On the way to the hospital, we drove through Chick-fil-a, where I supplemented my veggie lunch with grilled nuggets since the spicy sausage had not been working for me. Stephen and I talked about how funny it was that despite this being our third child, we had never driven to the hospital in labor. (I had obsessed a lot about when to go to the hospital in labor, considering my previous long labor, distance from the hospital, traffic and fact that this would be my second vaginal birth. Turns out, I didn't have to worry about any of those things.) I was so excited about having the opportunity to start the process of getting the baby born that I didn't feel as nervous about induction as I may have been a week earlier in my pregnancy. I was pretty much willing to do whatever it took to get the baby out. I was also really happy because the midwives on call over the next 48 hours were two of my favorites.
When we arrived at Atlanta Medical, we drove into the parking deck and started circling, looking for a spot. We drove all the way to the top without seeing a spot, looped back down to the previous level, then had to get back on the twirly down ramp to go down another level before we finally found an empty parking place. I was really glad that we weren't trying to find parking with me in labor. We casually walked into the hospital and took the elevator to the maternity floor. We told the lady at the nurses' station that we were here to meet Linda to start an induction, and they sent us out to the waiting area and told us they would come get us. While we were sitting in the waiting room, this man approached us to ask if we were interested in giving blood "while we were waiting." Ugh--no. We're here to have a baby, not to give blood. Sorry. Didn't the big pregnant belly clue you in?
After we had waited a while, Linda came out to the waiting room and told us they had a labor and delivery room that had opened up (Yay! We wouldn't have to start the process in a triage room!) and walked us back to a large, pleasant LDR room with a fabulous view of the Atlanta city skyline. A nurse came in and hooked me up to the fetal heart rate and contraction monitor. I was surprised to see that the itty-bitty, wimpy contractions I had been noticing were actually showing up on the monitor. Another nurse (I had two nurses assigned to me) asked me many questions, including if I knew when my last menstrual period was. I looked at her blankly and told her that was a long time ago, but I told her my due date instead. Finally we finished the Q&A session, and she left the room. After taking a bathroom break, I decided to stand by the bed and try to encourage the contractions with some gravity instead of sitting in the bed. They still didn't hurt, but they were coming in a pretty consistent pattern. Stephen and I waited quietly in the room for about an hour before Linda came back in to do a cervical check in order to decide if my cervix was open enough to place a Foley bulb. She checked my cervix, and then said we wouldn't need a Foley bulb at all. I was 3 centimeters dilated and 80 percent effaced. I was pretty surprised at the progress I had made since the previous day, especially since I had slept well all night, and had not had so much as one painful contraction. Linda said she thought a slow Pitocin drip would likely be enough to get my labor going.
Stephen and I continued to wait. At one point, we heard a woman cry out. I said, "That woman just pushed out her baby--or she's about to get an epidural." A minute later, we heard a baby cry. It was about 4:30 in the afternoon at this point, and I decided to call my doula. I asked her to start heading our way pretty soon so she would be there around the time that they started Pitocin. I told her no hurry, since at this point I didn't even have my IV in, but that it would be good if she could get there in a little while. Linda came by and told us she was about to go off shift, and Anjli would be taking over. Anjli took a minute to discuss the game plan, which was to start Pitocin at a very low dosage and possibly break my water at some point to get labor going. Finally the nurse came in to start my IV. My past experiences with IVs during and after birth have not been good. Not only have they been difficult to place, but they have hurt the entire time they've been in. I was dreading the IV so much that I had actually considered exercising my right to refuse despite Atlanta Medical's policy that all VBAC moms must be at least be hep-locked. Obviously, since I was about to start a Pitocin drip, foregoing the IV was no longer an option. However, I had an entire paragraph in my one page birth plan about the IV placement. I requested that the IV be placed in my left forearm, and that the smallest possible needle be used. The nurse said that could pretty expertly place an IV, and I told her I really didn't care if it took a long time or multiple sticks to get the IV in as long as it didn't continue to hurt once it was in. She took a look at my forearm, declared that my veins looked fine, and got ready with the needle. Two unsuccessful sticks later, she said she could try sticking my left arm again, or we could try to get it into the right forearm. I told her I was fine with it being on the right, as long as it was still in the forearm area. Thankfully, the third stick went in the vein and she was able to secure the IV in my right forearm. While the nurse was making her third attempt at IV placement, my doula walked in.
We did some more waiting, chatting about several random topics before the nurse came in with the Pitocin. It was 6:20 before she had the Pitocin hooked up to the IV machine and started the drip. Before the drip had even been started, Stephen had started asking me when I wanted him to call our moms to come. Our original plan (pre-induction) had been for me to labor at home until I was well into active labor and then have our moms drive to the hospital at the same time we did and meet us there. However, I knew it would be quite a while before labor picked up, and I didn't want a lot of people sitting around staring at me waiting for something to happen, so I decided we would call them once labor had gotten more active and have them drive up then. Stephen asked me multiple times when I wanted him to call our moms to come, and I finally got a little irritated and snapped at him, "I'll tell you when to call them--I need to be at least 5 centimeters!" Shortly after Que (my doula) had arrived, Stephen asked me if I thought he
could go down and get a coffee at the Starbucks on the hospital campus. I
said that was totally fine; Que was there with me, and even if they started the Pitocin while he was gone, the effects of the drug would not begin that quickly. He got his coffee and had made it back up before the nurse arrived with the Pitocin.
The midwife started me at 2 units of Pitocin (barely a whiff), and the plan was to turn it up very slowly to mimic the natural progression of labor. When I had arrived at the hospital, I had been attached to the standard plugged-in fetal monitor, but I had expressed my interest in using one of the telemetry machines. At that point, the nurse had told me that the units were all in use, but that I could certainly have one as soon as it became available. When Anjli had been in the room to discuss the game plan, she had reiterated to the nurse that I needed to get one of the telemetry units so I could stay mobile, and use movement to facilitate labor. Around the time that the Pitocin was started, the nurse brought in one of the telemetry units and got everything set up. Apart from the cumbersome IV pole, I was free to move about as I pleased. I decided to go out and walk the hall before the contractions really kicked in because I knew that walking was one activity that could really facilitate labor, and I wasn't really sure that I would feel like walking once the contractions really kicked in. Stephen and I walked around the hall that looped the labor floor a couple of times before a nurse at the nurses' station looked at me suspiciously and said, "What's she doing?" I gave her a puzzled look, but kept on walking. We had barely rounded the corner of the hall my room was on before my nurse came to me and said I could not walk out in the hall while on Pitocin; that was against the hospital's policy. I was a little irked at this completely unreasonable policy and continued to pace the hall immediately outside my room for about five more minutes. Then three nurses approached me (both my current nurses plus the nurse who was coming on call and would be my nurse through the night shift), and said that the charge nurse was adamant that I needed to go back in my room--it was a liability risk for the hospital. I decided this was not a hill worth dying on, and returned to my room where I regrouped my efforts to facilitate progress by pulling out my birthing ball to sit on. As I sat on the ball, we all continued to talk, but I started to fade out of the conversation long enough to breathe through my contractions.