would come at 3:00. In the early evening we took a short walk to the post office, had a short meeting with Neal our financial advisor, and watch a little TV. The contractions pick back up again, coming every 10 minutes or so and over a few hours back to every four to six minutes, and between 7 and 9 pm they grow in intensity. Now I have to stop what I'm doing and breathe through them, though they're still pretty manageable. The main problem is not the pain of an individual contraction, but the cumulative exhaustion that develops from being in pain for a long time.

At 9:00 Geoff says it's time to call the doctor, and I agree. I want to at least know what's going on.

The doctor okays me to head to the hospital, and we get there about 9:45. Geoff points out later that at first everyone is pretty skeptical that I'm really in labor. It's very much "lets hook you up to the monitor, and we'll see if you can stay." They change me into a robe, hook me up, and I wait for the resident OB on call to come check to see if I'm dilated. While we're waiting the monitor is showing pretty regular contractions, and I'm squirming and breathing through each one. My L&D nurse says I'm convincing her that I'll be staying.

The resident comes in, checks me, and says I'm at 3 cm. I'm staying. It's about 11 pm.

I had already been asked about an epidural and said that I would like one, so the resident asks if I'm ready for it now. I say yes. If the doctor was agreeable to it, there didn't seem to be any benefit to waiting longer. Plus I know it will still be a while before I actually get the epidural--I had to have a certain amount of IV fluid first, and the anesthesiologist was tied up in a surgical case--so I figured we'd better get the ball rolling.

At almost 1 a.m. the anesthesiologist rushed in. The epidural was a little disorienting. I expected needle sticks and having to hold still, etc., but was surprised by the little electrical jolts shooting through my back, and the foreign sensations of having my spine messed with. The anesthesiologist was clearly in a hurry and wasn't offering much in the way of explanation of what he was doing or what was normal to be feeling.

Plus now I had to have an IV (and I have difficult veins, so they ended up putting it in my hand), catheter, and blood pressure and pulse monitored every half hour. I can see why people would decline the epidural, but I ended up being glad I had it, and plan to have it again next time.

Within minutes my legs felt warm and relaxed. Geoff asked if the epidural was working for the contractions, and I said "I don't know, have I had any contractions since he put it in?" And the nurse said, "Yes, you just had a big one." Sure enough, I looked at the little piece of paper and could see the huge contraction being marked there. "Wow, then yes!" The resident checked me again, ruptured my membranes, and determined I was at 4 cm.

By 1:30 we were tucked in, theoretically to get some sleep. The lights were turned low and Geoff was reclined in the chair next to my bed. I could see contractions on the monitor, but couldn't feel them at all. I drifted around near sleep, but it's such an exciting event that it's hard to actually sleep. Plus every half hour the nurse had to take my blood pressure and pulse.

At one point I looked over and noted that the contraction line had gone flat. I knew an epidural can slow labor, and sure enough, soon afterward, the nurse came in and hung pitocin on my IV. I went back to near-sleep.

They had told me to alert them if I was having any "rectal pressure," because that often happens when you're fully dilated. Near 5:30, I started being aware of each contraction, and experiencing them as pressure. It was enough to wake me up with each contraction. It didn't seem rectal at all, though. More like someone was trying to jam her giant head through my cervix.

I told this to the nurse the next time she came in, and she said okay, let her know if things changed. At this point the pressure wasn't painful, just an awareness of the contractions. It was clear they were expecting this to progress slowly.

Instead, each successive contraction became rapidly more pressure-ful, to the point of pain, until I was having to noisily breathe through each one. Geoff woke up and asked if he should go get the nurse. When he brought her in I explained that I was having a LOT of pressure. The resident came in and determined that I was at 9.5 centimeters. They had paged the attending in to do the delivery, and she lived close so she should be there in plenty of time "Unless you're some kind of championship pusher." Geoff said watch out, I could be just that.

We talked about whether my epidural should be topped off. At that point I was in pain, but could still tolerate it. The advantage to being in that state is that you can feel the contractions and can tell when and where to push. They explained that if you're more or less okay, they don't like to top off the epidural. I was pretty borderline on whether I felt I needed it topped off, so they didn't. Had I stayed at that level of pain, that would have been fine.

The next half hour or so is a bit blurry. Things quickly became a lot more painful, which I'm not sure they expected. The epidural basically went away completely--my legs felt normal, like I could get up and walk away from the bed if I needed to. The pressure increased a lot, and now I was making all kinds of involuntary noise, and as I exhaled, my breath would catch in my throat and kind of result in involuntary pushing. It took all my concentration to blow past that and not push, and I was clearly losing that battle. We were still waiting for the attending. I told the resident that I was coming to the point where I couldn't not push. She cheerfully said "Okay, then we'll push" but it was clear that this was not ideal.

She had Geoff hold my one knee up toward my shoulder, and said to push with "little grunts." Even being able to do that was a relief compared to trying not to push. This semi-pushing was meant to keep control of the situation, and it helped, but about a couple hundred thousand years of biology was pushing this kid into the world, and there was only so much we could do to slow it down. The resident said that even this semi-pushing was moving the baby down, and when the attending got there, I wouldn't have to push long at all. I was glad to hear it, because I was in a huge amount of pain at this point. She also said the baby had some hair! Geoff said later that he thought the resident was going to have to deliver the baby. The resident used the bedside computer to text to the attending what was going on, "in case she was thinking about parking."

At 6:15 the attending came running in the room, pulling on her paper boots and introducing herself. I'm not sure who was most glad to see her. Within a minute they had the lower half of the bed removed and the stirrups set up and everything in place. Geoff pulled one leg back toward my ear, the nurse pulled the other, and it was time for the regular pushing--like on TV, chin to the chest, hold your breath and push for a count of ten, and do it three times within each contraction. The only good thing about that part was knowing that it was almost over. I absolutely wanted each push to be the last one, and I pushed like hell. The hardest part was trying to slow down my breathing in the rest between contractions--I was gasping like a sprinter. At 6:35 it was the last push and she was out and they put her on my stomach. It really was amazing. She was so warm and I loved her immediately in her tiny little wiggliness. It was hard to believe all this was really happening.

Geoff cut the cord and went with Cora over to the baby area, where they weighed her and said she was 9 lb. 2 oz. I was oddly pleased that she was over nine pounds, like most babies in my family. Her head was hardly molded at all, and her face wasn't very swollen. One of the doctors pointed out that considering she was a first baby, and that large, and being round-headed, and still being pushed out that fast--I'd better watch out because my next baby would come out fast.

Geoff got to hold Cora for a long time while they finished working on me. The doctor explained that I had a second-degree tear, which isn't bad at all. I asked if she was going to use a local to sew me up, since I didn't have any epidural left. She said "can you feel this" and touched me with something sharp. I said yes, and she said I'd need a local then. Glad I asked!

So I'd say the whole thing was about 20 hours--from mid-morning on Thursday when contractions formed a rhythm to 6:35 on Friday. Of that 20 hours, about three hours were medium sucky (the three waiting for the epidural) and one was very sucky (the final hour without the epidural), and the rest were pretty comfortable or manageably comfortable. Even the bad part I wouldn't say was traumatic, though, as an hour isn't really that long, and at least I was well-rested to face it. Although I hope the epidural thing goes better next time, overall I think I had a good birth experience, and I feel very lucky.