IMR: 1998: January: 26

IMR: 1998: January: 26 -- Monday, 4:37 p.m.
Birthing Center, Kapi`olani Medical Center, Hawai`i

Jen's trying to catch some sleep now. The last few contractions were pretty rough, so she asked the nurse for some painkillers. Instead of going with an epidural, though, we took a baby step with Stadol. It wasn't supposed to be much, but it seems to have done the trick.
The contractions are about three minutes apart. Thanks to modern medicine, they hurt but are no longer agonizing.
I'm glad Jen can rest. It's been... I can't adequately describe the helplessness I feel when she's in pain. I hold her and coach her and tell her it'll be over soon, all the while feeling horribly stupid. We've been here nine hours, and we could be here at least that much longer.
Doctor Boyens, who pretty much only stopped through at about 1:30 p.m., anticipates a 4 a.m. birth. The nurses here, however, are thinking midnight.
I think the nurses have been slightly upping the doctor's recommended pitocin dosages to speed things along.
From 1.5 units (about a drop a minute) at 2 p.m., Jen's receiving 21 units now. I thought I heard Boyens insisting on a two-per-hour increase, versus the six-per-hour traditionally ordered. I suck at math, but I think we're ramping a little faster than the doctor ordered.
Then again, I'm not a doctor. And Jen doesn't mind, either way... when I was trying to puzzle it out, she said through gritted teeth: "I don't care... I just want this over with as soon as possible."
We're in unit 301 of Kapi`olani Medical Center's famous birthing center. Barring major problems, everything from labor to delivery to postpartum happens in this quaint, pastel-appointed bedroom. Both mom and Gayle, who've visited in mid workday, were thoroughly impressed with the facility.
Actually, this state-of-the-art ward is just a year old, and the computer system only two months old. A few of the latter's quirks have frustrated the nurses that have checked in from time to time, but they seem to be managing.
Jen's got an IV with two suspended bags: the pitocin/glucose mix and "Lactated Ringer's Injection USP," which is basically electrolytes (a la Gatorade) to give Jen energy and keep her from getting hungry. Two fetal monitor are strapped to her belly, one measuring contractions and the other measuring the baby's heart rate (holding steady at about 133 beats-per-second since we've gotten here).
It's an enormous operation just for Jen to go to the bathroom. Disconnect the

Monday, 9:48 p.m.
Birthing Center, Kapi`olani Medical Center, Hawai`i

Man, how things have picked up.
The pain was getting unbearable, so Jen asked for an epidural.
She took it like a champ. I couldn't. She was amazing. Curled into a ball, breathing through contractions, while the anesthesiologist did his work behind her back. I purposely didn't look, but the gauze and pads that came off...
Then bang. Everything happened at once.
The nurses were in mid shift-change, so there were three in the room. The anesthesiologist was watching Jen's blood pressure. Dr. Boyens showed up. The room was bustling with activity.
While performing a routine exam, Boyens found a bag, or pocket of fluid, ahead of the baby, apparently part of the reason progress has been so slow. Acting as a cushion between the baby's head and her cervix, the opening wasn't being stimulated to open right.
He popped it, cleaned everything up, and the next thing we knew, Jen was eight centimeters dilated and 80 percent effaced.
Jen, free of most of the pain, was elated and talkative. Everyone was energetic and supportive. The end, which seemed so far away not twenty minutes before, suddenly seemed right around the corner.
Of course, it wasn't.
Jen breezed through dozens of contractions, down to 90 seconds apart at one point, but as the epidural wore off she asked for a "topper" -- a recharge or boost of the pain meds. Since then, her contractions have become mild, indistinct (rolling hills rather than distinct mountains) and further apart. It's about 10 p.m. now, and Jen has been stalled at about 9 centimeters for a couple of hours. Boyens, now in his scrubs and in the birthing room to stay, estimates another two hours before things get colorful.
They've been slowly increasing the pitocin drip (it's at 39 units now) to get things jumpstarted again.
So hard labor has yet to come. She's already got the urge to push, but true to her lamaze training she's breathing through it.
Mom's here, back from a short rest stop at home. She's doing word puzzles, while I'm trying to eat a cold McDonald's cheesburger she brought five hours ago for my dinner.
I guess this is the calm before the storm. Jen's peaceful -- resting if not quite sleeping -- and Katie's robust, galloping heartbeat is the only sound in the room.

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