(Read Part I here.)
I’m wakened from a very sound sleep to realize, almost before full consciousness hits, that my water is breaking. As I scramble out of bed and grab a nearby towel to catch the flow, I tell Bryan what is going on, and by the time I’ve hobbled over to turn on the light, he’s already in his jeans and is pulling a t-shirt over his head. During my three seconds of hobbling my mind has been racing to deal with the unexpectedness of beginning labor away from home – do we have time to get back? will my doctor let us drive an hour and a half even though my water has broken? I’ve been mentally locating my cell phone so I can call him immediately and ask – but when I turn on the light, my train of thought stops abruptly.
Bryan doesn’t notice the blood immediately, as he’s glanced at the clock to check the time and is busy swearing at what he sees. (He tells me later that he’d been hoping it was seven o’clock, and when he saw it was only two, he knew it would be a long day on very little sleep.) But as soon as he notices the blood he freaks even more. Oddly, I feel calm, the forced calm I've used in the past when dealing with minor emergencies. I tell him to find the cell phone while I run to the bathroom to clean up and get dressed.
But while I’m in the bathroom it suddenly hits me that this is quite possibly not a minor emergency. I know enough about birth to know that a sudden blood gush can be very bad news, so I dress at warp speed and run back down the hall. I can hear the panic in my voice as I tell Bryan that we don’t have time to call my doctor, that we need to go to the hospital immediately. On the seven-minute drive I call 911, where the operator ascertains that we’re already headed to the emergency room, and my parents, who live even closer to the hospital and will meet us there. Bryan drives sixty miles per hour through the deserted streets, and to calm our nerves we joke about how this is our one chance to drive this fast and not have to take the consequences.
At the hospital, the nurse on duty in an empty ER sends us upstairs to Labor and Delivery, which is also empty. Mere moments later I’m wearing a gown and hooked up to a monitor, and instantly reassured by the familiar 140 beats per minute of my baby’s heartbeat. The monitor also shows that I’m having occasional contractions, and I can feel them but talk through them quite easily. I’m still bleeding some, but what seems like a lot of blood to me doesn’t alarm the nurse on duty, who explains to me that the cervix can bleed while it’s dilating, which I knew. She checks me, I’m 80% effaced and 3cm dilated. They waylay Bryan to get insurance information; my parents arrive; I’m given health history paperwork to fill out.
It’s rather an odd feeling to be suddenly sitting there calmly checking boxes on forms, the residual adrenaline in my system compounding the shakiness of relief. I’ve been almost expecting to be whisked off for a real emergency c-section (I find out later if I’d been having a full placental abruption it would have been a lot more blood, but I’ve got no frame of reference and the amount I was bleeding was plenty to scare me), and it’s wonderful, if surreal, to find that the baby is fine, that I’m fine, that the nurses are treating my labor like it’s completely normal. (It wasn’t quite, but we didn’t find that out until later.)
Forms completed, my parents and Bryan and I have just enough time to say a quick prayer before I’m trundled down the hall to my room. I’m pleased to discover that it’s big and very nice, and even more pleased that it’s a labor, delivery, recovery, and post-partum room, which means we’ll be in it for the duration. Our home hospital has luxurious LDR rooms, but the mother-baby unit where you spend the two days post-partum is ancient; the rooms are tiny and you have to walk down the hall to shower. The prospect of spending two nights in this room instead of in an eight-by-ten box is a silver lining.
And at this point, as I’m trying to adjust mentally to all the changes in plan, I need all the silver linings I can get. I’m discouraged to discover that the policies of this hospital are not as accommodating to my birth plan as the ones at our home hospital. I understand that my bleeding means I’ll have to be on the monitors constantly, and although I’d hoped for intermittent monitoring, I can handle the monitors. But they’re hooking me up to an IV as a matter of course, and it doesn’t appear to be negotiable. I also learn that, while my home hospital offers juice and jell-o to women in labor, here I’ll get only ice chips, a dismal prospect because I’d like to be able to keep my blood sugar up.
Another cloud is that I’m under the care of a completely unknown doctor. She’s from a local practice (coincidentally, the same one my mom went to when pregnant with me) whose doctors rotate month-by-month taking all the walk-ins and patients without their own OBs. I know nothing about this doctor and her philosophies about birth, and I’m discouraged to hear that although she won’t be in until later in the morning, she’s told the nurses to put me on Pitocin around 7:30 if I’m not progressing quickly enough. (“Not progressing” goes undefined, but I’ve got a bad feeling that if I’m not already in transition by 7:30, I’m going to have to fight the Pitocin.)
Still, the nurses are kind and friendly, Bryan and my mom are there, and all is cheerful as they bustle round me setting things in order. We’re introduced to our labor nurse, Deb, who has just started her shift and will be with us until three o’clock that afternoon. She inserts my IV, apologizing profusely because the first try fails, but I laugh off her apologies because it hardly hurts at all. (Although the bruise does stick around for more than a week afterward.) She asks what I’m planning for pain relief, and I tell her that I want to try avoiding any drugs. She seems dubious and keeps repeating that most women get the epidural, as if I’m bound to be one of them. It frustrates me a little because my plan to go drug-free isn’t based on a desire for heroism; I’ve done the research and decided that the risks outweigh the benefits. (Later my resolve is shaken as I discover a whole new meaning of what pain is – I completely understand why so many people choose pain relief and would never judge that decision, and in fact I applaud it if that’s what it takes them to make it through – but for me it still remains true that the risks outweigh the benefits.)
Eventually all the staff disperses. Deb makes sure I’m comfortable, shows us the call button, and leaves us. Presumably there are other patients around, although we won’t see any of them during our entire stay. Because it’s a weekend and there are no inductions or scheduled cesareans (they do an average of five of those per weekday, we’re told) the ward is nearly empty. Before the nurse who admitted me leaves, she checks my cervix again, and marks me down as 3-4cm dilated, 90% effaced. I glance at the time as she enters the information in the computer. It’s 3:21am exactly.
The monitor indicates that I’m still having contractions quite often, although not at regular intervals. I’m starting to feel them more, but can still talk through them, and am only mildly uncomfortable. I’m breathing well, and feeling encouraged. Nearly four centimeters and it hardly hurts at all! I have an incredible pain tolerance! This labor thing is going to be a snap!
We send my mom home to gather stuff, including a toothbrush for me – the fact that I could still think about mouth ickiness should give you a clue how low my pain level was at that point – and food. (Another thing our home hospital has that this one lacks is a snack room for labor coaches.) Bryan and I, remembering that we still don’t have a darn name if it’s a boy, borrow a baby-name book from the front desk and discuss options. Ambivalently we talk about a few of the names we’ve discussed before, but don’t agree on anything. My mom returns.
Although my contractions haven’t settled into any regular pattern, the pain is escalating, and I’m using the deep breathing we learned in Lamaze class. My mom is happy to coach me the way she did with my sister, talking me through each breath. I’m grateful for her support but soon learn that I do better if I self-direct my breathing. (She says afterward, “With your sister I was the coach; with you I was more like a cheerleader.”) Still, I like having her and Bryan nearby, during contractions I grip their hands and arms.
By this time it’s around five o’clock, and we say Morning Prayer with the prayer book Mom has brought from my parents’ house. My head is fuzzy enough that I can’t quite grasp the meaning of the psalms and readings, but the familiar words are comforting. Prayers take about ten minutes: we have to pause twice so that I can breathe through a contraction.
Deb comes in at six o’clock to check my cervix. I’m almost fully effaced, but still around 4cm. She charts it as 4.5cm, but tells me that she tends to be generous with her measurements. I’m not thrilled to learn that two-and-a-half hours have brought so little progress, but I’m still feeling okay, thanks in part to the juice that I’ve been drinking surreptiously when the nurse has been out of the room.
My contractions, although increasingly painful, continue to be sporadic; sometimes I’ll have five minutes between them and sometimes I’ll get two in a row. It would be fairly easy to manage but for the fact that I’m having trouble resting between them. So far I’ve been sitting up in the bed the whole time, which is uncomfortable posture-wise and my upper back is killing me.
(My lower back felt great, however, and in fact I was lucky enough to avoid any back labor at all, probably due to the baby’s beautiful positioning. Based on where I’d been getting kicked and the way Camilla came out, my mom – who knows of such things – thinks she’d probably been left occiput anterior for quite a while, and stayed that way through labor.)
Bryan digs around in the cupboards and finds a large vinyl mattress-type thing, origins and intended use unknown, which we unroll on the floor so I can try sitting between his knees. I’m still bleeding, so we protect it with the large cloth pads provided, and we maneuver me and all my attached equipment into position. Deb the nurse looks surprised when she comes in and discovers what we’ve done (perhaps most patients are obedient and just stay in the bed?) but she doesn’t say anything. I stay on the floor for about twenty minutes, but it doesn’t turn out to be comfortable, and I decide to try getting back in bed and lying on my left side. Lying down totally screws up the monitors, but it helps so much with my comfort level that Deb works very hard to get the heartbeat monitor working, and decides that we don’t really need the contraction monitor. It is at this point that I start to like her better and better.
I’m supposed to start Pitocin at some time in here (the sequence of events is a little screwed up in my mind) but Deb wins my heart even more by offering to call the doctor and ask her if she’d be willing to let me wait until she’s come to the hospital and checked me herself. Wonder of wonders, the doctor agrees, and I’m given a temporary reprieve from the prospect of Pitocin.
I stay on my left side for a while and manage to doze between contractions. Bryan comments later that it’s remarkable to see how I can wake up, breathe myself through the not-inconsiderable pain of a contraction, and fall back to sleep immediately when it’s over. I spend an hour (or maybe more; my memory is fuzzy) doing this. But even though I’m having contractions fairly regularly and they definitely hurt, I’ve got a feeling that they’re not accomplishing much. For some reason I know that I need to sit up in order to get things moving along, so I steel myself and do it. We turn the lights back up. At my request, Mom digs out a Sudoku book to distract me, and I actually work on Sudoku through several contractions, which seems crazy in retrospect. (Although I’d like to look at the puzzles I did to see how accurate they are; I have a feeling they’re probably ridiculously full of errors.) In the next half hour, the contractions start to come more frequently, and they’re noticeably stronger. I’m sitting cross-legged in bed now, with one person near each arm, and rock from side to side through the pain. Labor is picking up.