How to get un-pregnant: A Labour Story (PG mildly medical)

Today is Louisette’s due date. So she came early, after all. I’m so glad she did. Being pregnant really sucked.

My pre-labour contractions (that is, contractions that were causing change in my body – I begged the midwife to do an internal exam so I’d know for certain, and was relieved to find out that at least something was happening – and that relief never completely went away) began thirteen days before established labour. For ten days it was like having an irritating child poke me in my (sore and nauseous) stomach every hour, and up to 15 times each hour). It didn’t quite hurt, but it was annoying, and sometimes it cost me many hours of sleep. (Once I’d had one internal examination – uncomfortable and personal but the information gained was always so very very worth it – I wasn’t nervous about having many more. In fact I deliberately rationed them out as rewards – a very good idea.)

Three days before established labour began, I had a pink show (a little like a period, and a great sign that labour will likely begin with 24 hours). The previous night I’d been unable to sleep more than 1.5 hours at a time, and I was exhausted.

That night, I barely slept (again). My contractions were painful (enough to make me gasp and stop whatever I was doing at the time) and usually about twenty minutes apart. They kept waking me up despite how tired I was.

The contractions continued on Saturday, picking up around 4pm to about ten minutes apart. Then in the evening they slowed down (without getting any less painful). The instant I tried to go to sleep, they started coming closer together. Lying down made them much more painful, but I was desperate to get some sleep. I took panadol (which I’d been taking every night, as per the midwife’s advice) and asked CJ to stay awake for a while and keep rubbing my back (which hurt a lot each time I had a contraction).

We got up and watched the end of “The Lord of the Rings” trilogy (part of my personal pain relief strategy, along with blogging – I always saw labour as a story in which I was the main character, and chose to hold on to that as a way of making myself behave more heroically – did I mention I’m a writer?) and began timing the contractions. (Sidebar: As you’ve probably guessed, all the updates past a certain point were dictated to either CJ or my sister.) Over the next eight hours they grew more painful, and closer together. I was hungry around 2am and managed to eat an English muffin (very very slowly). That was the last thing I ate. CJ’s back massages and general comforting presence was on a par with saying “OuchOuchOuchOuchOuch” (or juicier language), and he remained my primary source of pain relief for the entire labour. (I knew he’d be good, but I didn’t know he’d be THAT good.)

At 8am my contractions were going for two minutes each, three and a half minutes apart, and I called the midwife. My primary midwife doesn’t work weekends (this was Sunday morning) so I was passed on to another member of the four-member team (all of whom I’d met, because the Canberra Midwifery Program strongly believes that your best bet for a natural birth is a familiar midwife by your side). She wasn’t certain that I was in established labour (AAARRRGGG! By this time I was actually hallucinating with tiredness just because of lack of sleep – and tended to fall asleep between contractions, then wake up gasping and writhing in pain) so she came to my house and did an internal examination. Before she came, she said, “We’ll see whether we should be slowing this labour down or speeding it up.” “Slowing down” meant giving me morphine to make me sleep, which I really didn’t want but which was starting to sound desperately appealling. Was I going to get on drugs before my labour was even established? So much for my close-held hopes of a natural birth.

On the up side, I could finally stop timing the contractions. I immediately went and had a warm bath, and it drastically helped with the pain (so much so I told CJ to go to sleep for a bit). Unfortunately, it also drastically slowed the contractions (apparently a very common problem). This was a very very bad sign. . . but it was also SO good to get a bit of a break. My attitude of, “Come on pain! Let’s do this thing and get me all un-pregnant!” slid away, never to be seen again. Concerned over my sudden slowing down of labour, I forced myself to stand up every five minutes – since standing up gave me contractions.

The midwife came and did her examination thing around 9:30. As it turned out, I was 3-4 centimetres dilated. . . officially in labour.

Well, probably.

She told me to stay home until I was getting contractions at my current maximum pain level at least every five minutes for an hour. She also said to drink something, and to go for a walk. (I couldn’t bear the thought of leaving the house – particularly the notion of going farther than the mailbox – but she said walking up and down the stairs would be fine.)

I managed to eat an icy pole, which took half an hour to eat and made me feel sicker for another hour. I was terrified of standing up at all, let alone walking – and of having contractions while standing up (even when I was standing up to make contractions come, I at down during each one). It took an extremely long time to build up the courage to move, and then the walking itself, though painful (as always in late pregnancy for me), actually didn’t seem to do much. But of course it did. Within another half an hour my contractions were much more severe – I was now clinging to CJ and yelling at the same time (I guarantee our near neighbours heard me). They were five minutes apart (interspersed with those lurching blackouts you get when you’re very tired but sitting up), so once an hour had passed we went to the hospital.

Driving to the hospital is always hard – my most comfortable chair was at home, there wasn’t really room for much foot-stamping or fist bashing, and CJ couldn’t even hold my hand. I had a contraction in the driveway (CJ stopped the car and helped), and managed to have another one at a red light. The movement of the car (especailly around corners) hurt, but we made it just fine. I hobbled inside the centre unsupported while CJ parked the car.

The new location immediately made me feel more positive and more awake, and I was cheerful and chatty between contractions (while obsessively asking for reassurance that I really was in labour – after almost two weeks of pre-labour contractions, can you blame me?) I didn’t even feel scared (except of the pushing stage, which I blocked out of my mind every time the thought of that painful future occured to me), not even during contractions. As I yelled, I knew I only had to hold on for about thirty seconds until I’d feel like myself again. CJ and the midwife tried to get me to eat or drink, and I had another icy pole.

The midwife asked if I wanted to summon my sister or have an internal exam, and I said no to both. I was rationing them (and also rationing my F-word usage until later, being aware of psych experiments saying that swear words are more effective in pain relief than ordinary words. . . hurrah for SCIENCE). She gave me a shot of antibiotics for Strep B (a common infection that has no real symptoms but can infect the baby on its way out if untreated), and tried to get me to drink more. When I said that I’d rather have a drip, the penny dropped and she went and got one straight away. Drinking water has been stupidly difficult all pregnancy, and the drip was a genuine treat.

When she checked Louisette’s heartbeat it was a little low, which can sometimes indicate quite a late stage in labour. She recommended an internal exam so I could be absolutely sure my sister wouldn’t end up missing the birth. I was certainly willing – and so she looked, and I was 5/6 centimetres dilated. That was about 1:30pm (so each centimetre had taken two hours). She said I should tell my sister to come on in, just in case. (They say each centimetre takes about an hour, but I now realise that’s an average – each centimetre tends to be faster than the one before, which is fair enough given the increasing pain.) From then on, I no longer needed reassurance that labour was happening: I was having a baby. That was also about when my nausea stopped (until then, it looked like I was on my way to throwing up – but I never did) – not that I particularly noticed at the time.

I was getting badly sleepy again (including mini hallucinations) when my sister arrived, but her arrival made me more awake again (and from then on the contractions were never far enough apart for me to fall asleep). It’s always nice chatting to her, and that still applied. The three of us carried on enjoyable conversation between my contractions. My sister pointed out that although normal pain feels wrong, labour pain actually feels natural and correct. It’s extremely odd I know, but it’s true. Even before CJ and I left home, the pain was like touching my hand to a hotplate for thirty seconds each contraction – the kind of pain that would leave a serious blister. But it was far more bearable than it should have been – because of the breaks between contractions, but also because the pain does actually feel completely different to normal, “something’s wrong make it stop” pain.

In a pretty short time, the benefit of my sister’s presence was outdone by the increasing pain, and I got in the birthing centre bath. Until that point, even in the middle of a contraction I was aware that all I had to do was wait a few seconds and I’d be myself again – but I was starting to struggle to hold on to that thought. Each contraction I buried my head in CJ’s chest and wrapped my arms around him as tightly as I could.

Again, the warm water helped instantly, rewinding my pain levels by about two hours. I didn’t like the floating feeling of being in the water – I wanted to kick against something, and it just doesn’t work in a bath. But there was no way I was getting out without a good reason. The contractions continued to get worse, and were soon as bad as they were before the bath. Sobbing hurt worse because it shook me (and my poor belly), but I couldn’t help sobbing a bit. I was starting to feel like I couldn’t handle any more, so I released the F-word (moments after my sister had written a comment in her own notes that I was being amazingly polite – which, to be fair, I was. One of my concerns was that I’d be horrible to her or CJ while in labour, and I never was). It helped for perhaps fifteen minutes, then it just didn’t cut it. It was time to bring out the big gun of encouragement: the internal examination. The midwife offered to break my membranes (making the waters break) to help speed things up, and I said yes.

I got out of the bath with much assistance and lay down for the internal exam. An ominous new level of pain reared its head in the contraction that happened in the short time between bath and examination. I knew things would be more painful out of the water, but the extent of it still surprised me, and I screamed in pain for the first time in my life.

“You’re fully dilated,” the midwife said.

“What?!” I said. “Really?”

“Yes – just give me a moment while I scratch your membranes. It won’t be long now.”

CJ and my sister and I exclaimed at one another, thrilled to hear that only the pushing stage remained – a stage that usually takes two hours at most. My membranes popped and various fluids gushed out over the bed. (Things were pretty messy from then on.)

I was still myself, and I said, “It’s too late for an epidural now, right?” No-one answered me, because they all thought I was asking for an epidural – which I wasn’t. I wanted to know that the drug-taking window was now closed, and whatever level of weakness I reached, I was going to have a natural birth. It would be something to hold on to.

A few moments later, the midwife said she had some bad news. She really, really did. My fully dilated cervix had been held open by the bulging membranes. . . and the instant the membranes were broken, it shrank. By two centimetres.

“Oh, that’s nasty,” I thought. “It’ll definitely give this story better pathos when I tell it later.”

Which just goes to show that you are who you are, in labour or not.

I figured the two centimetres wouldn’t take long, since I’d already been open, however briefly. I was right; they only took about an hour. But because of my Strep B infection, I was not allowed back in the bath after my waters had broken.

So, pain.

With each contraction, I screamed uncontrollably, and kicked out vicously with my arms and legs (I was concerned at the time I’d jerk up my head suddenly and break CJ’s nose, because he always wrapped his arms around me and bowed his head protectively over mine). The midwife told me repeatedly to calm down, but I couldn’t. If someone had stood in the room with a bomb and told me that if I screamed again everyone in the room including myself and Louisette would be killed, I still would have screamed. If someone had offered to end the pain by causing Louisette to cease existence, I’m not 100% sure I would have refused. I THINK I would have. Even in the middle of that, I noticed the worst parts of the contractions were very short. But I’d come farther into pain than ever before, and all I wanted was to press pause and come back later. Now I think of it, the fact that I wanted to pause, not stop (I never actually wanted to stop having a baby), means I still cared more for Louisette’s life than for the pain I was going through. That’s a pretty amazing thing to know about myself. I definitely wouldn’t have predicted that.

My body began to seriously shut down. I was drenched in sweat and shivering violently (my teeth chattering). Temperature-wise I was fine (the midwife even checked) – it was sheer exhaustion. I was also so weak I couldn’t move except when I was kicking out and screaming.

And still my writing instincts stayed with me. I wanted so much to say, “I can’t do this any more” but. . . well, it’s such a cliche (so much so that it’s considered a sign that the pushing phase has begun – which also meant I’d be giving false hope to the others, and I knew I wasn’t about to push yet).

Besides, one mustn’t grumble. At least not in such an unoriginal way.

I held on about half an hour (still rationing myself), then went ahead and said it. Stupid support people thought it was a great sign, but I knew better. I begged for another internal exam, and I was nine centimetres. Everyone but me was impressed.

I was extremely concerned I’d get overenthusiastic and push too early – a problem that caused a close friend of mine to have four extra hours of labour due to the swelling that resulted. I repeatedly begged the midwife not to leave the room (she was setting up a crib in case Louisette had health issues), and to do another exam. She said she’d do another exam in an hour. I wasn’t impressed. My contractions were starting to feel a bit different, and I had no way of knowing if I should be “listening to my body” and pushing – or if I was fooling myself.

With each contraction, I wanted to get up and run from the room, or smash the windows in – but of course I was too weak to do any such thing. At some stage I slid from the bed to the floor, and pissed everywhere (nothing unusual, and no-one cared). The midwife kept telling me to relax and stop screaming. I ignored her. She wanted me to stand up and lean on a bench (so gravity would help) – yeah, right.

After asking permission and getting a grudging yes, my sister took this photo (CJ’s stomach is wet from when I was in the bath):

It was half an hour since my last internal exam, and I wanted another one. Should I be pushing or shouldn’t I? The midwife said, “Does it feel like you need to do a poo?” but I knew perfectly well that if I answered, “Yes” then she’d say I should go ahead and push – so I didn’t say yes. I didn’t know exactly what I felt.

If someone had offered me an epidural, I would have emphatically refused – for one simple reason: I’d have had to move. I simply didn’t have the time or the energy to have an epidural.

And then my screaming changed to a deep yelled moan. Was this the pushing thing or not? Why couldn’t I have an internal exam, NOW?! The midwife got down next to me and observed as I moaned. “I can see the head when you’re contracting,” she said. “That means you’re fully dilated.”

“Definitely?” I said. “You’re absolutely certain? It’s time to push now?”

“Yes.”

My sister was thrilled and moved around to get a better view (I had forbidden CJ to do likewise, despite his reassurance that, “I grew up on a farm.”)

You may remember I was scared of the pushing phase. It turned out (not that I cared at the time) the worst of the pain was over. But now I had to get off my arse (literally) and work for the first time, and that was by far the hardest part. If only babies would just get to a certain point and fall out (well, they sort of do, but not until after the mother has pushed out the head).

I’d learnt months earlier that giving birth on all fours tends to reduce tearing, so that’s what I’d said I wanted to do (despite the fact that I found the thought unpleasantly animalistic). It worked well for me to kneel on a mat at the end of the bed, leaning on the bed with my arms and head. Between contractions I buried my head in my arms and begged aloud for a break. No-one commented on that, which was good: I wasn’t talking to them. There were still breaks, but not enough for my liking.

Pushing correctly is a learned skill, and I wasn’t a fast learner. I could feel the head pressing against the exit and then  falling back as contractions faded. It took more pushes than I care to calculate. But I could definitely feel the difference when the midwife told me I was doing it right – it felt right, too – I just couldn’t get it right every single time.

So, more contractions. I even had a tiny bit of choice about whether to push or not, and sometimes I just didn’t.

It doesn’t take a genius to figure out that a birth canal is pretty small and a baby’s head is freaking enormous. It felt ridiculously large and weird. It was still going backwards between contractions, and the midwife enlisted CJ and my sister to count to ten aloud as I pushed, so I was making progress instead of just making the head yo-yo back and forth. The counting was excellent. Ten seconds of pushing was manageable, at least some of the time. Other times I didn’t last more than two seconds, and the contraction was wasted.

Somewhere in there, Louisette was far enough out that they said I could feel her head by reaching down. I did: it was like touching a slimy, squashed peach with hair. She wasn’t even slightly head-shaped. I suppose I was touching the place where the soft bones of her skull were overlapping.

The midwife kept listening for Louisette’s heartbeat, and I suspected something was wrong and she was carefully not telling me. I wasn’t afraid for Louisette: I’ve been oddly certain of her safety since I first knew of her existence. But something was wrong: I was taking too long, and Louisette needed to come out. Unsurprisingly, having one’s head squashed inside someone’s pelvis can be what medical personnel call “distressing”. The midwife told me so, rather sternly, and I tried to make my pushes take the full ten seconds – and to push in the right way.

So, more contractions.

Heads are so big. . . I felt the stinging, burning sensation just as all the books describe it.

And then the head was out. That was probably the weirdest feeling of the entire pregnancy, especially when the three assistants then hauled me up on to the bed ready to catch her as she slid out. I was dazed and shaking, but there was still more pushing to do.

And then, like a slimy little cthulhu, she slid out all in a rush. Three seconds later she was in my arms.

 

I might not look particularly over the moon here, but I was. Even knowing I still had to push out the afterbirth, all the various awfulnesses of pregnancy and labour were instantly irrelevant – as I had suspected they might be.

Thirty seconds later, CJ and my sister had helped me pull off my nightie so Louisette was skin on skin ready for her first breastfeed (it takes three or four days for milk to start happening, but the baby sucks down small quantities of pre-milk in the meantime).

The midwife gave me the “make the afterbirth hurry up” shot and with a bit of mild pushing it flolloped out (apparently it was very nice looking. “Would you like to see it?” the midwife said. “No thanks. Really.”)

I was still shaking, and my teeth were chattering, but it was time for the next challenge: breastfeeding. As instructed, I let Louisette muddle around until she started opening her mouth looking for a feed, then I helped her find my breast as well as I could. Since I was unable to move, getting her in position was a team effort. It took about half an hour. But she definitely knew to suck, and I gave her half an hour on each side, then passed her to CJ for his first cuddle.

In the meantime, my sister called our parents and CJ called his, letting them know they could come and see Louisette in two hours (which gave CJ and I just enough time to greet her ourselves and of course to breastfeed). And of course my sister also posted the blog entry and photo for the rest of the world.

I was surpised to find out that I had torn my girl parts and needed stitches – I hadn’t felt the tearing, and honestly my nether regions felt pretty okay under the circumstances (80% of women have tearing, and mine was a pretty normal amount – for the record, Louisette’s head circumference was 37cm). The rest of my body was shot – I could barely lift my head or arms. Others have described the post-labour feeling as being like a marathon runner after a race. Since I’m no runner, I’d describe it as the immediate aftemath of having thirty-three angry oompa loompas slap you with frozen herring all over. Later on, I discovered cuts on my right foot and bruises on my left arm and forehead (when did THAT happen?) but mostly my muscles just ached like crazy. I have just got to the point today where walking and turning over is on a par with the difficulty level of late pregnancy (but from here it gets better) – CJ is giving me lots of massages.

The shaking gradually subsided, but I asked if the stitches could wait for a few hours please. “The doctors will have to look to know if they can wait or not,” said the midwife, along with the info that the doctors had just come on shift and would certainly be around for a while.

Soon the doctors came in, and I was able to experience firsthand the drastic difference between midwifery and standard hospital practice. The doctors dismissed my request for a break by saying, “Let’s just get it over with” and made me immediately get up and move the few steps to their portable operating bed. This immediately restarted the shaking and teeth-chattering. (“Don’t worry,” they said. “We can work around it.”) It also caused my ruined muscles to cramp.

They strapped my feet into stirrups and pushed my aching legs apart, just like the old-style doctors used to do for all labouring women (a strategy clearly designed for the doctor’s convenience at the expense of the mother). The doctors were both women, which was nice (as was the portable bed, so I didn’t need to go into the main maternity ward), and they were polite – but I was a problem to be fixed, not a human being to help. They didn’t even pause to let the anasthetic take effect before they began stitching.

Meanwhile, my midwife held my hand and talked to me about pancakes.

That says it all, really.

The End.

So now labour is done – for my first child, at least – and, to my enormous pride and high-level surprise, I had a fully natural birth. The most effective pain relief for me was CJ, and the bath (although the first time in the bath was a tactical error – generally the bath should be saved until labour is at least half over). Having my sister there (knowing exactly what I wanted from her) meant I didn’t need to think about anything except what I wanted at the time – and all the well-wishers were being taken care of too. I’m still not taking visitors, and today I was very glad I’ve been so firm with everyone (day 3 and 4 are usually a nightmare; today is day 3 and it did suck a bit – my milk hasn’t come in yet and Louisette has had to have some formula to avoid dehydration).

My sister asked if labour was the hardest thing I’ve ever done, and you know what? It wasn’t. I’m still getting PTSD-style flashbacks in which I remember screaming, or trying to push, or shaking so badly with exhaustion, but they’re already bleached clean of most of the emotion. Labour is hard and scary, but it’s a lot shorter than a lot of other hard and scary things in life – and the end result is easily worth it. One of the surprising things for me was that I didn’t feel like I lost my self or my humanity partway through. I even kept my sense of humour (although if anyone had made a joke at my expense I’d have assigned one of my helpers to kill them).

My heart goes out to all the women that have had difficult births – especially those who hoped to have a natural birth and weren’t able to for whatever reason. I was in established labour for eleven hours, which is pretty close to average, and nothing went wrong.

Here, by way of epilogue, is my sister’s family with Louisette: