Tuesday, January 23, 2007

Baby Day: Part II

Part I

When we got to OB Receiving and found that I hadn't dilated any more, I nearly cried. Five days earlier, I'd been in false labor for over 18 hours, and I was so afraid that I'd go through the same thing again. However, they weren't about to send me home without monitoring me, not with me being 35w6d pregnant with twins, 3 cm dilated, and contracting every three-four minutes, and I was admitted to see if I was in active labor or not.

In retrospect, it's hard to remember what the contractions were like. I don't specifically have a memory of them being painful, although I know that they were, if not as intense as later-stage labor might have been. What I remember is that they were almost like out-of-body experiences -- I went somewhere else when one started, huffed through it, and came back to myself as it ended. I was having them frequently enough, and they were long enough, that I only got about two minutes of rest in between.

I know I thought about one of the few times I've been really scared for my life, when I was sailing a Sunfish on Lake Michigan and a storm blew up quickly. I was farther out than I should have been, the wind kept turtling the very small boat nearly as fast as I could right it, and there came a point when I thought, I'm not going to be able to right it again if it goes over. That's how I felt, like I got swamped again as soon as I caught my breath, endlessly over and over, with no end in sight. Knowing that I could have to go through long hours of this again, without necessarily having babies at the end, was beyond discouraging.

I think I would have had an even harder time with it if I'd actually intended to have a vaginal delivery, but that was never part of the plan. I'd decided very early on in the pregnancy that I wanted to go ahead and plan on having a C-section, regardless of the position of the babies. To a certain extent, this was because of endless harping from my mother about pelvic floor integrity, but mostly, I was terribly afraid of having to have an emergency C-section for Baby B. I never had any particular attachment to the idea of a natural birth anyway, given that so few things about my pregnancy were natural and easy.

Some women, in that situation, turn their energies toward envisioning a perfect birth, but I wasn't going to get that no matter what -- my hospital's policy is that vaginal twin deliveries happen in the OR, not in cushy birthing suites with family and friends, and epidural catheters are strongly recommended even if no medication is given. Plus, I was secretly convinced that my babies were going to wind up in the NICU anyway, and that I'd go through all the pain only to get cheated out of the mother-baby bonding experience. So I went for the delivery option I knew would give me the least chance of things going haywire. Unlike Stacie, I didn't mourn my C-section -- it was how I always knew things would go, and by planning it all along, I knew I wasn't as likely to wind up with a rushed and scary operation, or feel like a failure.

So, the only reason I even cared about actually being in active labor was so that I could have the babies. My C-section was formally scheduled for 37 weeks on 9/14, but they'd do it as soon as I made it to active labor, which my hospital defined as 4cm + contractions. I was desperate to have the babies NOW, and I certainly had the contractions, so all I wanted was to dilate that last measly inch. Unfortunately, I was having a really hard time with that, and there was no cervical change when the resident checked me after an hour.

At that point, they started talking about sending me home if I didn't start going somewhere soon, to which I was adamantly opposed. I kind of knew at the time that I wasn't really being logical, that simply being in the hospital wouldn't help me have the babies if it wasn't time, but I couldn't wrap my mind around the idea of leaving without babies, or going home while contracting so intensely. I was afraid that I'd wind up having the babies at home -- everyone kept telling me that I'd know when they were really coming, but I didn't know it would be any different from what I was already going through, until it came time to push. They said they'd check me again in another hour, but that if I hadn't pulled it off by then, it probably wouldn't happen.

Of course, when the next check came, there was no change. However, I straight-out refused to go home (I actually said, "You can't make me"), at least not while I was contracting like that. That's when the doctor suggested a shot of terbutaline, to calm down the contractions; standard practice is not to stop labor after 34 weeks, but I technically wasn't actually in labor, and I guess stopping not-labor is OK. I was getting pretty tired by that point, and if I wasn't going to deliver, I figured I might as well get comfortable and contraction-free. The contraction pattern was starting to get a little disorganized, too, so it seemed plausible that we might be able to shut it down.

When they gave me the terb, though, a funny thing happened. I got the shakes, as I had the previous times I'd had terbutaline, and just like all those times, it didn't stop the contractions. This time, though, the contraction pattern changed. The intensity of them lessened a little bit, but the frequency actually increased to every two minutes like clockwork. This was apparently interesting enough to warrant watching me for another hour, and at the end of it, my own Dr. Dreamboat appeared to do the check himself.

The jury will probably always be out on just what happened next. There was a cervix check, which seemed much longer and more painful than the previous ones, and Dr. Dreamboat announced, well, you've progressed, you're officially in labor. He did *not* say that I'd dilated to 4cm, and I think everyone in the room noticed that. At least, all the residents had "oh, really?" looks on their faces, according to G, but it's not like they were about to argue with the attending physician. I am deeply suspicious that I hadn't actually progressed any farther, and that he just went ahead and called it out of pity. I also wonder if he stripped my membranes while he was in there, with that very invasive cervix check. The contractions afterward, while we waited for the surgical team to assemble, seemed steadier, and I had a feeling of inevitability, like the babies would come now whether or not I had the section. However, it's hard to say; perhaps it was all in my head, or the terb really had kicked my stupid irritable uterus over the edge. However, I'll never know, as Dr. Dreamboat subsequently left the practice before my 6-week checkup, and it's not like it matters to anything except my curiosity.

In any case, I was finally granted a trip upstairs to L&D to await my surgery. Dr. Dreamboat wanted to do the surgery himself, anesthesia had to get their act together, family had to be summoned, and nurses had to ask me the same thousand questions they'd asked every time before. My L&D room was sunny and warm, and had the same view as my room from the OHSS hospitalization in the very beginning of the pregnancy. For some reason, that was the little detail which made the whole thing sink in -- I'd made it all the way through, and now I was going to have our daughters.

I was still laboring pretty intensely for the two hours it took to get everything ready. I remember being desperately thirsty, and feeling really annoyed at all the people who kept trying to interrupt me and ask me things, and wanting to yell, "figure it out yourselves!". I was also really peeved at G. I felt this intense need to be close to him -- I wanted to have my hand held and my hair stroked -- and he wasn't doing a very good job of it. He had what he claims is the worst headache he's ever had, prompted by not having had any breakfast and missing lunch to take me to the hospital, and he kept letting go of my hand. I'm willing to believe he really did feel awful, but I WAS IN LABOR. I win, the end. I'm not mad about it now -- it's not like I needed him to support me while I pushed the babies out -- but it's definitely one of those things he'll get tweaked about until the end of time.

After a lot of hurry-up-and-waiting, we agreed that I would have a spinal, that G would be in the room with me (which had been in some doubt), and that my brother (who had just finished his OB rotation in med school) would assist on the surgery. I had originally been against that idea, but when it came down to brass tacks, it really didn't matter to me -- he's (sort of) a doctor, after all, and by that point every other doctor, resident, and student in the hospital had been up in my business anyway. If it's weird that my brother was involved, well, it's also weird that all his buddies were also involved. For that matter, my mom's boss got me pregnant, and my former babysitting clients did some of my OB care, so most of my personal boundaries were pretty much long gone.

It took over two hours in all, but at about 6:15 PM, they came to wheel me away. I watched my mother as I left the room, thinking, next time I see her, I'll be a mother too.


laura said...

I love it .. you're a wonderful storyteller. It sounds like you had a very incestuous pregnancy (not in the bad way ... you know what I mean)!!

Eva said...

Okay, we need part 3 asap, I've been checking every day!

Nico said...

Yeah, part 3 please!!!