Thursday, February 4, 2010

In The Beginning... Continued....

    I was closely monitored during my first pregnancy. I had frequent appointments with my OB, the diabetes educator, and later, when I developed hypertension, I became part of a study, which increased the number of visits I had, as well as the number of caregivers and number of lab draws, diagnostic testing, and worries.
    Honestly, I think my naivete reduced my worry. I don't even remember if N and I attended childbirth classes. I do remember that I knew very little about pregnancy and birth, and that I did not know enough to question many of the "routine" tests, etc. that I was subjected to. I did know that I wanted to be as healthy as I could for my baby, and I did a better job of managing my diabetes during my pregnancies than I have at any other time in my life so far!
    I wanted to have a natural childbirth. I did not want to subject my baby to unnecessary interventions or drugs. I wanted to breastfeed, to care for my baby on my own terms, but I did not have as many tools then as I do now. I was young, underprivaleged, and treated as though I didn't know anything, and mostly as if I was not to be trusted with my own body.
    At my 37 week appointment, on Friday, April 14, 1995, I was diagnosed with preeclampia ( I don't recall how my doctor explained it to me, whether or not I was offered any "choices" regarding how to proceed, but I do remember the interventions started with an amniocentesis to determine if my baby's lungs were mature. (
     The test came back, determining my baby would likely be able to breathe on her own, so my doctor proceded with an "emergency" induction. I was in a tiny room by myself, lying in bed, bored out of my mind, anxious, scared, and stunned, like a deer caught in the headlights. N made it as soon as he could, and I remember my friend and her husband stopping by to visit. It was a very long process. I was given a cervical ripening agent, though I don't recall which one. (  (
    Late Friday evening I was started on a pitocin drip, (, ), and on Magnesium sulfate (, ).
 I don't recall either of these drugs being thouroughly presented to me, in terms of indications, possible side effects, or even what they were intended to do. Nevertheless I received them.
   I do not recall when my contractions began. I do remember I maintained a sense of humor and the ability to communicate with those around me for hours. I also remember wishing I could sleep before active labor began, but being distrubed by the nurses every hour for vital signs checks, blood sugar checks, etc. To this day I believe my labor would have progressed differently if I had been allowed to sleep that night, but that's not the way it happened.
   I  continued to labor without pain medications, despite the pitocin, mag. sulfate, and immobility ( I was not allowed to get out of bed. I had an IV in each wrist, a baby monitor, and a contraction monitor attached to me). Sometime on Saturday my labor had progressed to a point that my doctors wanted to break my water to help "speed things along". I was at a teaching hospital so I had several residents, interns, fellows, and other types of doctors visiting me and directing my care throughout the day. I only saw my OB for a few moments on Saturday morning.
    As soon as my water was broken my pain increased beyond my ability to tolerate it. I requested an epidural block be placed. ( I was given a very strong epidural, so that I could not move my legs on my own and I felt very little pressure with the contractions.
      Sometime around noon it was time for me to push. I only knew this becuase I had been told by the doctor who had examined my cervix and found it to be completely dilated. So I began pushing. I was already exhausted from getting no sleep, the anxiety of an unexpected induction, laboring for hours and hours, and not having any significant calorie intake in over 24 hours. I was put on oxygen as I, and my baby, became more and more tired.
   So I pushed, and pushed, and pushed. Not very effectively if the comments I received from the careproviders were any indication. (Of course I couldn't push effectively when I was exhausted and couldn't feel anything!!) One resident in particular was very aggressive in the way she spoke to me, basically threatening me with a cesarean  (,%20   if I didn't get to work and push more effectively.
   I know now I was lucky in having a vaginal birth. It was a very different birth culture when my daughter was born. If the same situation were to happen today I'm confidant I would have had a cesarean for her birth.
   After nearly four hours of pushing (unheard of today), I was exhausted (of course), my baby was showing increasing signs of  distress and exhaustion, and it was decided that I needed help getting the baby out. I was given an episitomy ( and forceps ( were used to pull my baby down, through my bony pelvis, through my vagina, and out into the world. As her head emerged, my episotomy tore, leaving me with a fourth degree pelvic floor injury. (, ). There were no less than 15 people in the small hospital room when my daughter was born. Students, interns, residents, fellows, maybe on offical OB, nurses, and some friends and family. Like I mentioned before, it was a teaching hospital, and what an interesting "case" I was!
   N, was horrified when our daughter emerged. He remembers her being blue, almost purple, and floppy. She did not cry for a few minutes and he believed her to be dead. I was so exhausted and overwhelmed I don't remember feeling anything for several minutes after her birth.
   My pelvic floor repair was performed by an intern, who did not know what he was doing, and I suffered from the effects until just this year when I had a pelvic floor repair surgery performed. The repair took nearly two hours, during which time my baby was taken from me, given oxygen, suctioned repeatedly, scrubbed and rubbed with roughness and force. And worse of all, for me, she was given a bottle of sugar water when I specifically told the nurse I did not want her to have a bottle. I wanted to breastfeed her.
  This was particulary disturbing to me, and still is, because it was one of the few times, if not the only time, during that birth experience, when I spoke up for myself and my baby. And I was ignored. How infuriating!
    I don't remember how long it took for me to have my baby placed in my arms, but it felt like an eternity. She was red and her face was bruised. When she cried she turned almost purple. My mom said she looked like a "beefsteak tomato".    N and I stared at her with awe and such incredible joy and love. Truly amazing!
     She and I had a difficult time establishing breastfeeding. I could not even see her clearly for the first 24 hours of her life due to the side effect of blurry vision that magnesium sulfate had so generously provided. It took months for my pelvic floor to heal, though as I mentioned above, it never did heal properly.
  So that was my first birth experience, in a, not so small, nutshell. I experienced many interventions, many medications, many side effects, and what I consider to be traumas, and I have taken those experiences and applied them to my second birth and to my work as a birth doula, lactation educator, prenatal yoga instructor, and I will bring them to my work as a birth nurse, and, in the future, as a midwife.
   Thankfully my daughter recovered from her birth, though I know she carries the traumas she suffered deep inside her and they are unexplainable with words. But she and I have talked about it. She has watched her birth video, and I have held her, apologized to her, and rocked her while we both cried.

   My second birth was very different from my first... but I'll save that for another time.

No comments:

Post a Comment