intensely trivial


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Disappointment

Well, it’s a good thing I put a question mark at the end of my last post: “Labor?” Long story short, Sondra wasn’t in labor. I’m back home now.
Here’s the long version: The drive out to Sondra’s town 45 min. away is very quiet and dark at 3:30 a.m.; good thing I indulged in my worst doula vice when I was pumping gas: a 44-oz. plastic cup of Diet Coke. You do what you have to. Boy, was I a fabulous, loud singer on the way out there!
Vince, Sondra’s husband, let me in the front door of their darkened house, and I found her upstairs, laboring in their bedroom. Lying down was not comfortable. In order to keep the Sondra’s mother-in-law, sister, son, and her MIL’s three yappy dogs from awakening, we moved downstairs. I did my doula thing: helping Sondra stay focused during contractions, coaxing her to eat and drink, encouraging her, encouraging Vince to sleep when he could, because it was going to be a long time. I thought she was probably in early labor — which can last a long time. Sondra was already vocalizing through contractions; I hoped this meant that they were very strong and there would be a baby relatively soon. Vince was ready to take Sondra to the hospital, but she was still too much in her thinking brain to be in really active labor, and she wasn’t having any bloody show, so I tried to bring things down to a patient, energy-conservation mode. Sondra’s hope was to labor at home until close to the birth, so she wouldn’t have to be hooked up to monitors and tubes any longer than necessary.
Soon, we heard birds tweeting, and the darkened windows started turning gray, then white, then bright blue. The rest of the household slept till about 8:30, which was restful for Sondra. Vince slept off and on near Sondra, while I stayed with her constantly. Contractions seemed to be intensifying; Sondra was working harder. An attempt to get into hands-and-knees position so that she could drape herself over a birth ball and possibly doze turned into a bruised knee that plagued her the rest of the day.
Then the sister and mother-in-law and three-year-old and Facebook friends woke up and started watching and inquiring about the birth. It was hard to keep Bryan quiet, and that was bugging Sondra, so Grandma took him and Sondra’s sister elsewhere to play for several hours until such time as Sondra would leave for the hospital.
Hours passed. By 11 a.m., things were difficult. Sondra had spent multiple hours in the bathtub, with me pouring water over her belly and back. Vince learned how to support her better. I tried to get Sondra to eat and drink. She drank about 1/4 cup of apple juice and ate 3/4 of a granola bar, and throughout the 12 or so hours I was with her, she drank maybe 2 cups of water. I knew this might be a problem, and I told Sondra what I thought, but she was nauseated (even threw up once) and it didn’t sound good to her. I kept thinking if she would only get some rest, hydration, and food, labor might get going. As intense as it was for her, it didn’t seem to be productive. Contractions were spacing out, and I wasn’t seeing any of the telltale signs of progress, like bloody show or spontaneous rupture of membranes.
Finally, I convinced her to try to sleep. With several pillows and some bossy talk from me to give it at least two contractions before she wrote off the sleep idea, Sondra did drift off into a snoring sleep. About every 10 min., she’d have a contraction, moan through it, and drop right back to sleep. I knew she was exhausted. I believed her body would not give birth without healthy levels of food, drink, and rest.
After about 45 min. of napping (with 4-5 contractions), Sondra woke up, discouraged. She was tired of the pain; she wanted to get the show on the road; she wanted to know if she was dilating. Even though she had wanted as natural a birth as possible, she confronted the possibility of being disappointed in herself, and her husband’s potential disappointment in her, and she decided to go to the hospital and ask for an epidural. We packed up, painstakingly got her in their minivan (moving can be hard for any woman in labor), and set out for the hospital, 20 min. away.
Arriving at the hospital, Sondra was put into a wheelchair, by her choice, and wheeled up to labor-and-delivery. I went with her while Vince parked their van. The nurse who admitted her to triage sounded skeptical of Sondra’s actually being in labor. Sondra was *sure* she was in labor; what had she been doing for the last 12 hours? The monitors showed a healthy fetal heartbeat and fairly regular contractions every five minutes. When asked her pain level from 1 to 10, Sondra said she was at 10, then changed her mind to 7.
Then a doctor and a midwife came in to do an internal exam. They found that her water had not broken, and she was a “tight 1,” which means she was just barely 1 cm dilated. Those of you readers who have had a hospital birth, you can probably imagine how Sondra felt upon hearing this news. She had to exercise some mighty self-control in responding to that.
So. . . no, the hospital would not admit her. Sondra is going for a VBAC, and this hospital, thank goodness, will not use drugs for induction or augmentation of labor, because that raises the risk of uterine rupture. She could either stay at the hospital and walk around for a couple of hours and see if her cervix changed (walking a couple of *steps* was a stretch for her, though); go home and continue as she had been; take an Ambien and sleep for eight hours, during which time contractions would either mercifully go away, or gather fresh strength and lead to strong, baby-producing labor; or ask for a cesarean. As frantically as Sondra wants to be done with pregnancy and birth, she was not irrational enough to ask for a cesarean. (I’m not sure they would have done it, anyway; she has a cesarean scheduled for July 1 — my thoughts about which I have already hinted at.) She couldn’t continue laboring as before, because she was completely worn out. So she opted for the Ambien.
Now, what is up with all of this??? There were a few of us very disappointed, some angry at the way this fell out. My strong suspicion (and that of the medical staff) is that Sondra was dehydrated and sleep-deprived enough for her body to imitate productive labor, but not actually get much done. (Any of my readers who are childbearing, please, please, please take this seriously.) Dehydration can cause contractions strong enough to make your baby be born premature. It can lower the amniotic fluid level enough to make your doctor want to induce your labor immediately. Dehydration is bad. (Sorry — I am very sleep-deprived myself and can’t think of a better way to phrase this.) And sleep-deprivation is bad, too. I know it’s hard to sleep when you’re heavily pregnant, but for goodness’ sake, make it a top priority to try — especially in labor, as counterintuitive as that sounds. Laboring women *can* get sleep, even if it’s only in snatches of a few minutes here and there.
So Sondra’s home tonight — angry and disappointed and embarrassed, too. She’s been ordered multiple times, by multiple people, to drink plenty of fluids first thing, then get into her bed, and take her little white pill (I’m not a big drug fan, but in this case, I think it will be very helpful). I ordered Vince to make sure she drinks enough. With proper care, her body should either stop contracting or ramp up and really get something done once she’s refreshed herself and her baby.
And me? Well, wow. I’m disappointed, too. I couldn’t know for sure how dilated she was, although I had my suspicions. Checking her cervix is beyond my scope of practice, and I wouldn’t do it, anyway, even if I were a midwife now, unless there was a good reason. I’m terribly tired and, like Sondra, I’m frustrated that all that work (mine, too) did not bring a baby. I wouldn’t have left her side once I was there, because that’s not what a doula does. I’m unspeakably thankful that my kids got to spend the day with their dad, whose generosity toward me supports my generosity toward others.
This is the gritty side of doula work: walking through repeated disappointment with people, spending your time, gas, and energy in extravagant ways, fighting battles with women against maddening odds, because that’s what you believe in.

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Trackbacks & Pingbacks

  1. Michael’s birth « intensely trivial pingbacked on 7 years, 4 months ago

Comments

  1. * Terri says:

    I am feeling your disappointment! What a night and day for all of you.

    I am also now drinking a glass of water. šŸ™‚

    Posted 7 years, 5 months ago
  2. * carmen says:

    Oh, I commented on the wrong post…My tears are after this one. Oh, and I’m still worked up about that “maybe this is God’s way of saying…” comment. God give her strength!

    Posted 7 years, 5 months ago
  3. * shelley c says:

    Rest up, Rachel! And three cheers for Dan!!! I wish Sondra could know just how much we are all rooting for her!

    Posted 7 years, 5 months ago


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