An Unconventional Way to use an Epidural – Janice’s First Birth Story
“I felt the first contraction when I woke up from a nap at 7 pm Saturday night. I just knew this was it. I was so excited, because at 41 weeks I was just so ready for this baby to come. I just sincerely hoped they wouldn’t stop like they had two days earlier. I lay in bed for a few minutes and when they didn’t stop I got up to see if that would change anything. No change. Knowing it would probably be my last chance I got something to eat. We talked to some people on the phone, but I didn’t let on what was happening. Obviously they were very mild contractions at this point. Then we went for a walk, knowing that if they didn’t stop at that, this was the real deal. I was still having contractions after my walk, so I called my doula at about 10:30 to give her the heads up that I would be asking her to come over at some point. I felt kind of silly about having a doula because these contractions were so easy I could manage them just fine. But having read about the benefits of a doula I decided just to stick with the plan and have her come. We made last-minute preparations for our imminent departure and then went to bed to get some sleep. The contractions came about every 10 minutes, but I went right back to sleep between each one. I did think that if they were starting out at 10 minutes apart this whole thing was going to drag on for a long time.
Then suddenly around 1:30 a.m. I had two 7 minutes apart, and then they went to 3-4 minutes apart and got a lot more intense. I suddenly had no idea how to get through them and manage the contractions, so I quickly called the doula to come. I managed the best I could until she arrived about a half an hour later. With her coaching, I was able to stay on top of them and manage them much better. By 4:30 or so the contractions were coming sometimes right on top of one another with no break, so the doula decided we should transfer to the hospital. I was really scared of the transfer, because I didn’t see how I could possibly handle contractions in the car, but true to what they say the transfer disrupted my rhythm and I only had a few contractions on the way which I handled fine. I was really excited about going to the hospital. I knew it wouldn’t make the baby come any sooner, but it did seem like great progress. We got to the hospital around 5 a.m. Sunday where I was found to be 3-4 cm dilated, compared to the 2 cm I had been at my appointment on Thursday.
I was admitted and spent the next hours just focusing on labor and getting through it. The night nurse seemed incompetent, dropped all kinds of things, asked if we were doing a circumcision (no; it’s a girl), and couldn’t get the telemetry unit to work. I had requested intermittent monitoring and telemetry (wireless fetal monitoring) so I could move around freely. But no one seemed to know how to make telemetry work, so they put me in bed until they could get a 20-minute readout. But every time I had a contraction the fetal heart rate monitor would pick up my heart rate instead. They insisted I stay hooked up until they could get 20 minutes of a proper reading, so I was stuck in the bed for a whole hour until they got that working. I was very happy when the day shift came and the nurse seemed much more competent. On the day shift someone knew how telemetry worked, so I wasn’t stuck in bed at all after that, for which I was very thankful.
I had planned an all natural birth and written a birth plan for the hospital. I was extremely happy with the hospital and how they followed exactly what I requested and never questioned anything or tried to change my mind.
Once I was allowed out of bed, I used various positions to labor which were much more effective than being in bed. The morning seemed to drag on and at times was difficult. Several times throughout the day I sincerely wondered what an epidural would be like, but I had requested that no one offer me one, and they did exactly as I requested. And I was too stubborn to back down on my decision and ask.
I kept longing for the pushing stage, knowing that would mean I was finally getting close. The hours rolled around, and eventually sometime before 1 pm, maybe 12:45, I was laboring on the toilet which I found an especially helpful position when I began to feel the need to bear down. The doula realized this and encouraged me to try holding my breath and pushing. That didn’t feel right at first, though I tried from time to time. But soon it not only felt right to push, but it was impossible not to. While still in the bathroom I heard activity in the room and when they moved me onto the bed to push at 1 p.m. I saw they had brought in everything needed for the delivery of the baby. I finally felt like I was making progress. Everyone was encouraging me and standing by the foot of the bed in readiness. The midwife checked me and said she could see dark hair. But after a while it seemed that everyone started drifting away and looking less expectant that something was about to happen. That worried me.
I proceeded to push in every position known to women, it seemed––on all fours, on a birthing ball, sitting up in bed, squatting at the squat bar, lying down in bed, in the shower. I worked very hard at it, and it started to be very long, too. One o’clock turned into 2 o’clock into 3 o’clock. Finally at 4 o’clock, after over 3 hours of pushing, the midwife checked me and found the baby was only at 0 station, meaning she still had a long ways to come down.
I began to realize my plan was falling apart and there was nothing I could do about it. I was getting extremely tired and now I was getting scared how I would ever get the baby out. I asked the midwife what my options were and she said that pretty much a c-section was the only way. She was too high for anything like an episiotomy and forceps or vacuum extraction. I was really scared. There was NO way I wanted a c-section! There must be another way! So I asked, “Can I get an epidural to give me some rest and sleep and then try pushing again?” The midwife said it was worth a try and might work, but it was totally up to me. I knew I would need an epidural anyway for a c-section, so I decided it was worth a try. “Yes, I have decided. Please give me an epidural now.” Then they told me it would be 20 minutes before the epidural would be in and take effect. I thought I would die. I didn’t think I could take another 20 minutes of pushing. But there was no other way. It was good thing I didn’t know it would be an entire hour before the epidural was in place and working.
So the doulas (a second one had joined us at the hospital) coached me and I pushed as little as possible while waiting for the epidural to conserve strength. But the anesthetist wasn’t very nice. He said, “This won’t help you. Epidurals are for labor, not for pushing. You won’t be able to get any rest. It won’t do any good. You’ll still feel the pressure.” I was frantic. This was my last hope and it wouldn’t work? But the midwife had assured me it would work, and the rest of the birth team encouraged me to go ahead and try it. I knew whatever way this went I would end up with an epidural anyway, so I told him to go ahead and give it to me anyway. Then he said that I would not be allowed to move around while he was giving it to me. Fine, I said. Do it between contractions. But no, he said. I couldn’t move for half an hour afterward. No pushing whatsoever. I was terrified. It is impossible not to push once you have to. It is much too painful not to push. Pushing feels good. I just about freaked out. I tried to not push for the next contraction, and it was not possible. I couldn’t do it. But the birth team encouraged me once again and insisted I could do it and they would help. The nurse told me out of the anesthetist’s hearing that I could bear down in a pushing fashion as long as I didn’t move and that would be perfectly safe. I figured I could handle that, so I gave him the go-ahead.
Finally, at 5 p.m., over 4 hours after starting to push, the epidural took effect and I completely relaxed. I felt SO good! The epidural was wonderful! It did work. It took away all the pain. I could still feel a little pressure sometimes, but I was able to sleep through it. For over 2 hours I rested and slept. They put me on my side and put the top leg up in a stirrup in a last ditch attempt to keep the birth canal open enough so hopefully the baby would descend on her own even if I wasn’t working with the contractions. It was a little hard to sleep as they kept turning me from side to side and then gave me an oxygen mask because the baby’s heart rate was dropping during contractions. Thankfully the oxygen fixed that.
Around 7 p.m. the doctor came to check on me. I felt I had a lot of strength back and had rested well. I had prayed a lot during that time for the baby to descend if possible and if not to help me accept and handle whatever had to be done. I was at peace. When he checked me he announced that I was at +2 station. I was soooo excited! That was great progress! I was so happy when the doctor said there was no need of a c-section.
He gave me two options. Either he could perform a forceps delivery right then or I could try pushing. I elected to push and keep the forceps option open if needed. Around 7:15 I started pushing again and within half an hour or less she was crowning. They set up a mirror so I could see, which really helped me focus my contractions. The couple inches of hair visible on top of her head gave me such determination. I pushed valiantly, all coached this time because I couldn’t feel my contractions (which was wonderful!), but after around an hour of crowning I could see that there really wasn’t much progress, even though the birth team constantly encouraged me, said how great I was doing, and insisted she was coming. But I could see that she wasn’t coming anytime soon, and I was getting tired again. I asked the midwife if an episiotomy would be necessary for a forceps delivery. She said not necessarily but every situation was different and it was impossible to tell. I said I wanted to consider the forceps anyway. So the doctor came back in and asked what I would like him to do. I was so impressed with the doctor, because never once did he push interventions or want to utilize them too early. He took a very conservative approach and was cooperative with natural methods. I asked him if an episiotomy would be necessary for a forceps delivery, because I reeeally wanted to avoid an episiotomy. He looked surprised and said, “I almost never do an episiotomy. Only 1 in 100 times.” And he proceeded to explain that he wouldn’t pull the baby out, just work with the contractions to help her along. He also said he wouldn’t attempt it if he couldn’t get the forceps positioned well. I liked his approach to it. So I told him I was ready to be done and wanted the forceps. A total of 6 hours of pushing was enough!
It was so exciting to watch him gown up and get ready and know the moment had almost arrived!! (By the way, forceps are HUGE-looking.) He positioned the first one and announced that the fluid released had a lot of meconium in it. He got the second one in place and announced they were positioned well. I don’t know how long, it seemed it was in the next push or two, her head was well on the way out and he asked me to stop pushing. I saw him slip the cord over her head. Then the head came and the shoulders. He asked me to reach down and take her around the waist. At 8:49 p.m. on April 8, 2012, I pulled her onto my stomach. That was an awesome moment! But within seconds they had whisked her onto the table to try to stabilize her and clear the meconium. I was able to watch which helped distract me from the 20 minutes of stitching the 2nd degree lacerations. They announced her weight as 8 pounds, 1 ounce, and her length as 20-¾ inches. They handed me to her wrapped up in a blanket and allowed a moment for a family snapshot before whisking her off to the special care nursery where she was placed on CPAP and continuously monitored for breathing issues and possible pneumonia.
While I didn’t have the natural birth I had planned, I am very, very happy with how everything turned out and with all the decisions I made. I didn’t chicken out or give up on natural birth; I was able to do everything I had wanted and planned. When those plans didn’t bring about the desired results I was very, very thankful for the interventions available. I feel I made the right choice in going the route I did, and I am very thankful that I didn’t need a c-section! Many people think that an epidural increases the rate of c-section (research actually shows this isn’t true—epidurals increase the rate of other interventions such as forceps and vacuum extraction but not c-section), but I am here to say that the epidural saved me from a c-section.
Finally, I was EXTREMELY happy with the work of the doulas. I absolutely couldn’t have done it without them coaching me, breathing with me holding me up. I wouldn’t have had any idea what to do, and I know I would not have had confidence and things would have gone much differently. Also, the doctor was excellent, and I appreciated his conservative approach and willingness to use at little intervention as possible. Lastly, the hospital staff was amazing! They respected all my birth wishes and provided a supportive and safe environment (well, the anesthetist may not have been supportive, but the rest were). The lactation consultant and nursery staff were also amazing and wonderful!
PS: She didn’t have pneumonia and when she was 4 days old the meconium had completely cleared from her lungs and we were abel to go home.”
This was Janice’s first birth. To read about her second (and very different) birth, click here! It’s a story you don’t want to miss!