Josie's Birth Story
Pre-eclampsia (aka toxemia or pregnancy-induced hypertension) kept me in bed for the two months prior to Josie's birth; once my blood pressure spiked and I was sent to the hospital for observation overnight in the 35th week. My doctor, Pete Reagan, discussed possible outcomes with us, and we decided to induce the birth two weeks early on September 9th, 1997.
The week before the scheduled birth, Pete did a vaginal exam and found my cervix "wasn't even thinking about having a baby," as he put it; it was high, tight and thick. On the recommendation of my doula, Amber, I started taking evening primrose oil capsules, 3 a day, in hopes of ripening my cervix. The Saturday before the induction, my husband John and I went in to Providence Hospital and I got an application of prostaglandin gel applied to my cervix; at that time, the primrose oil (or time, who knows) had softened my cervix some, but it was still far from ripe.
The night before the birth, John and I checked into the hospital for the duration. At 7 pm, the nurses inserted a misoprostil suppository near my cervix to ripen me up a little more, and natural contractions did start that night. They continued about 2 minutes apart for the rest of the night. They weren't very hard, but they did make sleeping difficult.
The next morning they broke my waters, which can either be completely unnoticeable or hurt like hell; unfortunately for me, it was the latter. My doctor's wife, Bonnie, also a doctor, came in to do it around 7 in the morning. The "crochet hook" thingie didn't work, so she used the scalp monitor. This was one of the worst parts of the whole experience; it hurt very much and I think I scared the nurse helping Bonnie. I was not expecting the pain at all and was completely unprepared, taken completely by surprise by it. That got contractions going in earnest, and I could cope with those; they were good and strong, but I had lead-in time and lead-out time and time to rest in between.
At noon they started to taper off and I agreed with my doctor that we'd better do the pitocin. At 1 pm they started the drip, after 3 failed attempts to insert the IV (2 weeks later I still have bruises from the pokes, and pain at the site where they finally got it in--and they wonder why I hate IVs so much). Within the hour I was having contractions with no lead-in or -out time and very little time in between to rest. And they kept turning up the pitocin! Soon I was having a great deal of difficulty staying on top of the pain. The only thing that helped was vocalizing. I would bellow "OOOOO" in a very low tone with every out-breath.
I struggled with the pain for hours; we'd try changing my position, but as soon as I started to move, it would trigger another contraction, even worse than usual, so I always ended up the way I started, in "barcalounger" position with my head and legs elevated and my butt down. Around 6 pm I started to make the decision for an epidural and had started preparing my birth team for it--at least, I had started saying "I can't do this" to which they'd respond "Yes you can."
Around 7 we decided to try the jacuzzi; getting me there, even though it was next door, was a trial. I had to stand half-dressed in the hallway going "OOOO" several times. The jacuzzi made no difference in pain relief to my despair, and added to my panic; I was afraid I couldn't get out, and the contractions when I moved were almost unbearable. I said, "Seriously, I can't do this." "Yes, you can." "No, REALLY you guys, I can't do this. I am so close to panic I can't tell you. I am asking for the epi, or you're gonna have to strap me down." My doula promptly went out and got the nurse who got the anesthesiology team assembled. I felt defeated.
The first one didn't take, which was a whole other area of despair ("this is so bad an epi won't even touch it??") but the second one took. I was lucky; it numbed my torso but only tingled my legs, and I could feel everything. I was still in pain, which I considered lucky since I *wanted* to be there for the birth and experience it, but it made the pain manageable. It clipped the top off the pain, the unbearable, I'm-going-to-gnaw-my-leg-off pain that nearly made me crazy, and gave me the pain that I expected--pretty damn bad, but bearable.
During the procedure I swear I left bruises on my doctor and my doula; you have to hold still while they're threading in the catheter into your spine and holding still through a contraction that feels like you're being slammed against the wall is pretty hard. My doctor held me through the first epi, and my doula through the second one; the doula got bruises *and* fingernail marks, I'm afraid, because by then the contractions had gotten even stronger. Looking back, I think I may have been entering pushing time. Strangely enough, the epidural procedure was one of the least onerous ones; it hurt less than the IV, to my great surprise.
As it turned out, I got the epi just in time; when they checked me for dilation I was at 10 cm. If I'd let them check me before the epi, they might not have let me have it, in fact, just before they checked me, the anesthesiologist was saying "I want to give you more, this isn't the amount of pain relief we want to see you getting" and after the check was saying "whoops, no more for you!" But that worked out just right.
Not long after the epi took effect, I had the very strong urge to push--nobody had to tell me it was time. Some people would say, well, if you were headed into the pushing stage, you should have just held out and not had the epidural. I am here to tell you that I am a strong woman capable of handling a lot of pain, and there was no holding out, pushing or no pushing. I only pushed for about an hour, not even that says the DH.
Somehow the doula and my DH got me over on my hands and knees for the pushing part. My legs nearly gave out, and John and Amber had to keep reminding me to move my weight off them and more onto my arms; John says at one point they turned purple. I couldn't see what was going on at all, and even if I could have, I wouldn't have. I was in a world of my own. If ever there was a time when I connected with the Universal Female, this was it. It was timeless; I floated almost in a void, just me and the pain and the baby, who I could feel slowly moving down me.
My doctor almost didn't make it back in time; he was having dinner with his daughter about 3 minutes away from the hospital and when he poked his head through the door, the nurse said get your scrubs on RIGHT NOW because Josie was poking HER head through MY door. :) He got there just in time for the last two series of pushes. They were saying, wait, wait for Pete (my dr), and I said I CAN'T. I thought I WON'T. I think that's why I tore (2nd degree); I was so much at the end of my rope that once I felt her crowning it was like GO GO GO. Kristen the labor nurse and Amber my doula have caught a few babies, they could just catch this one.
I was so afraid I couldn't do it that I just went for it. I'd feel her head start to crown as I pushed and I'd be thinking "I can do this, I can do this," and then I'd stop pushing and she'd slide back up the birth canal, and I'd sob "I can't do this, I can't do this" inwardly. And then the next set of pushes would come and I'd feel her a little further out and think "I can do this, I can do this"... :) until finally I felt what had to be the widest part of her head and everyone got very excited and so I just kept pushing and pop went her head out of me and this wave of relief and shakiness went through me. I heard her take a breath, and heard them suction her, and heard John start crying, and I pushed again and her body came out all at once and I just about passed out from it all.
Josephine Marie Siprelle Ark was born at 9:48 pm, 8 hours and 45 or so minutes after we started the pitocin. She was 7 pounds 8 ounces and 22 inches long--a tall, lean kid with her father's body type, apparently, since that ain't me, babe. She had a head of glossy dark brown hair, dark blue eyes, and chubby red cheeks (that part resembles Mama).The epidural didn't seem to affect Josie much at all, probably because I waited so long to get it; her apgars were 8 at birth and 9 five minutes later.
Her head was amazingly well-formed; she looked as if she'd come c-section rather than vaginally as more than one nurse commented. John says that when she was born she was all cone-headed, squished and purple, but about 30 seconds after she was born it was as if someone stuck a bicycle pump in her ear and inflated her head--poink! Hard-headed kid--not a surprise considering her parentage. A more beautiful baby would be hard to find, and I'm not saying that just because I'm her proud mommy. :)
I didn't see Josie for about 5 minutes after her birth. I stayed on all fours, panting, for a bit until Amber and John helped maneuver me onto my back again. When they brought her to me she was still covered in vernix, wrapped up tight in two receiving blankets with a little cap on her head. The cap had a "stem" like a pumpkin, and her little face all round and rosy completed the look. I unwrapped her a little, did the finger-and-toe count (all present) and tried to nurse her. She licked at my nipple a little and promptly fell asleep against my breast.
I still maintain I could have handled a non-pitocin birth without the drugs. The difference in contractions for me was night and day. As for the tear, Pete my doctor was philosophical. He knew I'd have rather torn than be cut, though John tells me he was reaching for the scalpel when I tore. Bad Pete. :) Pete says if you have to tear, couldn't have done it better than I did; he says it was right along the "dotted line." Two weeks later it's healing very well, though I'm still taking Advil for pain if I sit too long on it.
The biggest difficulty for me was the aftermath of the birth. The only word I can come up with for the experience was "traumatizing." The first few days I actually had flashbacks, a la Vietnam; something would remind me of labor and the next thing I knew, I was *right back in the worst of it,* as if it had never stopped. It got between me and my daughter, me and the world, really. Time has faded the memory already and the flashbacks have mostly stopped, but I do feel the violence of the birth has affected my relationship with Josie. I'm hoping time will heal that as well.
Copyright© Lynn Siprelle