The Details

Only 10% – 15% of women have their bag of waters break before they go into labor, and I didn’t expect to be one of them. Once the waters break, there is a real risk that an infection could occur if the baby does not arrive within a reasonable period of time. When the waters break when the cervix is dilated to 8-9 centimeters, which is the usual situation, this is not a problem because the baby will come in a few hours. However, if the waters break earlier on, it can mean that labor isn’t going to progress fast enough.

When my waters broke, Mac and I had a discussion about whether to go into the hospital immediately, or wait a bit to see if my labor would progress more first. I had been having moderate crampy sensations since Thursday, but after my water broke I started having actual contractions – 4 minutes apart, about 30 seconds long. Since it was night (11pm, Friday), we decided to wait until morning to reevaluate. Unfortunately, I was unable to sleep all night. Not so surprisingly, it’s pretty difficult to sleep when you’re having contractions every four minutes. In the morning, the contractions were somewhat longer and a little closer together, but we knew we couldn’t be very far along yet. We had to decide if we would go into the hospital (as our doctor wanted) or wait longer to allow labor to progress naturally. Infection is not very likely to happen, and if we had waited longer things probably would have been fine. On the other hand, infection is a real risk and can be very bad if it happens. It didn’t seem like a good idea to wait longer and risk something bad happening. We knew it probably meant giving up our ideal birth situation, but that was the best option when the other option was possibly putting my health and the baby’s health at risk. We went into the hospital around 7am.

When I got there, I was only about 1 centimeter dilated. It has to get to 10 before you can deliver a baby, so I was a long way off. But since my waters had ruptured, they admitted me to the hospital. Initially, the contractions were moderately painful, but tolerable. I was able to work through them by walking, using the birthing ball, hypnosis techniques, relaxation techniques, and massage. Mac’s support and presence really helped me to focus and remember to relax. All was going well from my standpoint, but the doctor was concerned because my labor wasn’t progressing very quickly – I was still at maybe 1-2 centimeters. My labor was pretty much stalled. She wanted to start a Pitocin drip to encourage labor to progress more quickly. Pitocin is the synthetic form of the natural hormone oxytocin, a hormone which causes contractions to come quicker and harder and for labor to progress. Mac and I discussed it and although we both had really wanted to avoid the use of Pitocin, we recognized that it was important that the baby be delivered in a reasonably timely manner. Ultimately you have to trust you doctor to make a good medical decision for you. So, they started the Pitocin drip. At this point I had been in labor for 12 hours and awake for 26 hours. I was getting extremely tired and discouraged because there had been no progress after 12 hours of labor.

The Pitocin did bring on stronger contractions, but I was still able to deal with the pain. It was not unbearable. However, I was quickly running out of energy. At this point, the self-hypnosis techniques became invaluable. Although I was now hooked up to the IV and out of energy to get up, move around, and use some of the more active techniques anyway, I could still listen to my hypnosis CDs. They were very effective in allowing me to lie in bed, relax and deal with the contractions. When I was able to focus on the self-hypnosis techniques I had learned, it helped me relax and see the pain as something far away and not important. It also helped to think about the contractions as being something productive – they are trying to pull the cervix open so the baby can come out. I mentally turned into a cheerleading section for my uterus during contractions – I would think “Okay, uterus, do your job. I’m going to mentally sit over here on the beach and drink some sangria while you go about your business” and somehow that made it much easier to deal with.

As things wore on, though, I found myself unable to use those techniques because I was physically and mentally exhausted and unable to sleep. I just couldn’t effectively concentrate on the self-hypnosis techniques. Around 6pm on Saturday, after I had been in labor for 18 hours and awake for 31 hours and trying hard to deal with the stronger Pitocin-induced contractions, they checked my cervix and I was still only at 1-2 centimeters. I started crying. The pain of each contraction was bearable and I knew that I could deal with the next one … but for how much longer? And with no sleep? I was also convinced that my utter exhaustion was hindering labor – I think that the tiredness was not letting my body do it’s job. I could probably have chosen to continue in that state, but I had a real fear that with my level of exhaustion my labor would not be able to progress. If it did progress, would I still have any energy to push the baby out at the end? If the labor did not progress or I couldn’t push the baby out, I would end up with an emergency C-section – something I definitely wanted to avoid. So Mac and I discussed the options again and realized that the only thing to do was to take some medication so I could get some rest. So I requested an epidural to numb the pain, I got one, and mercifully immediately fell asleep.

I slept for an hour or so, then when I awoke they checked my cervix. I was at 3 centimeters! I slept another hour or two and when I awoke I felt like a new person. One thing I thought was very telling is that I was actually able to MORE easily move my legs and lift myself up AFTER the epidural and nap than I was beforehand when I was exhausted. I woke up because the nurse came by because she was concerned because the baby’s heartbeat was a little bit irregular. She was going to do a procedure where saline water is injected into the uterus to replenish the amniotic fluid that has been lost. Before she did the procedure, though, she wanted to check my cervix. When she checked, I was already at 9-10 centimeters! She said that they didn’t need to inject the saline water – the baby’s heartbeat was a little irregular because she was almost ready to be pushed out! I had gone from 3 to 10 centimeters in less than 5 hours once I was able to sleep a little.

Soon after that, they said it was time to push the baby out, which I did in less than fifteen minutes. They were very impressed at my pushing ability. Seda was born at 1:36am on Sunday. The cord was around her neck at birth and the doctor had to cut it as she emerged, but Mac got to trim the cord after that.

My biggest issues with the use of the epidural are that it is more likely to lead to using Pitocin, to the mother being unable to push effectively, and to more C-sections for labor being stalled. Since I was in a situation where Pitocin was already being used and where I felt I was more likely to have stalled labor and be unable to push due to exhaustion if I didn’t have pain medication, I feel like it was absolutely the best decision I could have made. Once I was able to get it and get some rest, labor progressed beautifully and the baby and I got through it healthily and happily.

I’m still a little bit sad and upset that birth didn’t go the way I had envisioned it or planned it, but looking back I think we made the best decisions available at every step of the way. There’s nothing I can say I should have done differently. And, you know, even if things had gone just the way I wanted, nothing would be different today – I’d still be sitting here with a beautiful baby girl in my lap.