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And for once I was SuperMom

Saturday, December 5, 2009

Childbirth Education

I read all the pregnancy books and birth books that I could get my hands on here in Nairobi. All of them ones that I knew to be reputable and written by responsible sources, and then I re-read them. I committed the stages of labor to memory, I knew all the terms, I wrote out an all natural birth plan, I acquiesced to a few interventions ‘in case of emergency.’ I was prepared to let my body do what it needed to do as women have been doing for centuries. I was ready to have an all natural beautiful vaginal birth that would be a culminating experience in my understanding of my womanhood. A beautiful rite of passage into motherhood, I would nurse my healthy baby instantly and instinctually right in the delivery room and walk back to my labor room, just like Dr. Bradley and Dr. Sears promise. (Why are there birth books written by men?)
By the end of my pregnancy I was so big and so tired that I am not sure that I even cared anymore. As a good friend said to me, ‘they can pull it out of my nose.’ Now the actual anatomical possibility of that makes one cringe it does send the message, by the end your back has never hurt so much, your ankles have never been so big, and you’re so large that you’re sure you’re being tracked by satellite. I still wanted that natural birth experience and was determined not to become a victim of overly controlling obstetricians and nurses.
After a few weeks of on again off again prelabor contractions on Saturday November 1st at 2:30pm they became fairly regular. About every five to six minutes I would have a contraction and they would speed up when we walked. I thought I felt a dribble of amniotic fluid that morning, in retrospect I am pretty sure it was sweat. We tracked these contractions for about fours hours and at the urging of my doula, Jane, we went in to the hospital at 6:30pm.
We gleefully leapt out of the car and bounded up the steps into the maternity ward of Aga Khan hospital. I entered the waiting room carrying my birthing ball jauntily under one arm like a beach ball, Jane looked at me and said,
“You’re still smiling.” A wave of doubt washed up my back and tensed up my neck. Did I come in too soon? Did I not follow the advice of everyone and come in to the hospital too soon? Was I destined to be watched too carefully and become a downward spiral of unnecessary medical interventions that leads to a false failure to progress and a c-section?
“Should we go home?”
“No, you’re here and you may have leaked amniotic fluid, we should get you checked out.”
Nurses usher into a series of labor rooms, starting with a meager one, giving us a deluxe suite (which we determine our insurance won’t pay for) and then back into one that is more normal. Eventually a nurse comes to check my dilation, Scott, Jane, and my friend Jessie leave the room, it is at this moment that I realize that some doctors and nurses are better at their job than others. After violating me and declaring me only 2cm dilated she leaves. My ‘team’ comes back in the room, the wave of doubt keeps crashing at the back of my neck and I feel that this is going to take a long time. We decide to stay a few hours until the doctor gets here and talk to her about whether or not I should stay.
Dr. Rachel arrives at 9:30pm checks my dilation, she is better at her job, and I have not progressed. We decide it’s best to send me home to rest for the night and see where we are tomorrow morning. Scott and I sleep as best we can, with me waking at each contraction and him in a more heightened state of nervousness than normal.
In the morning my contractions are still 5-6 minutes apart and increase to 3-4 when we walk, the same loop around our neighborhood that we have been walking for days. They are getting stronger and by late afternoon I have to stop what I am doing and focus on relaxing through the contraction. If I relax and hang my belly out and breathe the pain lessens and almost disapears. On our walks this, of course, bring stares as I lean against Scott. I close my eyes and ignore it, because I might just pop someone in the face if I catch them staring at me.
After a few conversations with Jane we go into the hospital at 4:30pm. Another internal exam shows that I have progressed to 3cm, this nurse decides to leave her hand in there to feel for a contraction and to see if my bag of waters is bulging. I rest in knowing that one day she will have to answer to someone for her masochistic health practices.
The next few hours are spent chatting, walking around the hospital with Scott, and me sitting on a birth ball. During this time we experience three twenty minute power outages, I am blithely not bothered by them, because I can push a baby out in the dark. Why would that affect me? At around 9:30 a different nurse checks my dilation, I have achieved 5cm. This is the night nurse, and she does not check for a contraction or my bag of waters breaking. I like this nurse. After this exam I elect to lie down to get some rest, because it still looks like it’s going to be a long time. I adopt the side lying position and pray for rest, which is hard to come by.
At 12:30 the same nurse checks me again, and announces,
“She’s at nine centimeters!” In a flurry of excitement Scott and Jane flank either side of me as I pull on a white hospital robe and hurriedly walk me down the hall to the delivery room. I haul myself up on the delivery room bed, the is a rush of nurses around us, and new doctors and personnel show up in the room. The nurse tells me if I feel like I have to take a ‘long call’ (go poop) I should let them know, because that means I am ready to push. Dr. Rachel arrives, she breaks my water (at this point I am so out of it I don’t even care and since I had not really formed any opinions about AROM I just let it happen), and gives me another internal exam, there is no announcement and whispering in the room. Now, with each exam I am gripping on tight to both Jane and Scott’s hands and trying not to squirm. My threshold for pain has gotten lower as my body has gotten more and more tired. I have started ‘sounding’ with each contraction because it releases all the pressure of each contraction. I do feel like I have to take a long call, but know that I can’t yet so I am no longer trying to relax with each contraction and feel as if I am almost fighting my body. I have to ask,
“How far along am I?”
“Five centimeters,” I can no longer put on a brave face, I cry out and tears roll down my face as I grip Scott’s hands. He leans in and whispers to me on each contraction. I don’t even know what he is saying but I know he loves me. Disembodied torsos and heads of nurses move around me, someone asks if I want painkillers, I shout yes, twice just to make sure they hear me. They give me a shot of Demerol and an IV of some kind of muscle relaxant, in the hopes that I can sleep. After this I am so groggy that I am falling asleep between each contraction, when I look up during the contraction I can see that Scott’s head is down as well. After awhile I try a bath to see if that will help, I give up when I feel it is not. Jane gets me up on the birthing ball again, I am so groggy I am falling off it. Back to the bed.
At 4:30 Dr. Rachel comes back, I have progressed to 7cm. I see a dark shadow of her face floating above the IV, she suggests Pitocin to speed up and help my contractions, I ask how much longer, she estimates two hours. I have read so much about it and heard so many horror stories about Pitocin that I know I can’t do two hours of stronger harder unnatural contractions.
“Let’s just do a C-section,” I announce.
“Wait, wait, wait, that was one of the last things you wanted to do. Why didn’t you want to do a c-section?” Scott won’t let me make a rash decision.
“I didn’t want them to cut through my abs and I don’t want a scar.” I left out the whole unconscious for the first hours of my baby’s life, but right now that seems like a fair trade off for more immediate gratification. I hear Jane from behind me,
“They don’t cut through your abs, and you will hardly even see the scar.”
“Let’s do a c-section, can we do a c-section?” I beg.
In a matter of moments Dr. Rachel is putting a form in front of me that consents to the surgery I thought I never would have and I eagerly sign. Disappointment follows the nurses and doctors around, a black shadow in the background, but I am too exhausted to really give him the time of day.
I get lifted onto a gurney, I am wheeled into the hall, past my friend Jessie, she waves as if I am getting on a cruise ship (later she tells me I was so non-responsive that I scared her). Powerlessly I am wheeled about, soon a perky woman with a hindi accent appears at my head and puts a mask on my face and tells me to breathe in, it will stop the pain, it does. At this point I am writhing with each contraction, trying to hold my baby back. The perky woman (later I will meet her in a conscious state and will know that this is the anesthesiologist), asks me if I want a spinal or if I want to sleep. I choose sleep, sleep sounds good right now. She turns around and announces very loudly to someone that I want to sleep; this strikes me as strangely comical at the moment. I feel wiping and tugging down on my lower abdomen and it occurs to me that I am being shaved. I call out for the mask again, the perky woman plants it over my mouth, God bless her. Someone takes my hand I turn my head. My mind takes a few moments to register that this man in a medical mask is my husband. At this moment I can’t help but think how handsome he is….

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