Active, Birth Story IV

From the Mayo Clinic  Active labor: During active labor, your cervix will dilate to 10 centimeters (cm). Your contractions will become stronger, longer, closer together and regular. Your legs might cramp, and you might feel nauseous. You might feel your water break — if it hasn't already. You might feel increasing pressure in your back as well. If you haven't headed to your labor and delivery facility yet, now's the time... Don't be surprised if your initial excitement wanes as your labor progresses and the pain intensifies. Don't feel that you're giving up if you ask for pain medication or anesthesia... Active labor often lasts up to eight hours. For some women, active labor lasts hours longer.

The Team was soon present: Sheffield, Mom, our new nurse Juliet, Joyce the midwife (think hippie fairy godmother from New Hampshire; she says "put your ahm up" instead of "put your arm up"), me, and of course, Little Fetus Froo Froo.

We are now, without doubt, in Active Labor, and at this point everything becomes a blur. I can report with certainty, however, that the contractions had gotten significantly stronger.  And despite my careful list of stuff to bring, we'd forgot my iPod, which meant no "baby playlist" in Labor and Delivery like I'd had to help me at home. I was still upright, shuffling around a very few square feet, leaning on things, conjuring up more relaxation methods I'd learned. I was back in my own clothes, a T-shirt I'd put on that morning out of ease rather than any sort of plan. The hardest part for me was allowing the muscles to relax below my belly button: the uterus, to be exact. I'm pretty good with muscle memory, identification, and isolation, (years of movement training to release tension, as a personal trainer teaching other people where and how to relax, and regular yoga practice) but Lord help me, was it a challenge to relax the lower half of my innards during active labor...

"Relax down," I would murmur, moan, exhale to myself.
"Relax down."
And
"Turn it down..."
"Turn it down..."
("It" meant pain, but I was refraining from using that term...)

Sheffield later reported that when Joyce the midwife arrived, chipper and fresh, she asked for the birth plan, and read it straight through. Like avoiding induction, I feel a small victory is won. Even if we stray from "the plan," writing it (or just having it) was not totally in vain. Then Joyce got down to business. I hadn't allowed anyone to touch me up to that point, but Joyce didn't wait for permission. She walked right up and pressed her hands on my back, shoulders, hips. I moaned. She stayed positive: "Good! That's great!" And then she'd educate us on the stages of labor. From my birth plan she knew I wanted to move around, but I had locked myself in stillness, having moved "inward" to focus and get through each contraction. (There was a span of time when my view was nothing more than a crease/corner of hospital bed where my head was buried.)  When Joyce cheerfully suggested a new position I would say, "okay, just give me a minute." And Joyce would nod and say, "Okay. Okay... Let's try now" and boom! I'd be in a deep squat.

No matter my position, I wouldn't let Sheffield stray more than about 2 feet away. When a contraction came, I would call "Sheffield!", squeeze his hand, and say "I need you. I need you to breathe with me." And he would stand there and bear my hand squeeze (except for once when I caught him wincing, and let him go with whispered apologies. Hint: no amount of squeezing can match contractions.)

My mom quietly took this picture during my active labor.

Also I wanted quiet!

Four people is a lot to have around a Laboring Woman, if you ask me, and two of those four were super chipper-chatty. Wanna guess who?  My mom and midwife Joyce hit it off like two peas in a pod. (I swear, at one point they were discussing where they each went to high school, and how they wore their hair in 1960...)  Perhaps it goes without saying that this chitchat was not on my birth plan, and not at all tolerable.  I found myself shushing a lot. Or I would whisper to Sheffield "someone please make them shut up!"

And you know what?
They did.
They shut up.

...At least for a little while.

And cell phones! Without lifting my head or gaze, I finally said to my mom, "why don't you just put it on SILENT?!"

And you know what?
She did.
She put that phone on "silent."

And lastly. The door to my room... Seemed like a lot of coming and going. Joyce had another mother in labor that day, so she had to bounce back between our two rooms.  Occasionally an additional nurse or medical professional would come in.  (To this point: I hazily overhear Joyce instructing Sheffield about clearing the room as delivery neared. I couldn't quite make out the details, but something like, if a gaggle of medical students came in, it was his job to gently ask them to leave. As a colleague, Joyce couldn't ask this herself, but the request of the husband/dad usually had the proper impact, and got them out. I registered this, and felt confident with Sheffield on the lookout.)  And, nurse Juliet, as much as I love her --and intend to send her a valentine every year forever-- had a habit of leaving the door open. I wasn't visible to anyone because of the curtain but it was

the NOISE!

So, my Active Labor meant a lot of hand-squeezing, shushing, and requesting that someone

Shut the fucking door!

And you know what?
They did.
They hurried over and shut the fucking door.

I guess my labor was slow. To the Team, anyway; I tried not to know the time of day.  Still, there were indications... Each person had left the room for lunch, including the reluctant father-to-be, leaving my mom to endure the hand-squeeze. I was offered food several times (my birth plan was adamant that I be allowed to eat.)

Ha ha hee hee ho!

Not only did I not want to eat, not only did I have an empty stomach, but I managed to vomit two more times. This Sheffield could not bear.  During early labor at home, he had gagged audibly when I threw up. In labor and delivery, he had to leave the room. My mom held the plastic thing-y to my mouth, and never flinched.  *This is precisely why it's good to assemble a TEAM.

At this stage, each contraction set me on fire, and I would kick off sheets/blankets/my sweater. But immediately after it passed, I'd be shivering and Sheffield would hustle to get me covered up. Joyce called it my "James Brown" labor: Cape on, cape off! ...Cape on!

After several hours, I wasn't dilating more, and so required a few "interventions."  I was still managing a drug-free natural labor, and I tried to turn down every intervention at first. But the team, and specifically Joyce, always convinced me otherwise.  Pain management was never offered for these interventions.  They were each administered "between" contractions, though still uncomfortable.  I just kept up the breathing and mantras.

These interventions --which now make me grateful I was in a hospital-- are as follows:

• Turning the baby's head from nose-up to nose-down
• Draining my bladder with the catheter
• Hydrating me through an IV (lots of vomiting, remember? And an empty stomach.)
• Pushing back the cervical lip on which the baby seemed to be stuck

All this was in addition to the intermittent monitoring of baby's heart rate and mine, both of which tethered me for a short duration each time. I always fought these measures, even though I knew they were necessary and I'd agreed to them. The intermittent monitoring I'd negotiated was hardly intrusive compared to the continual monitoring that typically keeps a woman "hooked up" to machines for the entirety of labor.

More time passed.
Hours?
I noticed it was no longer daylight.

And then there was...

A break.
A change.
A lightening.

My focus moved outward.
I began connecting with my team.
It was about 5:00 PM.
I'd been at it for eighteen hours on an empty stomach and no sleep.
It was time to push.
I felt it was safe to assume that things were not about to get easier.
This was the moment I comprehended how far we'd come...
And that there really would be no pain medication.

To be continued...
Final chapter up next!!!