Zephyr Jackson Smith
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FORESHADOWING
This birth was full of uncertainty. With the information we had from the last birth, which was missing a lot of important details, it was confusing what we should try to attempt here. With Eureka ending in a cessarean after 2 days of labor and full dilation, it was unclear why the birth went the way it did.
So when I found out I was pregnant, immediately Barbara (the midwife from Eureka's birth) was involved. It just seemed understood that I would gamble again with a homebirth, so we started prenatal care together. A few visits into the pregnancy, I realized that I was having a hard time sorting out what I wanted to do vs. what everyone expected me to do, and what would normally go along with my personality. i hate hospitals, I don't trust doctors, I don't agree with much of what we consider conventional medicine, and I don't like the idea of doing something like birthing in a hospital setting. After all, its not an illness. BUT given the fact that my last birth ended up in the hospital, and with no planning how hard that was for everyone involved, I somehow couldn't face the idea of just winging it again. If I wanted to have a vaginal birth, then it seemed we might need some help. Zac was pretty against the hospital idea, he hoped and encouraged for me that I could have a homebirth, and especially since he would become the advocate for myself and the unborn baby, it would be stressful for him. We both fantasized that the baby would be born so fast we wouldn't make it to the hospital.
Barbara the midwife tipped us off about a doctor in Dequeen, ARkansas who was VBAC (vaginal birth after cessarean) compassionate, and who got along with midwives, and was at least familiar with the concept of natural childbirth. So we went to go and see Dr. Mitchell, who to date is the only doctor in Arkansas that we know of who does VBACs, and we actually liked him. The two hour drive was a bit of a bummer, but those prenatal visits were actually like a little family roadtrip. The distance brought up a slew of more unknowns like, who will watch Eureka during labor? Where will they stay? Should we call some family out, or will that just make things more complicated? When will I go into labor? Will the doctor mind if I'm past my due date? Why am I not just scheduling a cessarean here in town, have my baby in 20 minutes, and not have to mess with any of this? Why is my life so complicated?!
So we talked. And talked. And I talked to Barbara, and to my friends, and to strangers, and to my family, and to pretty much anyone who would listen, trying to work this out, and looking for some obvious answer to my dilemna that maybe I hadn't thought of. Nothing doing. Some people said, your crazy, just get the cessarean, its whats going to happen anyway. Others said, have your homebirth, every birth is so different, you really dont have any good facts against you. Others liked the middle ground.
Meanwhile my pregnancy was going just great, moderate weight gain, no discomfort, just like with Eureka there was no indication that the birth would be anything but blissful.
So we hit 40 weeks (full term) and there were no signs of labor. I was hoping that I would go early, or that my duedate would be wrong enough that it would seem I was going early, but no luck. 40 weeks, and two days. I finish this quilt I've been working on, its all by hand, and I started it when I got pregnant with Eureka. Surely thats what my body was waiting for. NO beans. Dr. Mitchell says, by Wednesday we'll induce if your not in labor. Zac balks at the idea, I hope for labor. Wednesday comes, and no signs of baby. The inducing brings up a lot of issues, if you start there, it seems impossible to end with a natural childbirth. You start with drugs, and its too painful (not natural!) to not get the interthecal (Dr. Mitchells version of the epidural, a brand of spinal)...and it goes from there. Intervention city.
So Wednesday morning I say, I want to go. Lets just go and get on with this, I was driving myself crazy trying to manage the details of it all, and truly not knowing the outcome and not really having a gut feeling...BUT we go and turn ourselves into the hospital, and Dr. Mitchell checks me, I'm not dilated at all, and the baby is still up high. He says that inducing might not even work, and we would be better off to wait till I was a bit riper. Whew. Another decision abated.
So we agreed I would come back Sunday night and start the pitosin (inducing drug) if I hadn't gone into labor. Ok. I can do that. So I was relieved and yet a bit frustrated that I still had to wait! Wait! Like Tom Petty says, the waiting is the hardest part.
There is a midwife in Dequeen, her name is Gabriella. She is different from Barbara in that she seems a lot more comfortable with hospitals, and drugs, and intervention in general. She has the 'whatever works' attitude. She also has a doctor who respects her, and she gets along with the hospital staff. Unlike Hot Springs, where the doctors treat Barbara like some kind of witch, and don't seem to have any respect for the concept of homebirth (its bad for business!) So Gabriella has this three day herbal labor starter that she swears by. A mix of blue/black cohash along with 8 tablespoons of castor oil on the last day. Barf.
But on Friday morning, I started up PRAYING that by Sunday night I'd be in labor all by myself and wouldn't have to turn myself in to the hospital. Day three Zac checks me and I'm not dilated a millimeter. Dang. But a day of walking and castor oil and dread of the hospital must have done something because ON OUR WAY to dequeen, after dinner, I started having contractions every 3-4 minutes. I got so excited, I felt like every woman. Go Birth!! So we went to Gabrielles birth center instead of the hospital, and she called them up and told them we weren't coming, and checked me, I was somewhere between 1-2 cm. But I'll take what I can get. So we spent the night at the birth center, and by 2 A.M. I was having some strong contractions. How exciting! And then I fell asleep and woke up again at 7. Not a sign of heavy labor. Shit. When we got up in the morning, I was not contracting anymore. We went out to breakfast, and discussed it again for the thousandth time. Induce? Run away? Go to the Farm in Tennessee? Zac wanted to evacuate. I wanted to have the darn baby. I decided that if we truly wanted to have a vaginal birth, which was the goal, then I should go and get along with the medical community. We agreed after breakfast, we would turn ourselves in to the hospital staff. OY.
Our friend Jen was coming out to get Eureka and hang out with her till the baby came. She arrived at around 11 and got Eureka from the hospital.
THE BIRTH
10:30 AM We check in to the hospital. The great nurse on duty, Joyce, just laughs. Here we are again. Lets do this thing. We were in luck, there were two other women there having babies, so they couldn't actively induce me. She was only allowed to administer pitosin to two women at a time. (does anyone get a baby out on their own anymore??) So we sit tight and wait for furthur instruction. I put on my hospital gown, and we work a crossword puzzle.
Noon. Joyce comes in and hooks me up to an IV. Intervention number one. We aren't allowed to plug our radio in until maintenance checks it out. They come and check it out, we aren't allowed to plug it in, its not grounded. All these rules! Is this the beginning of something good? Or really bad? Zac goes out to get batteries.
1 PM. They start the pitosin drip. Gentle, ever so gentle, since the other ladies have not had their babies yet. The idea is that it'll just soften the cervix if its a low dose. So I am hooked up to the contraction monitor, and the baby heartbeat monitor, and the blood pressure monitor, and the IV. I stay this way for a few hours, and the contractions are minimal. Nothing painful yet. We visit with Jen and Eureka, we talk, we listen to some music, its kind of nice. No sign of Dr. Mitchell yet, but thats OK. There really is nothing for him to do yet. Its a sunny day, and we have a big window in our room. I am thinking about places where they put all the laboring women in one room, bed after bed of women having this incredibly personal experience. I feel lucky to have our own room. Zac is feeding me peaches, and a Gouda cheese sandwich.
4:10. The monitor in our room that showed my contraction pattern also had the contraction pattern of the other two women. We watched one graph as the woman pushed her baby out, and then how it just stopped after they disconnected it. And the other women's contraction pattern was all bonkers and inconsistent, and then finally it was cut off too, but you could tell all was not well. Yes, she ended with cessarean. And my contraction pattern was all funny too, mainly because I wouldn't sit still, and I was sneaking food. But at this point I was definately contracting, just not that strong. The nurse came in and upped my pitosin level. Oh boy. I remember this from Eureka's labor, its easy at first, and then it goes too high and you feel like your going to bust open. Here we go.
4:23. Upped it again.
5:18. upped it again.
6:00. Ow. Now we are having some serious contractions. I had already decided that if I were to be induced, I would take the pain relief. Because the strength of induced contractions comes on so much faster than if you were left alone, and it doesn't seem fair to do that to a person. But because I had decided I would take the interthecal, I seemed less able/willing to tolerate the pain. I no longer could think about eating at this point. Another clue we were on our way. I was ready to get numbed.
6:36. Upped the pitosin again. Dr. Mitchell stops by, he checks me I'm at 4cm. I ask him about the interthecal, he says lets wait a little bit, he makes some joke about how maybe I'll just pop the baby out. i had expressed interest before in NOT getting the drugs, so I think he was holding onto that hope for me, that it would all go so fast...So I look at the clock, surely I can contract for another hour. But by 7:30 I am GETTING the drugs.
7:30. No sign of Dr. Mitchell. Liar. He is home having dinner, I hate him. His wife probably made dessert. He'll never get here. We call the nurse, can we get the drugs? This hurts like hell, I'm very uncomfortable. She says, He wants the head to be engaged before we give the interthecal, to make sure the labor is going to take. Ah, shit. Ok, is the head engaged? I'll come back to check you.
8:05. Donnie the nurse comes in to check me. still around 4cm, head not engaged. Ok. Nothing to do, but I swear I thought I'd be numb by now. Zac had said Dr. Mitchell wouldn't be back till 9, I thought he was crazy. Now I believe it. Nothing to do, except breath. My face is tingling, like last time, and it makes me think they are giving me too much to fast, and I mention this to nurse Donnie, she says, its because your breathing to shallow. Your hyperventilating. Easy for you to say, I think to myself, while calling her a few other choice names.
8:45. Joyce comes in and gives me Reglin, something to clear my stomach. Here comes the Gouda! A precurser to the Interthecal, help is on the way...Now does that mean 3 or 30 more contractions? Keep breathing. These are definately working contractions, and sharp and intense. At least I can watch the monitor, its like a video game, that really hurts.
8:55. Dr. Mitchell comes in, I can recognize his perfectly white tennishoes from the curtain that blocks the direct view from the door. He is wearing green scrubs. So he checks me, I'm at 5cm + 80%. He breaks my water. When my water broke with Eureka, it didn't seem like that much liquid, but this time, it was a torrent. The tide was HIGH, it just kept coming, and it was clean water. So after he broke my waters, I had to sit up for the injection. He had me sit on the edge of the bed and I was supposed to arch my back forward, jutting out my lower back. This hurt, and was about the most counter-intuitive position one could be in while they contract. And then the contractions kept pushing out more water, and it was pertinent that I sit completely still while he put a needle in my spinal fluid. Yikes. Talk about intense! But he did eventually get it in there (after two tries) and soon enough I was back on my back with this strange tickling cool sensation running through my body. Then the itching, I was overcome so fast with the need to itch frantically all over my body. Neato! Now I know how morphine addicts feel when they try and stop. Drugs are nasty nasty stuff. The interthecal does not numb you like an epidural, instead it removes the pain, but allows you to feel pressure. So i could still feel the contractions and had to breath through them, just as before, but they were no longer painful. But it isn't quite the free ride an epidural is, when they gave me an epidural with Eureka, I went straight to sleep. Taking a nap while in the later stages of labor is a bit strange.
9:25 PM. Dr. Mitchell comes in to check me, sure enough I'm now 6cm +85%. Moving right along. Breathing, and trying not to stare at the clock and make estimates about exactly when the baby will be born. (if I wait till midnight, it'll be born on Zac's birthday, if I wait till midnight the nice nurse Joyce will be gone and I'll be left with mean Donnie and who knows who is running the nursery right now, they might give us a hard time about doing everything in the room...)
9:40 PM. Change out my IV bags, and back off the pitosin. Tilted my body to the left side.
9:50 PM. Cut off the pitosin altogether. My body keeps contracting on its own at this point. I think it got the hint.
10:25 PM. 8 cm and thinning out. Can I make it till midnight? This is so textbook, these people really have this timely birth thing down!
11:13 PM change out my IV bag again, wondering why I'm not going to the bathroom.
11:45 PM Still at 8 cm.
Midnight- I'm reading off Zac's notes for the details of this, and he has 12:00 Turned 33. Looks like the little tike is coming on his birthday. Even with all the drugs, I don't get the 3 hour labor.
12:52 9cm'
1:15 The nurse comes in and tells me to start switching sides every 15 minutes. I am feeling extremely dopey now, so dopey I can't stay awake between contractions, but I feel like I need to wake up and stay with this experience, so I can push the baby out. I am a little helpless, I think the drugs are messin with me.
2:20 AM. Donnie comes in and checks me, looks like I am a full 10 cm with a lip in front. What does that mean? I dont know, but it means the baby isn't racing down the birth canal. Must be something it gets hung up on. But I think, here we go! i'm going to feel like pushing any minute now, so I HAVE GOT to wake up and concentrate on this birth (as I fall off asleep again...)
2:45 AM. Catheter to make me pee, they've given me lots of fluid now, so why am I not peeing? I don't know. I guess I'm using up all the IV juice just as fast as they give it to me. I'm sweating a lot.
3:45 AM. Still trapped in my daze, can't wake up except for contractions, no change. No pushing yet.
3:50 AM. MOre rigalin for settling my stomach. I'm still contracting fine, just no pushing. What is this child doing? Dreading the fresh air?
4:13 They start the pitosin again. and continue to up my dosage for the next hour. Wow, I'm not ready for all this again. What is going on? Why am I not needing to push?
5:26. Dr. Mitchell arrives and instructs me to start pushing on contractions, whether I need to or not. When he leaves the room, Zac and I look at each other and think, "cessarean". I was sure next time he came in the room he would say, look this just isn't progressing, you could do this all day, lets operate. I personally was getting siked up for this possibility, because suddenly I felt like I was really going to start beating myself up (with the false pushing and more pitosin) and really straining myself and my body for nothing, only to end up extremely worn out and with a cessarean in about three hours. So I pushed some, but it was only half hearted, and besides, I don't know how to push. They say strain like your taking a poo, but I couldn't get into it. I didn't believe. I decided to relax, and get ready for the surgery.
5:33 AM they give me a dextrose drip, some sugar to give me some energy.
5:50 AM Dr. Mitchell checks me, the baby is still way back up in there, so he tells the nurse to start upping the pitosin again. Ah, gee, I don't know if I should stop him, if I should just say, c'mon doc, who are we fooling here, don't kill me, just get the baby out. But for some reason I let him leave the room without saying any of that.
6:22 AM Vomiting begins. I threw up four times, this thin liquidy green stuff. Looked and smelled pretty scary. Is that the lining of my stomach?
So Dr. Mitchell comes in the room. We are all ready to concede to surgery. I tell him, look, I can see whats going on here, go ahead, I know what your thinking. And he takes on look at me and says, look, if you wanted a cessarean, we could have done that two weeks ago and saved everybody a lot of time and effort. Your here, you want a vaginal birth, and there is one more thing we can try. VACUUM EXTRACTOR. Of course, me being an advocate of natural childbirth, I had not bothered educating myself on things with names like extractor. I immediately think, no way in hell. Just no way. Ow. Yikes. I can still run out of the hospital if I have to, right?! I would rather have a cessarean than a vaccuum cleaner hooked up to my twat to have a baby with a deformed head. I express some of these feelings, and Dr. Mitchell is like, LOOK its the last thing you can try. If you don't try this then you haven't tried everything you could, and you haven't done the best that you can. Well, that appealed to my harsh dutch guilty "life is painful" tendencies. Yes Doctor, your right. It would be a sin for me not to try everything I could. (my family lineage cheers in the background) Zac seemed game for it, and I got this adrenaline rush, this feeling of intense nobility. YEs, I CAN do it. I have more energy. This isn't so bad, one day, I'll be sitting in a field of lillies with the sun beating down listening to birds. I'll see the mountains again, I'll sing again. Just now right now. Right now is reserved for hell.
The next hour is a bit of a blur. It seems like as soon as I consented, my feet were in stirrups, blue non-absorbant pads surrounded me, I'm flat on my back. Nurses coming out of nowhere, Zac grabs one leg, a nurse named Julia grabs the other, Joyce appears out of the mist with something that looks like a bike pump, bright surgical lights are in my face. my tranquil room had transformed into a TV set. And it was all about me. Me me me! The vacuum extractor, with all its scary name, was really a pink hand pump with a long hose and a littel suction cup on the end. The suction cup was about 2-3 inches wide? It seemed very small, and harmless. So they should change the name, something like the 'people mover' or "gentle birthing device". From this point, i laid back and looked at the ceiling. What the hell am I doing? I tried to think of life outside this room, (there I am at a wooden bar in a hippy western town, in overalls, ordering a pizza and a beer, lighting up a cigarette) Shit there was no denying it, I'm in over my head. I am about to have to do something impossible. Think of all the other women in the world. THink of your grandmother, mother, great grandmother, did they all have it this hard? How is my lineage still going? Why do we breed at all? Are you kidding? We CHOOSe to go through this? This THIS is the result of sex?
Well, I can only say when Dr. Mitchell (who I must say, had a somewhat rough bedside manner) inserted that vaccuum extractor people mover device, I though I was going to die, this is when I started making loud noises like people do in the movies. I said words I shouldn't have (my dutch ancestors take a step back, not so sure if they are still proud of me) My body was so tensed up, I didn't think I could ever relax or trust someone to touch me again in my life. They are saying, do you feel a contraction?? I'm telling them, the only thing I feel is that small building you just inserted in my vagina, get out of there!!! The nurse Julia is saying relax, relax your legs, move your pelvis towards the doctor (every bone in my body was trying to get to the top of that bed and away from him)
But suddenly I realized, this was not just about me, it also is a baby, a little baby stuck inside my stomach, and this is gonna hurt so bad, and its not even right to ask this of a human being, but we have got to get this baby out. This baby is in limbo right now, and the longer I fight this, the longer we have for something to go wrong. Like deadly wrong. From that thought on, I was determined to move quickly, and try and be obedient. I relaxed my legs, Dr. Mitchell ( at the request of Zac) stopped putting more small buildings up my twat in between contractions (when I was supposed to be relaxing) and we started pushing. The pushing made me feel insane, it was me pushing, my body never took over and made me push, which i can only presume must be a great and overbearing feeling. I pushed and yelled, and Zac yelled and counted for me, the nurse Julia cheered me on, Dr. Mitchell would pop his head up every now and then and say c'mon Cheryl, I need you to push, thats it, or thats not it, push like your taking a poo. Is there any dignity left in child birthing? I felt like fluids of all sorts were gushing out of my lower area, and I couldn't even speculate what wonders Dr. Mitchell was witnessing, I guess this is why Doctors make the big bucks. I sure wouldn't have wanted to be in his seat. What must he dream about?
He says, you've got about 4 inches to go, PUSH!! and I did, i pushed as hard as I could. Joyce keeps manually pumping that pink little bike pump, and you could hear the suction coming off the babies head every now and then (thats backsliding! Stop it!) I felt Dr. Mitchell give me an episiotomy, and I knew we must be getting close. We all worked together, and then when I started to get the hang of it, I felt the little babies head crowning. It was quick, one contraction to crown, (wait two minutes) one contraction to push the head out (wait two minutes) then one contraction to get the body out. Zac said it was pretty aggressive, which I believe, but damn if that doctor didn't get that baby out! He says ITS A BOY!! and i look up and Zac looks totally amazed and surprised and happy and I feel it too, like holy shit, its over, just like that. Now its done and we have a BABY BOY!!! 45 minutes of hell!! Now about those wildflowers in the mountain valley... Dr. Mitchell says push two more times, to get the placenta out, I have this vague memory of Zac cutting the cord, which looked like a rope that some glass blower made out of all his reds and greens, its really pretty. ANd he starts stitching. I ask him, how many stitches am I getting? OH, Cheryl, you don't need to know that right now. True enough.
They put the little guy right up on my chest, and I thought he would immediately start nursing, but the shock of it all must have been a bit much. I just held him and looked at him, he had a head of black curly hair! And the same eyes as Eureka when she was born, super dark blue. He was dark skinned and not so terribly newborn red, but olivey. What a pretty baby. So they are stitching, and cleaning, and dumping who knows what out into the biohazard bin, and I'm laying on the bed holding the little one, and Zac is there, and I just couldn't believe it was over. It was such a strong feeling of relief, and then the excitement that the birth had really worked out the way I wanted. I wanted two things and I got them, a vaginal birth, and a baby boy.
AFTERBIRTH
The amazing thing was that when it was time for me to transfer to the recovery room, I could just stand up and walk. After my cessarean with Eureka, I couldn't get up till the next day, and even then it was one step at a time, I made it into the hallway, and had to turn around again. I was much worse off after the cessarean. They say its the same, and its not a big deal, but after doing both, I must say the cessarean is a much bigger deal, just in a slower less immediately painful sort of way. The difference is in the recovery time, and in the instance of labor. If you schedule a cessarean, you miss it all, but you do the work slowly over the next few months. When you have a vaginal birth, most of the work is done on the spot, and you recover much quicker. How exciting, that its possible! Its been 8 days since the birth, and my crotch is already feeling somewhat fine, I think it may be recognizable once again someday. Maybe.
Zephyr Jackson Smith.
Ouch!
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