Mon 28 Jan 2008
Isabella Granick Stone and Calista Granick Stone were born healthy and squealing on December 8th, 2007. Here’s how it went down:
On December 7th, my doctor called to inform me that my test for preeclampsia came back positive. Preeclampsia is a pre-seizure condition marked by high blood pressure and protein in the urine. The cure is delivery of the baby. So now I had a medical reason for induction, and I went in to the hospital later that afternoon.
Given my condition, we all expected the induction to take quite some time. Instead, they gave me a hormone to “ripen” the cervix and that sent me into full fledged labor less than an hour later. I think they gave me a quick release rather than slow release dose by accident. I also think I was ready to have the babies, as I was at 40 weeks and 5 days.
After a difficult hour or two, I settled in and spent the next 10 hours in unmedicated labor. I remember it as the same 5 minutes over and over again. Sleeping, noticing pain, breathing and moaning 5 times, pain receding, breathing and moaning 5 times, falling asleep again. Early in the morning on December 8th the anesthesiologist came to put in the epidural needle “just in case” it was needed. There were several scenarios where I definitely wanted the epidural, including a breach delivery of Baby B. However, getting the epidural in wreaked my concentration and resulted in a pretty painful 45 minutes as I tried to find a position that exposed my back for the doctor, but was also comfortable enough for managing the pain. Once that was done I tried to settle back into my pattern, but I’d lost my concentration and was getting close to 8 cm dilation. I got the epidural at about 7AM.
It was odd after the night of contractions not to know if I was having one, and to be sitting there chatting with Brad but knowing I was in labor. It was nice not to be in pain, but it was a strange disconnected feeling. At around 11A, the doctors came in to tell me that it was time to push the babies out, a process for which Kaiser requires mothers of twins to be in the operating room.
The operating room has a lovely view of the city, and when I got there there was a blimp lazily floating above the houses. I was to look at that view for the next 5 hours as I attempted to push out Baby A. The problem was that my contractions were six minutes apart. So even though I was pushing very effectively, the baby was sliding back in the interstitial period. I needed more contractions. First I agreed to pitocin, but that didn’t work. Next I wanted to stand up to allow gravity to help me, but I wasn’t permitted/able because I’d had the epidural. The nurses suggested other potentially helpful supported positions, but those did not work.
I believe the problem was that I was on magnesium sulfate for the preeclampsia, and that is a muscle relaxant. Taking a muscle relaxant when trying to have a muscle, the uterus, do the difficult work of pushing out a baby, is not helpful. After about 4 hours of pushing, they asked me how long I was going to keep at it. I told them I planned to push until the baby came out, and that I felt fine and would keep going. Having had the epidural had given me the break I needed (and a few hours sleep) to feel strong and rested. Still, the doctors began to talk about delivering the babies by Cesarean, which I did not want. I refused steadfastly, at which point they offered me “one last option”. They would use the vacuum on Twin A’s head to hold her in place, and I was to push her out. Brad asked everyone to leave the room, and we discussed it. I agreed to the vacuum, but would not agree that it was our last option. Nonetheless, the previously empty operating room flooded with people, clearly preparing for the surgical birth of the babies. One of the doctors was trying to tell me why the procedure was necessary. I remember saying “Let’s not talk about that. Let’s just win this thing right now.”
They put the vacuum on Isabella’s head, a contraction came, and I pushed her out in a single effort. Calista came headfirst 24 minutes later. It was the most exhilarating thing that ever happened to me.
Regarding my last post about induction, risk, health and welfare, here’s what my experience has lead me to conclude.
One medical intervention leads to another. Because I was induced, I needed morphine for the first two hours. Because I was on magnesium sulfate, I needed pitocin and eventually the vacuum.
You need a lot of medical knowledge if you want special treatment. I credit Charity Pitcher-Cooper, my Bradley Method teacher, with helping me have the experience I wanted. Charity said or showed us films that said a number of things I didn’t agree with in our 12 week class. In the final analysis, however, it was because of her that I knew to ask for the labor stimulating hormone that was less powerful and had less side effects (I can’t imagine what would have happened to me with the stronger agent). I was able to agree with the doctor about what signs indicated the babies were having trouble and what the absence of trouble looked like. This emboldened me to resist the surgery just because it was taking longer than they liked.
I have other thoughts about the experience, but an election is coming up, and I’ve got other posts I need to make very soon. Remember, if you want to receive the Granick Slate Card, which should be out in the next day or so, you need to check back here, or subscribe by visiting here.