Birth part 2: the bit with the hollering

Into the birth center, where the midwife checks me out. Bad news. Small has a fetal arrhythmia--a hiccup in his heartbeat.

We'd known this was a possibility. He'd had the same hiccup at his last prenatal checkup, and though the midwives were pretty sure it was trivial--the sort of thing that often resolves at birth--we were scheduled for a fetal echocardiogram to make sure. But the echo doctor was out of town and couldn't see us until two days before the due date--and here we were, in labor five days earlier. The midwives had warned us that if the arrhythmia was present during labor, we would have to be in the labor and delivery ward, not the birth center, so I'd willed the hiccup to vanish before then. To no avail.

Ok, we'd known this was a possibility, so down to the L&D. Except, no. L&D had no rooms open. One room was being cleaned up, would be ready in twenty minutes. So, now tethered to the damn external fetal monitor and IV I'd hoped to avoid by being in the birth center, we waited.

Ever waited through a hospital's "twenty minutes"? Two hours passed. The contractions were strong; I was encumbered by the monitor, which slipped if I moved too much, and I felt unable to get up and move around. Sitting across the room, taunting me, was the lovely large hot tub I had been fantasizing about. Full of water, even. Our bathtub at home hadn't been deep enough to submerge my giant belly, and all I wanted in the world was to get into a deep hot tub.

But instead, there I sat with Dr Hyde, the doula, and intermittently the nurse and midwife on duty, waiting. It was like sitting on an airport tarmac. You can't open your laptop because you're not in the air yet. You can't fall asleep because you're anticipating take-off. You are penned into your little seat and aren't supposed to get up. And you wait.

I couldn't settle into labor--my body knew that we would be moving, any time now, and so it sort of went into withdrawal. Not that the contractions stopped! Ha ha, no. But they stopped accomplishing anything. The midwife said my cervix was only 4-5 cm, a crushing bit of news, since it'd been hours since my doula had said the same thing. I dozed a bit more, as did everyone else--I remember waking up for a contraction and being a little affronted that both Dr Hyde's and the doula's heads were lolling back in their chairs. If I am in pain you should be, I don't know, witnessing.

Finally, finally--now about 4 pm--we were moved down to L&D. It was 20 hours into labor, and I was exhausted and cranky. Still only 5 cm. Well if there's one good thing about being in L&D, it's DRUGS. And I wanted some, pronto. If I had to put up with hours of waiting and NO GODDMAN HOT TUB, I was sure as hell taking the one recourse available to me.

Doula D asked, "Do you want an epidural, or do you want a short-acting narcotic?" she asked. "Because if you have the narcotic and you want more, we can always go to the epidural, but once you have the epidural, you can't go back."

So I had a dose of the narcotic Nubain, and then another when the first wore off. It took the edge off the pain and made me quite sleepy--we were back to dozing between contractions. The sleep was good because I was so exhausted (the night before I went into labor I had slept uncharacteristically poorly, and obviously the night of labor hadn't been real restful either). All told, I spent four hours under the influence of Nubain, but alas, the labor made little progress--I was only at 5-6 cm. So that was the end of the Nubain (and you're not really supposed to take it late in labor anyhow due to its effects on the baby).

8:30 pm, 24 hours into this. How to get labor moving again? My midwife had an idea. "We're going to break your water, ok? And everything's going to get more intense--are you ready?"

I peered at her through the haze of pain and fatigue. She couldn't possibly be expecting a hearty assent, could she? I was already miserable, and she wanted me to say, "Yes, please make this worse"?? (Also, was there a choice?) I gave some sort of sullen acknowledgment that she had spoken, the way that as a teenager angry at my parents I knew better than to say "ARE YOU FUCKING KIDDING THAT'S A BAD IDEA" but still had to make clear that I was Not On Board with their plan of going to the farmers' market at 8 am or whatever.

So they broke my water. It felt as though my body was a bathtub and the drain had just been opened. "AAAAAAUUUUURRRRGGGGHHH," I said. In fact, from this point forward you should assume that I was saying something like that nearly nonstop unless otherwise specified.

I couldn't believe the volume of fluid I was disgorging. It felt like I was creating my own personal Slip 'n' Slide, and hurtling down it at Mach 2. Also, pain. The stage of labor from 7 to 10 cm is called "transition," which I now understand as meaning that you will "transition" from a comparatively normal adult in significant amounts of pain to a crazed animal unable to see straight.

The next couple of hours are pretty hazy. I was panting so shallowly that my blood oxygen kept dropping, necessitating yet another damn sensor, this one a finger clamp that monitored blood ox. Periodically someone would tell me that I needed to breathe more deeply to keep my oxygenation up, which never failed to puzzle me because I was breathing LIKE TWENTY TIMES A SECOND LIKE A GODDAMNED MOUSE so how could I be out of oxygen, but I cooperated nonetheless, or at least I think I did.

Time passed. Dr Hyde says that the nurses and midwives changed out the sopping wet bed pads underneath me, but all I remember is the sensation of my toes going squish underneath me whenever I moved. At some point I asked whether it was the pushing phase yet, and someone asked me if I felt like pushing. Instead I felt like dying, which made it difficult to assess much else.

"You're doing great!" the doulas kept telling me. This was so patently false that I was irritated. Pretty CLEARLY, I was hollering at full strength, ergo NOT SO GREAT. But this seemed so obvious that I hesitated to point it out.

10 cm! Only 2-ish hours after they'd broken my water. But a new problem: every time I pushed, the baby's heartrate dropped low. After a few rounds of this, my midwife announced that unless we could get the baby out within 45 minutes, she would have to call in the obstetrician for possible vacuum / forceps / Caesarean.

The doulas helped turn me around so I could hold onto the raised head of the bed for support as I knelt on the (still squishy) lower half, both to accelerate the process and in the hopes that a position shift would fix whatever was causing the rate drop. Still his heartrate decelerated when I pushed. My right leg was pulled up so I was half kneeling, half squatting. Still the heartrate dropped. They decided I should switch to left leg squatting, right leg kneeling. I had had about enough of this, and, in a brief moment of clarity and coherence, much as you might experience during severe drunkenness, said politely, "Actually, I'm ok like this."

They all laughed at me (in my memory, probably not in reality) and said, "It's not for you, it's for the baby!" FUCK THE BABY, I did not say, instead shifting my weight. Still Small's heartrate dropped during contractions.

So now the pressure was on to deliver the baby asap. My hollering had shifted to more of an "OWWWWW" sound. Doula S stood by my head, next to Dr Hyde. "Ouuut," she urged me. "Ouuut."

I could do that. I wasn't hollering OW, I was chanting a fucking mantra! "OWWWWWWWWWWTT," I said, enunciating the final T like I was in goddamn singing class. See? Not a cry of pain. A mantra. A mantra that could be heard two miles away.

I did some pushing. It wasn't apparently doing very much. Doula D uttered the following words of wisdom: "Are you feeling rectal pressure?" (YES OH YES) "Do whatever makes that pressure the strongest and most intense."

This was the clue I needed. What's more, it helped me focus on the sensation of pressure, as distinct from the pain. Delivering a baby I didn't know how to do, but pooping seemed (barely) within my competency. And that was exactly what it felt like--taking a 7 lb poop, with 8 or 10 people cheering me on (Small's arrhythmia and heartrate had brought an entire NICU team into the room on standby).

Within half an hour, Small had emerged, his hollering picking up where mine left off. The cord was wound around his neck and stomach, but not in such a way as to cause harm. And as soon as the doctors could listen to his heart--not a single arrhythmia to be found. He was as healthy as they come.

Oh but there's one last step! The delivery of the placenta. Pushing something else through my vag seemed like the worst idea anyone had ever had, and the midwife's cheery "Don't worry, the placenta has no bones!" was not in fact reassuring. If someone had offered me an epidural right then, with Small over on the warming table, I would have taken it. In fact I was contemplating requesting a Caesarean. But out it somehow went.

And then they brought over Small and he headed right for my breast as though he'd been doing it for years.