Rants from the Crib

An Ob/Gyn gone mad

Archive for the tag “delivery”

The Cynic’s Stages Of Pregnancy

1)  Thinking About Having a Baby:  has no effect on whether or not you will actually have one.  The universe will pregger you pretty much as it chooses,  (or not) any time that it chooses.  A general rule of thumb:  your chances of conceiving a pregnancy are inversely proportionate to how much you want to be pregnant.

2)  Conceiving a Pregnancy:  Did you really think I was going to give you instructions here?  I will say, standing on your head may be helpful.  If you need to have conception explained to you, call your mom.  And then enjoy watching her freak out.  Especially if you are older than forty.  The internet is jam full of very interesting videos (OK, porn) which will offer you limitless ideas for different approaches to conception.  Or gonorrhea.  You’re more likely to get gonorrhea.  Fact:  pregnancy IS a sexually transmitted disease.

3)  Finding Out:  First, you have to deal with the baffling intricacies of the pregnancy test.  Most people choose to pee on an average of at least 6 sticks before they accept the verdict.  The home pregnancy tests available over the counter are exactly as accurate as the much more expensive Doctor Ones.  I’d do them at home unless you are having problems.  You may get the dreaded “kinda pregnant” result with the little faint pale fuzzy line.  Just repeat in a week.  If still fuzzy, call your doc to get sorted out.

4)  The Response:  divides more or less into three camps, although they may intersect somewhat.  You will either be Team Ohhhhh Noooo, or you will be Team Yessssss, with Team Ambivalent hovering in between.

5) Telling Everyone:  may be as follows: The OMG So Excited Twitter FB LinkedIn Email Text Phone Call Billboard strategy, also affectionately known as The Drama Approach, b) telling your partner, your family and your close friends, also known as the Moderate Approach or c) telling only your partner until you hit 12 weeks and your risk of miscarriage is pretty much gone – which is a very smart approach.  Up to 1 in 3 early pregnancies may end in miscarriage – if something happens, do you really want to face the painful questions and watch your friends fumble to think of the right thing to say?  This is the Cautious Approach, and as an OB, I must say I recommend it.
6) Early Pregnancy: you will look like you are getting fat and letting yourself go instead of looking pregnant. It is possible that you may barf up your toenails your entire first trimester. Maybe longer. Your boobs will hurt really bad and you will want to assassinate your partner for merely dragging the bed sheet across your chest. Your refrigerator and your trash will smell so bad you will vomit, because your sense of smell becomes so acute.
7) Your OB: by now, you’ve probably found one. Your first visit will be interminable, you will be asked all sorts of embarrassing questions, and they will remove approximately half of your blood from your body for labs. The ultrasound is really cool, though.
8) Second trimester: you will actually start to show, and get a baby bump, thank goodness. Your raging hormones will chill out a little. You may actually feel almost normal. I will warn you, the “glow of pregnancy” is actually grease.
This is when strangers will start to touch your belly and ask questions. Because the national pastime is scaring pregnant women to death, they will give you wrong and scary advice, tell you horrible stories, and you will call your OB in tears multiple times. One major plus: you get to feel the baby moving. Sometimes your partner can’t feel it yet and gets really jealous. Another bonus: you get to find out the sex of the baby. Or you may argue vigorously with your partner about whether you are going to find out the sex of the baby.
9) Planning For Delivery: you will be terrified of the impending delivery until you are so uncomfortable near your due date that you no longer care – you just want that baby OUT. If you are gung-ho, you will most likely have read at least 8 books about pregnancy and delivery, all of which made you more terrified than you already were. If you are really intrepid, you may have created a birth plan, or you may have gotten a doula or a midwife to attend your delivery. This is all OK with us, but OBs have a cynical expression:  “Birth plan + doula = C-section.”. This is not because we want you to have one; we want you to be happy with your birth, but it seems that the universe always conspires to make those who really want a natural birth need a C-section, which sucks for us and for you.
10) Delivery: I won’t delve into this much because everyone’s experience is different. This is a good time to give yourself a pep talk about control. As in, you don’t have any. We happily try to accommodate you, but what we need to do in labor is completely dictated by the baby’s well-being and by what your body does, and you can’t control either. This will help you to accept that you will have no control over most of your parenting either, because kids are little people and they often have other ideas about how any given day may proceed. Also, during your delivery, your partner may or may not pass out.
11) Bringing baby home: a properly installed car seat is a must. Then there is that moment where you pull up your driveway with a whole new person and you look at each other and think, ” Holy crap, what did we just do?!? “. And so it begins…

Birth A La Mode; No Cherry On Top

I miss the good old days. I admit, it’s hard to miss something you never actually witnessed, although that’s how things were when I was an infant.

No one who had a baby in the early sixties remembers giving birth. When women arrived in labor, their husbands were promptly dispatched to the waiting room, and the mothers were taken to a labor room.

They would not have signed a consent to give birth. The lawyers had not yet mucked up the entire medical system. What a laughable thing, signing a consent to give birth. What the hell happens if you refuse to sign the consent? That thing is coming out anyway; I can assure you of that.

On admission, they were administered a cocktail of at least two medicines: Demerol, a powerful painkiller, in doses calculated to make one gutter drunk, and scopolamine, also called the zombie drug, because if you give enough of it to someone, they are in a trance-like state and will almost certainly be suggestible and compliant with any orders. Scopolamine also has a powerful amnestic effect: given in sufficient doses, the recipient will remember virtually nothing from the time the drug was given.

Doctors back in the day tell me that those women were still awake; they still felt pain and yelled, but they did as they were told and didn’t remember a BIT of it. My mother remembers nothing about giving birth to me. And she doesn’t seem to regret that one bit. She told me, “Well, I had some contractions, so I did the laundry and vacuumed the house, and went in to the hospital. When I woke up 2 days later, I had a baby.”

That would be AWESOME. And I say this not because I am a narrow-minded misogynistic control freak, but because the pendulum has swung WAY too far in the other direction. The change began in the late 1960’s when the hippies decided that childbirth was a beautiful and natural experience and they wanted to live every bit of it. Grudgingly, the physicians agreed to allow the husbands to be present at the delivery. That meant no more doping the patient, so now they were dealing with a wide-awake very scared little person in massive pain, because they didn’t really do epidurals back then. And then they had to deal with the baby’s FATHER (I don’t say husband, because that was around the time of free love and marriage while procreating was optional at best).

I can just imagine the ambiance. The physicians at that time would still be all male, serious as all get out, and doing things the way they were done in the 1950’s: clinical and sterile and blue gowns and drapes and sterile instruments and obedient nurses all doing things very, very seriously.

And in the middle of all this would be the father of the baby (which we heretofore will refer to as the FOB, which is what we call the biological paternal unit, even on the chart, because it gets rid of all need to establish whether or not the patient is married, or if the guy in the room is indeed even the one who donated the DNA, or just some new guy). The FOB would be intoning things like, “Just stay groovy, baby. We want the little dude to have a peaced out aura. Like, so, you probably shouldn’t be screaming and stuff.” At which point, the woman in labor would probably do what all women in labor do at this point, and scream, “Shut the hell up, and get this damn thing out of me!” Hispanic women in labor scream this in Spanish. It is universal.

And then IT happened. After the major adjustment made by the obstetrical community, and the drastic move of allowing fathers in the birthing room, the slippery slope began. The logic being, well, if my FOB can’t be here, can my mom be in here? Which then extended to, well, if my husband or my mom can be in here, can they BOTH be in here?

And that is when stuff just fell all apart. It became anarchy. Allow me to describe a common scene when I enter a labor room: the patient is in the bed, hanging out comfortably with her epidural. Her boyfriend is in the bed with her. The mom and the mother-in-law are both there, because if HER mom can be there, then why can’t mine? Grandma is there too, over in the corner, reeking of gin. There is some young girl with low rise jeans and her thong hanging out sprawled in the recliner meant for the FOB, and her boyfriend is sitting on the armrest. We are not sure who she is but we think she might be the patient’s half-sister. It is explained with some giggling that the boyfriend in the bed is, well, not the FOB, because the FOB is in jail right now, but he didn’t do anything. There is someone’s toddler on the floor. No one is watching him; his diaper is dirty, and he is fondling the patient’s foley catheter bag.

When I enter the room, there are cries of, “Who’s that?” from the imbeciles who arrived late, and from those in the know, cries of “Hey doc, has she done dilated yet? Can we have this baby now? We done waited a long time!” I announce that I am going to examine the patient. Nobody moves. I pointedly say to the patient, “I am going to uncover you and check your cervix. Would you like anyone to step out?” The patient shakes her head. Over from the corner, where it emerges that the patient’s own father is lying on a sleeping bag on the floor, the father yells, “Naw, I done seen it before! Done changed her diapers all these years!” Again, no one steps out. There is a mass craning of necks (from the ones NOT passed out) and they all wait eagerly for the verdict. This is better than reality TV for them. We get more visitors yet on days when there is nothing good on cable, and they’ve already seen that episode of Duck Dynasty.

Now you may ask, why do you put up with this? The answers are multiple. First, this is now part of the birth culture. These people have already attended multiple other labors and would not understand why they were not allowed to hang out for this one too. Second, most of the time, they aren’t really hurting anything; they are just being picturesque and inappropriate. If they are really in the way. I will boot them out. If they are upsetting the patient in any way, we will boot them out, with the help of Security (or the police, if need be), and yes, I cannot begin to enumerate the number of times cops have been called to drag out feuding potential FOBs or belligerent family members.

The other reason for the tolerance is this. All these clowns seem to reduce the anxiety level of the patient and FOB by distracting them, and they are not staring at the baby monitors and pushing the nurse call button multiple times and yelling down the hall, “Hey, the baby’s heart beat done went down!”

Also, we are not nearly as tolerant at the births. After all, birth requires focus. And there can be complications of a birth, certainly, and you don’t want a room full of panicky bystanders with camcorders getting down every second of it. Most hospitals allow two guests at pushing time, usually the FOB and one of the moms. If the patient and family are well behaved, I may allow one more, so we have, say, the FOB, his mom, and the patient’s mom. I reserve the right, at any time to boot everyone out.

Everyone who has been shooed out into the hall for the pushing phase now gathers in the hall. Despite multiple warnings from the nurses, they ooze back out of the waiting room and materialize right outside the door. From out in the hall, we hear audible speculation on what is happening with each scream that is heard. Usually, there is a pool for the weight of the baby or the time of birth. Wagers are cast. I have literally exited the labor room to get something during the pushing process and had people who were pressed up against the door actually fall halfway into the room.

The plague of locusts is rousted one more time, hopefully timed so that the poor girl gets some privacy during the birth and her creative swearing and screaming may not be heard. I hand over the baby, give my congratulations, and head out to the desk to do the paperwork.

After the paperwork is done, I usually swing by the room to make sure everything is stable and mother and baby are well. At this point, all the starlings have come back to roost and are perched on every available semi-horizontal surface and playing Pass the Baby. The TV is blaring. Multiple cell phones are in use. Pictures of the baby and the bleary-eyed mother are being uploaded to every single social media site known to man. I can barely see or speak with my patient because the room is so full of family, friends, and random acquaintances who may have just wandered in.

So this is where we are. It is a far cry from the calm, controlled circumstances in the 1960’s, and all dignity pretty much seems gone from the process of birth. So, I feel I can hardly blamed for being nostalgic for the good old days, where the dads were out pacing the waiting room with cigars, and the moms were pliant and drugged to the gills. There is a happy medium somewhere between where we are now and where we were then. But since when does mob mentality settle for happy medium? We’re just another reality show.

Things That Men Say

Let me preface this for those who do not know my by saying that I am an OB/Gyn – a doctor that takes care of women, doing, you know, women stuff like baby birthing, hysterectomies, icky periods… yeah, that stuff. Because I care for women for a living, I get to spend a lot of time with their men, frequently under bizarre circumstances like childbirth, or a really icky pubic rash. Shhhh… I’ll tell you a secret. OB/Gyns have a saying: “All women are different, but all husbands look alike.” Their men are a constant source of amazement, embarassment, stereotypical behavior, sweetness, and hilarity, planned or not.

I made a previous post about things that patients say that amuse me. This one’s just for the guys! Here’s to you and thanks for all the laughs (and muffled sobs)!

1. When you do her hysterectomy, can you get the mean out of her too, doc?

2. Hey doc, while you’re sewin’ that up, can you throw in a couple extra stitches, just for me?

3. You mean that thing’s an extra nipple? Babe, you’re a FREAK!!!

4. Only YOU would ask the doctor for something like that, Princess.

5. I thought she’d go back to normal after the baby came out.

6. We both dug around and looked for it, doc. Just can’t figure out where the damn thing went!

7. Are you gonna stick that duck thing in ‘er?

8. I’m leavin’ the room. I don’t wanna see this.

9. Oh, my God, what’s THAT?

10. What’s that brown stripe in the middle of her belly for?

11. Hey, if you’re gonna do that to her, you oughta at least buy her dinner first!

12. I dunno, doc. She got off your scale and just started cryin’.

13. What do you mean, she got pregnant in April? I wasn’t here in April!

14. What’s THIS for?

15. Is it OK if we keep the litter box in the kitchen?

16. Don’t worry, doc. I ain’t gonna pass out. It’s just like guttin’ a deer, right?

17. If it’s a girl can you put it back?

18. If it’s a boy, you only got one dick you gotta worry about. If it’s a girl, you’ve gotta worry about ’em ALL!

19. She caught that somewhere else.

20. I AM payin’ attention, hon. You just keep pushin’!

21. I’m just gonna sit over here.

22. I feel a little…. THUNK!

23. There ain’t another un in there, is it?

24. You swear it ain’t twins?

25. Does that hurt, babe? That looks like it hurts! What do you mean, shut up??

26. OW! You’re gonna rip my fingers off!

27. What do you mean, this is all my fault? You was there too!

28. My wife is hurtin’! Fix that Goddamn epidural thing, NOW!

29. She done broke her water all over my truck upholstery!

30. What do I do? What do I do?

31. Damn, Babe! You’re big as a frickin’ HOUSE!

32. Is she gonna be OK?

33. I am NOT drunk!

34. Can’t you just grab its ears and pull?

35. Why’s his head all pointy? Is that gonna go away?

36. What do you mean, you don’t want my mom in here?

37. Some things a man just shouldn’t have to see.

38. What do you mean, she can’t just have it now?

39. Can you just spay her?

40. Damn, I can’t even look at her but she gets knocked up with another one!

41. What do you mean, we can’t have sex til the baby comes?

42. Seriously, what do you mean, we can’t have sex until the baby comes?

43. How long do we have to wait to have sex?

44. Tie her tubes? Cut ’em the hell out, set fire to ’em and STOMP ’em!

45. Semen analysis? Hell no, doc, I know it ain’t ME! Ain’t nothin’ wrong with ME!

46. How soon can you do a paternity test?

47. Where’d the red hair come from?

48. She said it was a alien probe! That’s funny Babe! Ain’t that funny?

49. I can’t wear one ‘a them things! Like taking a shower with a raincoat on!

50. It can’t just get lost up in there, can it?

51. Damn, looks like you’re stickin’ your whole HAND up in there!

52. Oh my God! I shouldn’t’a looked down there! Oh, CRAP!

53. What’s that stuff comin’ out of her now?

54. That is just so GROSS!

55. Gawd, doc! How’m I gonna compete with THAT thing?

56. She told me she couldn’t get pregnant.

57. Can you give her somethin’ to make her wanna, well, you know… ?

58. Why’s she squallin’ like that?

59. Damn, her boobs got BIG!

60. Her nipples look like dinner plates!

61. Her boobs are bigger than my kid’s HEAD!

62. That thing makes her look like she’s on a milkin’ machine! OW, Babe!

63. I can’t pick him up. I don’t know how to hold his head.

64. COOL! He blew poop out his diaper right up his back! THAT’S my boy!

65. What do you mean, I get to have the next one?

66. I swear I didn’t think that thing’d get stuck up there.

67. Oh my God! Why’s that woman next door SCREAMIN’?

68. Did you really have to go into labor right in the middle of the Iron Bowl?

69. Do some jumping jacks, Babe. We need to have that thing this year – we need the deduction.

70. Can’t tell if she’s walkin’ or rollin’.

71. Why does she still look pregnant?

72. She can’t have the baby Thursday. I can’t get off work then.

73. She cain’t have the baby on Halloween – he might be a WITCH!

74. What the hell’s a onesie?

75. If her mom don’t leave I’m gonna go nuts.

76. No, you can’t buy all new shoes if your feet spread.

77. How come you need your toenails painted? You can’t even SEE ’em!

78. Stirrups? You mean like on a horse?

79. Why’s she so grouchy when she’s on the rag?

80. Oh my God! That needle is huge!

81. Don’t worry. I’ll make her take her pills.

82. Damn, girl! Your Tweety Bird tattoo’s done turned into Big Bird!

83. Is she gonna have to take that piercing out?

84. Looks like he’s a little alien tryin’ to crawl out your belly.

85. What’s that cut for her c-section gonna look like?

86. She doesn’t want an epidural. You don’t want an epidural, hon. We want an all natural birth.

87. Just breathe, hon. You’re not breathing the way we practiced. What do you mean, shut the hell up?

88. What the hell do you want me to do??

89. Why are all the magazines in here for women?

90. She’s a MILF in training.

91. I forgot the camera.

92. This wasn’t in the birth plan.

93. You’re not the doctor we’ve been seeing.

94. How can you stand looking at this stuff all day? Why’d you decide to do this?

95. Don’t you feel weird looking at women’s crotches all day?

96. Will she still be a woman if she has a hysterectomy?

97. Will she still be mean when her periods go away?

98. You gotta do something, doc. She’s rippin’ the covers off and freezin’ my ass off every night.

99. I told her I was coming in with her to make sure she addresses this issue.

100.Thank God I’m a man. That’s all I’m gonna say.

A Typical Call Day

My day started at six AM sharp as I jumped out of bed and into the shower. My husband got up too as he had been tossing and turning for the last couple hours anyway. He went downstairs and turned on the fire for me. I shoved my wet hair up under a cute surgical cap, grabbed a couple Atkins bars and a Coke Zero and ran out the door for my seven AM c-section. My daughter wasn’t even up for me to hug goodbye.

I got to the hospital and parked in the doctor’s parking lot. It was still raining, which it has been doing steadily for the last three days. Things are starting to flood. I had my call bag, my purse, my heavy coat and my portfolio of paperwork I’m working on for my new job in North Dakota. I scurried my way in through the rain and found my way upstairs to Labor and Delivery.

One of the across-town doctors, whom I have not really worked with before, but he and I found we have a lot of friends and contacts in common, was waiting there to help me with the c-section. He just thought it would be nice to operate together before I left. We gowned up and did our c-section, which went quite smoothly. Nice healthy little girl baby.

After the c-section, it was time for me to round on all the OB and delivered patients on Labor and Delivery. Between seven doctors that amounts to quite a lot. I had two inductions, which are patients who are having labor started for various reasons. One was past her due date and had elevated blood pressures, and the other was a diabetic with elevated blood pressures. I was pretty sure the first one was going to wind up with a c-section. I got their pitocin started and it was time to do circumcisions.

The first circumcision was a baby who had been born the day before. This was my first circumcision in the new hospital, and the equipment and the location were unfamiliar. I got his done well with some minor frustration. The second baby was not a newborn – he was a twin who had been born prematurely and had been too small to circumcise at the time he was born. By that time I was adjusting to the new equipment, which contained a nerve-wrackingly sharp pair of scissors – not exactly the sort of thing you want to be waving around a little penis. Everything went fine. One of the nursery nurses was from our old hospital, so it was good to see her there.

Then I had to answer a bunch of phone calls. One was from my husband, who was trying to arrange some things for my new job in North Dakota. I had some calls from patients to answer, and a call from my recruiter for the North Dakota job who was calling to tell me that the hospital had booked the wrong hotel for me and that I didn’t have any call days for my first ten days in North Dakota. Call days equal more money, so I was a bit perturbed about that.

I went to the call room to lie down and rest, since I always lie down and sleep if I can if I have the chance. That way if I’m kept up all night working, I’ve gotten some sleep. I was just on the phone with the computer people who were assigning me a new password for their computer system, since my old one wasn’t working, when I got a panic call from Labor and Delivery – a patient who had come in in labor that morning was about to deliver in the bed and hadn’t been able to get her epidural because there was no time. I ran into her room and she was screaming quite piercingly. The nurse was entreating her to stop screaming. The baby’s head was right there – I could see it peeking out. All we had to do was to convince the patient to stop screaming and flailing around in the bed. She finally got it together enough to push and she pushed the baby out, screaming like a banshee the whole time. Can’t blame her too much, since she didn’t get an epidural. She continued to freak out after the delivery, despite my reassuring her that she was done, the baby was out, and she didn’t need any stitches. I wasn’t sure why she was still so panicky. The baby was fine.

I got a panicked phone call from the husband of one of my patients. She was scheduled for a D&C the following day, but apparently had started miscarrying at home. Her husband sounded very very scared and very very grossed out as he described how heavily she was bleeding, and how he thought one of the clots in the toilet might be the baby. I told him if he could to scoop the specimen out of the commode and bring it with them when he brought her to the ER. The ER was going to assess her and determine if she needed her D&C to go ahead and be done that night, or if it could wait until morning. They never called me back. I called the husband later in the evening and he said they were told she had not passed the baby. They were still coming for the D&C in the morning. He still sounded panicked and upset.

I was notified that one of my induction’s water had broken, and she was going to need an epidural. I OK’d that and then got a very interesting phone call from the ER of my old hospital – they had a lady there who spoke no English and who had two tiny baby feet protruding from her vagina. There was no heartbeat. They put her in an ambulance and sent her across town, since my old hospital no longer has the facilities to deliver or recover a pregnant woman. The OB nurse from the ER had to ride over on the ambulance with her, in case she delivered on the way, because the ambulance drivers were freaking out. When she arrived, the little feet were still protruding from her vagina. They appeared as if they had been there for some time. There was little bleeding. With pushing, she delivered the fetus in the bed. Fortunately I speak enough Spanish to let her know what was going on. The little baby was stillborn. From its appearance, I felt it was between 16 and 20 weeks and had been deceased for at least several days. With a little more pushing, she delivered the placenta, so, thankfully, I did not need to do a D&C to get the placenta out.

At seven PM it was time for shift change. One of my inductions was six centimeters dilated. The other one wasn’t doing a darn thing. I left orders for the night shift and retreated to my cave with several blankets – it’s cold in there. I was waiting to see if the six centimeter one would need a c-section or not. I slept a little while and was woken up by the nurse: “The baby is coming now!” I jumped out of bed and ran down the hall. The baby was NOT ready to deliver. She had gotten me up about an hour early. I went and laid on the couch in the call room until they were ready to call me back.

The patient delivered her baby and did NOT need a c-section. She did not need any stitches either. I was very grateful because for some reason, I felt really dizzy and needed to sit down. That happens to me sometimes with early morning surgery or late night deliveries. I don’t know why it happens. We’ve checked my blood sugar and everything and it’s been fine. Anyhow, I did my paperwork and retreated to my bed. My alarm went off at 6:30 AM and my call day was over!

Wild Cat Birthing

Every once in a while you enter a delivery room and just know that you are doomed.  Something about seeing a pregnant naked teenager hunkered wild-eyed up against the wall at the top of the bed just tips you off.  I entered such a room today and the goat rodeo was in full swing.  The baby daddy and the girl’s mom were yelling “Push!  PUUUUUSSHH!” and trying all manner of ineffectual pushing urgings which the feral girl did not even register.  They had had her pulling on a towel in an attempt to get her to bear down in the appropriate place, which was in her bottom and not in her head as she imagined.

When I walked in, she was yelling, “GIVE ME SOME MORE SPRIIIITE!”  which struck me as an odd thing to say when a baby’s head is half out.  There were two nurses in the room trying to help each other through this awful mess.  Each one held a leg.  Instead of gracefully dropping her legs back and open as the girl had been asked, she was shoving her legs straight out and threatening to crush the baby’s head between them.  She was pushing so hard, intermittently, that her naked bottom with half a hairy baby head protruding from it was waving up and down in the air.  Alternately, she would bring her knees together and threaten to slam them on the baby’s head again.  The two nurses were fighting her with everything they had.

The girl’s momma was yelling, “You got to get it out, baby, you gonna hurt him!” and the baby daddy was hollering, “Get yore LEGS back!  Pull on this TOWEL!”  The nursery nurse was hollering at her to get off the baby’s head.  The nurses were hollering at her to get her legs back and PUSH.  And the poor ward clerk was actually in there attempting to give her some more Sprite in hopes that that might calm her down.

She finally managed, despite her wild-eyed bucking, to get the baby’s head out.  Then of course the baby’s shoulders stuck.  A shoulder dystocia is a possible emergency even in a calm environment and we REALLY had to get her legs back, no fooling.  I had a nurse pushing just above her pelvic bone to try to get the shoulders to rotate.  The girl was screaming, hollering, fighting.  To my relief the shoulders rotated and came on out.  THANK GOD the baby was out!  After a little rubbing and stimulation he started to scream, having survived the squeezing and pushing fairly unperturbed.

“Now I want Sprite,” my patient said.  “Was I bad, Doctor?”  I told her with as much sense of humor as I could muster that she was quite the wildcat and I wouldn’t want to meet her in a dark alley.  Fortunately, she needed very few stitches and she actually submitted to them without too much fuss.  “Did I hurt the baby?” she wanted to know.  We reassured her that the baby seemed to be fine.  We got her cleaned up and united with her baby,  and I escaped from the room.

Outside at the nurse’s station, the nurse who had been in the room helping was shaking her head.  “I haven’t had a wild delivery like that in YEARS,” she said.  “I think I actually hurt my back trying to get her legs in position.  WOW is she strong!”  I shook my head.  “Well,” she said.  “I’m off to get her some SPRIIIIITE!”

Tales From The Crib: My Hellish Delivery Experience

As an Ob/Gyn, I know that one of the most important rites of passage of a mother is to describe in detail her hideous delivery experience.  Lord knows, I have heard enough of them over the years.  Mothers also love to describe their horrible deliveries to pregnant women, who aren’t paranoid enough about pregnancy and delivery, and need to be told tales of the worst experiences to be put in their respective places.  I, however, had a truly hideous delivery experience, and thus feel obligated to share it with you!

I had a perfect pregnancy.  I worked up until the day before I delivered, and did not miss a single day due to illness or pregnancy problems.  Now, we have a saying in our Ob/Gyn world (in fact, we have numerous sayings):  first, you will either have a horrible pregnancy, or a horrible delivery, or a horrible baby.  You will not escape all three.  And second, if you are even vaguely in the medical field, and particularly if you are an Ob physician or nurse, you will have awful things happen to you, crazy things, that seldom happen to anyone else.

I arrived at the hospital on a Tuesday, ready to have my labor induced.  I was past my due date, and I just wasn’t going into labor.  My Ob doctor (also my partner) was going out of town later in the week, so we decided to just go ahead and induce.  So I came in with my Sonic 44 ounce lemonbery slush (totally addicted, people, in pregnancy and afterwards) and plunked down in the bed and vowed to be a model patient.  I was certainly not going to freak out, or yell and scream, or otherwise distinguish myself as a freak since these were all people I worked with.  So my partner/doc came in, and put the magic medication up my h00-hah (very medical term here I am using) and waited to see if I would go into labor.  I had contractions all day after that, but they didn’t hurt and I nonchalantly sat in the bed and worked on a beadwork piece I had been making.

I sent my husband to get me some supper since the medication didn’t seem to be working.  However, the real contractions started kicking in while he was in the drive thru, about 5:30 in the evening.  I had one that seemed a little stronger.  Then another one that was stronger yet.  Then another and another and they HURT.  I finished my beadwork piece and with shaking hands put the beads away.  Damn.  These things HURT.  I called my husband and told him not to bring my dinner after all; I was going into labor.  I gripped the siderail of my bed.  I considered biting the siderail of the bed.  I realized I wasn’t going to get much farther without screaming, and I had vowed NOT to scream, so I called for some pain medication.  I told the nurse to give me a half dose at first.  No sooner had she given it, I realized that I was going to need the other half of it.  And pronto.  And the other half of the medicine didn’t do me a bit of good either.  I called the nurse back in the room.  I was really going to embarass myself, because I was going to have her check my cervix and see if I could possibly be ready for an epidural.  And I had a funny feeling I was still going to be one centimeter and then I would have totally embarassed myself.  But hallelujah!  I turned out to be 4-5 centimeters!  I was not embarassing myself!  I was actually eligible for an epidural! 

So they called the anesthesiologist to come and put my epidural in.  At this point I was considering chewing the bed I was in into matchsticks.  I was biting my arm to keep myself from screaming out loud.  Around this time, my husband returned, looking a bit alarmed.  They put the epidural in and miracle!  The pain was all gone.  Now the pain medicine that I got before the epidural kicked in, since I wasn’t hurting any more.  I was stoned out of my mind.  I literally slept until I was ready to push.  I didn’t even look at the fetal monitor once, that’s how stoned I was.

Now, understand that up to this point, there is nothing horrific about this story.  This was just normal labor.  So far, everything was going OK.  But now is when the fun kicks in.  First of all, I pushed for three hours.  Three hours is a long time to be taking deep breaths and pushing down in your bottom as hard as you can, every two minutes.  It turns out the baby was facing up instead of down, which makes the head jam down in your pelvis where it won’t come out.  Then my epidural stopped working, in one spot.  It just happened to be the spot where the baby’s head was.  I had this agonizing pain/pressure of this huge head right, yes again, in my hoo-hah.  My partner offered to put forceps on, but she had a tendency to get bad tears when she did forceps, the baby’s head had scarcely moved in three hours, and I had no anesthesia right where she was going to shove those forceps.  So I said no, we would do the c-section.

They redosed my epidural and the horrible pain/pressure went away.  It was such a relief.  I thought my troubles were all over.  They wheeled me back to the c-section room and my husband came with me.  I was totally exhausted from all the pain medicine and pushing for over three hours.  They started cutting, and, so far, so good, it didn’t hurt.  When they got down to my bladder, ZINGO, that hot spot in my epidural kicked in again and I felt EVERYTHING.  I felt them peeling my bladder off my uterus.  I felt them cut my uterus.  It burned like I was being branded.  They say I was screaming but I don’t remember anything.  I could feel them grab the baby’s head and yank it up out of my pelvis.  It made a squelching, ripping noise.  I think I was begging them to stop.  The anesthesiologist drew up some medicine, slammed it in my IV and twisted the IV bag to get the pain medicine to go in faster.  The drug they gave me was ketamine.

Ketamine may be known to some of you as a rave drug.  It is an anesthetic that induces vivid hallucinations.  It is also used in veterinary medicine.  The pain went away as it knocked me unconscious.  And then… I woke up.  The first thing I remember was looking at a pulsating blue brain.  Then the brain dissolved into blue triangles.  As the drug wore off further, I realized the blue stuff was actually the surgical drape that was protecting me from the surgical field.  That made me realize I was in an operating room.  What was I doing?  Oh, I was having a baby.  Having a baby?  How?  Oh, I was having a c-section.  What was a c-section?  I couldn’t think.  Then I realized that that was a surgery.  Was I having an awake anesthesia experience?  There have been people who have woken up during a general anesthetic who have been aware of everything that was happening to them, and feeling pain, but were paralyzed by the anesthesia medication and were unable to move or make anyone aware that they were awake.  Was that happening to me?  Had they put me to sleep?  I next noticed that there was no tube down my throat.  No.  They had not put me to sleep.  They had just given a drug that was wearing off.  I decided it didn’t matter, either way, as I was no longer hurting any more.  Then I heard the baby crying and they brought her to me to see.  My first thought was, she looked just like my cousin.  Who is related to me by adoption.

I found out later that more lovely things happened to me while I was under the influence of the ketamine.  I developed a hematoma (blood clot) on my bladder.  They could not seem to keep it from enlarging.  My uterus turned inside out.  INSIDE OUT, PEOPLE.  How often does that happen?  As an obstetrician, it has never happened to me.  Personally, of course, it happened to me.  I lost a LOT of blood.  My husband was horrified at the rags full of blood they kept tossing in the container.  He had never imagined so much blood.

When they took me back to my room, I thought the worst was over.  But the hits just kept coming.  Despite all the pain meds I had received I developed this awful referred pain that was well ABOVE where the surgical incision was.  It was horrible.  They thought it might be the bladder hematoma enlarging.  I had to have an ultrasound.  They gave me two doses of demerol and I had to beg them to stop.  The demerol was making me woozy and drunk, but it was in no way touching the pain.  I made them send anesthesia to the room to redose my epidural.  That was the only thing that made the pain go away.  However, I now had the epidural shakes from a near lethal dose of epidural medication.  My whole body was shaking violently.  To keep the shaking from ripping at my incision, my husband had to grab my wrists so I could direct the shaking into him.  We went on like this for at least an hour.  At no time during this time was I well enough to see or hold my baby.  When they finally brought her to me, I had had so much pain medication that I could not focus my eyes on her.  I had to have them take her away because I was terrified that I would drop her.  So that was my terrific birth experience.  Oh, and the final word?  Remember when I mentioned that you would either have a terrible pregnancy (mine was great), a terrible delivery (mine is above – enough said) or a terrible baby.  Well, we got a terrible baby.  She was lovely and healthy, and she is seven now and I love her so, so much, but she had the Worst.  Colic.  Ever.  She screamed for about five months straight.  After all the pain and the blood loss and the exhaustion, I was totally unprepared for it.  So, I had a rip roaring post partum depression on top of everything else.  So, yay, me.  I don’t tell this story to any of my patients because I am kind enough not to terrify pregnant women.  But I will tell it to anyone else who will listen!

Has anyone else had a lovely birthing experience they would like to share?

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