> Alyssa's Story (Due Date: 2007)

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By 36 weeks, my IU contractions had degenerated to a rock hard belly, one constant, never-ending contraction that tightened as soon as I sat up, stood or walked, and loosened only when I lay down in bed—sometimes after just a few minutes, and other times after an hour or more.   By 38 weeks, I couldn’t handle the pain or the fear of what this was doing to my baby anymore and begged my OB to induce me.   After all, if contractions reduced the blood flow to the placenta, what did that mean for my baby if my uterus stayed continually contracted?   And if it was true that a uterus, like any other muscle, could get too worn out to do its job, what chances would I have of a successful delivery if I let this go on for another two weeks?  Luckily, my OB agreed with me.  We were confident of the baby’s gestational age and had done lung maturation earlier on (both my mother and sister had serious lung complications with babies delivered at 38 weeks), so he decided to go ahead with an induction using just prostaglandins to ripen my cervix---he said I was already too good at contracting and he would definitely not use any pitocin.

At 10:30 am, my husband dropped me off at the doctor’s clinic.  I had three bags - one for me, one for baby, and one of just books, a pregnancy book, a birth book, a baby book, and a philosophy book written by a friend.   My husband went off to work, thinking he had a lot of things to do and not very eager to sit and watch me waiting for labor to come on.  My mom had planned to come for the birth, but could not fly because she had swelling and a blood clot from a recent surgery on her knee.  Instead, she stayed home in Los Angeles and kept my two older daughters, who were visiting her for the summer, an extra 2 ½ weeks.  So I was all alone.  The nurse came in and asked for a diaper and the clothes the baby would wear after birth.   I also had to give her my clothes and maternity pads.  It seemed so surreal, since I was not even in labor yet.

A little after 11 am, the doctor arrived and checked me.  Although I had lost my mucous plug over the past week, I was still only 1 cm dilated.  At 11:30 am, he inserted one quarter of a prostaglandin tablet in my cervix.  In Ecuador, they don’t have prostaglandin gel because it has to be refrigerated and is too expensive to stock.  The tablets do the same job but can take longer to act, since they have to dissolve first.   I lay on the table for nearly an hour after the tablet was inserted and felt absolutely nothing.  I called my mom on my cell phone and told her it was not going to work, then resigned myself to going home that night with no baby.  Since the prostaglandin didn’t seem to be working, I decided to stand up.  As usual, my belly instantly turned hard.  And it stayed hard.  I stood, I walked in circles around the room and sat on the sofa...my belly stayed continually hard.  At 2 pm, I asked the doctor if everything was okay.   The baby’s heart rate was up, but still within acceptable range.  I was 2 cm dilated, and the doctor inserted one more quarter tablet of prostaglandin.  Since I still wasn’t in labor, I convinced him to let me have something to eat, and at 3 pm my husband dropped off my lunch.  Not long after I finished eating, my neighbor stopped by.  We chatted for a while as I sat on the couch, rubbing my back.  My belly was still continually hard.

At 4 pm, my neighbor left for a business appointment, promising to come back in an hour and stay with me for the birth.  I got up to go to the bathroom and then suddenly started to bleed.  The doctor checked me again and I was nearly 4 cm.  This time I knew we didn’t need anymore prostaglandin.  “Now we can say we are in labor,” the doctor said.  The nurse came in with an enema, and I begged her not to give it to me.  I already had a feeling that things were going to go fast.  Over the next 15 minutes, I went to the bathroom two more times, without the help of the enema.  I realized that my labor was progressing, but not like any normal labor.  I did not have regular contractions that were any minutes or seconds apart.  I just had the same, long contraction that grew more and more intense, deeper and deeper in my pelvis.  There was no space to escape the pain, no break to catch my breath.  I remembered my two previous deliveries.   The first was in a small third world town where pain medicine was not an option.  In my second delivery, I asked for an epidural so late on that my daughter was born before it took effect.  This time, I knew that I needed help and I had to ask for it now.  I called the doctor back in and told him to get the anesthesiologist, who was his wife.  My husband called on the phone to say he was going to get a haircut.  I told him I’d ordered an epidural and maybe he should come.  The pain continued to get worse.  My contraction grew tighter and tighter.  I walked out of the room and into the hall of the little clinic.  I walked in circles.  I banged my hands against the wall.  I imagined the anesthesiologist at her house, in her car, stuck in traffic, wherever she was, wondering when she was ever going to get here.  I went to get my OB, whose office was just on the other side of the double doors of the little clinic and told him that if his wife didn’t come soon, the baby would be here before her.  He looked at me in surprise.  Only a few minutes had past since he’d called her.  “You really are in pain, aren’t you?” he said.

Finally, the anesthesiologist arrived. The first thing I told her was, “I have to throw up.”  There went my lunch, but when they’d said I could eat, no one thought I was going to start labor so soon and progress so quickly.  The anesthesiologist told me to put on some plastic shoes to walk into the operating room, but I couldn’t concentrate on anything other than the pain.  My uterus was getting harder and harder.  The doctor said she’d wait to insert the epidural when I was in-between contractions, but my contraction never ended.  The pain just stayed continually, getting harder in waves, but the waves were so close together and never really let up that I couldn’t say when I had a break.  I felt like screaming at the doctor to just get the shot ready quickly and put it in.  I could hardly sit still.  My water broke over the table as she was sticking the needle in, and I was sure that the epidural had fallen out.  The OB checked me and the water to make sure it was clear. I was 6 cm.  The anesthesiologist told me to get up and walk.  She would not give a heavy epidural or one that limited mobility, because she did not want to slow the labor.  I knew that nothing would stop it.  It was going way too fast!  I was beside myself with pain.  The epidural felt like it had done absolutely nothing.  I just grabbed onto the anesthesiologist and cried.  I held onto her so tightly that I wouldn’t let her move.  I had never met her before, but I figured it was her job and she would just have to stay there with me.  I cried and screamed with the pain of this one long contraction that would not stop.  The anesthesiologist was stunned and kept asking “Where’s the husband?  Where’s the husband?”  I was in too much pain to answer.  Since the day the pregnancy test came back positive, my husband had told me how much it would hurt and that he could not bear to see me deliver.  And I was in so much pain that no words other than screams would come out, and there was no way that I could have walked back to my room, found the cell phone, and called my husband to tell him to come.  I just held onto the anesthesiologist and cried.  Her husband, my OB, was already worried that I was starting to want to push.  “With these kind of contractions, you can go very quickly,” he said.  He wanted to check me, but I refused to lie down because I thought it would hurt even more.  I didn’t know if I had to push or I had to scream.  I still didn’t have any contractions that were any minutes or seconds apart.  It was just that one, same long contraction I had had since 36 weeks, that kept getting more and more intense, with waves of sharper and sharper pain.  I begged and begged for more pain medicine.  I told the doctor nothing would slow down my labor, and if more medicine did, I didn’t care.  I didn’t care if I had a C-section or anything else.  I just couldn’t handle the pain.  Finally, I convinced her to give me one more dose.  We sat back down on the operating table and she checked my epidural.  It had come out.  There was nothing else they could do.

After that, the nurse and the doctors told me I should go lie down.  Even though it sounded so painful, I was exhausted.  I actually wanted to sleep.  I walked over to the room and lay down on the bed.  Before I could even think what was happening, the doctor checked me one more time and said, “You’re 10; it’s time to go push.”  They’d tricked me into lying down so he could see how dilated I was.  And he was right.  I couldn’t believe it.  We went straight back to the operating room and I screamed and pushed.  I told the doctor I didn’t care if he had to do an episiotomy (which at my appointments I had made him promise not to do, unless truly necessary.)  “That was all throat,” he said about my push, “You accomplished absolutely nothing.  I need you to be quiet and concentrate on getting the baby out down low.”  I’d honestly enjoyed screaming and was kind of miffed when he told me it was no good.  “Fine,” I thought.  “I’m getting this baby out!”  I really couldn’t handle a second more.  I pushed again, this time without screaming, but really trying.  “Two more pushes like that,” the doctor said, “and the baby will be out.”  Two more pushes!  Even that sounded like a lot, but he was right.  “It’s a girl,” he said.  They put the baby on my tummy, but I couldn’t even take her because I was shaking so badly.  She was born at exactly 6 pm, with no episiotomy and no tears.

A half hour later, I was back in the room and could call my husband.  “It’s a girl,” I said.  “And why didn’t you call me before?” he asked.  At 7 pm, my neighbor came back, only to find my husband in the room holding the baby and me in the operating room having my tubes tied.  They had to give me a new epidural, since the first fell out, probably as soon as it was inserted, when my waters broke and I thought it came out.  I was so worn out that the doctor didn’t make me change into a hospital gown and operated on me in my nightgown.   He started to make the incision below my belly button and I screamed.  “You can’t feel that,” he said.  I assured him I could.  “Then move your leg,” he said.  I picked up my leg.  The new epidural had only taken on one side of my body.  I guess I was just meant to feel pain.  The doctor ordered a general anesthetic into my IV to make me kind of woozy.  Within 45 minutes, I was back in the room with my baby, unable to move from the waist down, but I could still hold and nurse my baby.

When my first daughter was born, I had Dengue Fever.  My weakened immune system led to eclampsia during the delivery.  There was no one to help me recover afterwards, and I continued to get worse.  I hemorrhaged, my episiotomy came unstitched and infected, I developed mastitis in both breasts, and finally my condition turned into post-partum sepsis.  I returned from Ecuador, where my daughter was born, to the States, where an idiot doctor gave me an IUD at 3 months postpartum.  I bled for 11 ½ weeks after delivery, and an IUD is contra-indicated when uterine infection is present, and I am pretty confident that all that is what caused my IU in the second pregnancy.  The third time around, I’d still hoped for an easy, enjoyable pregnancy.  It started off with placenta previa and by 20 weeks the IU kicked in again.  At 36 weeks, the IU turned into a hypertonic uterus, and in the end I realized that because of my history an easy pregnancy would never be possible...

But today Miriam is totally healthy and so am I.  I have 3 beautiful girls.  Not one of their pregnancies or births was what I dreamed, but in the end I guess it doesn’t matter.  As difficult as the 9 months were, we have the rest of our lives together.