When the anesthesiologist showed up, I asked that I only be given enough to take the discomfort away but I would still like to feel the urge to push when the time came. He only administered half the regular dose which sounded fine to me but this decision would come back to haunt me later. It was about 10am by this point of the morning and with the contractions faded into oblivion by the epidural, I decided that now would be a good time to get some sleep and some rest. I can't imagine going through hours and hours of labour only to be exhausted and then have to push a baby (or two!) out at the end so the epidural was a good decision for me.
The worst part about having the epidural put in was the local freezing that they administered to numb the area. Like all of the needles we have experienced over the years, this was no different - pinching sensation with a sharp sting and then when the actual epidural was put in, you can feel what is going on but there is no pain associated with it. The epidural itself is a flexible tube that they then proceeded to tape to my back to ensure that it didn't move. I think my entire back was covered in adhesive to ensure that it didn't move with the tube fed over my left shoulder and then attached to a self-administering button that I could press at will to "top up" if I felt the need.
The doctors came back and kept checking on me throughout the rest of the morning and at 2pm they did one final internal exam and announced that I was ready to start pushing. Now a side note about internal exams and not to scare those of you who have not yet had one or haven't gone into labour...internal exams can be very uncomfortable and can be even painful. They put a glove on their hand, some lubricant on two fingers and then those are inserted into your vagina where they feel for the cervix. When you're
not in labour, the cervix should be high and closed. During an internal exam when your cervix is high, it really feels like they're trying to reach for your tonsils by way of your vagina. Truly. My first clue that internal exams were not fun was when I was in triage and the woman in the room next to me had an internal exam and yelled through the whole thing.
One of the nurses asked me if I wanted to "practice" pushing. Having never done it, I thought that this would be a good thing so she coached me through what to do. You're lying flat on your back and you need to get into a frog like position...you bend your knees and grab behind them with your hands and then lift your upper back, all the while pushing down with your abdominal muscles like you're trying to pass the biggest poo of your life. You do this for one long breath and then you exhale and inhale again quickly and then push again during the same contraction. I have never felt my face go so red and I felt like my head was going to explode at some points. Who knows if I ever got the pushing technique right because I proceeded to push for 4 hours (at my own request...I'm kind of stubborn that way) and little Victoria just wouldn't come out.
I have never pushed so hard in my life. I have never tried so hard in my life to do something and it was disheartening when the doctor would tell me that I needed to push even *harder* than I already was. I thought I was pushing pretty damn hard but the baby wasn't moving down so maybe I wasn't getting the technique or doing it properly. My doula helped me to advocate for myself at that point and we got to try different techniques...we tried squatting and we tried another technique where we wrapped my doula around the waist in a sheet and I pulled the sheet towards me while my doula braced herself and pulled against me instead of pushing. Same muscles were used in that technique, just a different way of engaging them. Still no change. At this point, it was about 5:30 and the doctor decided that it was time that the babies arrived. They were not in distress at all, it was just time.
I was wheeled into the OR at that point and I pushed a few more times there but still no change. Then we decided to use the vacuum and things began to happen pretty quickly then. They had to fit the vacuum in and when she was trying to work it in past my perineum, I noticed that what she was doing was pretty uncomfortable for me. Then I got an episiotomy and I definitely felt the "snip". Those should have been my first clues that my epidural was wearing off or was not strong enough for what they were about to do. I was asked to push again while they used the vacuum to help Victoria along and with the first push, I felt her head come out (finally). With the second push, I felt the rest of her body come out. I thought I heard her cry but she was whisked away almost immediately but a nurse did stop and show her to me very briefly from a few feet away.
The next thing that I remember was that my water broke - little Caitlyn was ready to make her appearance into the world and her sac ruptured after Victoria was born. There was a huge gush of liquid that went on for a few seconds and I just soaked the gown of the doctor standing at the foot of the bed. Now Caitlyn had been head down all along but with Victoria being gone from the uterus, she flipped around and became breech. All the doctor said she was that a foot was sticking out. I will be forever grateful to the doctor that was on duty that night because normally, this would have meant a c-section for Caitlyn as the breech position is not one that doctors like to deliver vaginally. However, I had told the doctor several times that I wanted to avoid a c-section if at all medically possible if there was no danger to the kids. So at first, the resident tried to reach up and grab Caitlyn but she couldn't get a good hold of her. Than, the doctor in charge reached up and grabbed her and with one or two pushes from me, out she came doing the splits! Caitlyn was taken away immediately as she did not come out crying so they wanted to examine her so I didn't even see her.
During all of this, I am realizing more and more that I can feel just about everything going on down there, not just pressure. When someone puts their entire hand, not just 2 fingers, up your uterus, it feels pretty uncomfortable. Like you're being really, really stretched in a not so nice way and that is no small feat for someone who is 8 months pregnant! I thought that the hard part was over at this point because the kids had been born and it was my misunderstanding that the placentas would just slip out and deliver themselves. Boy was I wrong.