We pulled up to the hospital at about 6:30am Sunday morning. The Daddy threw a “WOMAN IN LABOR” sign on the dash and then ran off to get a wheelchair. Once in, he raced me to the elevator where we had to make our way up to the fifteenth floor. Someone was playing a cruel joke, putting labor and delivery way the hell up there. Contractions in the hallway, contractions in the elevator. At least the hospital was mostly empty at that hour.
We wheeled up to the nurses station and as The Daddy was checking me in, I had a powerful contraction. I was still feeling a lot of it in my back and rectum, so sitting in the wheelchair was too painful. I didn’t wait for The Daddy to check me in – I flew out of the wheelchair toward waiting nurses and said, “Get me in a room and give me drugs.” and then continued down the hall, blood and amniotic fluid running down my legs, in the direction of open doors. The nurses raced ahead and led me to an open room and called the anesthesiologist. That was not my finest moment.
Aside from the initial drama and running down hallways, the home-to-hospital transfer was flawless. Our midwife beat us to the hospital, so she was ready and waiting with our prenatal charts. I was in a room before The Daddy finished checking us in and I had fentanyl administered and an epidural on the way within ten minutes. In addition to pain relief, the hope was that an epidural would slow contractions and let the baby recover.
The anesthesiologist came right away but we had to wait out two contractions before the epidural was placed. I bit down hard enough during the second one that I started wondering if it’s possible to shatter your own teeth. I had hoped that the fentanyl would take the edge off while waiting for the epidural, but its most noticeable effect was making me hear the voices of people who weren’t in the room every time I closed my eyes. Luckily after two contractions, there was a long enough break to get the epidural placed with no problems. Relief!
After my pain was under control, reality set in – I was in a hospital over 30 hours after my water had broken. Would they rush me into a cesarean section? Force antibiotics on me? Treat me poorly because we were supposed to be a home birth? I started questioning our decision and wondered if maybe I shouldn’t have stayed home and found a way to deal with the excruciating pain. Logic gave way to fear and I momentarily forgot about the other reason we transferred – the baby didn’t seem to be handling labor well. Those thoughts were interrupted by our nurse asking us to go over our birth plan and someone (I can’t remember who) needing to check my cervix.
When they checked me at 7pm, my cervix wasn’t swollen and was dilating again. Contractions had slowed down and the baby recovered a bit. My midwife then became my doula and the hospital staff were totally accepting and appreciative of her being there – she had all of my prenatal charts, a labor flow chart, and was so helpful in relaying our birth plan and wishes. The nurse who quickly jotted down our birth plan didn’t bat an eye at us refusing all but one of the newborn procedures. The doctors were AMAZING and accepted every single thing we asked for/wanted and didn’t push for antibiotics or cesarean section. They totally supported us on our vaginal birth goal and did everything they could to facilitate that. I was shocked and relieved.
We got things going again with the lowest dose of pitocin. Our goal was to get regular, strong contractions and to get me to 10 centimeters so we could finally push the baby out. We got to ten quickly and the swelling was gone, so we started pushing. After a few pushes, the contractions spaced out and I fell asleep. I woke up a few minutes later to alarms going off and doctors and nurses rushing into the room. The baby’s heart rate dropped to 80 like it had at home, but it hadn’t recovered for ten minutes. They jabbed a shot of terbutaline into my thigh to stop contractions and then flipped me on all fours (literally had to flip me, the epidural made my left leg completely numb and I couldn’t move it at all) and wheeled me to the OR for emergency surgery. The Daddy was in the bathroom when that happened and had no idea what was happening when he walked out and they were wheeling me away. I was taken into the room alone and confused, getting bits and pieces of what might be happening on our way down the hall. I was also concerned for The Daddy and wondering if anyone had stayed behind to tell him what was going on. As soon as we got into the OR and right when things were sinking in, her heart rate went back up. We went back to the delivery room to try again.
We restarted pitocin when the terbutaline wore off and she tolerated labor and pushing for awhile. Pushing was such a relief; the pain went away and I felt like I was finally doing something good and healthy and productive. We went from -1 to +3, The Daddy saw her head and reported that she had tons of hair. We thought we were going to make it (apparently I was an “excellent pusher” and pushed like I didn’t have an epidural). She kept getting pulled back up though and was getting distressed again. Her heart rate was still taking a very long time to come back up and dropping more than everyone liked. I don’t remember a lot of what followed. I know I got two more shots of terbutaline because the baby’s heart rate fell and didn’t come back up. I know they fiddled with my dose of pitocin. An alarm went off again. At some point, my epidural failed and I had to have another one put in. The second one failed, too. By this point, Sunday was nearing an end. I was exhausted and scared for the baby and didn’t feel like I could go on. The birth team came in and talked to us about our options.
We were given three choices:
-Keep pushing with the understanding that another decel would mean emergency surgery where I’d be put under and The Daddy would not be allowed in the room.
-Try forceps and risk vaginal tearing, injury to the baby, and the possibility of it not working and needing a cesarean anyway.
-Have a non-emergency but medically necessary cesarean section.
I asked the midwife her opinion on whether or not this was baby or the labor augmentations and if she thought forceps or surgery were warranted. She felt like it really was baby not tolerating labor and suspected a cord issue. We had a big team meeting and discussed options. We decided forceps were worth a try, and told the birth team.
The attending physician did a vaginal check and said there was no room for forceps after all, so our only options were keep pushing or head over to the OR. The hospital staff left the room for a few minutes so that me and The Daddy and our midwife could discuss again. We decided that with everything that had happened – the decels, failure to recover, the anxiety and fear of alarms, my exhaustion – that we’d have the surgery and that he would be present. And with that, they wheeled me to the OR while The Daddy left to get scrubbed and changed so we could begin phase three…