LABOR AND DELIVERY

A few months back, I asked my Facebook mommy friends to weigh in with their childbirth experiences.  A compulsive planner, the goal was to gather their collective knowledge and funnel it into my own birth plan.

But soon my simple query turned into a real conversation.  SO MANY amazing ladies responded; and as I eagerly absorbed their stories, I noticed some patterns.  It seemed the most disappointed women were those whose detailed birth plans were overruled by medical necessity.

So rather than attach ourselves to an unrealistic plan; spend money on classes we might not need and/or hire a potentially useless doula- Will and I decided the best plan was to wing it.

Yeah.  I know.  Me... wing it.  Crazy.

My only wishes were:

1. That my mom, sister and husband be allowed to coach me through early labor.
2. That I wait as long as possible to get the epidural.
3. That above all, we do whatever necessary to get our baby out safely.

As we drove to the hospital, I quietly prayed we made the right decision.

***

"Ohh..." said the on-call physician.

As she looked over my swollen, welt-covered body she conceded my case of PUPPS was in fact the worst she'd ever seen.

Moments later I was administered an invasive dose of Cervidil - a tiny tampon-like object covered in goo meant to soften my cervix.  I read that Cervidil could even kick my body into labor - but since the doctor's prediction for this induction was so confidently gloomy, I was prepared for massive disappointment.

As suspected there was no dilation when they checked me at 5 AM.

"So what now?"  I asked, sadly.  "Will I need to re-do the Cervidil tonight?"
"Hmm..." said the physician, inspecting my anatomy.  "I actually think an enema would help."
"An... enema?"  I trembled.

I was skeptical - not to mention scared for my tushie - but ultimately if it would get this kid out of me, I was game.

A couple hours after the interesting procedure, we received some good news:  I was 4 cm dilated and fully effaced!  Encouraged by my progress, the doctor agreed to break my water and get the show on the road.

Soon my mom and sister arrived.

"4 cm dilated!!"  I shouted as they walked through the door.  They screamed with excitement.  "The doctor just broke my water!"

They rushed over to lift my blanket and see for themselves.

"OH!" they simultaneously recoiled.
"Ali - that's the wrong color..." my sister said covering her mouth.
"What?  What do you mean?"  I asked.

The doctor came back and explained that there was meconium present in my amniotic fluid.  This meant Bobby had a bowel movement while inside me.

"So... I mean, is my baby going to be okay?" I asked.
"Yes - we'll have to monitor him very closely for stress;" explained the doctor  "and if he's ingested any of the contaminated fluid - he may need to spend some time in the NICU,"
I nodded sadly as I considered this possibility.
"Either way" she continued "time is of the essence.  I'll have them prep your delivery room and we can get going."

By the time transport arrived my contractions were in full swing.  The nurses helped me stand, at which point more of the discolored liquid came gushing out of me.  During the short, swampy walk to my wheelchair, I had to brace myself two separate times to breath through the surges - all the while trying to apologize for the mess I was making.

Once we settled into the snazzy new delivery room, I was free to concentrate on labor.  Will, Mom and Vic worked in shifts holding my hand and coaching my breathing.   Each time I felt a contraction coming on, I'd signal for help.  Whoever was 'on' would drop what they were doing and rush to my side.  Using this system, I found it easy to breath through the labor pain.  But after four hours when I still hadn't progressed, we started talking about pitocin.

Pitocin is a synthetic hormone administered by IV to strengthen contractions.  I labored for another two hours on pitocin and noticed the surges were coming on faster and more furiously.  Between bouts of tightening and intense breathing, the labor shakes took over my body - forcing me to flail wildly in bed.  I knew we were running out of time and I didn't want my pain threshold to hold me back.  So I told the doctor to order the epidural and crank the pitocin as much as possible without stressing the baby.  She agreed and soon the anesthesiologist was there with her giant needle.

***

Okay so here's my take on the epidural:

Why the hell would you NOT get the epidural???

Those contractions were OFF THE CHARTS and I literally - not kidding here - slept through them.

I SLEPT THROUGH THEM, GUYS.            

Moral of the story:  GET THE EPIDURAL.

***

In any event - after twelve hours of labor my doctor arrived to make the final call.

"You're still only 4 - maybe 5 cm dilated" she said.  "There's A LOT of meconium and I don't want to wait too much longer before we discuss C-section."

Will and I looked at each other, took a deep breath and nodded.

"We tried." I said, the reality slowly setting in.  "Nobody can say we didn't."

After I legally consented to the procedure my family came back in to wish me luck.  I hugged them one-by-one, realizing with each embrace that I'd never, ever had major surgery before.

My Mom was the last up.

"Mommy" I said, a tear working its way to my eye "I'm scared."
She smiled gently.  "You're going to be fine.  And you're going to be a mother."        

NOBODY TELLS YOU THIS SH*T!

Last week was my best friend's wedding and as matron of honor, I had a few tasks.  Wearing a giant orange maternity dress was first among them; followed closely by speech writing, gown wrangling, standing for long periods of time and being on call for pretty much anything the bride needed.

This girl is my ride-or-die chick.  I love her like a sister.  SO despite my condition, I wanted to do absolutely everything I could to make her day special.  Still, I was nervous my size and symptoms would somehow interfere.

Happily, they did not!  My dress fit.  My speech went well.  I wrangled that gown like a BOSS!  And not for one second did exhaustion or soreness get the better of me.  The best part:  I got to be there for my amazing friend on the most important day of her life.

I had done it!  I accomplished everything I set out to do while carrying my precious boy.  Only a few days more and my near-perfect pregnancy would end in gentle coos and long-awaited cuddles.

At least --- that was my reality until the following morning.

I awoke to some skin irritation on my abdomen.  Thinking it was just stretch marks, I got more aggressive with my cocoa butter regimen and went on with my day.

By nightfall, the minor irritation had spread like a raised, red spider web covering my entire stomach and itching me to within an inch of my sanity.  I did some research and was shocked to learn there is actually a pregnancy rash called PUPPS.  The rash affects roughly one in every two-hundred pregnancies - usually first time moms who are carrying boys.

A rash caused by pregnancy?  I had no idea!  Nobody tells you this sh*t!

I wrote an email to my doctor asking if there was anything I could or should do.  She advised there is no known cause or cure for PUPPS.  She then instructed me to use some over-the-counter itch creams and take Benedryl at night.  But by the time my Friday doctor's appointment rolled around the rash had spread with a vengeance.

My hands, feet, thighs and breasts were now covered in RELENTLESSLY itchy bumps that no cream in my possession could appease.  I couldn't sleep - I just paced the floor trying desperately not to scratch my skin from my bones.  When I explained this to my physician, she said the best way to get rid of the rash was to deliver the baby.  Since I'd already reached the 40 week mark, she encouraged us to consider induction.  So together we decided to schedule a slot at the hospital for Monday.

In the meantime, my mom and sister came over to help Will with last minute preparations while I rested up.  We found some natural home-remedies that seemed to manage the pain for short periods of time.  Yesterday I took four lukewarm showers with Grandpa's Pine Tar Soap, drank two V-8's and lathered myself in A&D ointment.  All in all it was a good day but still the rash persisted.

I woke up this morning bloody from an apparent bout of sleep-scratching and found myself conquered by agonizing welts from temple to toe.

Horrified, I called my physician's office and spoke with the OB on call.  She seemed completely disinterested in my plight but begrudgingly agreed to call my doctor for instruction.  About a half hour later, I received a call back.

I was presented with two options - move up the induction to tonight or take one round of steroids.  When I opted for the former the on-call OB sighed.

"You know this induction won't work right?"
"What?" I responded in shock.
"I mean, you're not dilated, your baby hasn't dropped and if you weren't itchy we'd make you wait another week."

I couldn't believe what I was hearing.  I've been nothing but an excellent patient this entire pregnancy.  My doctor KNOWS I'm not a whiner and my only birth plan is to get the baby out safely.  I have no agenda other than to do what is medically wise for myself and my child - so to receive this response was incredibly disheartening.

Sternly, I replied "my doctor and I are on the same page, thank you... and I opt for induction.  See you at four." 

With that, my friends and family - it's showtime.  One more pine tar shower stands between me and my party of three.  And whether this induction takes or ends in C-section, I'm more than confident I'm doing the right thing.

Thank you all for the readership and support leading up to this moment.

I love you all.