On Friday morning the 12th Kate and I went to an appointment with her OB-GYN. This was just a routine checkup sort of thing. The only reason that I went along is that I had some paperwork that I had to drop off for work; health insurance stuff. Kate had been feeling a bit uncomfortable, so she asked for a pelvic to see if she was dilated at all. The doc said that she was only about half a centimeter, and that it was going to be a while.
Kate's water broke at 4 o'clock the next morning.
She decided that she was dreaming, and went back to sleep.
At six she woke up in a puddle of amniotic fluid, and was no longer able to insist that she was dreaming. She woke me up and we got going.
First stop was Kate's clinic. She was supposed to be on-call for the weekend, which means taking appointments in the clinic on Saturday until noon. She arranged coverage, but we still had to stop by and drop off the communal beeper, and brief the covering doc on what was happening.
I dropped her off at the Hospital entrance at about 8:30 in the morning, and went to park the car.
I found her in the triage section of the maternity ward, where the nurse was telling her that her water was definitely broken, but they had to do a test to confirm it anyways. They did the test and confirmed what we all knew, and then we were faced with our first decision that required departure from what we had planned.
Kate didn't want any intervention with this pregnancy, labor, and delivery. Not because she has anything to prove, but because interventions tend to cascade, and once they start it's hard to stop things leading to the next one.
The problem was that she wasn't having contractions, and a baby in the womb once the water's broken is at risk of infection. It's not a great risk, but it's a risk.
The OB resident (who was pretty good, but looked about fourteen and was very by-the-book) explained this to us, and told us that she wanted to start Kate on pitocin in order to induce labor. Kate explained that we didn't want any intervention. The resident reiterated the risk, and then made a mistake. She said:
"...but I'm not going to make you take it right now."
Bad choice of words. Remember the birth plan?
I didn't rip her arms off.
However, suggesting that she could make Kate do anything wasn't something that I wanted to let go, that also has the possibility for cascade.
I told her don't worry, you can't make Kate do anything.
I didn't yell, but I can't swear that I didn't growl.
In any case, she backed off immediately.
The nurse was on our side in this, and interjected something in support of what Kate wanted.
This all took place in the triage room. The maternity rooms are suites with a private bath, and a fold out couch for the birth partner (me, in this case). There was only one suite available, and it was really tiny, but a corner suite was in the process of being vacated.
So it turns out that the "charge nurse" on the floor is a client of Kate's. She stopped by during the whole pitosin discussion to tell us that she was holding us in triage until the much larger suite was ready, and that she was having it cleaned up ASAP.
It's nice to have connections.
Kate and I went to wander the halls to see if walking would induce her labor. It didn't, but it gave the nurses a chance to tell the resident that they didn't know where we were the next time the resident came to talk to us about the pitosin. So we walked around in circles for an hour or so, not managing to induce labor. Eventually the resident caught up to us and told us that another option was a vaginal suppository that's supposed to "ripen her cervix", but that if labor didn't start soon we'd really be putting the baby at risk if we didn't do something to move things along.
This was at about 10:30 am at this point. We told her that we'd make a decision by 11. Then we went wandering some more and managed to avoid her until 11:30 when our suite was ready.
We decided on the pitosin, because the suppository would require Kate to stay in bed, and because once it started working it couldn't be stopped. The pitosin is an IV that could be removed at any time (though it almost never is). And Kate could walk around with it.
So, we got the pitosin drip setup and went walking around some more. By the time the pitosin was setup it was about 12:30 and Kate was beginning to feel contractions. It wasn't the pitosin, because it was still working it's way down the IV tube.
So we walked for another hour or so, maybe ninety minutes, with Kate needing to stop increasingly frequently in order to ride out contractions.
At about 2 she couldn't walk around any more.
Then things really began to suck.
I've read the books, we took the class, I know what I'm supposed to do as the birth partner, and honest-to-Jeebus I did what the books say to do. Mostly, Kate wasn't having any of it. We tried different positions a couple of times. Used the birthing ball for a bit. I got her water repeatedly, which she took; and offered to rub her back or arms or legs or whatever between contractions, which she didn't want.
By 4:30 or 5 the contractions were happening pretty much on top of each other and lasting longer than the breaks between them. They had a couple of monitors on her, one for the baby and one for her contractions. The bar graph for her contractions was pretty much a straight line across the top of the chart, with the occasional drop into a pointy little pit. It had started out looking like a mountain range, and by late afternoon it looked like a mining camp.
That's when Kate asked what were her options for pain management. They told us that we could do an epidural, which Kate didn't want, or she could have a morphine derivative that would take the edge off the contractions and help her recover between them. She could have that every two hours.
She took the morphine derivative.
I don't think it helped with the contractions, but it absolutely helped her recover between them, which (according to Brenda the nurse) made them stronger.
At some point in there Kate told me that she never wants to do this again.
After the morphine they checked her and told her that she wasn't technically in active labor yet, because her cervix hadn't dilated enough.
They gave her a second dose of the morphine at 8:45 pm.
At 9:45 it was getting really hard for her not to push. The doc came in again and examined her and told her that her cervix was almost ready, but she needed to not push for a bit yet.
At 10:15 the doc came back, examined her again, and told her that it was time to push; her cervix was ready and the baby was down in the birth canal.
The nurse and I set the squat bar in place. This is a bar that hooks up to the bed, and then the foot of the bed drops down so that the delivering woman can squat on the foot of the bed, using the bar at shoulder level for balance and to help push. Evidently squatting is a better position for delivery than lying on one's back.
Then the resident made another mistake.
She told Kate not to get her hopes up that she was done, the pushing can take up to an hour or two.
I know Kate very well. We've been together a long time, and I know her looks. So I know that the look that she gave the resident very clearly said:
"An hour? FUCK THAT!"
While this exchange was happening I was on Kate's left side and Lou the nurse (Lou is short for Louise) was on the other side. Lou reached to grab Kate's hand to help her get from the top of the bed to the bar. She looked at me and mimed that I should grab Kate's other hand.
But I know Kate very well, so I just stood there.
Kate slapped Lou's hand away with her right hand, while grabbing the bar with her left. She did a one-handed pull-up into position.
She pushed the baby out in about fifteen minutes.
She paid for it, with some tearing and a lot of bruising.
Having no desire to watch something the size of a nearly seven pound baby emerge from Kate, I stayed by her head. Not from being grossed out, but out of respect for her privacy. She told me it was okay if I wanted to see it, but I didn't feel like it was necessary, and still don't think it was.
Yes we're married, and I've seen all of her anatomy at one point or another, but this wasn't necessary.
I also refused the doctor's offer to cut the cord. I almost quoted the great Bobcat Goldthwaite, and asked isn't there anyone more qualified?
Almost, but I held back. I just said that I don't need to do that, and I didn't.
They put the baby on Kate's chest right away, which I had told them that we wanted them to do.
10:34 pm. We're parents.
The docs pushed on her uterus to get the placenta, which came out intact, and set it aside.
The docs (the resident and her attending) gave Kate stitches where she needed them (she didn't need many), and told her how to care for her injuries.
Then they gave us a "tour" of the placenta. I could have done without that, but Kate thought it was cool. Also, a friend had to have surgery shortly after delivery due to part of the placenta being left behind, so Kate wanted to be certain that they got the whole thing.
Then I held the baby while they helped Kate up so she could go shower.
Tells you a lot about the pain of childbirth... If Kate needs a painkiller!
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