This post has been rather a while coming now! As you may have guessed, I've
been busy having a baby, so I haven't had much time to write. There has been so
much going on, so much I want to talk about, that it's been a mission simply
writing notes for myself. To keep things from getting too out of control, I'm
going to break things d
own a bit. So let's start as I arrived at the hospital...
40 Weeks
It's a truly strange feeling to be going into hospital knowing that you won't
be leaving without having given birth to the child you've been carrying for the
past nine months. It's one of those things that the movies always depict as a
messy and spontaneous event. Sometimes though, there is somewhat more planning
and scheduling involved. I was admitted to hospital at 40 weeks exactly to be
induced. After the previous weeks attempt, we knew that I was unlikely to have
a reaction to the hormone they were using, so after a quick internal
examination, Dr D put some prostins gel on my cervix, to help it prepare for
baby's departure. The head was nicely down and my cervix was looking better
after another week waiting, though it was still long. This kid was being served
an eviction notice!
After the gel was inserted, I was kept on the CTG (cardiotocograph) to
monitor bubs heartbeat, to insure he/she didn't get too stressed as well as any
contractions I might be having. It didn't take them long to start at all. By
the time this all happened, it was about 3pm, with a progress report scheduled
for 9pm, when more gel would be inserted if it was needed. Baby was doing well
and I was having contractions about ten minutes apart, strong enough that I
could feel some of them, but really not causing me any sort of discomfort.
The dinner the hospital gave me really wasn't looking that appealing, so Tim
headed down the road and got us some burgers for tea. Turns out that wasn't
such a great idea. I'd read so many times about only eating small light meals
in early labour, but it didn't actually occur to me that what I was in
was
early labour. Not until after I went to get ready for bed and threw said burger
up again.
At my nine o'clock check, I was given another internal exam and found to be
3cm dilated already! This was great progress! My cervix had shortened up to
only 1/2 cm long (previously 4-5cm) as well, so things were looking good. So
good that instead of inserting more gel, the doctor did a stretch and sweep
instead. This is where they use a finger to separate the membrane from the
cervix, reportedly somewhat uncomfortable. I'd believe that, because even
though I couldn't feel it, I could feel my stomach and legs spasming as they do
when they really don't like something. By this stage I was up to 2-3
contractions over a ten minute period and ready to have my waters broken in the
morning, if they hadn't already done so by themselves.
By 10.30 pm my contractions were close and regular enough that I was moved
to the labour ward so we were ready for things to get started. I was put back
on the CTG for half an hour and had a catheter and canular put in, ready for
labour.
Not long after this I had someone from the anaesthetics team come talk to me
about an epidural. My thoughts on an epidural were similar to my thoughts on a
caesarean section. If I need one, fine, but give me a chance to try this myself
first. The anaesthetist spoke to me about the option of putting in an epidural
and setting it up so it was ready, but without actually hooking it up. I was
happy with this compromise, but once she had spoken with her boss, they decided
that actually, that was pointless. I was told I didn't need to make a decision
just yet and since Tim had finally fallen asleep and I didn't want to wake him,
(or make that decision alone) I decided to wait until they next checked my progress
at 1.
40 weeks + 1 day
At 1am I was given another internal examination and was still 3cm dilated,
with my cervix shortened right up. My vital statistics, otherwise known as ob's
were being taken hourly, so I really wasn't getting much rest. There was
another internal exam at 6am then I was left to get a bit of sleep before we
started. I was offered a shower but with so little sleep and a canular in my
hand that was just way too much work!
At 9am, Dr D was back to check my progress and get things started. She had
been kept updated on my progress throughout the night, even though she was off
duty. She broke my waters, using an instrument that closely resembles a crochet
hook. Again, I couldn't really feel anything, just a pressure and that
discomfort that I get when my stomach muscles protest. By this stage I was
losing track of the number of times someone had stuck their hand up my vagina.
Maybe 6? They do tell you to check your dignity in at the door....
When you go into labour, your body naturally produces a hormone called
oxytocin, which causes the contractions of the uterus and basically pushes the
baby most of the way out, until you get to the active stage of labour at the
end where you push. Since I hadn't gone into labour spontaneously, I had to be
given syntocin, an artificial version of oxytocin. I was started on a dose of
12ml an hour, going up 12ml at a time each hour. They do this gradually so they
can get the dose right for each individual and to give you a chance to keep up
with the progression, so neither mother nor baby end up too stressed.
Speaking with Dr D, she was happy for me to try without the epidural and see
how I went. I was being constantly monitored anyway and we had the anaesthetics
team on standby if things started to get out of hand. She was also regularly
checking up on me throughout the day.
I had another visit from anaesthetics, this time from the head of the
department. I'm not sure if he didn't hear me or just didn't think I was funny
when I promised him I wouldn't go walking off if they gave me a walking
epidural. This is a low dose epidural that allows you to still walk around
during labour, but the walking part isn't an option at my hospital, due to a
staff shortage. Walking epidurals require constant supervision due to the
increased falls risk. Since I couldn't feel if the epidural was in the right
place by the usual measure (loss of sensation and pain), we would have to use
other methods to see if it was working. The two main signs would be a drop in
my blood pressure and my legs should be very warm to touch as they became hyper
vascular. He also assured me that it shouldn't slow down my labour or impair my
ability to push. He was very keen to get this started to prevent me from
getting any dysreflexia, but I wasn't ready to go ahead with it yet.
Over the next couple of hours I was gradually given a higher dose of
syntocin, as well as fluids to make sure I didn't get dehydrated. I was having
semi-regular contractions, strong enough that I could feel them, but not really
more than occasionally uncomfortable. Certainly not painful in any way.
I sent Tim off to grab a quick lunch with his mum. Just after he left, Dr D
stopped in again. By this stage my blood pressure had been slowly rising for a
couple of hours. It was still well within normal range, but getting on the high
side for me. I had also had the occasional twinges of sharp pain in my head,
which I get when my blood pressure rises, a symptom of dysreflexia. Both these
things led me to ask Dr D how she felt we were going and if she thought we
needed to go ahead with the epidural. Her thoughts were that we would need to
be considering it soon. That was enough for me, and I gave her the go ahead to
organise it.
Once I said yes, things happened very quickly. One of the anaesthetists came
up and talked me through exactly what he was going to do and got me to sit up
on the side of the bed. One of the midwives stood in front of me to help brace
me and make sure I stayed in the right position to allow the epidural to go
straight in. I'd been in a hospital gown since the night before, but they need
that out of the way as well to do the epidural, so I was sitting there
basically naked in front of several people I'd never met before. Who am I kidding,
I was naked! You have to kind of hunch over, so they can get the needle between
the vertebrae. Tim wasn't gone very long, but he only arrived back just in
time. I was really glad he made it, because I got very nervous just before they
went to put it in. And scared. I was pretty sure I was doing the right thing,
but I really had no way of knowing. I'd let Tim know I'd given them the go
ahead to do the epidural, but in the end I'd made that decision without him and
I really wanted to talk to him. I hadn't wanted to have the epidural in the
first place, even though I knew it would probably be necessary, so I really
didn't want to do it alone.
It turned out to be pretty quick and easy in the end and was done before I knew
it. They then had to flush it and run a test through it, before they set it up
for the long haul. Safe to say he got it in the right place. My blood pressure
dropped right down, below my normal levels within minutes. This meant they then
had to pump me with fluids to bring it back up. This was another reason I'd
been reluctant to have one too early, as I knew the epidural would lower my
already low blood pressure. I'm not sure if it was the epidural itself, the
fluids or just the emotional toll of it all but I got cold afterwards and had
the shakes up a bit. My contractions had been starting to get quite regular up
to this point but had slowed down again. So much for the epidural not affecting
my progress. At least we didn't have to worry about dysreflexia anymore.
By midafternoon my contractions were getting better again with the gradual
increase of syntocin. I wasn't regular enough to be in what they called
established labour, but I was making progress. There had been lots of clear
amniotic fluid leaking out everywhere and we had had to change the bedding
several times already. The fact that it was clear was a very good sign, meaning
there was no sign of bleeding or infection. I'd had the risk of bub passing meconium
(the first poop) while still in utero in the back of my mind for months, so I
was glad to see that wasn't the case. Baby was still being very happy and
active. I was trying to get a video of my belly moving, so I could send it to
my sister in the Northern Territory, but I couldn't get my timing right. Tim
was smashing through the levels of angry birds on the ipad.
A bit later on, the head anaesthetist came by again to check up on me. He
didn't really have much to say. I sent Tim off to meet up with our neighbours
and get out of the hospital for a bit while he still had a chance.
Around 5, Dr D came by to do an internal exam. They usually do one after 4
hours of established labour, but since I was close to that, she checked me
anyway. I'd progressed to 4-5cm dilated. We made a plan for her to come back at
9pm, by which time I would hopefully be most of the way there. The syntocin was
still being gradually increased to help strengthen my contractions. This time
when Dr D examined me, I hadn't had any twitches in my feet or stomach spasms,
showing the epidural was doing its job.
I spent the next couple of hours sitting up in bed, instead of lying down.
It felt good to be in a different position for a bit. Tim ended up staying out
for tea with the others before he came back.
Dr D came by at nine for our next check. I knew when she didn't say anything
as she was going that something wasn't quite right. I was still only 4-5cm
dilated and baby was presenting posterior. It wouldn't have mattered who it was
on that bed, in this position, with a baby this big, a vaginal delivery wasn't
an option.
Dr D told me that we could leave it for a bit if I wanted, but that with the
position the baby was in, I wouldn't dilate any further, since the baby
wouldn't be pushing on my cervix. As well as that, the contractions would only
be putting pressure on the baby’s head, which would eventually cause the baby
to get stressed. She left us alone for a couple of minutes to decide what we
wanted to do, but there was never really any option. By this stage I'd been
having contractions for 30 hours, I'd had next to no sleep overnight and I'd
just found out that despite all our best efforts, I wasn't getting the birth I
wanted. I cried. Dr D came in and we gave her the go ahead. Since neither baby
nor I were in any danger, we had a bit of time to get things organised.
The next half hour or so was a flurry of people coming and going. They got a
hover mat onto the bed underneath me, to make it easier when they needed to
transfer me. The syntocin was turned off to slow down my contractions, since
they were no longer needed. People came and went. Dr D came in and explained
what was going to happen once we got moving. I was still monitored regularly. I
continued to cry. Just tears rolling down my face as everything happened around
me. I was so utterly disappointed. I knew it wasn't my fault, it wasn't anyone’s
fault, but that didn't change how I felt. I managed to calm down enough to call
my mum, only to start again as soon as she asked how I was going. Tim was
coming with me to surgery, but I wanted Mum there when I came out. Tim and I
passed the time trying to come up with baby names. Nothing like leaving things
to the last minute.
It was about 11.30 by the time we got to the theatre. I remember lying there
thinking how different this was to the last time I was going in for surgery,
when the guy pushing my bed had asked if I knew what type of theatre I was
going to, I was that jovial. This time I was quiet, just holding it together. I
managed a smile for Tim when we stopped to take a photo of each other, me in
bed, him in his scrubs.
 |
| Tim ready to go! |
They put some SCUDS on my legs, a kind of massaging
pressure stocking, a far cry from the teds I got when I broke my back.
 |
| SCUDS, to keep the blood flowing through my legs properly |
I cannot overstate how much of a difference it made for me, having built up
such a great relationship with Dr D. She had listened to me (and Tim, which we
both felt was really important) and supported me throughout everything I had
asked for and left me in no doubt that she would both try her best to accommodate
my wishes, without letting me put myself in danger. She had already gone above
and beyond and going into theatre knowing she would be doing the surgery herself,
when she could just as well have finished her shift and gone home to her own
kids, made the world of difference to me. It stopped something that was really
scary from being terrifying and downright traumatic. I trusted her judgement
completely. Having both her and Tim there, and knowing Mum was waiting, were the
things that kept me from completely falling apart; Although I’m not sure the
nursing staff thought I hadn’t already, judging by the number of times they
asked me if I was ok. I guess having your patient lying there in a constant
flow of tears isn’t the most uplifting sight.
Now I’m sorry, but I’m going to leave you all with a cliff hanger here. I
promise I’m already working on the next bit, but if I keep going now, this is
going to get out of control. So give me a few days and all will be revealed!
