The story of Alicia Cecille

I developed very mild Gestational Diabetes in the last trimester, so my OB was determined not to let me go more than 2 weeks over my due date (which was either 8/2 or 8/3, depending who you asked). I think I almost went into labor on my own on Thursday the 14th -- I woke up at 3 am with crampy, regular contractions that were every 3 minutes until I called my doula, Karen, at 5:30am and asked her to come over and check me. By the time she got here, an hour later, the contractions were slowing down and weakening. She suggested some breakfast, a shower, a walk and a nap, all of which I had and enjoyed. Walking around seemed to make things pick up, but I felt really tired and wasn't sure I wanted to completely wear myself out in the process of getting labor established. (I'd been up since 3am, had awakened Anthony around 4:30, and had called Karen and my mom at 5:30. So no one in the birth team was in tiptop shape.)

Although I no longer felt like labor was "happening", I called my OB and asked to come in for a check. This visit revealed that I was 2 or 3 cm dilated, the baby was doing fine, and the contractions had pretty much pooped out -- instead, I was having a nearly constant, basically painless, mid-level contraction (probably due to fatigue). The decision was made: I was to go home, try to get a good night's sleep, and call her (the OB) tomorrow morning to make arrangements to induce.

The OB gave me two sleeping pills (Vistaril), in case I needed some help getting to sleep. I took one, and gave one to Anth, because I figured he needed rest as much as I did. We slept adequately, and were awakened at 8 by my Mom, telling us it was time... The OB had called at 7 and said to meet her in L&D at 9. Suddenly, things were in motion. Only one hour to get everything together, eat a little breakfast, and freak out. We got it all done. :)

Karen met us at the hospital, and we spent an hour getting checked in and settled into our room (Room 1). The OB showed up at 10, and broke my waters around 10:10am. I got up and walked the halls for a while after that, and contractions soon got going; every 3 minutes, lasting about a minute. They felt like lousy menstrual cramps -- not agonizing, just uncomfortable, and they kind of sapped my strength. The OB said I could have whatever I wanted for lunch, so I ate pretty well: chicken breast, rice, green beans, and chocolate cream pie. Unfortunately, by 1pm I was seeing it all again, as the contractions continued to slowly strengthen. After I emptied my stomach they seemed to pick up a good bit, and they were starting to "bunch up": I'd have 3 or 4 big contractions in a row, really close together, with no decent rest or chance to recover, then 4 or 5 pain-free minutes. By 3 pm, the pain-free minutes were dwindling, and I was having a really hard time getting through the pain. The contractions were continuing to sap my strength; all I could think about was how nice it would be to sleep for a little while, and I had no desire to move from the bed. I asked for drugs, apologizing to my birth team repeatedly... They said I was silly to apologize. :)

We had to wait about half an hour for the OB to show up, so I could get a dilation check, before they could give me anything. When she checked me, I was at about 4.5 cm, which was enough that I could skip the IV drugs and go right for the intrathecal fentanyl, which is a one-time injection into the spine... I was warned of the risks, and told that only the pain in my abdomen would be relieved; the pain in my thighs and back would remain. They also said the shot would only last 2-3 hours, and I could get one more after that if I needed it. It took 5 or 6 more painful contractions before I got relief, but relief did come: suddenly I could handle it again. I whined and pleaded until my birth team agreed to let me rest for an hour or so, and that was a golden hour. The contractions were still coming, but the pain was manageable, and I could almost doze in between them. Unfortunately, the hour elapsed and I had to get up and start walking the halls again.

Unfortunately, the fentanyl only lasted about another hour, and then the pain was back, just as bad as before. A nurse checked me to make sure I wasn't too dilated to get the second shot... I was almost fully dilated, just a little cervical "lip" remaining. This meant no more drugs, but I was almost there (supposedly)! I had no urge to push yet. The OB put her hand up me and had me try to push while she tried to move the lip out of the way, but the attempt failed and was incredibly painful. We decided that we had to wait until I got the urge to push on my own. So I laid there, on my side, for 2 or 3 hours. The contractions were incredibly strong, incredibly frequent, and incredibly painful. Nothing I could do while laying there in bed made them any more manageable, and I had no strength left to get out of bed to try any of the great pain management techniques I'd learned in class and in books. All I could do was stare at the wall, breathe deeply, and ride it out. Meanwhile, the baby was not entirely happy. Every tenth contraction or so, the heart rate would decelerate -- not a lot, but enough that the nurses and OB noticed. They kept asking me if I had any urge to push, but I really didn't.

Finally, by 7:00 or so, I started to feel little, wimpy pushes, about 4 of them with each contraction. The OB was getting impatient to get the baby moving out of me, because of those occasional decelerations. We tried getting me up into a semi- sitting position and making me really push, but I hated it and told everyone so. My birth team convinced the OB to let me try laboring on my side, doing my little wimpy pushes, for a while, and we'd see if I could get there on my own.

Unfortunately, after an hour, the baby had hardly budged. My little pushes weren't strong enough to move the baby down and keep it down -- I wasn't making any progress. Meanwhile, the heart rate was decelerating more often, and more drastically. The OB decided things were serious. She told me I needed to really push, because we needed to get the baby out. She also called for the C-section team and the pediatrician to be on standby, and she had them bring in the vacuum extractor, all in case I couldn't do it on my own. I think I still had that cervical lip at that point, so the OB made me get out of bed and push while sitting on the toilet for a while. This was incredibly painful (as was everything that was happening to me by this point), but it worked, I dilated the rest of the way, and I returned to the bed to start pushing the baby out.

The nurse broke down the bed, I got up into a semi-sitting position with my legs up in the stirrup thingys, Karen took one leg and a nurse took the other. They gave me an oxygen mask, to make sure that the baby would get enough oxygen. As each contraction came, I had to take two deep breaths, then hold my breath, crunch up until I was folded almost in half, bear down and push as hard as I possibly could while everyone in the room (4 or 5 people?) counted (very slowly, it seemed) to 10, then a quick breath, then another push for 10, then one more breath and one more big push. The problem was, I still didn't really have the urge to push, so I needed the OB to put her fingers in me and stretch my perineum so that I could focus on that sensation while I pushed. If she didn't do this, I couldn't feel how to push right. So there we are: I'm folded up like a suitcase and pushing so hard my head wants to explode. [Anthony’s note: Jen actually turned purple while she was pushing.] Karen, Anthony, my Mom, and a nurse are holding my legs, supporting my back, counting to 10 and telling me I'm doing great and I'm almost there. The OB has her fingers in me, stretching me out, and she's yelling directions at me ("Harder!" "That's it!" "Keep going!"). The baby is moving slooooowly down the birth canal, and is in mild distress. This goes on for TWO HOURS!

Finally, I somehow got the baby down far enough that the OB could attach the vacuum extractor. During one of my pushes, she cut two episiotomies and attached the cup to the baby's head. I felt all of this, and it was incredibly painful. (I know I keep using that phrase, but words truly fail me here...) The cup popped off, blood flew everywhere, and I screamed. She reattached the cup and I tried to concentrate on my pushing. I never felt the baby crown, never felt the ring of fire -- everything hurt SO MUCH by this point, and my eyes were closed, so I didn't even realize right away that the head and shoulders were out, until my team told me. They paused here to suction the baby, and I started screaming at the top of my lungs for them to "Take it out! Take it the rest of the way out! It's kicking me!!" The OB yelled for me to grab the baby's hands and deliver it the rest of the way myself, and suddenly there she was, warm and heavy and wet and slippery on my chest. It was 10:10pm, 12 hours after my water was broken.

The OB asked Anthony if he wanted to cut the cord, but although he had planned to do it, he was just too shaken up from the blood and the pain and the screaming, so my Mom got to do it. Then, all too soon, they took her away and over to the warming table across the room. They had to suction her stomach and lungs to get rid of all the mucus that hadn't been squeezed out because the extractor pulled her out so suddenly. They had to do her Apgars (8 and 9). They had to do heel sticks, glucose checks, weigh and measure her. They gave her a bath, put her in a diaper, etc. etc. Her grandparents stayed with her for all of this, and Anthony stayed with me. Grandpop occasionally brought me bulletins, and told me she was beautiful.

Meanwhile, the OB worked on me. My episiotomies had lengthened into third-degree tears (i.e. I had torn into the muscle), and it took a long time to get me sewn up. The anesthetic that she injected into me beforehand didn't work, so I got to feel all of that. Partway through the repair job, my placenta detached from the uterine wall preparatory to my delivering it. Normally, there is a small gush of blood when this happens. In this case, about a quart of blood and fluid suddenly came pouring out of me, and no one was prepared for it. It splattered all over the floor. It ruined my OB's shoes. It ruined Karen's shoes. It splashed onto our hospital bag, my mom's pants, the room looked like a war zone. I don't know if this was indicative of a problem, or if it just ticked my OB off, but she decided that my placenta had to come out NOW and she started tugging on it. More blood, more pain, more screaming from me. After I delivered the placenta, she stuck her entire hand inside me, and checked to make sure there weren't any pieces of placenta left in my uterus. My God this hurt. In between screams, after she was done, I said "Please don't do that again!" (I just want to go on record right here that I never lost my manners throughout this entire labor!)