An Amazing Journey: Ch. 19 -- Labor is a Good Word For It About This Page:

[Jennifer Marx]

Labor is a Good Word For It

Well, as you probably know by now, there was no need to worry about my "expiration date" of August 13. Here's what happened...

The contractions I experienced on Wednesday afternoon after the third application of prostaglandin gel were the start of the real thing. As I mentioned, the contractions were now stronger and harder, though not yet regular. The regularity would kick in on Thursday morning. I was still able to get around and do a fair amount, though I did try to get some rest. I didn't know it yet, but I was going to need all the rest I could get.

On Thursday afternoon, Dave and I went out for lunch at a new Middle Eastern cafe near our house. After my meal of a falafel sandwich, hummus, tabouleh, and raspberry leaf tea, I stood up from the table and had the immediate sensation that my water had broken. I'm not talking about a TV-style gush and an "Oh, my water just broke!" exclamation. The trickle I felt is much more typical than that dramatic deluge, and with a trickle you can't be quite sure. But I suspected. By the time we got home, I was even more suspicious. We called the midwife and explained what happened. She advised us to wait a couple of hours but to call earlier if something changed. Within a few minutes of the call, I became certain that my water had indeed broken. At this point, the contractions ramped up and started becoming what I would consider painful.

The midwife asked us to go to the hospital at 7:00 pm. She explained that if my water had indeed broken, that I would be admitted and the baby would be born soon. I had tested positive for Strep B and that meant that baby couldn't wait once my water had broken - I'd have to receive intravenous antibiotics post haste. So while I sat on the birthing ball and managed my contractions, Dave went out to pick up Allie from day camp and drop off some recycling. But within 15 minutes, I called Dave to beg him to come back home because the contractions were now coming quickly, 4-5 minutes apart. He and Allie turned around and headed straight home with a minivan full of trash.

For the next hour or so, I bounced on the birthing ball and practiced all those relaxation techniques I'd learned in class. I was not scared or anxious, just focused. Dave put the recycling back in the garage, made sure everything we needed was in the car and called our doula to have her meet us at the hospital. I also packed away a last-minute meal, as once I got to the hospital I would not be allowed to eat. Then we were off to the hospital. Nikki, my sister-in-law and office helper, followed us in her car -- the plan was for Nikki to hang out with Allie while Dave stayed with me during labor.

The car ride to the hospital wasn't fun -- I felt every single one of those bumps and potholes. We used Dave's PDA to record the length of the contractions. By the time we arrived at the hospital, they were 4.5 minutes apart and lasted about 90 seconds. If that doesn't mean much to you, it meant that I was now in the full-fledged first stage of labor. The previous 24 hours would qualify as "early first stage labor," by the way.

At the hospital, Dave pulled up the entrance while I waited for the current contraction to stop. As I recall, this contraction lasted for what seemed like a long time -- over 2 minutes. More than likely this is what is called a "double peak" contraction -- two contractions that came one on top of another. Normally this doesn't happen until the late first stage of labor. I knew this and felt a bit of panic at this point. The contractions seemed to be progressing too quickly. Little did I know.

I was wheeled up to the Family Birth Center to be admitted. I remember sitting in the wheelchair for what seemed like 30 minutes while they processed the paperwork. A hospital tour group walked by and we heard someone say, "Hey, she was in our class," but I was too focused to look up and see who it was.

Finally I was taken into triage around 7:30 pm. There I was hooked up to an external ultrasound monitor to read the fetal heartbeat and my contractions, and they took my blood pressure and temp. The contractions were coming at the same rate but were now stronger. I was calling in every mental and physical resource I had to manage them, but I was managing. Walking was now out of the question. By the time a doctor showed up to check my cervix, I was moaning through the contractions. I never imagined I would be so vocal, and yet I was. It seemed natural and I made as much noise as I could while lying or sitting completely still and focusing. It seemed to help.

Alas, the cervical check showed that I was at exactly the same point as I was the day before: 1-2 cm dilated, 80% effaced, and -1 station. Hmm. Considering that my contraction strength and frequency put me in the late first stage of labor, this was NOT a good sign. But everyone seemed encouraging and I knew that these cervical checks can be a real bummer, so I simply tried to ignore the lack of progress. I knew that if I kept working at this, I'd make it.

By this point our doula, Wendy Pinter, was on the scene and lending her considerable help to my labor. Along with Dave, she helped me focus and ride each contraction to its conclusion. Dave was also incredibly encouraging, reminding me of what a great job I was doing and how proud of me he was. It really helped to have these two people with me.

An hour later, one of my midwives arrived and did her own cervical check with the same results. And with print-outs from the monitors, we could now see a pattern to my contractions. Instead of the single contractions and few double peaks that a laboring mother might experience during her labor, I was getting a good percentage of double peak and even triple peak contractions. I remember hearing people say they hadn't seen a contraction pattern like this before. What this meant for me was that I seemed to have very long contractions and extremely short breaks. As you can imagine, this was tough. Very tough. But I kept at it, encouraged by everyone's support.

Around 9:00 I was wheeled into a labor/delivery room where I continued my labor. My IV was started after a few ineffective pokes and my antibiotics began.

[Dave adds: "A few ineffective pokes?" Thanks to Jennifer's normally hard-to-find veins, they had to bring in a succession of "specialists" before they could start the IV. From nurse to certified nurse anesthetist and finally the resident anesthetist himself - all were needed to get a needle into a suitable vein. A week later her arms are still black-and-blue from the attempts.]

Not long after this I remember remarking that I was cold, and I was piled high with warm blankets by Dave and Wendy. Unfortunately, I began to shiver and when my temperature was checked, it had spiked. So now I was contending with very painful contractions and non-stop chills. I was given Tylenol for the fever, but it continued to rise to the point where I was told that I'd need antibiotics (in addition to those antibiotics I was already getting for the Strep B) and that my baby would need to go to the NICU (Neonatal Intensive Care Unit) for the first two hours of his life. This was disheartening. I'd really been looking forward to holding my baby during his first hour, when he's supposed to be alert. Oh well. I had to accept the things I could not control.

The fever continued for the next several hours, as I recall. I was given fluids intravenously as I was becoming dehydrated quickly due to my temperature. I felt like I was burning up but couldn't get warm at the same time. Shivering during a contraction is a bad thing, as I was taught to relax completely. Eventually the fever went down, probably thanks to the antibiotics. We still don't know why I got it, though.

[Dave adds: Back in Bradley class we had discussed how certain routine practices, like IV fluids, can slow down the natural course of labor. Perhaps the addition of IV fluids in routine labor does have a negative effect, but once Jennifer's fever moved things beyond the routine, she was dehydrating faster than a few sips of water between contractions could remedy. Clearly, dehydration would be worse than the effects of the IV.]

At 10:00 pm, I was riding each contraction with strength and determination that I never knew I had. Each contraction, especially those double and triple peaked ones, threatened to overwhelm me. I repeated the phrase "I can do it" in my head with each breath just to get through it. I tried so hard not to fight my body, to let it do what it was supposed to do. I really began to lose all sense of time and even place at this point. The contractions were coming fast and furious, every 2-3 minutes apart, and I heard the doula, midwife, and nurses tell me how amazed they were at how I was handling them without medication. From what I'd learned, this should most definitely have been late first stage labor, with transition stage and pushing stage just around the corner. I clung to this idea and persevered.

[Dave adds: Jennifer couldn't see the read-outs on the monitors, but the rest of us could. What felt like a single, triple-peak contraction to her looked to us like a range of three, very steep mountains separated by narrow, deep valleys - something you might see in a Chinese landscape drawing. Each mountain range was separated by a somewhat-broader valley (pause) of about 30 seconds to a minute. And Jennifer had to climb each and every one of those towering peaks. The baby's heartbeat was displayed on the same monitor as Jennifer's contractions. Fortunately, it held strong and steady, despite whatever stresses mommy was going through.]

My family came in very briefly to see me sometime around this point. I'd lost all sense of modesty by now and was moaning very loudly. I knew I should have cared about them seeing me like this, but I wasn't too troubled. But I wasn't up to communicating with them. They just came to my bed, gave me kisses and encouraging words, and left. It felt good to know they were supporting me.

My next cervical check showed some progress -- I was now at 4 cm. While that wasn't very far, it was progress, and that was what mattered. I think at this point the expectation would be that I would continue to progress fairly rapidly, based on my contraction frequency and pattern. So we were all encouraged.

I continued to labor for the next several hours. Looking back on it now, I don't know where I found the strength to ride out those double- and triple-peak contractions. I remember one nurse commenting that if I'd been on Pitocin (a labor drug that causes contractions), she'd be turning the dosage down now. Alas, there was no way to turn down what my own body was doing. So I kept toughing it out, reminding myself I was making progress.

[Dave adds: This is an understatement! One of my greatest fears as the pregnancy progressed was that Jennifer would lose her composure and control during labor. While most folks know her as a cheerful, even-tempered person, in the privacy of our relationship Jennifer doesn't hesitate to let her upsets and discomforts pour out (all over me). She has remarkable reservoirs of strength and determination, but she's not stoic. When things hurt she doesn't "suck it up," she lets me know, loud and clear. But not once during all those hours did she seem in danger of losing it. She just kept laboring over one mountain after another without complaint. Between each contraction she took a sip of water (even with the IV), caught her breath, and resumed her climb. She had her goal firmly fixed in her mind, she was going to make it to trails end with her head held high, no matter what.]

Somewhere in the middle of the night, my cervix was checked again. I'd made absolutely no progress. All those intense contractions and nothing had changed. It was almost beyond belief, but I knew that this sometimes happened. Dave, Wendy, and the midwife continued to work with me through each contraction, though by this point they were taking shifts -- everyone was getting exhausted. I just kept repeating, "I can do it."

Towards morning, another cervical check showed that I'd still not progressed. The midwife suggested that we may need to administer Pitocin to increase the effectiveness of contractions. It was at this point that I heard people talking about how my contractions seemed to be "dysfunctional," and they theorized that I was getting the double and triple peaks because the muscles of my uterus weren't working together, weren't synchronized. At the mention of Pitocin, and the realization that my contractions were going to have to get much stronger to complete the delivery, I began to doubt that I could continue without medication. Up to this point, I believed I could do it because I felt my body was doing what it was supposed to, just a lot more intensely than I'd been taught. But if I had to go beyond this level of intensity, which everyone already thought was beyond what most women experience, I simply didn't know if I could manage. Add to that my exhaustion (at this point, my labor had lasted about 38 hours, 12 of those in the hospital) and I began to seriously consider my options.

[Dave adds: Remarkably, after all she'd been through, Jennifer was able to calmly weigh those options. This wasn't a mater of simply going along with the experts' advice. She had studied all the possibilities in the months before birth, and remained in complete control of her treatment. I still can't believe how calm and rational she was as we all discussed the situation.]

After wrestling with the decision mentally, I suggested the possibility of getting an epidural (anesthetic). I asked each member of my support team for their opinion. They were all very supportive, though I could see they were hesitant to enthusiastically tell me to go for it -- they all knew how much I'd wanted an unmedicated birth. I felt that if I had to go to Pitocin for who know how much longer, that I'd also need help with the pain. I remembered learning in class that when an unmedicated labor goes on for a long time, women can need assistance to finish. With the help of everyone, I decided an epidural was the best thing for me if I still wanted to have a vaginal delivery.

[Dave adds: In some ways, epidural anesthesia was one of the scarier procedures I'd learned about during our birthing classes. While it seems around 80% of women in labor receive an epidural, it's not a simple matter of getting an injection. Using a very large hollow needle, the anesthesiologist threads a small tube between two vertebrae into the sac surrounding the spinal cord (actually, the sac extends below the end of the spinal cord, and that relatively safe area is the doctor's target). Once in place, the tube is attached to a small machine that feeds a steady, measured dose of liquid medication to the patient. There are several benefits, chief among them that they can regulate the dosage "just so." With the right dosage, the laboring mom has enough sensation to be able to assist in labor (pushing), while being relieved of the pain of contractions. So all in all, this can be a good thing, but the thought of needles and tubes in the spine, and the possibility of over- or under-anesthetizing to no good benefit didn't sit very well with me.]

Staying still while they put the epidural in was difficult, but I felt no pain from the pokes of the epidural itself. In fact, it was remarkably easy. I was expecting a much more painful process. But at this point, ANYthing was a welcome distraction from the pain -- even other pain. Nothing compared to the contractions I felt.

Once I took the plunge on the epidural, life got a lot brighter. The pain vanished instantly. I'd been told that the medicine only took away 75% of the pain, but it sure felt like 100% in comparison. I felt each contraction, but they no longer hurt. I could now talk to Dave and my support team, look around, keep tabs on my contractions on the monitor, and so on. I honestly never felt guilty about the decision to take the epidural -- it was well worth it if it meant I could continue.

The Pitocin was administered and the contractions continued painlessly. I rested and gathered my strength for the second stage of labor, pushing. Dave and Wendy also rested and had something to eat. I could see that they were utterly exhausted. Around the time of my epidural, midwife Elaine arrived to relieve midwife Helen, and so a new person was added to my support team. I looked forward to finishing labor and meeting my baby soon.

Next: The "C" Word

[chezp]

Jennifer, it is so good to see you back on the boards and posting and Alexander is so beautiful - what a wonderful photo in your signature, you look so happy and proud of him, as you should be after what you went through!

As someone who's never had children and is not planning any (partially because of a fear of pain and needles and labour in general!), I had nothing but admiration for you, reading your post. I cannot begin to imagine how you coped for so long with such intensity of pain and it seems to me that you deserve a medal for going through what you went through with such composure.

I'm looking forward to reading more - and I hope the next installment sees you carrying off when you left off, in a lot less pain.

[Jaya]

Alexander is beautiful! Look at all that hair!! Congratulations!!!

[Colexis Mom]

Wow Jennifer, what an ordeal that you went thru! I don't think I could have been as strong, or held out as long! Can't wait to read the next part.

[Snapple]

Alexander sure is a handsome prince! Thanks for letting us be alsong for the most magical time in your lives!

[MegglesMom]

Thank you so much for sharing this with us!! It sounds like you guys went through so much, yet kept it together... Wow!

[luvnwdwgal]

Wow Jennifer! You are the epitome of strong! Alexander is beautiful!

[HiddenMickey]

Wow Jennifer! ...And I thought my DS's birth story was tough! You are a strong, strong woman. Am looking forward to reading the rest.



-Suzi

[BritDisFan]

Wow Jennifer it sounds like you and Dave went through a lot, Well done for being so together through that hard labour, it really does sound like an ordeal.

Karen

[Chrissi]

Oh my gosh, you are so brave! I feel like such a chicken! I'm another one of those moms who labored forever - over 48 hours with DJ. But I'm such a wuss about needles - I nearly passed out at the thought of an epidural or other injection-type painkiller. I couldn't bring myself to try either. Not even an IV. I just hate needles! I'm fortunate that I had good strong contractions that did what they were supposed to, I guess.

You were so clear-headed and in control (again, my polar opposite - I yelled at everyone ). I can't wait to hear more of your story!

Alexander is just beautiful. The picture of the two of you together in your signature brought tears to my eyes.

[ilovelilo]

I'm sorry the labor was so difficult, but I'm so glad you made it through all right! And you look so happy in the picture with Alexander that I was almost crying! Thanks for the detail of the delivery (someday I'll probably go through it too, and it's nice to have a real account of how it is), and for the picture! He's so adorable!

[DrDolphin]

What a fantastic photo of mother and son. Glad to hear the epidural helped with the pain.

[KerryRae]

Jennifer you did an amazing job. Your son is beautiful. I am so happy for you.

[DouglasE]

Thank you for sharing your story. I particularly liked Dave's point of view being interjected. Your signature photo says it all.

[OffKilter_Lynn]

It must have been the raspberry tea!!

Congratulations on your beautiful baby. The experience and trial of his birth only serves to strenghten the bond between mother and child.