I recently participated in two studies on birth trauma. One on the effects of the anniversary of the birth and the other on birth trauma itself. I only found MN over a year after ds's birth so I have never posted my birth story. However, I decided to do it now, especially if it can in any way help others who are also suffering. Cognitive Behavior Therapy has helped me recover much of my former self.
My membranes ruptured at 8:00 p.m. on my due date (8/12/03). I was only a little alarmed initially that labor did not immediately begin. I had opted to use the West End Vanderbilt Midwife Clinic and was hoping for a natural, non-intervention birth experience. I immediately phoned the midwife on call who was skeptical that my membranes had indeed ruptured, as it was a slow leak and not a gush of fluid. I was told to stay home and wait for my contractions to begin but to call/come in if the baby?s movement slowed down. This made me very anxious as Aiden had never been a very active baby in utero. I told the midwife this, but she seemed to discount it, and encouraged me to try to get some sleep.
Sleeping proved to be impossible. I was more and more anxious that something would happen to the baby while I was sleeping and at 4:00 a.m. I woke my husband saying that I thought we should just go on in to the hospital. He suggested that we call the doula I had hired instead (we had already let her know about the possible membrane rupture). She dutifully came over, checked the baby?s heartbeat ? she is a lay midwife as well as a doula ? and said that everything seemed fine.
The next morning I called to say that no contractions had begun and was told to come in by 12:00 with or without the onset of labor. At almost exactly noon I began to feel some very mild contractions. We headed out to the clinic.
The midwife there examined me to see if I did indeed have ruptured membranes ? again with a skeptical attitude, although she was not the same one I had spoken with the night before. She exhibited surprise that I was correct in my assertion and instructed my husband and me to check into the labor and delivery unit. I was excited and relieved that things would now be progressing.
By 6:00 p.m. my contractions were still relatively mild and 6 minutes apart. The midwife seemed quite irritated by my lack of progression and insisted that we start a pitocin drip, which I had dreaded doing as I had read of the pain associated with this. I asked her if we could do a trial with the drip to see if it might jump-start labor and then discontinue but she flatly refused.
The pain with the pitocin was incredible. Contractions went almost immediately to 2 minutes apart. I developed a muscle spasm in my back that was debilitating. I have never known such constant excruciating pain.
At midnight I noticed that I was now bleeding considerably. I called the doula into the bathroom to ask her if this was normal. I knew immediately by her expression that it was not. She spoke with the nurse (the second one I had had by now) who called in the midwife. The midwife examined me and said with a note of concern that she wanted a second opinion on the baby?s position, that he might be face first. The OB on call entered accompanied by a resident. The OB examined me (I had found all internal exams very painful and this one was no exception) pronounced that the head felt ?squishy? so ?it must be the fontanel?. She then ordered an ultrasound to check that I did not have placenta previa. I remember looking at the screen thinking that a glimpse of my baby would help give me the strength to carry on, but the screen abruptly went black. She looked only at the placenta and never bothered to even glance at the baby. I was told that the placenta was fine and to ?carry on? since I was only 5 cm dilated.
Not long after that the pain increased exponentially, although I couldn?t believe that it was possible for it to get worse. I had to ask for something to throw up in and was told this was a good sign since I must be going through transition and ?it wouldn?t be long now?. I remember wearily thinking that surely I could last another couple of hours. The midwife came in soon after for another internal exam and pronounced me dilated to only 7 cm.
By 2:00 am things had not changed. I can remember lying in bed, looking at my husband and whispering, ?Help me,? over and over, knowing that there was nothing he could do and feeling guilty at being such a weakling. My husband left the room and came back with the midwife. She had told him that I was probably not progressing due to the high level of pain that I was in and needed an epidural. My husband was concerned that I might not agree with this as I had not wanted one (I am mildly afraid of needles) but at this point I was past caring. I just wanted the pain to stop and for it to be over with. I couldn?t even think about the baby very much anymore. I had started to hallucinate that there was a tray of medical instruments by the bed and that I could grab one and cut through the muscle in my back to relieve the spasm. I did have the presence of mind, however, to request a board certified anesthesiologist. My brother was director of a residency program for over 10 years and I was well aware of the increase in complication rate due to inexperienced residents in July and August.
The midwife and nurse proceeded to insert a catheter in preparation for the epidural, more excruciating pain. I could not understand why they were doing it only minutes before I would be anesthetized. The anesthesiologist showed up about 30 minutes later and seemed quite angry that he had to personally do the epidural. He told me to ?arch? my back. Having taken dance and yoga for years I did, thinking that this didn?t seem right. He curtly informed me to ?do it the other way?, which to me is rounding one?s back. The video I had seen in my prenatal classes showed the woman telling the doctor when she was having contractions so that he could stop in between. My contractions were now very intense and 1 ? 2 minutes apart. Even though I told him about each one he completely ignored me. After the first stick he announced that it had not worked and he would have to do it again.
With the epidural in place I was finally pain free. I was advised to try to get some sleep, which I gratefully agreed to do. I had now been up for almost 30 hours and was completely exhausted. I managed to get about 5 hours of sleep at that point.
A little after 7:00 a.m. the midwife returned and did another exam. She said that I was 8 cm dilated and would be pushing ?any time now?. I was happy to hear this, although too tired to be really excited. She then informed me that it would be better to have a ?fresh? midwife do the delivery at 8:00 and it wouldn?t hurt to hold off a little longer anyway. I agreed but was disappointed that I was still playing the waiting game. I was not upset that she wouldn?t be doing the delivery, however, as her entire demeanor in the hospital was completely different from that of my prenatal care. She seemed cold, uncaring, and almost hostile that things had not gone smoothly.
Sometime after 8:00 am the new midwife breezed into the room. She did another internal exam, pronounced me dilated to only 7 cm and said she would check me again in an hour. I was in shock. I immediately began to protest. Hadn?t this gone on long enough? Shouldn?t we be discussing a c-section? She looked at me with what I can only describe as pure contempt. The doula explained that I had been in contact with a family member (my brother) who was a physician and had strongly urged me to request a c-section at this point. She was obviously offended that anyone would dare question her judgment and said that I could safely labor up to 72 hours after rupture of membranes and abruptly left the room. I immediately became completely hysterical. I was convinced that she and the rest of the staff were going to leave me to labor until my baby (and quite possibly me, too) had died. I was inconsolable and the doula and attending labor nurse became quite alarmed. They rushed out to get the midwife who grudgingly agreed to get an OB for a second opinion regarding a c-section. He came in, did a brief exam and announced that this baby was in frank breech position and was never going to be born vaginally. He told me we would be going into the OR immediately. I have never been so relieved in my life. In fact, the midwife commented on this fact and I said to her, ?Of course I?m relieved! This baby will finally be born and this nightmare will end.?
Of course, the comedy of errors didn?t end there. As they got ready to wheel me into the OR, the anesthesiology resident tripped over my catheter. I luckily saw it coming and grabbed the line so that it didn?t get ripped out of my body. Once we got into the OR they strapped me down and increased the medication on my epidural for deeper anesthesia. I immediately felt ill and asked to sit up and for something to vomit into. No one paid the slightest attention to me. I asked several more times. I was becoming desperate, thinking that I would aspirate on my own vomit right there on the operating table. Finally, someone heard me and unstrapped me. As soon as I raised up I threw up what bile was left in my stomach, along with the anti-nausea medication I had just been given.
A minute or so later I began to shiver violently. I knew this was a reaction to the epidural and asked if anything could be done. Yes, they said we just have to add some Demerol to the drip. I had convinced them to leave one arm unstrapped after I had been ill, but my right hand was still strapped down. The shivering made my right shoulder jerk and twitch violently and I began to be concerned that I was pulling a muscle as it was starting to feel quite sore. After what seemed like an eternity, they arrived with the Demerol, explaining that it had not been available and had to be sent up by the pharmacy. If this is a common side effect why is it not ready in the OR and/or with the epidural cart?
As soon as my uterus had been cut open I heard someone say, ?Oh, there?s meconium.? I mentally groaned, thinking, ?They have let it gone too long, the baby?s going to be hurt by this.? Then someone else said, ?No, I just saw him do that.? I don?t know if that was a true statement or not, but it did relieve me at the time. Then I heard them give an APGAR score of 6 and again was plunged into a panic. In just a minute or so it was upgraded to 9 and the baby was brought over to me to hold. I was so exhausted, all I wanted to do was go to sleep. I was terrified that I would drop the baby and couldn?t understand how anyone could expect me to have the strength to hold him, especially as my right arm was still strapped down!