My douchebag cervix: A birth story

Good thing I never bothered to write that birth plan.  Then again, if I had, it would have looked something like this:

1. Push baby out of vagina.
2. Failing #1, get baby out safely by whatever means necessary.
3. Oh yeah, and try to make sure mom is OK too.

In the immortal words of Meatloaf, two out of three ain't bad.

The day before Easter I was 8 days overdue.  Since my OB didn't want me going more than 10 days over, and some inductions can take up to 48 hours from start to finish, at 8:30am on Saturday we headed to the hospital to get this show on the road.

Unfortunately, while I was basically 100% effaced I still hadn't started dilating at all, so I received an application of prostaglandin gel on my cervix in the hopes that we could get something going. I was monitored for an hour during which baby Q remained happy and I had two minor contractions, about half an hour apart.  The doctors seemed pleased that things were getting started, so M and I were sent home and told to come back in 6 hours for another dose of gel unless I went into true labour before then.

Of course, as soon as we left the hospital it felt like everything stopped.  Despite going for a long walk, I didn't have any more contractions and was pretty dejected as we headed back to the hospital at 5:00pm.  When I was hooked up to the monitors again, however, it appeared that I was in fact having fairly regular, very minor contractions that I was just barely starting to feel.  I was still only about 1cm dilated, but given the contractions I was having the OB felt that another application of gel would be risking over-stimulation of my uterus.  She put in a dose of Cervadil instead, which is basically like a medicated tampon that she explained they could pull out at any time if things got too intense.  They told us we wouldn't be going home again before baby arrived, so we settled in for the long haul and I was hooked up for another couple of hours of monitoring.

By about 10pm things had really kicked into gear, with the contractions becoming more frequent and painful.  At one point I was bouncing on a birthing ball as M was laughing at Saturday Night Live, and I distinctly remember feeling very resentful that he seemed to be having so much fun while I clearly was not.  My contractions were getting pretty painful and were coming every 2 minutes and lasting about a minute each, so it felt like things were going in the right direction, but I had no idea if I'd actually dilated any further.  I felt like if I had progressed at least a few centimetres, I could gut it out a bit longer before I got an epidural.  But if I still hadn't dilated at all, then I had a long way to go and I would definitely need an epi so that I could get some sleep.

Well, I've previously referred to my uterus as an asshole.  Turns out I should have been directing more venom towards my cervix, which was proving to be a complete and utter douchebag.  I was still at 1cm.  I believe my exact response was to shout "Oh for fuck's sake!!"

While doing the internal exam, the OB asked me if I'd ever had any procedures done on my cervix.  I replied that yes, I'd previously had a number of colposcopies and a Loop Electrosurgical Excision Procedure (LEEP) to remove some precancerous cells a few years ago.  Since this type of procedure can cause some scar tissue which is tougher than regular cervical tissue, the OB recommended trying to sweep my membranes to see if that would help.  If you recall, this is the same procedure my regular OB had declined to do the previous Monday since I wasn't dilated enough and she thought it would be extremely painful for me.  Turns out, she hadn't lied.  The sweep sucked.  But it worked to a degree, and in the space of 5 minutes I had dilated to 3cm.  They took out the Cervadil, and I decided to hold off on an epidural a little longer in the hopes that I could remain mobile and dilate some more.

Bad idea.  The membrane sweep just made my contractions much more intense.  I tried to focus on breathing, but within half an hour I had vomited from the pain and had decided that an epidural was the way to go from here on out.  I have to admit that I was disappointed, not because I was trying to be any kind of hero and go completely unmedicated, but because I really thought my pain threshold was higher than 3cm dilation.  I had hoped to hold out longer, but agreed with the nurse when she said it was probably time to call for the anesthesiologist.

This is the part where things kind of started to go off the rails.  The anesthesiologist numbed my back, and inserted the epidural painlessly.  However, before he even had a chance to begin the medication I started to feel woozy.  I told the nurse I was feeling lightheaded.  The next thing I knew, both the nurse and M were snapping their fingers in front of my face and calling my name.  My blood pressure had apparently plummeted and I had passed out for a few moments.  As I came to, I puked again.  My bed was quickly reclined and I was given a dose of ephedrine through my IV to get my blood pressure back up.  I also got a squirt of oral nitroglycerin under my tongue and an oxygen mask over my face.  I somewhat nervously noticed that there were now something like 8 medical personnel in the room, whereas before there had been only two.

Once the epidural kicked in I started feeling a lot better, despite the fact that the monitors showed me as having had 6 contractions in less than 9 minutes.  The problem at this point now became Q, whose heart rate (which had been in the happy 150s all afternoon) had leapt up into the 180 to 200 range (probably in response to the meds they gave me for my low blood pressure, I later learned).  The OB told me that I was now almost 6cm dilated, and recommended breaking my water.  It came out stained with meconium, which they said was not surprising given that a) Q was overdue and b) he'd just gone through a period of minor distress.  But wait...all of a sudden I was only 3cm dilated again!  The OB said that the amniotic sac had probably been pressing against my cervix and that, once the pressure was released, my "LEEP cervix" (as it was now being called with some disdain by the doctors and nurses) had sprung back in like a rubber band.  Like I said, my cervix was being a total d-bag.

It was looking like it was going to be a long time before I dilated enough to make any attempt at pushing, and in the meantime Q's heart rate continued to stay elevated.  While it wasn't dangerously high, the OB advised that it was essentially like he was running a marathon in my womb; the longer his heart rate stayed high, the more stressed he would become.  The doctors decided they wanted to do a procedure that would take a small prick of blood from Q's scalp to see how much lactate was building up in his system.  If it was normal, I could continue to labour but if not, they would recommend "another way to meet the baby".  They studiously avoided using the word "c-section", but unless my hospital had figured out a way to transport babies from the womb a la Star Trek, we all knew what that meant.

Unfortunately, my douchebag cervix wasn't about to start being cooperative now.  After about 10 minutes of shoving a little tube up my vajayjay in a futile attempt to isolate my cervix, the OB waved the white flag and admitted defeat.  My cervix was still far too high and apparently tilted to the left to allow them to do the procedure.  Since Q's heart rate had been elevated for a long time and they had no way of accurately determining how stressed he was, they recommended a c-section.  At that point I had been staring at the fetal heart monitor for over an hour, silently but unsuccessfully willing Q's heart rate to slow down to normal, and I just needed to know that he was going to come out of me OK.  M and I agreed to proceed with the c-section.  

I'll admit that this is the part where I cried a little, partially because I had been hoping for the quicker recovery time of a vaginal birth but more so because I felt responsible for causing all of this stress on poor little Q's heart.  Everything had started to go downhill when I had requested the epidural.  If only I'd been tougher, if I'd been able to hold out against the pain, none of this would be happening...but it was, and I was soon on my way to the operating room.

There was no immediate urgency to my c-section, so everyone was pretty chill and calm while getting ready.  The c-section itself was weird because I could feel all the pulling and tugging they were doing (some of which felt pretty rough, since Q hadn't descended at all and it felt like they had to yank him out of my ribcage), but there was no actual pain and M helped by keeping me focused on him throughout.  At 4:30am they pulled Q out to a chorus of "oh, that's a big baby!" (8 pounds 11 ounces) and showed him to us briefly before whisking him away to the warming table to be checked.  I let out a few huge sobs when I heard him cry, and then urged M to go be with him while they stitched me up.

Since Q had been swimming in meconium, he had inhaled a little of it and needed some suction and oxygen to clear his lungs.  The hospital had a video camera over the warming table so that I could watch what was happening on a screen over the surgical table, which was awesome but also stressful since I could only see what they were doing but couldn't hear why or how he was responding.  M came back to give me updates, and told me that though Q was doing well they'd be taking him to the resuscitation room for a quick check before he could come with us.  On the way out the nurses brought Q to me for a quick look and cuddle, and then he and M were gone and it was just me, shivering uncontrollably on the surgical table while the doctors put Humpty Dumpty back together again.

When they were done, I was wheeled to the recovery ward where I tried to stay awake while waiting for my husband and baby.  They arrived around 7am, and I was finally able to hold Q skin to skin and put him to my breast, which he took like a champ.  Just about 24 hours after the whole thing started, at 8:30am on Easter Sunday my new little family was brought up from recovery and installed in our room in the post-natal ward.  To call it the most emotional, terrifying, amazing day of my life would be a hell of an understatement. 

Oh yeah, and those of you who told me that all my donor egg fears would disappear the second I held this little guy in my arms?  You were absolutely right.