by Lisa Marie Fournier
Tue, 28 May 1996
I arrived at St. Ann's Hospital at 9:50 for my 10:00 induction on Friday, April 12, 1996. My husband Jeff and my labor coach Christine were with me. We were asked to wait in the waiting room for a while because the only clean birthing room was right next to some construction going on and they wanted me in a quieter room. At 10:45 they finally had a room clean and we went in.
My first labor nurse was Jane. She put me on an external monitor, which was difficult because Fiona wouldn't stay still and let anyone hear her heartbeat for more than a minute at a time. (I swear I hadn't had any caffeine or chocolate! :-) Then Jane put in my IV. She numbed the skin on my right forearm first (I'm left handed) with a very fine needle that hurt less than pricking myself while sewing or less than a finger stick before donating blood. Then she inserted a bigger needle, about the size of a blood giving needle, and taped it down. She took one or two vials of blood, then hooked up a long tube and attached it to a bag of Ringer's Lactate. (Holy "Emergency", Batman! (Am I dating myself there?)) She taped the tube to my arm, but it still jiggled a little so I put a little more tape on myself. It was very slightly uncomfortable, a little pinching feeling, but that was probably due to the tape pulling on my skin, which she loosened.
Then Dr. Nesselroad, a resident with short blond hair, slender build, and a very nice personality came in. He put a speculum in (the only time one was used for an internal during my labor), checked me out, and inserted the Foley catheter into my cervix. Then he removed the speculum. This didn't hurt at all, except he pulled my pubic hair a little by accident when he took out the speculum. Then he inflated the little balloon in the catheter with saline solution, and also started to pump saline through the catheter, which ran out the top, around the balloon, and down out of me. This was to help loosen up my cervix. Then all I had to do was wait. When the catheter fell out by itself I would be 4 centimeters.
This started a very long mostly boring stage of the labor. Something no one ever told me in birth classes or in the other birth stories was how gross the leaking would feel. I felt like I was peeing the bed, and I went through bed pads like crazy. Also, I had to go to the bathroom a lot both from the IV fluids and nervousness, and it was such a production to be unhooked from and rehooked to the monitor and the IV pump.
They began a pitocin drip at 1:05 PM, and my contractions began at 1:30. By 3:00 they were 3-4 minutes apart lasting 60 seconds. They were not severely painful, and breathing wasn't necessary yet. By 3:30 I needed to start my slow paced breathing. At 3:45 the catheter was checked and it wasn't ready to come out yet. At 4:30 the contractions were getting more intense and I needed to go limp and concentrate very hard on the TV. Chris had to push two tennis balls in a sock into the small of my back during every contraction. I felt the contractions mostly in my back, but my back didn't hurt between contractions. At 5:25 the contractions were even more intense, 2 minutes apart, lasting 90 seconds. I was beginning to think about pain relief medication.
At 5:45 the catheter came out with a slight tug from the doctor. I was 4 cm dilated. Dr. Nesselroad broke my water and attached an internal monitor, because they never had been able to get a reading on Fiona's heartbeat for longer than 3 minutes or so due to her vigorous movement. The water was clear, (I thought slightly yellowish about the color of very diluted apple juice), so they were glad that the baby didn't seem distressed. Then they left us alone again for a while to let things progress. None of these procedures hurt at all or were even a little uncomfortable.
At 6:50 PM I received an injection of Nubane in my IV to see how much relief I would get and if that would be enough or I would need something else. At 6:57 I noted that the Nubane had taken effect and that I felt a lot more competent and capable. I was able to drop back to sitting straight up in bed, bracing myself with my arms, and rocking back and forth during contractions. TV distraction and slow paced breathing also worked again. I had been having to use pattern paced breathing and had lost it a little during some bad contractions and started to cry.
The doctor and nurses came in periodically and checked my progress. I liked Dr. Nesselroad a lot because he was very sympathetic and kept telling me to breathe through the contractions, and he would pat me on the shoulder or leg to reassure me. At 7:00 Jane went off shift and Kim took over. Jane promised to come back tomorrow and see what I had. I was checked at 7:20 and found to be 5 cm and 90% effaced.
At 8:00 the contractions were intensifying and/or the Nubane was wearing off, but I was still mostly OK. I was managing with counterpressure and slow paced breathing but I decided I would probably want a renewal of the medication at 8:30. I knew that the second dose of a narcotic wouldn't be as effective, but I was needing a little more help with the pain.
At 8:40 I was checked and found to be the same 5 cm and 90% effaced. I requested additional Nubane. The contractions were starting to kick my butt again. I went to the bathroom and changed from lying on my left side to sitting up, which helped some. The contractions were peaking higher, which I think may have been due to sitting up.
At 8:51 I was still waiting for the medication. It helped to relax as much as possible into the contractions. At 9:00 PM I received the second dose of Nubane. The pitocin was to be stepped up and an internal pressure monitor inserted as soon as an RN was free; they were busy with other laboring moms.
The Nubane wasn't helping much at 9:19, but the pains weren't getting any worse. I decided, after talking to Chris and Jeff, that I would ask about an epidural or if there were other options I didn't know about. After a while, I decided that more IV narcotic injections wouldn't give me enough relief and to go ahead with the epidural, even though it scared me a little.
At 11:30 PM the epidural was put in place. I sat up with my legs dangling over the edge of the bed, my hands folded in my lap, leaning my head against the nurse's chest. First the anesthesiologist sprayed my back with a *very* cold antiseptic spray. Then he put a local anesthetic in my back with a needle he warned would feel like a bee sting; he was right. Then he was doing something with pushing on my back which suddenly made me yell and start to cry. I had bent over too far when he pushed and the needle went into a non-anaesthetized area. He wasn't mad; he just sat me up straighter, put a little more local in my back and tried again. This time it worked. He then sprayed my back with a spray to make the tape stick better so I wouldn't sweat it off, and taped the catheter to my back and up over my right shoulder. I laid back and he put a test dose of medicine in the catheter. It felt cold running down my back. I asked how soon I would start to feel better and he said a few seconds. Within a minute I noticed the pain relief, and after about 5 minutes or so it really felt a lot better. He hooked me up to a continuous drip and I sat semi-sitting for a while, letting it take effect. My toes felt puffy and like they were going to sleep, but I could still wiggle them and my legs. I couldn't believe how much relief the epidural was. Now I was turning to Chris occasionally and saying "I'm having a contraction, right?" or "I just had one, didn't I?" I never regretted getting the epidural for a second. The pain relief made me very sleepy, not in and of itself, but because I wasn't so tense I could relax. I tried to sleep but kept drifting in and out.
At 12:10 am I was at 6 cm. At 3:00 am I was at 7 cm. They had me lay on my left side and wear and oxygen mask because the baby's heart rate was getting too depressed during contractions. At 4:00 am they redosed my epidural because, by lying so long on one side, all the epidural medicine was sinking to the bottom. My right (top) leg was awake, but my left leg was asleep. It was such a weird feeling not being able to move my one leg by myself. They let me turn over so hopefully the medicine would run to my right side, but it didn't work very well. Then they put me back on my left side for the baby's sake, and I figured that if I had to stand it for the baby I would just have to.
At 6:00 am Dr. Nesselroad, Dr. Swarta (sp?), my labor nurse Kim, and another nurse named Connie were checking me. They let me roll on my back for this. (Thank God. The epidural medicine started to even out. I was also given a little more. However, I could still feel my right side.) Each person was unsure how the baby was lying. She had a caput, which is a swelling on the top of her head, and it made it hard to tell which fontanel was where. She was probably slightly posterior. Connie pushed internally while another person pushed on my uterus to try and scoot the baby over, but it didn't work. However, her stretching did finally get me from 7 cm to 9 cm. Dr. Nesselroad was concerned that the baby was getting too stressed, so he put a tiny cut on her scalp and checked her blood pH. It was 7.2, I think, which was good. A stressed baby will show an increase in acids. The team stopped manipulating the baby and decided to let me rest on my left side, almost on my stomach, for a while to encourage the baby to turn. This also did not work.
At 7:00 am they came back and told me to start pushing. I never felt an urge to. Connie stretched me internally, trying to get the last edge of the cervix over the baby's head, as I pushed. They said I did a good job of pushing, even though I couldn't really feel it or tell exactly what I was pushing. The baby scooted down hard against the cervix as I pushed, but couldn't get past the edge and popped back up as soon as I stopped. She was at 0 station. They said she was tolerating pushing very well and that her previous possible distress was gone. When I started pushing they let me take off the oxygen mask. At 7:15 am they turned off the pitocin to let me and the baby rest, and laid me on my right side, hoping that the baby's weight would finish stretching out the last bit of cervix, which was thickest on that side.
After a while they turned the pitocin back on low, and checked my again, but my cervix was still the same and nothing they could do would get it to finish dilating. Dr. Nesselroad explained that I had had my water broken for a while, I had been in active labor for a long time, I was running a low fever, and he was starting to get concerned. After consulting with Dr. Swarta and me, we decided that I needed to have a cesarean.
They cleaned and shaved my stomach, but I was glad not my pubic hair, except for the very top. Then the anesthesiologist came back in and gave me a lot more medicine in the epidural catheter. I was very very scared that they were going to cut me before I was numb. They pinched me and stuck me with what I figure was a little pin and kept asking me if I felt anything and if it was sharp or dull. I still felt a little on my right side, so they rolled up a towel under my left hip to tilt me and gave me some more medicine. I asked if I could be put all the way out and the anesthesiologist said that he'd rather not affect the baby that way, but he could put me out right afterward while they were stitching me up. He also let me breathe nitrous oxide through a facemask. It relaxed me and made people's voices fade to a buzz unless I concentrated. Chris held my left hand, and my right arm was very loosely taped down to remind me not to reach into the sterile field. I was still scared it would hurt, but I didn't realize that they had started till they were halfway through. Fiona was evidently wedged in pretty tight, because they had to lean very hard on my lower chest/upper stomach to loosen her. This was the only part of the operation that was uncomfortable, and even that was only because it made it so hard to catch my breath. I felt a release that must have been the baby coming out, but no one said anything, and I was too out of it from the gas to wonder why. Then the anesthesiologist said he would put something in my IV that would make me very sleepy. He did, I took a few more breaths of nitrous oxide, and I was out.
Twenty-five minutes later I woke up and asked, "Is that it? It's over? I'm all sewn up?" They said yes, and I asked what I had. They said it was a girl, but they had some bad news. I was still too out of it to realize what they meant. I thought maybe she had Down's Syndrome or something and I figured that that would be bad, but we could manage.
They wheeled me back to the recovery room where Jeff was. (Jeff said I woke up in the recovery room.) Dr. Nesselroad came to my bedside and explained that Fiona had massive congenital birth defects that were incompatible with life, and that she had died. He was crying, and then so were Jeff and I. He said that she was being kept warm in the nursery and if we would like to see her. I said yes, and they brought her in wrapped up in a blanket with a little striped hat on. I held her and kissed her and asked Jeff to as well; she was so soft and warm we could hardly believe she was gone. She had Jeff's mother's nose and a cute little pouting mouth. We took pictures on our own and also the hospital took its regular newborn pictures of her. When we were finished holding her the nurses took her away to give her a bath and wash her hair before the hospital photos. Later they gave us her brush and comb, a lock of her hair (she had my straight brown hair), the outfit she was wearing, her hat, her wrist bracelet, a little baby bead name bracelet, the wrist bracelets Jeff and I would have worn, and her hand and foot prints.
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