Sunday, January 3, 2021

Induction & birth

I feel compelled to write about this now, before my brain very wisely erases these memories. And I'm sure the memories will fade, because if they didn't we would all be only children. To be clear: this post is really just for me, so that I don't forget what happened. I can't imagine anyone else would be interested in all of these details. 

At 39 weeks pregnant, my doctor recommended scheduling an induction for the next week, if I hadn't already gone into labor on my own by then. Going to 41 weeks, she said, could be dangerous for the baby. I was fine with this, and very tired of being pregnant, so we scheduled the induction. I also asked her in that appointment if she had a sense how big the baby would be, and she said she could guess but it would really just be a guess and therefore not very useful. I had a feeling that she dodged the question.

I was hoping to go into labor on my own, but besides increasing discomfort, fatigue, and the inability walk farther than a block, nothing happened. So when we arrived at the hospital for the induction a few days after Christmas I was very ready to have the baby, though definitely apprehensive about what would happen. 

As it turns out, very little happened for the first two days. When I got to the hospital they hooked me up to two monitors: one for the baby, one for contractions. The baby was fine, and I was having some small but regular contractions already. The doctors seemed surprised that I wasn't able to feel them, but not concerned. They proceeded to give me a few different drugs to trigger labor and inserted a Foley bulb to dilate my cervix (which I won't describe here in detail, but I can assure you was extremely unpleasant).  At the end of about 40 hours, I had had multiple rounds of drugs and was 5 centimeters dilated, but I appeared to be no closer to having a baby. I was still having contractions but I couldn't feel them at all. 

I definitely started out knowing that an induction can take a lot of time—two days is not uncommon. But as we approached the end of two days I was extremely frustrated. It's the only time in my life that I've wanted to be in pain. I had spent two days hanging out in a hospital room, hooked up to an IV, pumped full of drugs, monitored constantly, letting dozens of strangers stick their fingers in me, and nothing was happening. It began to feel like they would keep doing this indefinitely—like we could stay in this loop for a week and I would get no closer to actually being in labor. 

In the hospital, you see your nurse regularly but the doctors only stop by on occasion—and usually it's a resident, the attending physician will only come by if some procedure needs to happen. I had seen an attending physician only once, when she came by to insert the Foley tube. When we reached the point where nothing seemed to be working anymore, I asked my nurse if I could see the attending again to get her opinion on what to do next. When she came, she did an exam and my water broke. 

This is when things finally (finally!) started to get painful—turns out amniotic fluid does a lot to cushion the feeling of having a baby's head in your pelvis. But pain, as it turned out, didn't mean that anything productive was happening. At midnight on Wednesday, about 10 hours after my water broke and over 48 hours since I had been admitted, I was still having regular contractions but I wasn't able to feel them. I also still hadn't dilated beyond 5 centimeters. 

It's also important to note that I hadn't really slept since I arrived—even though I wasn't in any pain initially and I wasn't close to going into labor, in the hospital someone is in your room every couple hours around the clock. If they're not giving you meds they're adjusting the fetal monitor or checking your vitals. The labor and delivery beds are also spectacularly uncomfortable—they are meant to be for giving birth, not for sleeping on when 9 months pregnant. 

So by midnight on Wednesday I was sleep deprived, in a lot of pain, and not even really in labor yet. The doctors decided two things at this point: 1) the baby was large and in a very strange position, and 2) it was possible all the contractions I had been having were too minor to be "productive."

For the first problem, they suggested I contort myself into a bunch of different positions to try and move the baby around—these were varying degrees of painful and didn't seem to do much. For the second problem, they decided to insert a monitor into my uterus to measure the strength of my contractions. If my contractions were as unproductive as they seemed, they would increase the amount of drugs they were giving me. 

That monitor, an intrauterine pressure catheter, is ultimately what broke me. It was excruciatingly painful when it was inserted, and they had to do it twice because there was some issue with placement the first time. And then they told me it would need to stay in until I delivered. And of course, no one seemed to think I was going to deliver anytime soon. 

I basically had a panic attack after that. I don't know if it was an actual panic attack, but it's definitely the closest to one I've ever been. Josh wisely decided at this point that this whole plan was no longer working, and called the nurse back in to insist that we needed to consider other options because even if the baby was still doing ok at this point I, clearly, was not. The baby had to come out, and soon. 

To their credit, during all my days and nights in the hospital all the doctors and nurses who I saw were great, and the team that night was no exception. They were not trying to torture me, even though it felt like it. Everyone was extremely understanding and in no way made me feel bad for losing my shit. They all came back in and very kindly talked me through my options, including explaining in detail the steps that they would take to ensure that I did not, in fact, spend the rest of my life in the hospital trying to go into labor. 

So we struck a deal: I would get a epidural, which I needed for a c-section anyway, and they would get 5 hours to monitor my contractions with the torture device. By morning we'd have a better sense of how to proceed. 

The epidural was amazing, and in my next life I want to be an anesthesiologist. I felt a lot better after that and managed to get some rest, which made me feel more like I was still a human being and not just a pregnant animal. In the morning, the doctors returned to deliver news I was not at all surprised by: nothing had changed. My contractions were not very strong, I was still 5 centimeters dilated, and the baby was still in his strange contorted position. The only new development was that the baby's heart rate was starting to dip slightly, which gave them some concern. So they gave me the option of continuing with the meds and seeing if anything changed, or doing a c-section. I chose the c-section. 

Even with an amazing epidural, the c-section was so, so, so painful. I do NOT understand how all those people on instagram pictures of themselves smiling with the baby while they're still on the operating table. I was writhing in pain the entire time, so much that they had to hold my legs down to stop me from moving. I actually begged the anesthesiologist to give me more morphine at the end, which she unfortunately declined to do. The only good part was that when they took the baby out, the doctors told me I made the right decision: not only was he really big, but he had a very cone-shaped head and a 5 centimeter edema on the end of it (I had been 5 centimeters dilated, remember). He had not enjoyed the induction process either. 

Josh got to hold him while I endured the unbelievable pain of being sewed back up, and it was a joy to see him. More joy became possible as I moved into the recovery room and back into my hospital room, where they got rid of the torturous labor and delivery bed and gave me very comfy post-surgical recovery bed. The baby was healthy, I was recovering well, and 48 hours later, we were finally allowed to leave. 

Despite truly excellent medical care and a great team of doctors and nurses, I'm not sure I'll ever recover from the trauma of this experience. Were I to have another kid (doubtful at this point) I would never, ever, EVER consent to an induction. I'm also not sure I could do another c-section: just thinking about the pain makes me tear up. And there's no guarantee that waiting a few extra weeks to go into labor naturally would have helped either: the baby would have been even bigger by then, and he still would have been in his weird contorted position.  

My unimaginative conclusion: childbirth is pretty awful. 

6 comments:

Alex said...

oh my gosh, i can't believe the c section was so painful. that is awful! well everything is awful, but the c section is not supposed to be that way. i can't believe they proceeded with you experiencing so much pain. i did not feel mine at all, and I couldn't have moved my legs if I wanted to. Actually my panic attack came about 12 hours after the c section, when I still couldn't move my legs, and was scared that I was permanently paralyzed.

Julia said...

It actually makes me feel a lot better to know that, Alex! I thought I was insane and everyone else just made it look easy. I'm also really glad that other people who get c-sections don't have to go through that much pain, because it was awful.

It's weird, though, because the epidural worked so well for everything up until the c-section. It didn't even occur to me that maybe it wasn't working right for the surgery itself! And yes, I agree, they probably should have tried harder to do something for me: when I was begging for morphine I really think they should have given me some.

Alex said...

Yes, they absolutely should have done something! I am horrified. I remember they made some very light incisions and made sure I felt NOTHING before they proceeded. (Although mine may have been too heavy given my not being able to move for so long afterward...the doctors were starting to get concerned that I couldn't move my legs, hence my panic attack.)

Emily Hale said...

I agree. I'm so sorry that the c section hurt. That sounds totally wrong and they should have helped you when you said you needed more medication! And no sleep and a panic attack! That sounds truly torturous. I'm sorry you went through all of that.

I think that the trauma of my first childbirth lasted really a long time. I found that writing about it and talking about it helped me (a little). Though, as you note, strangely most people seem not to like talking about childbirth:)

Julia said...

I remember you had a hard time with your first (and that the second was much better!). And yes, I decided to make time to write this today because I thought maybe it would help me process the whole experience better. Having a full and accurate account written out will make it easier to move on, I hope, though I doubt I will ever really forget it.

Miss Self-Important said...

I guess if your epidural was either wearing off by then or was insufficient, there may not be much they could do for you at the point when they're actually cutting you open? I don't know. Though in principle it's not supposed to hurt at all except maybe a vague pressure, which is all I recall.

I agree that induction is questionable. I had kind of the same problems as you, though I got pitocin b/c my water broke when I was not yet in labor, and nothing good happened after that. I didn't dilate fast enough, the baby didn't descend, her heart rate dropped, c-section. It took one day instead of three (!!!), but same result. When I went into labor naturally w/ the second kid, it was still very painful, but all the parts and stages did their job, or were "productive," as your doctor would say, and the baby was born within a few hours. I don't know why though, or whether a similar outcome could somehow have been achieved the first time if things were done or happened differently.

Otoh, having delivered both ways, I can say that your vagina is probably much happier now than it would've been had you delivered that 9-lb babe vaginally. Just sayin'.