laboring not so difficult

when we left off last, susan's water had broken. unfortunately one of the nurses caught hue using her charting terminal, and susan began feeling stronger contractions, so blogging became a low priority.

the contractions felt like her uterus was being wrung out to dry. she was pretty coherent in-between squeezes, but during contractions she went into an altered state. the slightest extraneous motion caused great discomfort. she had decided eariler that her threshold for an epidural would be a pain intensity of 8/10. (yet you never quite know what an 8/10 is unless you've been there before)

if an epidural is given too early though, labor can be prolonged, and too many internal exams are risky after the amniotic sac breaks. so she used her (what we thought were silly) lamaze techniques from 3 to 6 am. the breathing exercises along with squeezing hue's (insert body part here) proved extremely helpful.

the couple are then moved from the second triage room to a new labor room. when the pain reached a level of 8-9/10, susan finally requested an exam to see if she was ready for an epidural. at this point, she was nauseous and had to change position every minute or two to find comfort. she checked out at 3cm and 80% effaced, so anesthesia came to place the epidural.

basically she leaned upright over the side of the bed while a small catheter was placed in the fluid outside of the spine. fentanyl was provided at a constant rate, and susan was set up to press a button when she needed more pain medicine. relief was immediate and a great blessing. for the next 4 hours the couple was able to rest and conjure energy for the birth. susan is now seriously considering becoming the spokesperson for epidurals. she runs a low blood pressure at baseline though, ~90/50'S, so she did require 2 doses of phenylephrine and 2 of ephedrine when her pressure dropped to 80/30's, but aside from a little heart racing she felt no ill effects.

at this time, hue's need for rest and a shower were palatable. hue suffers from the need to move his bowels and uses the "private" bathroom, only to be walked in on by a nurse. it's an embarassing moment for him, but he is too tired to care and figures that these nurses have been desensitized to seeing people pooping.

at first the contractions weren't noticeable at all, then they came across as pressure, and finally around noon the pain began to increase. but the epidural/rest combo made the transition part of labor pretty tolerable, and when she was checked again she was fully effaced, 9 cm dilated and at 2-3+ station. she had the urge to push, but resisted while her OB drove in. it was still busy on the unit and the room we needed to accomodate the pediatic team and their equipment was already occupied by another woman in active labor.

so ~ 1pm we're rolled over to yet another room (our fourth), an OR where susan begins to push. initially she's on her back. our son experiences a dip in his heart rate and is not tolerating the pushing very well. they shift her to left side, which is no better. finally they try on her right, which worked best. tabsh arrives and recommends pushing every other contraction, as he's concerned that our son isn't getting enough oxygen. his heart rate dips down into the 90's during a push and bounces back up into the 150's in between. during alternating contractions, hue counts out as susan pushes. typically she's able to squeeze in three pushes for each contraction. after about half an hour of on and off pushing, our son begins to crown, which looks crazy. it looks like a tuft of hair coated white. it's hard to believe that this thing is actually going to pass through this little opening. tabsh threatens to use a vacuum, but susan is able to push the little guy out without mechanical assistance. susan suffers from a single small tear and was grateful to avoid an episiotomy. this is a textbook delivery.