Tuesday, July 14, 2009

Chapter Four: A Hard Day's Night

Shortly after midnight on the 14th (around 48 hours into active labor, 24 hours after hospital admission, and 13 hours post membrane rupture), I was declared “close enough” to 10 to start pushing. The nurses went over all of the instructions with me – where to push, when to breathe, etc. – and told me my doctor had asked to be called when I was “pushing well.” I pushed through a couple of contractions but became frustrated because I felt like I didn’t have enough sensation to know how/where to push. I asked to have the epidural turned off so I could use a squat bar. I tried squatting as the epidural was wearing off but it just wasn’t working. I tried sitting up on the edge of the bed but Elliot’s position made this impossible – his legs were up into my rib cage and I couldn’t contract my abdomen forward at all, even just to sit up versus lying flat. I should note that not once did that boy stop kicking, even during the time I was pushing. My mom could feel him pounding away below my rib cage even I was trying to push him out during a contraction.

Once the epidural was finally down all the way, I learned (in the form of blinding, searing pain that I am at a loss for words to fully describe) that I’d injured my left hip somehow during labor to that point. I don’t know if it was from laying too long on my right side or what, but the pain in my hip was at least as bad as the worst contraction I’d experienced so far and it was constant. I kept trying to push through it with M and our doula supporting my legs and a nurse doing the towel-tug-of-war thing with me, but each time, I dissolved into sobs before the end of the 10 count. I was also having painful contractions at this point (made worse by the infection, I now know) but it was really just the hip pain that I couldn’t handle. I couldn’t find a way to stop it from hurting and I couldn’t push against it. Near the end of this phase of things, I’d been pushing about three hours and I was falling asleep between contractions and waking up to push/cry. It was pretty awful. At some point, someone had thought we were close enough to a vaginal birth that they’d warmed up the table for him and laid out all of the supplies for his arrival, but I didn’t realize this at the time. I felt like I wasn’t making any progress and started telling M I wasn’t sure I could do this. A nurse overheard and asked me if I was asking for a c-se.ction. That is one thing I remember perfectly because – amazingly – it hadn’t even crossed my mind up to that point that we might be getting into that territory. I was completely shocked to hear her mention it as even the most remote possibility. I said that I wasn’t asking for that but I knew I was in too much pain and I didn’t know what to do. They decided to call my doctor at this point. They also turned my epidural back up to try to relieve some of the hip pain but it was too late. The pain from my hip and the infection had become so severe that even the epidural wasn’t able to get up over it. I felt completely delirious at this point and I was literally taking myself into another mental space to get through each contraction.

When my doctor arrived, she took one look at me and the fetal monitor strip and said it was time for a c-sec.tion. I was crushed to hear this, but I knew I didn’t have any stamina left for anything else. They called the anesthesiologist to administer the higher level epidural. While we were waiting, Elliot’s heartbeat was lost again. I knew from past experience that in a few seconds, the room would flood with light and people and I’d be manually flipped from side to side. My hip and uterine pain was so severe at this point, I had the thought that I had to make myself completely limp or I’d die (literally, I thought I would die), and so I did. My doula told me later she thought I lost consciousness at this point, but I remember it all. They came in and did the flip-check-flip-check routine. My doctor reattached the fetal monitor – 168bpm. And then someone said, “that’s Mom”. My heart rate was at 168. My whole family was in the room at this point – my mom had been there the whole time and my dad had just come in to wish me luck before the surgery, and this completely freaked everyone out. When they finally got Elliot back on the monitor, there was no more messing around. We were headed for surgery within minutes.

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