Labour
This started as an answer to J’s (love you J!) comment but it got long. I imagine there will be a labour channel on for the next 7 months. In fact I’ll add a tag.
I went into the OB when pregnant with Noah dead. set. on a c-section, for obvious reasons. My OB was a crusty old white guy who also happens to be a top teaching OB (I didn’t know this for a while, until a friend-of-a-friend who is Harvard educated clued me in). He listened to me and assured me that a scheduled c-section would be entirely possible. But he also asked me to consider what it would take to make me comfortable with a vaginal delivery.
Since I had spent Emily’s pregnancy hearing about the Evil OBs Who Make You Have C-Sections I was a bit surprised at this deviation from the script. But we agreed to set an appointment around the 26-week mark to think about it, and I got him the chart from Emily’s labour so he could see what I meant.
(Aside: No one at Mt. Sinai ever believed me about Emily’s labour the first time. My nurse apologized after reading the chart. But at Mt. Sinai they assumed I had misunderstood something because it was simply impossible for so many points of failure to occur.)
Anyways, by 26 weeks I had developed relationships with him and with the nurse. And I had come to understand a few things - one, that this OB is pretty into vaginal deliveries (I once waited for him while he finished up a discussion on turning breech babies). But second, that he had reasons for whatever he asked me to do. So I listened. And he very slowly and calmly, giving me his time and attention, went over research and his experience.
He did not sugar coat things. He said that while cord accidents are rare, they are badly understood. And no one knows why, but women who have had them do have a slightly higher risk of having them again. And that monitoring is generally pretty good despite the failure of it at Emily’s labour and what they would do about that for me (belly monitor, scalp monitor as soon as possible, manual checks with a stethoscope). He explained the difference between “okay” decels and “bad” decels.
Then he went over risks of vaginal delivery and risks of c-sections. He was really really clear. A c-section is major abdominal surgery and has risks - in the same statistical realm as cord deaths, some of them. He was perfectly happy to order and perform one, but only if I understood the list of risks.
And then we discussed comfort. He agreed that he would write orders that if Noah had two - two - decels of any kind that we would proceed to a c-section. Or if I asked. He also set it up so that I would have an appointment with every OB in the practice so that I would have met everyone (except one - the one I got - but that was a fluke). And then he encouraged me to try it. It took me a few weeks to come around to it but I did.
When we got into L&D triage the night Noah was born (early) for my miniscule ‘regular Braxton-Hicks’ contractions that had managed to get me pretty dilated (oy - I didn’t even really think I was in labour) everyone looked cross-eyed at his orders. The nurse said I’d better get an epidural so I could be awake for the c-section that was surely coming.
It was during the epidural placement that I had my one and only ‘real’ contraction with Noah, which made me throw up. And Noah’s heart deceled, because he was coming down the canal and also (I’m convinced) because I was sort of sitting on him. The labour team was in grand annoyance, because labour was going so well and yet they were bound to move to a c-section at the next decel.
So the one OB I hadn’t met asked me why I was freaking out (I was freaking out) and I stammered out something like that I was afraid the baby would get stuck and die. And she of the hadn’t-seen-Emily’s-chart looked at me with complete confusion and said “well that won’t happen!” (I think she was a little offended that I had so little faith in her powers.) And then who knows how many decels Noah had because as soon as they let me back onto my back he was born - two pushes. No time for a scalp monitor either. The epidural never got turned on. Carl says he thinks he had three, but the third was just as his head was coming out. We don’t really remember though, but I suspect the orders were abandoned - for good reason.
I think what I learned from that is that fear can be addressed in a lot of ways. I really did feel throughout my pregnancy that my OB and my nurse were completely committed to me as a patient. But they also were not really into unnecessary interventions if there was a more — dare I say it — holistic way of supporting me.
I found that really mind bending, because this was the high-tech group and all the natural childbirth literature would have you believe hospitals and OBs are all pushing c-sections on you like mad. And here I hadn’t had one when I needed one, and I’d been talked out of one when I didn’t.
Whatever it is, I was glad for being able to go vaginal with Noah. The first 6 weeks were hard enough without having to recover from surgery. Plus, it was healing for my relationship with my body.
But his labour was really unusually pain and fuss-free; he was also a small baby (although not for being so early). It would be nice if there were a guarantee that this one would be the same (much faster and it would probably be a roadside delivery).
And it’s not like the good labour overwrites the bad labour; 2 minutes of pushing vs. 4 hours does not train one’s body out of the bad body-memories. It’s more fraught than I thought in a way; in theory, I assumed that I would feel better if I got to this point, having had Noah just fine. But I am discovering that no, it’s Emily’s labour that comes to mind over and over. It makes sense; I’d just not given myself that much room.
So I will discuss a c-section, especially if the pregnancy goes to term. (None of mine have, yet.) I think I would like to go for vaginal as a first wish. But I know it will all be difficult. The nice thing is that this will almost certainly be the last one.
And yes, I’m trying to get back in with the same OB but he’s pretty booked. Plus I’m waiting for this blood test to see if I’m getting transferred to an OB who specializes in blood disorders anyway (sigh).
Comments
2 Responses to “Labour”
Leave a Reply
Being 5 weeks out from my own c-section/4 day labor, lurking in the back of my mind is one own one-day decision about whether the next child will be a scheduled c-section or we’ll try again for a v-delivery. While I don’t have nearly the concerns you do, it’s a tough decision that I’m thankful I don’t have to make in the next year or two. Your willingness to try a v-delivery after Emily is amazing, and I’m so glad you had a caring and cooperative doctor. Hopefully he can take you on again this time.
Oh Jessika congrats! What an ordeal but I’m glad he’s here and well.