From "The Bradley Method" Class Workbook
Class 7 Relaxation Exercise: "Positive Expectations"
Work through your birth plan and make all the arrangements necessary as you prepare for your labor and birth. Then write a realistic story together, of your target birth experience. Include as much detail as possible. Make it a normal, realistic progression, but be sure that it is positive and reassuring. Every day this week, read the story to the mother when she is deeply relaxed. Then have her sit up and discuss her feelings. Did any part of the story make her feel tense, upset, uncomfortable? If so, you still have some things to work out. This does not guarantee that you will have this target experience, but it will help you both feel more confident and tranquil about what you are likely to face.
Mid-July - Bradley Method Class 8
Instructor: So, I hope everyone did their homework and did the relaxation exercise from last week?
John: Nope. We didn't want to do that one. It seemed counter-productive.
Instructor: What do you mean?
Heather: Don't you think it's a little bit of a setup to write out your ideal birth experience? You're bound to be disappointed by how it really turns out.
Instructor: Come on, guys! You know how important relaxation and positivity are! Remember, it's up to you! Let me read you a great birth quote from Dr. Bradley: "If it is to be, it's up to me!"
We checked into the hospital quickly and efficiently. Our midwife had told the hospital we were coming and forwarded our medical info, so we were able to go straight to our labor room. Heather labored steadily as we settled in, and I was relieved that her labor hadn't started to backtrack. We had heard that some women get flustered in the unfamiliar hospital atmosphere, and their labor can really slow down.
July - Bradley Method Class
Instructor: Remember, guys, you have the right to refuse ANY medical procedure, okay? So don't let anyone tell you you have to get an IV buff cap, or fetal monitoring, or anything, okay? You can always tell them no, or tell them you want more information before they go ahead.
John: I appreciate the fact that we have a legal right to refuse medical care, but come on. If a doctor tells you that there's an emergency, and you or the baby are going to die if you don't follow their advice, you don't really have a choice. Anyone in that situation is going to take the doctor's advice.
Instructor: A lot of people have that attitude, class, but you always have options. You can ask the doctor what study proves that the procedure you want is medically necessary and safe.
John: But that's my point. Even if he gives you evidence, you can't evaluate it. He can just say, "Oh yeah. It's in JAMA 52:1:35" and I have to trust him. I don't read the New England Journal of Medicine.
Instructor: Bingo! That's why you ask him to show you the article!
Heather: Wait a minute. You're saying that I should ask a doctor to produce a journal article proving that the life saving emergency intervention he recommends is a good idea?
Instructor: Yes indeedy!
Heather & John: Right.
The nurses came in to give Heather her buff cap (a little semi-permanent valve they install on the back of your hand so they can pump you full of whatever drugs they want). Heather and I were annoyed by this, because we had no intention of pumping any drugs at all into her. But our midwives and doula had assured us that it was a waste of time to fight them on this point of hospital policy. If we pressed the issue, Heather would be identified as a problem patient, and then we would be fucked.
It's been my experience that, in a hospital, whenever a needle needs to be inserted into a vein, the nursing staff immediately begins a desperate search for a nurse that is visually impaired, palsied, or mentally enfeebled (if you are insured by Kaiser, they may be able to scare up a nurse that is all three). This is just a "first draft" needle insertion that no one seriously believes will work, so it all happens in a relaxed atmosphere of trial and error, where no one gets hung up on "results", dig?
So while Heather was having contractions, a nurse arrived to insert the buff cap. She had the squeamish, unfamiliar manner of a woman who was just moonlighting at this nursing thing to help pay her way through beauty school. After a few practice stabs, she announced (as tradition dictates) that Heather's veins were very difficult to find. She would have to call in Nurse Patty.
Now, I'm sure that there are some bigots out there that read the name "Nurse Patty", and immediately leaped to some stereotyped image of a huge, overweight lesbian with an unnecessarily gruff bedside manner. You would be correct.
Nurse Patty strode in, took one contemptuous glance at the first nurse, and decisively stabbed the needle home.
And missed the vein entirely.
So with great confidence, concentration, and precision, she inserted the needle again.
And missed the vein entirely.
Not wanting to make a human pin cushion out of poor Heather, she did not attempt to insert the needle again. Instead, she left the 2 inch needle in, and began working it back and forth under the skin of Heather's hand, like a windshield wiper, while Heather continued to have contractions. Luckily, the contractions probably helped put the pain of the needle torture in perspective. (Interestingly, of all the gory carnage I would witness over the next few days, the squirming outline of the needle under Heather's skin was the only thing I couldn't stand to watch). After several minutes of needle sweeping, the nurse was finally rewarded with a gusher of blood that shot up into the buff cap. Success!
Except they had to test it, so they ran some saline through the buff cap. Heather's hand began to swell up like Veruca Salt, but then, mercifully, something clicked into place and the saline began to circulate.
With the painful humiliation of the buff cap over, we were finally able to settle in, so Heather could labor in the way that made her most comfortable and confident.
Well, almost.
First Heather had to endure 20 minutes of continuous fetal monitoring. Fetal monitoring involves having two very tight belts strapped around the mother's abdomen during contractions. This causes a certain amount of discomfort (in much the same way that wearing a metal cock ring while passing a kidney stone might involve a "certain amount of discomfort"). Fetal monitoring technology is a robust and well established field, so it should come as no surprise that the slightest movement will cause these devices to self-destruct.
By this point, Heather's contractions had begun to slow down. I attributed the slowdown to the pain of the buff cap insertion and the pressure of the constant fetal monitoring. Heather suffers from medical monitoring anxiety, to the point where she does a little self-hypnosis routine before using the blood pressure monitor at Safeway. And, sure enough, when the nurses left the room, her contractions started right back up again, as strong and frequent as ever.
Unfortunately, it was hospital policy that Heather needed to be monitored for 10 minutes every hour. So for the next few hours, Heather would labor along like gangbusters (whatever that means) until about 10 minutes before the next monitoring. And then her contractions would begin to space out. A nurse would arrive and hold the fetal monitor against her belly, and say that she just needed to monitor a few contractions. And Heather's uterus, horrified that it might inconvenience this nice young lady, would panic, and not have a contraction for 10 minutes.
As soon as the nurse left, the contractions picked right back up again.
After about 3 hours of this, I called in our midwife for a conference.
John: The thing is, every time you monitor Heather, her contractions spread out. So maybe there's a way we could skip an hour of monitoring, just to let the pressure off a little-
Hagatha: No, no! Absolutely not! I don't think you appreciate the absolute seriousness of this! And, look, if Heather were really in serious labor, her contractions wouldn't be so dependent on circumstances.
Hagatha's lecture continued for several minutes, ending with a suggestion that we should go home if Heather's labor didn't start to pick up. Needless to say, hearing a medical care professional say that Heather wasn't in serious labor did wonders for her confidence, and the contractions grew even further apart. I sat, gritting my teeth in rage, unable to meet her eyes.
Luckily, our doula was an expert in hospital diplomacy, and she was able to broker a deal where Heather would be hooked to the monitors every hour, but the nurses would watch the results from another room. We knew the talks had been successful when our midwife came storming into the room, with our doula following meekly, geisha-like behind.
"Well, we're going to monitor you from the next room now, but since you aren't going to have anyone in here for a while, I think it's time for a vaginal exam."
Vaginal exams are never pleasant, but they're even worse for a woman who is having contractions. She gets the pleasure of being roughly fingered while flat on her back; just about the worst possible position for labor.
After a moment of diddling, Hagatha pulled out her hands, whipped off her gloves and announced (perhaps triumphantly?) that Heather was only dilated to two centimeters. As she left the room, she said with a chortle:
"Okay, I'm leaving. I don't want to scare off anyone's contractions."
To which I responded with an enraged display of silent cursing and flipping off that was so energetic, our doula averted her eyes. Really.
Ten minutes passed without a contraction. The doula and I tried to comfort Heather, who was feeling incredibly guilty and stupid for coming to the hospital too early. She seemed unable to remember the shivering, trance-like state she had been in when we left our house.
Near tears, she got up from the bad and began to plod towards the bathroom, saying "I'm so sorry guys. Maybe we should just go hoOOOOOOOO!"
The doula and I raced over to grab her as she doubled over from a powerful contraction.
Heathers contractions were back, but the damage had already been done. Her contractions were back to being 6 to 8 minutes apart, where they had been 10 hours before.
It took 8 hours for the contractions to build back up to where they had been when we got into the hospital.
I watched the sun rise and set through the crack in the hospital curtains.
I was introduced to 3 different nurses as hospital shifts went through their 12 hour rotations, each nurse assuring us that she would be the one to deliver our baby.
I watched the woman I love endure the terrible monotony of one long contraction after the other. Every 8 minutes. Every 6 minutes. Every 4. With each one I held her hand, or her head, or her shoulders, as she moaned and shook through the obvious pain.
Around 10:00pm on Monday, I was holding Heather's head as she worked through another 2 minute contraction. As I held her, I realized that Heather had been doing this for more than 36 hours. In all those hours she had never complained about the pain, even when she was obviously in agony. And as I thought about how strong she was, and how proud of her I was, I realized that I was crying. And Heather was looking up at me, smiling. And she was crying too.
When we came out of the bathroom, with our arms around each other, Hagatha was there.
"Your contractions look like they're finally on track, so let's see how we're doing."
...
...
"Well, not bad... We're up to 4 centimeters."
If this were an episode of 24, this is when the clock would appear:
<boop> 39:59:57
<beep> 39:59:58
<boop> 39:59:59
<beep> 40:00:00
Wow John! What an ordeal! And thanks for bringing back the horrible memmories of the last time I passed a kidney stone with a cock ring on . . . talk about bad timing!
Posted by: Chris Boeckx | August 31, 2006 at 09:08 PM