Tuesday, January 30, 2007

Adriana's birth story, part 2: The birth center

Contractions in the car were hard, but it became easier to manage them because I knew we were on our way. Somehow the fact that they were coming three minutes apart hadn't convinced me that I was really in labor. I breathed through one as we sat at the traffic light near the Washington Masonic Memorial, and then told Brian, "It just feels weird in my low back. We're going to get there, and Marsha's going to tell me I'm just constipated and to go home." But when we arrived at the birth center, Marsha called Pam and said, "They're here. I haven't checked her yet, but she looks like she's in labor. You should come." I told her I still wasn't sure. She had me undress and lie down on the big bed in the birthing suite, while she checked me. "You're five centimeters," she said, laughing. "Now do you believe you're in labor?" She called Pam back with an update, and Brian called our friend Marisa, who was planning on joining us at the birth center, to provide support to both Brian and me. We listened to the baby's heartbeat on the Doppler, and then Brian began to bring things in from the car, while Marsha set me up on the exercise ball to labor. After awhile I got back into the shower, since that had helped before.

When Marisa and Pam arrived I was back to laboring on the bed. It was mid-afternoon, and I was handling the contractions well. When Brian needed to get up, Pam took his place at my side, applying pressure to my back as contractions hit. The rest of the time, Brian knelt on a stool at my side, massaging my low back, while Marisa lay beside me on the bed, stroking my hand during contractions, so that I wouldn't hold tension there, and Pam stroked my calves and squeezed my feet. In between contractions, I was able to talk with them and enjoy their company. After some contractions, I felt strange for being the center of attention; it didn't quite make sense to have three people so focused on me. I mentioned this and everyone laughed at me. Periodically, Marsha or Pam would get out the Doppler to listen to the baby, who seemed to be doing well. They encouraged me to eat and drink, and I managed to drink a bottle of water, which Brian then refilled with some of my sports drink. I nibbled on a couple of pieces of dried fruit, but refused everything else Brian offered. I just didn't think I could handle it. Eventually I participated less in the conversation between contractions, letting my mind float as the soft voices surrounded me. Contractions came and went, as did nausea. I had been good about trying to stay hydrated, and Marisa would hand me my drink after each contraction, but once or twice I had to throw up. It didn't occur to me, though, how little I had been able to keep down since the night before.

I think it was starting to get dark outside when I decided I wanted to try laboring in the jacuzzi. Pam or Marsha went to begin it filling for me. It seemed to take forever to fill, but finally it was ready. I let myself float around in it a bit. Brian put on trunks and got in the tub with me, holding me through contractions. Being weightless helped at first: the pain in my back wasn't so intense, and if I turned onto my hands and knees it seemed easier to breathe. Plus, when I was on my hands and knees, I could finally feel the contractions in my belly a bit. I'd been able to feel my belly tighten with my hand, but this was the first time I'd actually felt the tightening--low and strong across my abdomen. As we labored in the tub, the contractions intensified. I stretched out in Brian's arms, and felt the contractions lasting longer and coming on stronger. Soon it seemed that they never ended. Instead, the intensity just rose and fell in slow waves. I tried to control my breathing and moaned with each exhale, trying to keep the sounds low and deep. Brian sing-songed to me, telling me to relax, to breathe the baby out, to let the water relax me. My mind was divided at that point into a small part that was still very conscious of what was going on around me and intellectually aware of what it was I was supposed to do to relax, and the larger part that was consumed by contractions. The small, aware part was almost amused by Brian, but also very grateful, because his voice was calming, and the part of my mind that was consumed by contractions needed his calmness. Every now and then, when the seemingly unending contraction would peak again, I would lose control of my breathing and my low-pitched moans would become more shrill. I remember telling Brian that it wasn't fair, that the contractions weren't stopping, that I was afraid, that I hurt to much, that I couldn't do this. Then he would guide me through the pain with his soft voice, and the pain seemed more manageable as I could relax a little bit again. Pam came into the bathroom and during a low point in the contraction, she told me that I was having run-on contractions--one coming right on top of another.

I can't remember what made me decide to get out of the tub. At that point the run-on contractions had eased, and I was able to get at least a few seconds of rest in between each contraction. Brian and Pam wrapped me in a big towel and helped me dry off, as I began shaking uncontrollably with cold. We went back to the bedroom and Pam turned on the space heater to help me stay warm. It was dark outside, and through the blinds I could see the lights in the trees along the street outside. We checked again for the baby's heartbeat, and it was harder to find this time; it wasn't that there was anything wrong with the baby, just that it was getting harder to find a good place on my belly to listen. Pam said she and Marsha thought I might be going through transition, and Marsha offered to check me again.

I lay down on the bed, excited: if I was in transition, I was almost there; I was going to meet my baby soon; I had successfully labored. As a contraction eased, I relaxed so Marsha could check my cervix. I tried to read her face. She looked at me seriously and told me I was at six centimeters. My good mood plummeted. I wasn't in transition. I was still a centimeter away from transition. I had been at the birth center for almost five hours, and had only gained one centimeter. I moaned through another contraction, and then Marsha encouraged me to move around a bit. She wanted me squatting, or on the exercise ball, or walking around--something to help move the baby down. Exhausted and discouraged, I agreed. I tried the ball first, because my legs felt so tired. Brian put a pillow over the footboard of the bed for me to lean into and he continued to apply pressure to my back through contractions. I was getting 30 seconds of rest between each one, and those seconds were blissful; I was surprised when Brian told me how short the breaks were, since I was able to rest so much during them. I suppose in comparison to the run-on contractions, any amount of rest would have felt good. That also gave Pam more time between contractions to try to listen to the baby's heartbeat. I was restless, though. I couldn't just stay on the ball. We got up, and I walked up and down in the hallway with Brian. He would lean on a wall and support my weight when a contraction would hit. He kept trying to get me to eat something, and I agreed to try some lentil soup. Marisa heated the soup for me, while Brian helped me walk up and down stairs. That wasn't as difficult as I thought it would be, but I was still restless and discouraged, so it was hard for me to focus on doing one thing. We went back into the birthing suite and I ate a few bites of soup and drank some water. I got onto my hands and knees on the bed for awhile, but that position was getting more and more difficult to sustain. I threw up again, and then got back up to pace the hallway some more.

Regina, the midwife I had seen the day before, was at the birth center and came up to the suite. "Some people will do anything to get out of going for an ultrasound," she joked. It was nice to have another person there to talk with when I felt up to talking. Marisa had to leave at some point. Shortly after that, my water broke. I alternated between walking the hallway and lying on the bed. My throat was getting sore from moaning out contractions. I admitted to Pam that thoughts of an epidural were crossing my mind. She didn't make me feel guilty for that, but encouraged me to go on laboring. I think there was a decision around this time that the baby had definitely turned into a posterior position, which was why it was becoming more and more difficult to find the heartbeat.

I got sick again, and I could see concern in Marsha's face. She said she was worried about my energy level. She suggested a shot of Nubain, which wouldn't really help with the pain, but would help me get some sleep. But Nubain is a narcotic, and after experience with similar drugs for migraines when I was a teenager, I declined, explaining that I didn't react well to narcotics. Someone suggested I get back in the tub, and Pam began adding hot water to it. Brian didn't get in the tub with me this time, and I didn't ask him to. I could see worry in his eyes, worry that was probably reflected in my own, although I tried not to show it. I eased myself around in the water between contractions, trying different positions. I hoped that if I spent more time on my hands and knees that the baby would turn, and being in the water made it easier to support my body that way.

After a fairly short time in the tub, Pam and Marsha joined us in the bathroom. There was talk of a hospital transfer, so I could get an epidural and a bit of rest. The idea certainly appealed to me at this point. I was exhausted and wanted to sleep almost more than I wanted to meet my baby. But I was still worried about going to the hospital, and I felt self-conscious about giving up on my natural birth. In my mind I saw the sheet of statistics from the birth center, with the number one reason for transfer to the hospital: maternal exhaustion. I saw myself getting closer and closer to being a part of that category.

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