The Birth of Roman: Part III

At 3:41 pm on Wednesday, November 25th our nurse, Alice, checked me again and I was 9.5 cm dilated. She called the doctor and rolled in all the equipment for pushing. Dr. G arrived and checked me again and said there was still a cervical lip. Both my mom and sister had a cervical lip for awhile, so I wasn't surprised. I rotated back to my left side and waited some more. An hour later Alice checked me again and there was still a lip. Our families started placing bets on when the baby would be born. They joked how Brad and I were both born around the 6 o'clock news, so that had to be when this baby would come. A lot of "had to be's" never came true, we should've known the house always wins. Alice upped the Pitocin and as we waited, Brad told everyone what he was most excited about when he meets our baby for the first time is looking into his or her eyes. Those little moments in between the madness is what I never want to forget.

By 6:05 pm there was a new doctor on call and he came and introduced himself. He was a resident, and a male, two things I didn't really want, but it was the night before Thanksgiving so our options were limited. I repeated to him as I had repeated at each change of shift the 4 things we wanted most out of our birth: Delayed cord clamping, no episiotomy, immediate skin to skin, and for Brad to be the one to announce if it was a boy or girl. Dr. E said that was all fine and he checked me again. I was STILL 9.5 cm so we waited. And we waited. And we waited.

At around 6:30 pm the door creaked open and a familiar face poked his head in. It was my dad! It was supposed to be a surprise that he was coming, but Brad had asked my mom in front of me when he would get here, so I knew he was on his way. We smiled at each other, as he gave his usual, "Hey girl," and he made his way over to my bed.

"Brad, is that your breath!?" It was one of the most awful smells I had ever smelled and it didn't help that I was in labor. My mom was standing behind my dad and pointing right at him.

"Dad it's YOUR breath!" I almost gagged.

"Oh, sorry. I just had chips and salsa," he laughed. Good choice, Dad.

My family was in and out the next few hours while Brad and I literally set a timer on my phone for every 20 minutes so we could hit the pca button to boost the epidural as soon as possible. I didn't want to feel that pain again. Alice checked me again at 9:10 pm. By this time the 6 o'clock news had come and gone and the birth equipment that was set up so long ago was staring back at me and reminding me of all my failures thus far. Failure to have a home birth, failure to have a natural birth, failure to progress. They would have to wipe the dust off that had accumulated if I ever got to pushing. I still had an anterior cervical lip, but it was loosening around the baby's head and she could push it up a little. The baby was still looking great on the monitor, and I never got a fever. Alice increased the Pitocin to 16.

Around 10 pm, and still at 9.5 cm for the past SIX HOURS, the attending physician came in to our room and told us we needed to have a c-section because I wasn't progressing. Brad was furious that she had waltzed into our room and suggested a c-section before she even examined me. She checked me, roughly, and said there was still a cervical lip all the way around and I needed the c-section. Here it was, the moment I feared. The moment when our wishes and the doctor's wishes would collide and there would be conflict. I hated conflict. Thank goodness I had Brad. Brad always says in that moment, after being awake for about 29 hours straight, he never lost his decision-making ability, just his patience. 

"Can I speak with you outside?" He asked the two doctors sternly. 

"No," said Dr. R, "she's the patient and she's the one that has to make the decisions."

We told them how we didn't understand how our nurses who had been taking care of me all this time told us I only had an anterior cervical lip, and that it was softening, slowly. Then she comes in and tells us I have a lip all the way around and I hadn't progressed for the past 6 hours. Something wasn't adding up. I asked Dr. R if we could have a moment to talk about it, and she said of course. The doctors departed and it was me, Brad, my parents, and Alice left in the room. 

"How long have you been doing this?" My dad asked Alice.

"21 years [if I remember correctly]," Alice replied.

"And what are your thoughts on this situation?" He pressed on.

"I would be comfortable giving it a little more time." You could tell she felt a little awkward disagreeing with the doctors. "The baby is doing great on the monitor, and her cervix is much softer now, so I don't see a problem with waiting."

My mom was visibly agitated and upset. She doesn't hide her emotions very well. Another thing I inherited from her other than my stubborn cervix. 

"Please don't hurt my baby," she pleaded with Brad. 

As if everything we had gone through wasn't uncomfortable enough for me, my family was now split down the middle. We had my mom, Brad's mom, my sisters, and the doctors on the "c-section team". Then there was me, Brad, my dad, and the nurses on the "waiting team". Our baby had never shown any signs of distress so far, I didn't have a fever, and I was finally on top of the pain. We called the doctors back in.

"If I sign the refusal to have the c-section now and I needed one later, I could still get one, right?" I asked Dr. R.

"Of course," she replied.

Much to the dismay of my mother, I signed the piece of paper that said if me or my baby died, then the hospital wasn't liable because they told me I needed to have the c-section. It was just the first of many important decisions I would have to make as a parent when all the options seem bad. Of course I wanted my baby to be safe and healthy, but I also wanted to be safe and healthy and I knew a c-section was a major surgery. I told Brad if I would've consented to a c-section then, I would've wondered for the rest of my life if I would have dilated to a 10 and been able to push my baby out. He supported me 100%, and in that moment I knew he loved me more than he loved himself because it would've been easy to tell me I needed to listen to the doctors and have the operation. It would have been quick, it would have been over. But he didn't. He fought for me and for what I wanted. We really did give birth together. 

At 11 pm there was another change in shift and we had to say goodbye to "the closer", Alice. She wished us luck and handed us off to the next nurse. I was ecstatic when in walked my mentor and good friend, Meagan. I followed Meagan for 3 months during my last semester of nursing school, and she was one of the smartest nurses I knew. I knew we were in good hands. She checked me right away and I watched her face, cautiously optimistic.

"No lip here, no lip here, no lip all the way around. You're complete!" I loved her even more in that moment. I was finally 10 cm! "I'm going to let you labor down for awhile, you're still at a +1 station and we like to be at +2 before we start pushing." Brad practically ran out to the hallways and waiting rooms to announce to our families that I was a 10. Baby Lepper would be here soon! 

Midnight rolled around, FOR SURE the baby had to come today. I had forgotten that it was Thanksgiving, I was focusing on trying to relax and let this baby's head come down. I was starting to feel a lot more pressure, like there was a bowling ball between my legs. It was a deep, heavy feeling, but I welcomed it because I knew that meant I could start pushing soon. At 12:50 am Meagan checked me again and I was a +2 station. We did a few test pushes, and she decided it was time to call the doctor and start pushing. I asked her if I could bear down a little with each contraction while we waited for the doctor and she said yes. I was going to be the best dang pusher they ever saw, just wait and see. 

At 1:25 am Dr. E gowned up, and the room filled up with nurses turning on the warmer, flipping on the spotlight, and putting my feet up in the stirrups. I had a surreal moment right before I started pushing where I was sitting up on the bed, legs spread eagle for all to see (it's true, you really don't care), looking around at everyone in the room and thinking about all the times I had been there. How many births had I attended as a nurse and a doula, and now it was MY turn. So this is what it felt like to give birth. Well, I couldn't feel anything from the waste down, I was making sure of that. Meagan removed my catheter and everyone took their places. There was a second wind of energy as I started pushing for the first time, it was finally time to play an active roll in this birth and I was going to own this. Meagan counted to 10 and Dr. E coached me with Brad on my left side as I pushed with every ounce of strength I had left. My eyes were bulging out of my face as I held my breath, but I didn't care if they popped out of my head at this point, I was going to push this baby out. 

It felt strange holding on to the back of my numb thighs as I pushed. It was like holding on to someone else's legs while trying to give birth. I remember looking up at my right foot in the stirrup. The pedicure I had gotten at 39 weeks pregnant with my friend was starting to chip off, and my legs I had meticulously shaved every day for this moment were starting to grow stubble. Oh well. My right foot was so swollen I had to look away. I would deal with that later. In between contractions I was smiling and laughing. This was awesome. Brad was there, encouraging me, reminding me to push my button, and getting me sips of water as I was breathless from pushing so hard.

"Easy on the water," Dr. E warned. I knew he didn't want me peeing on him, but I really didn't care. I was trying to push out a baby here, give me a break.

We tried different pushing strategies between holding my legs, playing tug-of-war with a sheet, and grabbing on to the handles on the bed. I knew that it can take 1-3 hours for a first time mom to deliver her baby, so I wasn't concerned until Dr. E started sighing and shaking his head after I would push. Was I a "bad" pusher? Oh no, I would not let that happen. I dug into the stirrups, praying for the strength I needed to move this baby. I was getting extremely fatigued, but I wouldn't let Brad or the doctor know. I could do this, I know I could. I closed my eyes and rested my head between contractions as I tried to recover.

"So...what is everyone thankful for?" I asked the audience. It was Thanksgiving, after all. They chuckled softly. Rough crowd, I thought.

After about an hour of pushing and Dr. E sighing and shaking his head he said, "I think we need to look into a c-section." HA! Ya right, I did not just go through 46 hours of labor and get to pushing to end up in a c-section. No way. I basically ignored him and pushed on with each contraction. 

"Harder, HARDER!" Dr. E yelled as I was bearing down. I was already giving it all I had, I couldn't push any harder! "The baby is not moving at all, and you're pelvis is really tight. I really think we need to talk about a c-section," Dr. E pressed me.

"But I thought it was normal to push this long," I said.

"It's normal for a first time mom to push for a few hours, but it's not normal for the baby not to come down," Meagan explained. I kept pushing anyway. Everything I believed about birth was starting to come unraveled. I knew it was extremely rare for a baby to be too big to come out. True cephalopelvic disproportion was more common in the Victorian age when women never went outside and they didn't get enough Vitamin D for their bones to develop properly. I had certainly spent enough time in the sun, I was young, and I was healthy. Why wouldn't this baby come out??

I pushed and I pushed and I pushed. Brad could see the head, and there was a lot of hair. We proved the doctors wrong when they said they didn't feel any. We also proved them wrong when I was able to get to 10 cm. Maybe I could prove them wrong again and push this baby out. The doctor left the room after 2 hours of pushing, yet I wouldn't give up. I turned myself around in bed, and got my numb, wobbly legs up under me and started pushing on my hands and knees even with an epidural. 

"Is anything happening!?" I asked. The pressure was getting more uncomfortable the longer I pushed.

"No, baby," Brad replied. "The head comes to a point and then stops, it won't budge past that point."

I pushed and I pushed and I pushed for another 30 min before the doctor returned. I was still on my hands and knees, gripping on to the back of the bed.

"Do you see this heart rate?" He asked, pointing to the fetal monitor. He was done messing around. "Tell me what this means." He knew I was a nurse and I looked up at the screen. After about 24 hours in the hospital, the baby's heart rate was looking "flatter", and starting to dip which can be indicative of stress.  

"It's less reactive," I begrudgingly answered. I didn't like him patronizing me, but I could see what he was seeing.

"Hannah...," Brad grabbed my hand. I flipped back on my back and looked at him. I knew that voice. That, "we need to talk" voice. 

"No no no, don't you give up on me!" I begged him. It felt like the rest of the world had, I couldn't lose him, too.

"Hannah the baby isn't moving, I don't know what else we can do," he apologized. He knew this was breaking my heart.

"It's not moving at all? Like, not even a centimeter?" I was grasping for straws.

"No, not at all." By this time everyone had quietly left the room and it was just me, Brad, and Meagan. "Fine, whatever," I said defiantly. Meagan left to tell the doctor. Brad reached for me and I pushed him away for the first time since my water broke. "No!" Like it was somehow his fault.

"That's fine," he said softly as he sat back down. "You can be mad at me."

I started crying as the reality of what was about to happen sunk in. After 48 hours of labor, 24 hours unmedicated, 2.5 hours of pushing, I had to have the ONE thing I was trying to avoid this whole time. I was okay with transferring to the hospital, I was even okay with getting the epidural, but I wasn't okay with a c-section. 

"I'm never going to get over this!" I cried to Brad. I began the process of grieving the birth I never had right then and there. It was the last few minutes I had with my husband, pregnant, before I was cut open, and my stomach, and my heart, would be scarred forever. We cried together, okay I was bawling. How could we get this far and not finish it? It was like running a marathon only to quit before you run through that ribbon. I could see the finish line, but it was just out of reach. 

At some point Meagan came back in and her and Brad were trying to reassure me as I was attempting to wipe my tears with those crappy hospital tissues that don't absorb anything. I was listing off all the reasons I never wanted a c-section. I knew the 2 hospitals in my town didn't "allow" VBACs, I knew c-section babies can have problems with breathing, latching, and bonding.

"You have to remember you went through labor and labor is good for babies," Meagan encouraged me. It really did help me feel better, a little.

"This is just another thing I'm going to fail at in my life!" I wailed. "I'm never going to get over this Brad, I'm not." 

At 4:25 am the OB, Dr. H arrived and sat on the end of my bed to discuss the c-section with us. She acted as though we hadn't decided to have the surgery yet, and she was trying to convince us.

"The baby's head is too swollen to use a vacuum or forceps, and I wouldn't do it even if you asked. [I didn't want those, anyway] And honestly I'm surprised you're worried about having repeat c-sections in the future instead of the health of your baby."

Ouch.

"We're going to do the c-section," I mumbled. She left the room to get ready and things started moving really fast. I started feeling the contractions again as Meagan brought the faded, green scrubs Brad was supposed to change into.

"No, don't leave me!" I wouldn't let him go to the bathroom. "Why am I feeling these again!? I can't feel these again!" I had started to feel the contractions because when I was pushing on all fours, the epidural wasn't flowing down my back with gravity anymore and it was wearing off. I asked Brad how many minutes until I could push the button again (I was pushing it already, frantically) and he said 11 minutes. Okay, 11 minutes I can do this. "NOOOO!" I would scream as the contractions overwhelmed me. How many minutes now? 9. Then 6, then 2. I pushed the button as the familiar cold wave trickled down my back. Meagan had called the nurse anesthetist again and I was surprised how quickly she got there. She put the medication I needed for a c-section into my epidural and I started to feel much better within a few minutes. Brad went to the bathroom to change into his scrubs, and I grabbed Meagan's hand before they took me to the operating room.

"I'm glad it's you," I said.

"I'm glad it's me, too," she smiled.

They wheeled me out of the room I had been in so long, and I glided by my family, all huddled in the doorway of another labor room. Their faces all looked the same, full of concern, but relieved.

"Love you Han," Kasey choked out. I don't remember if I said I love you back. I had just got done crying and I couldn't start again. I was tired, defeated, and scared.