Thoughts on Labor and Delivery #2: Induction

Dutifully and optimistically we made our weekly pilgrimages to Tripler Army Medical Center, waddling approximately 8 miles each time because that hospital is insanely confusing (who decided to divide the place into Oceanside and mountainside?! Honestly, it’s an island; every side is Oceanside.)

At the 40 week visit, we had a scare for low fetal heart rate, but we were sent home after babygirl perked up and tested out.  5 days later she started moving around a little less and we just didn’t feel good about it. After dinner, we optimistically threw our go-bag in the car (more on that later) and in the process greatly alarmed our already tense pit-bull who was convinced we were moving out without her, never to be seen again. 

We sat for hours with other rotund women on uncomfortable chairs in a fluorescent – lit waiting room while some ridiculous Eddie Murphy movie from the 90’s played on the TV at a volume that demanded attention.  By the time we were called in to be assessed, I was ready to go home to just take a nap and see if that made me not pregnant anymore. 

Around 10 PM, we got called back and strapped up to a monitor for my contractions and for baby’s heart rate.  After watching the lines dance up and down for 30 minutes it was determined that baby’s heart was beating faster than it should.  The resident came to talk to us and stated, “It’s not alarming, but if you are open to it, we would like to admit you and start an induction tonight.”  For all my big talk of wanting baby out, suddenly, I was terrified.  PIC was celebrating that it was finally happening and we were going to meet our little girl… which I almost ruined by telling the resident I would rather just go home and not have to ever labor.   That’s still an option at this point, right?

We sat and listened to the consent process (basically, I give the doctors permission to help me deliver a baby…which naturally begs the question, what is the protocol if people don’t consent?  As I had forced myself to accept – labor is pretty much a given.), got an IV and were issued a pink hospital gown with holes in places strategic for breastfeeding and just modest enough to make you feel covered if you lay perfectly still in a hospital bed and only have people you know very well in the room. 

This rather unflattering picture of me was taken immediately
after donning the official hospital gown. Admission!

Depending on the state of my cervix, we would have two avenues for initiating labor: mechanical or medicinal.  Mechanical is used when almost no change has already happened – a small balloon on a tube (known as a foley bulb if you care… it’s the same thing as a foley catheter, just a different orifice. Thank goodness for Dr. Foley!) is inserted and then inflated and the pressure on top of the cervix tricks the body into thinking it is a baby head causing the assault.  Medicinal is used when the cervix has already begun to change – it is a synthetic version of the hormone the body naturally produces in labor.

Of course my cervix had done nothing, so we got to do the “fun” one.  I was warned it would be a painful procedure… essentially someone has to reach in, pull the cervix forward and insert something through it.  None of these are pleasant sensations. 

I am not sure when it started, but my mechanism for coping with stress is to chatter incessantly. When I got my belly button pierced (over 6 years ago now, but my parents know about it now that it has been closed for 5 – so I can mention it in a blog post!) I ranted to the piercing artist about the ridiculous standards set by our society that I feel the need to punch painful holes in my body in order to feel beautiful.  He was unmoved… appropriately, I suppose, given his profession. During my first tattoo, I explained the necessary autoclave procedures for the equipment to ensure that I didn’t acquire a life threatening infection.  The two individuals lucky enough to accompany me on these endeavors informed PIC that they would pay him for sound bytes from labor.  Luckily, he was too distracted to comply, but I believe he did make mental notes for sharing later.

I employed this same method during balloon placement – it was less than ideal for 2 reasons: 1. You don’t really want someone with a grip on your internal organs giggling at you. 2. It was probably distracting.  I apologized to him for my noise.  I told him if he takes issue with it, he could blame my parents. When I was a small child and said things sometimes they laughed and thus reinforced my belief that I was funny.  There was no going back.

What the balloon lacked in pleasantness, it made up for in efficiency.  Almost immediately I started to contract. They were pleased with my progress and got some hormones flowing through my IV.  Let the labor begin.

At this point, I had been having contractions for over a week– and they had never hurt! So obviously I was just a unique specimen who had evolved beyond the pain of birth.  I was a maternal glowing warrior. Nothing could hurt me! As one OB had put it when I expressed my confusion to her – maybe I was just built for having babies. Another line for the resume!

That changed. 

Quickly.

It started as about 2/10 pain. Then 3, then 4.  Think really bad period cramps.  For guys reading this looking for a point of reference – like needing to have a bowel movement: one of those ones so big it gives you cramps.  But it won’t go away.  So its like needing to have a BM in the middle of a long run. In a public place.  A very clear sensation that something needs to get out, but no easy way to accomplish that. 

Ironically, this experience also gave me a point of reference of what it is like to be a male.  With the balloon in place, I was still able to get up to go to the bathroom.  When I finally decided it was time, I had the nurse unhook all my tethers and gathered my bathroom entourage (made necessary by the IV / IV Pole / 2 different monitors strapped to my stomach/ general limitations caused by my shape) and stood up.  I still had the tube from the balloon dangling between my legs.  I was not anticipating this sensation and expressed to the room at large “so this is what it feels like to have a penis”.   Apparently it was the first time they had heard that particular observation.

After returning to my bed, I settled into an oxymoronic comfortable pain. I was able to fall asleep.  I drifted off, once again reassured in my ability to get through this.

Of course, this delusion was quickly shattered by a nurse who came in and told me that my contractions had spaced out a bit and decreased in strength.  Time to crank up the medicine and yank on the balloon.  Nah, that’s ok… this level of pain is working for me currently, let’s just see if it makes the baby come out without making it worse.

Cue immediate low back pain.  Severe low back pain.  I placed two tennis balls under my low back to help provide counter-pressure which gave some small degree of relief.  I explained my discomfort to the nurse and asked for a heat pack for my back.  She helpfully responded that “back labor is the most painful kind of labor” and then got me a heat pack and said “you poor thing” as she helped me get it situated. 

She was, however, impressed by how much she was able to pull on the balloon.  Generally, it comes out after the cervix has been dilated to 4cm.  This tends to take anywhere from a few hours to 6 hours. Mine had been in place for only 2 hours – but apparently it was “loose enough” that she thought it could come out.  From what I understood, during the process you dilate and sometimes you dilate enough that it will just fall out on its own without any prompting in a painless unnoticeable little plop.

This nurse had a different opinion. “Let’s just give it a gentle tug and see where we are at.” Painful tug. “Oh, I think it could probably come out now.” Painful tug. “Let me know if it becomes too painful.” TUG THAT WAS PAINFUL ENOUGH TO MERIT CAPITAL LETTERS and also caused the rest of the uterus to hurt in solidarity.

Me: “That hurts.”

Her: “It tends to be a little uncomfortable for everyone at this point.” (Still pulling)

Me: “THAT REALLY HURTS”

Her: “This is a sensitive point for everyone I think it can come out.”

Me: “WHY ARE YOU STILL PULLING? IT REALLY HURTS AND I DON’T WANT YOU TO ANYMORE”

Balloon comes out, end scene.

Ironically, at the next cervical exam, I was only at 3 cm. … So ostensibly, it wasn’t ready to come out, but apparently my cervix is no match for an ambitious nurse who felt it was “time”.