Part II: Active Labor/Sh*t Gets Unreal

When my doula got to my place at 8pm, I was holding onto my husband.

I was scared. The contractions were intense, and I couldn’t imagine that I would be able to deal with pain any worse without being severely traumatized.

She suggested I move from the bedroom floor to the bathtub. I looked at her like she was nuts for suggesting that I move at all, but I remembered from what I read that water could help with pain. I doubted that my pain would be relieved at all by moving into the bath, but I decided to be a good sport. Just moving might help distract me, I told myself. We moved into the bath, and they directed the shower head onto my lower back. I bent over my birthing ball and rested my cheek on it, leaning on my knees. In a few minutes, I agreed, the warm water helped with my pain.

I breathed through the contractions, and laughed in between at jokes my doula was making, and at my cat trying to get into the tub with me.

Every so often, I felt as if my contractions were increasing a level. I could distinctly feel where each level of pain notched up. Later, I realized this was moving from the beginning of labor to active labor.

I could feel my contractions gaining strength. I lost track of time. It felt like I was only in the bath for about 20 minutes. Later I realized it had been more than two hours.

I told my doula when she arrived that I wanted the epidural. I had been laboring for about six hours without her already, and I had been alone with my thoughts and fears.

I told myself that if the pain were to get much worse – and based on the timelines I had read about, I was only in the very beginning of labor, so obviously, I figured, my pain threshold was pretty low – that I wouldn’t be able to push my daughter out without inflicting major trauma on myself.

I distinctly remember thinking very clearly while in the bathtub: I absolutely know I can do this unmedicated, but I don’t have to. I don’t have to prove myself to anyone, or to myself anymore. Of course I can do this unmedicated. But I don’t have to. Thousands of women get pain relief through epidurals and their births go fine. So if I don’t have to, I don’t want to.

That was my logic in the throes of the massive pain barreling through my body.

The thought of getting an epidural, of turning myself over to the safety of the hospital, gave me peace. They would make sure I was safe, was my underlying feeling.

Sadly, I couldn’t have been more wrong.

I told my doula I wanted to go to the hospital. We had some kind of conversation through contractions where she said something like, if I would feel safer at the hospital, we should go. She said it like she didn’t believe I would feel safer there. I heard this in her voice, but I was too much in pain to address passive-aggressiveness and hidden meaning. I could only communicate at face-value. It was like I didn’t have enough energy or brain power or patience to work through complicated communication issues. My thoughts were disturbed every minute or two by back-breaking pain. By the time a contraction churned through me, I had lost my train of thought.

She warned me then that I might only be at two to four centimeters when we got to the hospital, and not to be disappointed. I remember again thinking she was nuts. Surely I was further than that. If I was only two centimeters, I thought, I was screwed, and certainly not as strong as I had thought. I judged myself harshly. What about my friend who had done it completely unmedicated? Was I seriously this pain-intolerant? These thoughts made me feel inadequate and felt that I needed the hospital even more than I thought. They’re right, I thought. This is awful. If I’m only two centimeters, transition must be unbearable and traumatic, I thought.

My doula and husband helped undress me out of my soaking clothes from the shower and bundle me up for the December mountain air. Then I threw up in a plastic bag from the pain. I remember reading this happened around transition. Again, I was confused. Why was I reacting so harshly to what could only be “pre-labor” from a typical timeline?

My doula had taken over my phone app to time my contractions and they were anywhere from five minutes to two minutes apart, and completely inconsistent. I would learn later that this is fairly common, and that the hospital’s guidelines were often incorrect about where a woman might be in labor.

Somehow, we got down my steep outdoor steps. I had a contraction between my apartment and our car, and hugged my doula tight. It was frigid out. I looked at the snow on the ground. The clear black sky. I watched my breath billow. It felt amazing to be out in the cold.

I don’t remember getting into the car, but I remember willing my husband in silence to remember the short cut to the hospital. It was hard to see the hospital sign with the high snow berms in the middle of the road. We’d already had a couple significant snow storms by mid-December.

He pulled up to the ER and I got out. Homestretch, I thought, with joy and anxiety. Once I get in this room, I thought, I will not return without my baby. I was so excited.

My doula helped me walk into the ER, stopping what seemed like every 30 seconds for me to concentrate on a contraction. The ER was empty except for two people quietly reading magazines. No one was at the check-in window, where we were supposed to have them call L&D, just down the hall. I waited by the locked door into the rest of the hospital, including L&D, while my doula walked up to the check in window. A hospital employee saw me laboring, and said, “Do you want me to let you in?” I nodded enthusiastically. He opened the door with his key for me and my doula. I almost laughed, thinking I should have brought my own hospital badge to let us through.

At L&D they buzzed us in. There was some angry whispering as I labored, standing in the hall, asked to wait. Nurses shuffled by us without looking. I could see my doula was already annoyed.

Finally, I was let into a room. We got in about 10:45pm. The night before, when I thought my water had broken, almost exactly 24 hours before, they told me I had taken the last room available. They told me I was lucky or I would have had to wait hours in the hall. Did women give birth in the hallway here when L&D was too busy?

My nurse was not in a good mood. I could feel every ounce of her being projecting that she wanted to be anywhere but checking me into my room. She didn’t talk to me, smile at me, introduce herself, or even make eye contact with me as she walked me to my room and concentrated fully on the computer next to the bed. She told my doula that I needed to put the belly strap on and to lay in the bed. She didn’t address me. I stood next to the bed, leaned over it, and labored. I tried to get into their ill-cut mesh band, six inches long and not wide enough to fit over my belly. The mesh was supposed to hold the doppler in place. I was frustrated. My doula was frustrated.

My doula gave me my printed birth plan to give to the nurse. I knew it was in my chart already, but remembered they might pretend they didn’t see it if I didn’t hand it to them. I held it out to the nurse. She didn’t look at me and extended her hand to receive it. Her disinterest intimidated me.

“Here’s my birth plan” I said to my nurse’s hand. “Sorry,” I added, feeling inadequate, like a burden, or like I was in her way somehow. She wanted nothing to do with me. She asked me loudly, in front of my husband and doula, if I was experiencing any abuse in the home. She asked me if I had or had ever had, any STDs. I told her no. She asked again, are you sure? Yes, I told her, uncomfortable.

She checked me and found me to be 6 centimeters dilated. I was ecstatic. I looked at my doula. Yes! I wanted to shout. Immediately, I felt more confident. Look how far I got, I told myself.

My nurse walked out without another word, leaving my birth plan on the table beneath the monitor, flashing our company’s mission statement and patient experience goals as the company’s standard screensaver:

Providing consistently excellent care.

Consistently Compassionate Care.

Somehow, I got onto the laboring bed, leaning over a birthing ball my doula had found in the department. The nurse told my husband to hold the fetal monitor over my lower abdomen and the nurse left.

A young woman came in to insert the IV needle into my hand. She asked me which hand. I shook my head. Didn’t she know I couldn’t talk? Didn’t she know how much pain I was in? Didn’t this department see laboring women every day, all day? I didn’t want anyone to touch me.

She stuck my left hand. She wiggled the needle around. “I can’t find a good vein,” she muttered to herself. She stuck me two more times with more frustrated mumbling. I looked at my doula. Get her off me, I wanted to say.

Two more women came in, and stood oddly far away from me, and I felt like an animal, moaning, squeezing my eyes shut, breathing heavily, and bent over a ball in a bed without my underwear, in my sundress-like laboring gown. They stood with their hands clasped neatly in front of them, one with a white lab coat, and a smile like we were all about to go on a scary rollercoaster she had been on a thousand times. Don’t be so dramatic. This is nothing, her smile said.

She introduced herself as Dr. Sayago and the woman next to her as my new nurse, Connie. The other nurse either changed shift or was re-routed to another woman. Connie looked scared and very deferential to Dr. Sayago. She gave a small wave, and looked at me like I was part of a scene – me, my laboring, my doula, my husband. An uncontained animal. I watched her assess the scene, and I saw anxiety in her eyes.

Dr. Sayago spoke slowly about something. I couldn’t concentrate on what she was saying, as contractions rolled through me, one on top of the other. Suddenly I thought, epidural!  That’s what I want. That’s all I have to say. I opened my mouth to speak, but no one was looking at me. I locked eyes with my doula. “Epidural,” I gasped.

“Yes, she would like the epidural,” my doula said to the doctor and nurse. They left.

Time went by. It felt like an hour. A nurse came in. I looked at my doula and said, “Epidural?” She said, “Sara asked for the epidural?” The nurse looked confused. “I thought,” she started. “But your birth plan…”  she just looked at me. I said, “Changed my mind. Epidural.” She left the room. I looked at my doula. We rolled our eyes.

I was beginning to feel like no one knew what they were doing. That the nurses were too busy. I was beginning to regret going into labor at this time, this night. I was annoyed.

The doctor and nurse came back in. They didn’t look happy. The doctor stood with her arms crossed, and observed me, heaving away on the birthing ball.

“We read your birth plan,” the doctor said. She said it dryly. Oh no. Her tone alone sent all my warning bells off. “And just so you know, just because I love doing c-sections, doesn’t mean you’re going to get one.”

I felt terrified then that she was not on my team. She did not read my birth plan, complete a confession of being sexually abused as a child – and needing informed consent – as a plea for grace, mercy, and respect. She read it as a threat to her authority. From then on, I felt she was out to prove that she was in charge of my labor, my body, my baby, our lives. We were at her mercy. I knew this was bad. I also knew my only other option was to check myself out and have this baby in our car or on my apartment floor. Another contraction rolled through me. This wasn’t ideal. Nor was there an ideal solution.

Another nurse came in, and presented papers to me. As I moaned on my hands and knees and rolled back and forth on my ball, she stood in front of me with a plastered smile, like she was talking on TV. She was chipper. She handed me seven forms and it seemed like she talked through almost every one. I couldn’t concentrate or even hear anything she was saying. Unbeknownst to me, or probably anyone except my doula, I was well into transition, in my own world, taking it breath by breath, trying only to survive the vicious contractions. It was this hospital’s policy not to allow signing forms in advance. I cursed this stupid fucking policy. One of these forms was about how to install a carseat. She went over it, in detail. I tried hard not to punch her in the mouth.

After she left, more time went by. Another nurse came in. My doula inquired about the epidural. I thought at this point I wasn’t going to be able to get an epidural. I thought about myself, on this bed, pushed onto my back, with my legs being held by these ridiculous, clueless nurses, impervious to my pain and how to talk to a woman in labor. I thought about trying to push out my baby, in extreme pain, with these clueless people ignoring me. I felt anger and fear.

The nurse smiled at my doula’s question, wryly, like she thought it was funny. She didn’t look me in the eye. “We left two messages with the anesthesiologist, but we haven’t heard back,” she said as she looked at the monitor. She shrugged. Shrugged. 

My doula expressed my outrage. “Well, how far away is he?” My doula asked.

“In the keys,” said the nurse.

I knew the nurse was referring to the Tahoe Keys, less than 10 minutes away. But I knew my doula, from Reno, thought the nurse was making a snide joke about the anesthesiologist being so far away he might as well have been in the Florida Keys. I heard my doula clarify.

A couple minutes later, my doula asked me if I wanted an IV drug to “hold me over” until I got the epidural. I was thinking, and I assumed she was thinking, that I probably wasn’t going to get this epidural. I imagined the anesthesiologist being called at home, slowly stretching, making coffee, realizing he had to shovel the driveway. At this point, it had been over an hour since I had originally requested the epidural. I felt terrified. I felt like none of the hospital staff was taking my labor seriously. I felt like they didn’t care whether I was in pain or not.

I said yes to my doula, thinking, this will have to do for pushing her out. My doula told me that it would only work for a short amount of time, and that the next dose would need to be higher. I had a feeling I wouldn’t be laboring long enough for the next dose. I felt the time for my daughter to be born was close.

About an hour later, I still had not received the IV of Fentanyl to “hold me over.”

At about 1:30am, almost two hours after being checked into the delivery room, my nurse walked back in with a man. They positioned me to sitting on the delivery table, and told me to be “still” as contractions roiled through me.

“Don’t move,” my nurse said. “You have a huge needle sticking out of your back.”

Her words did not give me peace.

My husband later told me that this was when the Fentanyl was distributed, right before my epidural, not to hold me over, as the nurse had suggested to my doula. The anesthesiologist told Nurse Connie to give me 50mg. My husband said he watched Connie ignore the doctor and push double the dose in.

As they tried to reposition me onto my back, I felt the room spin, like I was immediately drunk. I felt extremely tired, and tried hard not to pass out, to just keep my eyes open. I couldn’t see or hear anything going on, though I knew they were there, hustling about my body.

Then Nurse Connie said loudly, dramatically, “The heart rate! What should I do? Should I call the doctor? What should I do?” I don’t know who she was asking. It seemed rhetorical. Any faith I might have had in Connie for assisting me in delivering my baby was lost. My doula just stared at her.

It seemed like seconds later, my doctor and and about five people in lab coats, looking tired, annoyed even, were standing in the room in front of my bed, waiting. It was really quiet. I didn’t know what was going on, but I knew something was wrong because so many people were in my room. I looked at my doula. She was holding my hand. “Everything’s fine,” she told me calmly, confidently. From the looks of the room though, it seemed that the hospital didn’t think everything was fine. I tried to breathe deeply, to give my baby oxygen. Hadn’t I read that somewhere?

I wanted to know what was going on, but no one spoke to me, and I hardly had the energy or ability to stay awake. I felt like I was in a dream where I wanted to scream, but no sound would come out. I learned later that one of the symptoms of Fentanyl overdose is not being able to speak. Another is dizziness, and yet another is intense sleepiness. All things I felt intensely and immediately.

Everyone left, except my doctor, nurse, doula and husband.

My doctor looked tired, bored. Smirking, she sat between my legs. I was flat on my back, and I couldn’t sit up. I couldn’t see anything she was doing.

“Eight centimeters, water bag bulging,” she said to the nurse.

The OB turned to my husband. “We’re going to put the internal monitor on,” she told him. No. I wanted to scream. No, I don’t want this. I said this in my birth plan. I don’t want this. No one was looking at me. How come no one was looking at me? Was I still here? “It’ll help us keep an eye on the heart rate,” she told him.

I willed him to look back at me. He didn’t.

She didn’t explain to him that she would have to break my water to do it, and that could cause complications, including variance in heart tracings. She also didn’t tell him she’d have to screw it into our baby’s head.

“Membrane ruptured, nine centimeters,” she told the nurse, smiling.

“I can’t seem to get it,” she laughed, fiddling with the internal monitor screw. She tried again. And again. “Nope, I can’t get it.” She asked the nurse to help her. The nurse screwed it in to my baby’s head.

“This whole time I’ve had my hand in your vagina!” the OB said, laughing, looking at the nurse.

The nurse looked at the monitor, and it went quiet in the room again.

“That’s it. I’m wheeling her into OR,” the nurse said.

I was aware of my bed suddenly rolling, and again I felt dizzy. If I could have felt any physical sensation, I’m sure I would have felt my blood go cold.

No. Not a c-section. I don’t want a c-section, I thought with drug subdued terror and shock. That’s it? That was nothing. Hardly a blip. No discussion? No one is going to ask me or get my consent? No one was going to look into my eyes or address me and explain to me what the fuck was going on?

My bed was  already in the hallway. What the fuck was going on?

The nurse leaned in toward my face. “This is about your baby now, Sara! Don’t you care about your baby?” she hissed.

I blinked. I opened my mouth to say something, anything. I was confused. I felt tears come to my eyes. Was my baby really in danger? What about the second opinion? I felt like I was in a dream state. It wasn’t real. Where was my doula? Where was my husband?

The OB came to the head of my bed and hesitated. “The heart rate came back up,” she said, pausing. “But we have to do this.” She left.

I was semi-conscious of being slowly rolled down the hallway. Someone was pulling the bed behind me. My husband came running out into the hall. He looked so sad. I wanted to laugh. How ridiculous this all was. How was this an emergency? I wasn’t even given a chance.

Everyone was waiting in the operating room. Like they had been there. No one seemed rushed. Everyone seemed tired.

As I was lifted like a corpse from my labor bed and dropped onto the cold metal table, something inside me clicked on. I was panicked. Everything became real for a split second.

No, what the fuck?! They were going to operate on me. No!

I tried to make eye contact with someone, anyone.

But everyone was looking down at my body like I wasn’t in it.

My heart raced. I felt panicked. Sick. Terrified. There was someone to my right. I looked into his eyes, and begged for my life.

“I’m scared, please! Please!” I begged. He looked back at me. I held onto his eyes. Please don’t hurt me. Please don’t cut me open.

I wanted to run. I couldn’t move anything. No one spoke to me. Everyone was masked, capped. Everyone looked the same, and they all avoided looking at me.

Then Dr. Sayago addressed me, with bravado.

“You can’t control everything, Sara,” she said, standing at the end of the operating table. “Sometimes you just have to let go and let God.”

In that moment, I felt utterly defeated. She was going to do what she wanted to me. She was right, I had no control.

She had all the control.

I slipped away. The next thing I remember, my husband’s face was next to me. He had tears streaming fast down his face. He was looking at my stomach behind the curtain. He sat facing the edge of the curtain, straddling it, in the tiny rural operating room.

Something must be wrong, I thought. I must be dying. Suddenly, I felt so sorry for him. Poor Mike, I thought. He’ll have to take care of this baby all alone, without me. He looks so scared. And I’ll be gone, I thought, not having  to deal with any of it. This thought gave me comfort.

But then I thought, with sudden horror, maybe something was wrong with the baby. Where was my baby?

I tried to look in his eyes, but he looked at me differently, like I wasn’t me anymore. I saw that he was holding my hand, although I couldn’t feel it. It was trembling. Every part of me seemed to be shaking hard, like I was freezing, or in shock. I’m still here, I thought. You just can’t see me.

I drifted away again, feeling numb.

I came to, unable to catch my breath. I felt like someone was sitting on my chest. I turned to my right, conscious somehow that the anesthesiologist was there. “I can’t breathe!” I shouted. It came out a hoarse whisper. I told him again, and again. I slipped away again.

I heard a cry. And another. Something in my brain nudged me – it’s a baby. My baby. I came here to have a baby. I roused myself. My baby! She must have been born.

“Where is she?” I shouted. “Where is she?” No one spoke to me, or looked at me. Where was my husband?

Suddenly, she was on my neck. Her eyes were about two inches from my own and heavily glazed over. She smiled sleepily. She was high as a kite.

I tried to laugh. I tried to feel joy. I tried to feel anything. But it felt all closed off. I couldn’t seem to access myself. I had the sense that this was supposed to be an important moment, but it felt ordinary and dull. The next event in a string of surreal events.

I also had the sense that this moment would end shortly.

The next thing I did, I did for my future self, for when I came back. Someday, this moment might make me feel something, I thought. I wanted to touch her. I wanted to hold her. I wanted her to be mine. The only part of her I could reach was her lips, with my mouth. Every part of me – my whole torso, arms, hands – where were my hands? – was paralyzed. I kissed her and I landed on her lips. It just felt wet, like some kind of sea creature. Not like kissing my baby.

Her eyes were smiling at me. She knew me. She was probably happy to see me. I willed myself to feel happiness. Something. But I couldn’t feel anything. She didn’t look like I thought she would. Her hair was light. Her eyes were blue and slanted. My ugly eyes, I thought. She looked like me, not like Mike. She looked like my baby, but she didn’t feel like my baby. Did she really come out of my body? It didn’t seem like it. Something wasn’t right. None of this was right. Where was my husband? Wasn’t he supposed to be here? To see this?

She was removed.

Someone was at my side, telling me something was wrong. She needed to be put on some kind of machine for breathing. The person seemed like she was asking me. I almost laughed. Was there a choice? How could I communicate? I couldn’t speak or move.

Someone asked my husband if he wanted to be with our baby. He looked down at me. He looked torn. I think I tried to shrug or smile. He left.

The hospital staff turned the radio on low. I felt like I was in a car shop, but the car everyone was casually tidying up was me. No one looked at me, spoke to me, or knew I was there. I looked up at the lights. There, in the reflection, was a bloody mass. Organs. Someone split open. Gross. And then – it occurred to me – that was me.

I felt terror, disgust, then laughter. How ridiculous, I thought.

When I woke up, I was in a dark, fluorescent room. There was a clock. It read something crazy, like 4 am.

My doula was next to me, holding my hand. All at once I realized my baby was outside of my body, and yet not with me in my arms. And that I had missed my birth entirely. It was like I had been laboring and then fast-forwarded to this moment, where I was empty, and alone in my body. The horror of this hit me suddenly and hard, and I started to sob. I shook. I felt sick. My doula looked like she might cry.

Then, as quickly as it had come over me, I couldn’t remember why I was crying. “I don’t know why I’m crying,” I said. My doula looked at me like she felt sorry for me. “You’re a great candidate for a VBAC,” she said. I almost laughed. Who cared. I could never get this back. Never make this right.

We tried to figure out why I was upset. I was blocking it out. All I could say was that I wanted to see my baby. My doula texted my husband and he texted her back some photos of our daughter holding his finger from down the hallway. I held the phone in my hand and stared at the photo for a long time. But it was just a photo, and this made me ill.

Then, suddenly, a nurse was putting a baby on my chest. They were putting her on my breast. She latched. She drank for almost an hour.

My next memory was of my doula telling me she was going to bed and would come back later. I was back in my original laboring room, where I had labored for less than three hours. I don’t remember getting there, being transported. One sad fluorescent light was on, over the counter in the corner.

Our daughter woke up almost every half hour, screaming. My husband brought her to me, put her on my chest.

This is it, I thought. This is what people celebrate. But I didn’t feel celebratory. I felt like the birth hadn’t happened.

I felt confused. The baby was here, yet, she wasn’t birthed. I missed the part to celebrate, I thought. What were we celebrating? The mood didn’t feel celebratory. It felt lonely and dark and numb. It felt like perhaps there was a car accident, a death. There was grief in the air. No one told me congratulations. No one acknowledged that this baby had just been inside me. Not here, not back in the operating room.

Instead, a different nurse came by every four hours or so and gave me pills. Percocet, I heard one say. I didn’t want to take all these drugs. I felt drugged enough and completely removed from whatever warped experience this was.

What about breastfeeding? I asked. The nurse shrugged and said, “You just had surgery. You have to take them.”

When she turned around I put one in my mouth and hid the other in my hand. Two hours later, I woke up in horrific pain. I was going to die. I called out for my husband. He rang the buzzer.

“I’m going to throw up,” I told the nurse. “It hurts.”

She looked confused. Then she saw the pill on my tray. “You didn’t take both?” I shook my  head, ashamed. “I’m scared. I don’t want to throw up.” I knew if I threw up, all my stitches would come apart and my organs would fall out. At least, that’s how I felt.

“No, you don’t want to throw up. That would be very painful,” the nurse said. Finally, someone was taking my  pain seriously. She rushed, then stabbed a big shot into my thigh. Immediately, I felt peace. “Thank you, thank you.” I felt so much gratitude. I fell asleep.

My parents were in my room. I don’t know how they got there. I don’t remember texting my mother that I’d had the baby. Then I remembered that I didn’t have the baby. I had surgery instead.

They came in quietly, the one fluorescent light shining a sick light into the sad, gray room. I don’t remember talking to them. But they were holding our baby. Something was on TV. My dad was watching it. There wasn’t joy in the air. The mood was something of pity. My mom felt sorry for me. My husband brought in some kind of oil diffuser. He mentioned the room smelling.

I felt only shame. No one took pictures of me with the baby. I took a selfie of her and me by myself. I sent it to a few people. I decided I would have to pretend to feel joyous. These were important moments, even though they were spoiled. I would not get these back. I texted as many people as I could think of that I had the baby.

I felt like a liar, saying “she was born.” She wasn’t actually born. I decided to tell only a few people the secret I was so ashamed of – I didn’t actually have her. They performed surgery on me, and suddenly, she was here.

Some “friends” visited. My husband excitedly told them I got to 9cm and then I had a c-section. Don’t tell them, I wanted to scream. It’s none of their business. Instead, I said, “It was horrible.” One of my friends smiled. “I heard that’s hard for some mamas,” she said and walked over to my baby in the tray, several feet from my bed, helping herself to hold her. I wanted to kill her, this ridiculous woman who had never been pregnant, never given birth, never had it stolen from her. Who the fuck did she think she was? Still, she sat in my room, and I couldn’t escape. My husband chatted with her, keeping her company.  I was quiet. I stared at the TV, willing her to leave. “You’re in such a bad mood,” she teased me. Again, I fought back thoughts of her demise. The nurse came in and offered me my pain meds. My friend thought this was hilarious. “She needs them,” she said. My nurse looked sorry for me for a second. I took them down quickly. Take me away.

 

 

 

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