Pregnant & Posting: 39 weeks & Delivery
I worked right up until the day before I delivered my baby. In hindsight, I wish I'd had some time off beforehand. It would have made life easier and less stressful. However, we don't always have ideal situations. I had some days that were better and some days that were worse. I spent the last week of my pregnancy talking to baby a lot about making sure she waited until our scheduled date and time. Or, at the very least, if she was going to come early to try to do so during regular business hours on a day where my OB was working so that I didn't have to worry about being delivered by someone else. I was having some contractions and was worried that she was going to try to make an early appearance, which I hoped to avoid. I delivered my first child around 10 days early after my water broke spontaneously (as I've previously discussed here, that delivery was a difficult situation in general). I was lucky that time that the OB I liked was the one on call and thus the person who did my delivery. (With that delivery, I'd been under the care of a midwife but ended up having a c-section after regular business hours. That meant that the on-call doctor for the practice was the one who delivered.)
On the evening before my surgery, I started having a few more contractions than I'd had before. After dinner, I started timing them to get an idea of what was happening and discovered that I was contracting around every 6-7 minutes for 30 seconds at a time. Sometimes they were spaced further out (more like 10 minutes or so). The contractions were low in my abdomen and uncomfortable, but not terribly painful. This wasn't that concerning since my surgery was scheduled for the next morning, but I was still hoping that things would settle down so I could sleep. I tried to relax and go to bed early that evening.
Around 10:30pm I woke up having more contractions. This time they were more uncomfortable and seemed (as I laid there in bed in the dark) to be closer together. They also were in a different place than the contractions I'd had earlier in the evening. While they were still low in my abdomen, they now wrapped around my lower back and hips as well. (These contractions were also different from those I'd had with my first labor. I remember the contractions from that labor being more "all over." My whole belly seemed to contract then, while these were centered much lower.) This wake up also kicked off a series of very frequent trips to the bathroom. It seemed like I had to pee after every third or fourth contraction. I also had to get up several times to have bowel movements. I laid in bed and tried to breathe through each one and lay or move in ways that would help me manage the discomfort (like rolling my hips in a circle). I tried to keep quiet so that my partner could continue to sleep, since I knew the next few days would be long and I wanted him to be able to rest at least.
This strategy worked for around an hour, at which point I finally was having enough discomfort that I couldn't stay as quiet anymore. During a trip to the bathroom sometime around midnight, I lost my mucus plug. This also happened during my first labor, so when something that looked like a large ball of bloody snot showed up on the toilet paper, I knew what it was right away. At this point, I asked my partner to go ahead and put in a call to my OB's office answering service to ask what we should do. My contractions were closer together, coming every 2-3 minutes (with very occasional intervals that were longer), but still quite short. And now that I'd lost my mucus plug, I was starting to get a little concerned. Thankfully, my doctor was the one on call and he got back with us right away. Because there was still some irregularity and my water was not broken, he suggested that we stay home and try to wait it out until morning. If my contractions got longer or more regular or if my water broke, I should definitely go ahead and go in, but until then he suggested taking a hot bath and relaxing.
So we filled up the tub and followed the doctor's advice. Unfortunately, I have a very small bathtub, so I'm sure I did not get as much benefit from that as I would have with a tub where I could get completely under water. But I tried anyway. I stayed in the tub as long as I could but ended up getting out and moving back into bed eventually. I continued to breathe and move through my contractions, which were not very consistently 2-3 minutes apart and around 30-45 seconds in length and becoming quite painful.
I continued to manage my pain as best I could until around 3am. At that point, I suddenly got very hot and promptly threw up all over myself and my bed. Twice. At this point, I'd had enough. Often during labor, if a woman is going to deliver in a hospital, a 2-3 minute interval means it's time (or past time) to be at the hospital. (Note: I apparently don't have normal or textbook labors. So if you're looking for a description of what labor looks like for most women, I'm not the example you want.) I told my partner that I wanted to go to the hospital. NOW! So we woke up the relatives we had in town to stay with our other child, tossed the bag in the car, and were on our way to the hospital.
When we arrived, I explained to the person on duty at the desk that I was having contractions and was there a few hours early from my scheduled arrival time for my c-section. They pulled up my information, had me sign a few papers, and took me back to the surgery preparation area. Here I was given a gown to change into and a nurse hooked me up to 2 monitors. The first was to monitor my contractions and the second to monitor the baby's heartbeat. These were not painful or bothersome, just belts with leads that were positioned on my belly. This let them keep track of my contractions and see how baby was tolerating them. (I knew she was doing fine because I could feel her moving around a lot between contractions.) She also checked my heart rate, temperature, and blood pressure. The person doing the registration also came back to get my ID & insurance card to copy and checked my information in the registration system. After monitoring me for a few minutes, the nurse started an IV in my arm and then asked if they could check me manually. The concern this time was to make sure we didn't have a baby that was trying to make her appearance right away. Based on my feeling, I thought she was still pretty high in my belly, but the nurses were worried because often when contractions are consistently 2 minutes apart, you can have a baby getting ready to come out very soon. The nurse tried to check, but had a hard time reaching my cervix (which was quite high and posterior). She ended up calling in another nurse to try to reach it. This was quite painful, especially as I was contracting the whole time. Eventually, they decided that my cervix was not open at all and baby was still quite high. This was a relief for me as it meant that we probably would be waiting until the appointed surgery time.
The nurses called my doctor to update him on the situation and then came back to give me some medication for the nausea and an IV pain medication. While the doctor could have ordered a medication to slow or stop my contractions, he chose not to because it is actually better for the baby to have some labor before being born. In basic terns, the contractions help their bodies get ready for life on the outside. He hoped that the pain medication would be able to take the edge off my pain though. (By this point, I'd been quite uncomfortable for quite a while.) I must confess that I'm not good with pain. Some people are good at dealing with pain. Many women spend months learning about and practicing various pain management techniques for labor. And for many of them it is quite successful. I'm not one of those women though. Regardless of what techniques I try, I'm just not good with pain. Again, I think a lot of this is simply an issue with my particular body. Thankfully, the pain medicine helped me to relax and the nausea abated as well. Additionally, I got a bag of IV fluids to help make sure I was sufficiently hydrated.
After that, we pretty much just waited. The nurse spent about 15 minutes verifying all of my health information (medical history, medication list, etc.) and then had me read and sign a bunch of paperwork. There were many consent forms and several other things I needed to fill out for myself and the (soon to come) baby. Then we sat/laid there and waited. My partner and I filled the time by talking about a variety of things, comparing this to my last labor, laughing about some of the things I'd done or said, talking about our hopes for this delivery, etc. It was actually not a horrible time, aside from the remaining discomfort from the contractions.
My doctor decided to come in about half an hour before our scheduled time and start my surgery a little early. The nurse returned to start my actual surgery prep. They went ahead and did the necessary shaving to prep my body for the incision. I had intended to shave myself the night before so that there would not be much to do, but had not managed to do so. While this wasn't a big deal, I did find it rather annoying. When they shave you for surgery, it's a dry shave using a less-than-powerful electric razor (in this case). It's not the most comfortable thing ever, to say the least. So I'd have preferred to trim and then shave myself to save some of the discomfort. (They would still have shaved me there, but it would have been less uncomfortable if I'd taken most of it off myself first.)
Once that was done and the appointed time arrived, I was walked back to the surgery room. My partner remained in the prep area and was given a coverall, booties, a hat and mask to wear since he would accompany me during the surgery. Back in the surgical suite, I sat up on the table and met the anesthesiologist who would be handling my surgery. He told me he was going to place the spinal and we talked about the risks, benefits, and specifics of the procedure. This means injecting special medicine into my spinal cord to numb me from around stomach level down. I was somewhat nervous about this. I had an epidural during my previous delivery, but was in so much pain at the time that I'd have done about anything to have some relief. So someone sticking a needle in my spine seemed like a fine idea. But when I wasn't in so much pain, it seemed much more difficult to consider sitting still while this happened. However, it wasn't as bad as I thought. They first gave me an injection with a short acting muscle relaxer to help relax my back, which also happened to basically make me fall asleep for a couple of minutes. When I woke up, the spinal was done and I was laying on the table with them finishing the rest of the prep. They shaved the incision area (again), wiped the entire area down with a special disinfectant, and placed my catheter. Then my doctor came in and we talked for a few minutes while they made sure I was sufficiently numb. I couldn't feel anything from my stomach down. They hung the drape (so I would not see what was going on during the surgery), brought in my partner and we were ready to go.
I was excited and a little bit anxious. My OB is one of the best in our area (he's the one that other doctors call if they run into trouble), so I had a great deal of confidence in him. Even knowing that I trusted my doctor, a c-section is still major abdominal surgery and not something that is without risk. Happily, everything went according to plan. The doctor and surgery team did their part. I felt some pushing and tugging (but nothing painful at all) and then I heard my child screaming. She came out angry and screaming right from the first moment. I think this was the point around which I started crying. The doctor held her up so that I could see her and the team took her over to be weighed and measured (she's just slightly smaller than my first child was), and have her Apgar scores checked. (She was fine.) After a quick check, they wrapped her up and brought her over to me for another look and a kiss before she went to the nursery (with my partner) for a more thorough checkup and I got stitched up. The anesthesiologist gave me some medicine to help me rest and not remember the part where they closed by my incision. When I woke up, they were bandaging me up and putting warm blankets on me in preparation for wheeling me out to recovery.
I spent some time (my partner tells me it was around 30 minutes) in recovery before they brought my baby (and partner) back to me and we tried nursing for the first time. (It's best to try to start nursing as soon as possible after delivery. For women who have healthy babies after a normal vaginal delivery, they often try right away. Since my delivery was surgical, I had a somewhat longer interval.) After another half hour in recovery, I was wheeled up to my postpartum room where I would spend the rest of my hospital stay.