Making peace with my beautiful 'plan B' epidural after 20 hours, prodromal labor, and painful cervical checks

Melanie

I tried to go into my labor experience with no fear and lots of flexibility. Even thinking that I would have a plan A -low medical interventions, plan B- epidural, or plan C- c section birth. But looking back to be completely honest I was really hoping for an easy low medicated birth, just like my mother had for me. I was actually pretty afraid of the idea of a cascade of medical interventions or me possibly reacting badly to the medications. I was also deep down afraid of pain and the unknown, like just about every 1st time mom in our culture bombarded with scary birth imagery our whole lives. During my labor I had to let go, trust and ultimately forgive myself for using pain medication and not being what I thought of as 'tough or fearless enough' to move through labor quickly without medication.

I had noticed contractions the week leading up to my child's birth and I just had a feeling she was coming soon. On Thursday night I went to bed kind of late around 11am and woke up with contractions around 1am. I tried to go back to sleep but they had become too strong to sleep through. I tried taking a bath to "slow things down" but that only seemed to speed the contractions up. I had started timing them and they were getting closer to 5 min apart. I woke my husband at 3am and he helped me monitor the contractions, finish packing for the hospital/call midwife and doula.  We ended up getting to the hospital around 5 or 6am in the morning Friday. We were excited and I was managing the contractions well with movement, vocalization and counterpressure. At the hospital they confirmed my contractions were stronger and closer together. I labored in the shower awhile and they thought I was close to pushing because the contractions seemed to get closer together and more intense.

They wanted to do my first cervical check, I had never had one in my pregnancy because the midwives said it wasn't necessary if I didn't want it. The check was excruciatingly painful. I yelled out in pain and could barely let her check me. She reported that the baby's head was already +1 or 2 station which means she was already coming down and out of my cervix. But my cervix still wasn't thin enough and was only dialated 4 cm. At the time I didn't know, but the severe pain of the check for me was probably due to a few factors. 1- I have a tilted uterus, 2- I have an extreamly tight pelvic floor and have had to go to physical therapy for it, 3- to check my cervix she had to reach around the baby's head! The pain scared me so much, I remember crying and asking my husband to please tell them no more checks.

I continued to labor for several more hours and I used pain management with my doula and nitrous oxide. My contractions seemed to slow down. I'll never know if the painful cervical check had something to do with the stall or not, but I suspect it may have had at least a little influence. They eventually tried giving me a narcotic pain medication to rest briefly and got me up to walk the halls for about an hour but it didn't seem to move things along.

They did another check at some point and put something under my butt to help elevate my uterus and it was still very painful but more doable. I had not progressed. I remember a doctor saying to the midwife, I'm sure without meaning to do harm, that she was concerned that if I couldn't handle the cervical checks I would struggle with pain of transition phase and birth. Her words were disheartening and scared me even more. I was exhausted by then, it had been almost 20 hours and I couldn't manage my contractions pain well anymore. I had barely eaten, barely slept since Wednesday night. It was now very late Friday night. I had no concept of how much time had passed at the time. I just knew I was struggling. I was angry with my body for "not working right" and afraid of intervention that could lead to c-section.

They gave me some options including going home with meds to sleep and see what happens, breaking my water or giving me an epidural to get rest. We chose the epidural and within a short period of time I was able to relax and my water broke on it's own. We held off on pitocin to see what my body would do and I got to sleep for a few hours. When I woke up they checked me (no pain at all) and I was fully effaced and fully dialated ready to push! My body had finished the work while I was asleep! I thought that was kind of amazing and it restored some faith in my body.

All of the things I was afraid of happening with an epidural didn't happen. I didn't need extra interventions, I didn't react badly to the meds (only slight shaking which was manageable and normal), and I could still move and feel my contractions. I was able to push and feel pressure.

My daughter's birth was beautiful. She came into the world on Saturday at 2:20am. I felt clear headed and present after getting a little rest and taking the pain down a notch. In the room with me. helping me was my husband, doula, mother, mother in law, midwife and nurse. They all had jobs to do. I ended up flat on my back, to keep my pelvis open, with them holding my legs. I waited and did 'laboring down' until my midwife arrived and it was time to push. My midwife helped me know how to push and I focused on her during the pushing with everyone else quiet. In between contractions and pushing there was talking and laughing and excitement. I reached down to feel my daughter's hair as she was coming out and I found myself with tears of joy and wonderment. My husband was allowed to catch her and guide her out and then place her on my chest. She nursed within the first hour. It was wonderful, calm and exciting for all of us.

After the birth I had some trouble with shame associated with having the epidural and stalled labor. I thought that my experience was all because of fear or weakness that my labor stalled or I couldn't handle it. I did research and learned a little more about what might have happen and I talked and wrote about it. I'm still processing it, but I'm making peace. I am so thankful I had access to a good quality epidural. Epidurals are tools and it's ok that I used that tool along with nitrous and other pain meds to have have a more peaceful and fulfilling birth experience. In fact I kind of wish I had used it sooner. And I might consider using it on purpose if there is a next time. I'm not weak or less of a woman for not having an unmedicated birth and giving birth is still the craziest thing my body has ever done before.

Birth is the ritual of transition into motherhood, and in mine I was reminded of the importance of perseverance, patience, flexibility and forgiveness of myself and my body. I am reminded to let go, make peace with and find joy in the unexpected. And now I have this beautiful child and I'm learning to be a mother. I have a feeling I'll need all of those reminders.