The sun was down and it was dark. At about 5:30pm we decided to do another internal check for progress. I'm pretty sure Cathy was hoping things would get moving before her shift ended. She loved us and we loved her.
2-3 cm dilated, about 80% effaced. Still.
I believe this is when I broke down. It started to seem like my worst prediction was coming true. This induction was failing. These contractions were worthless. Though I had successfully kept the pain at bay, I was getting pretty exhausted from the effort. I know Erich was too--he was the one getting me ice chips, popsicles and damp towels for my neck and food and coffee for himself in between being there with me for every contraction, helping me manage the pain.
But I needed a break, and if this baby was going to come out naturally, it was going to take a long time, and something had to give. I asked for a narcotic to take the edge off. Erich knew how I felt about pain medication and encouraged me to wait half an hour. I waited for about one more contraction, and then I really knew I couldn't continue like this. Within 30 minutes or so, I was hooked up with a dose of Dilaudid and very quickly got to rest.
I continued to feel everything, but the edge was definitely off and furthermore, I just didn't care. The room seemed quieter, probably because everyone was acting like I was asleep. I wasn't. I could hear everything and responses to conversations going on took shape in my head, but I couldn't care enough to make them come out of my mouth. I decided to enjoy this sensation, and I tried to visualize my cervix thinning and opening with every wave. The theme was relaxation.
After probably about an hour, the narcotic started to wear off a little and I started to get more active. Though all the changing positions I had done all day hadn't seemed to do much yet, gravity was my best chance of getting the Pit to work.
It was time for a nursing shift change. Cathy bid us farewell by taking my hands, praising me again for my stamina and telling us how much she liked us. (Cue the tears.) She assured me I was "doing everything right" and whatever happens, even if I have to have a section, there will have been some reason I didn't progress, like a big baby or something along those lines. She asked for permission to call and find out what happened later that night, which I of course granted.
To be honest, at this point I was nearly certain this would end in a c-section. Wanting that not to be the case hadn't helped yet, and it seemed like I was running out of time. My water had been broken for nearly 12 hours, and they would certainly expect me to deliver within 24 hours of rupture. Doing the math, I knew my progress would have to speed up a whole lot for that to happen. I knew I could still try an epidural, but I would want to be more than 3cm dilated for that. And even then, I would use it only to see if it could help the Pitocin work better and not because I really needed it for pain. So I tried some optimism. Labor is unpredictable--maybe at my next check I would magically be in transition and deliver soon after!
Our new nurse, Melinda, was also very nice. She came in focused and ready to get down to business. She laid out the situation: progress was slow. I was up to 28 mU/min of Pitocin--most women deliver at half that amount. She checked the contraction printout and observed that this was not a normal contraction pattern. Luckily, the baby was doing splendidly and was tolerating everything well. My BP was fine, except for the one after the last exam, which was sky high for understandable reasons. Her recommendation was to get serious about moving around and trying more aggressive positions, hopefully to even out the contractions and make them effective. Meanwhile, we would stop the Pitocin and start increasing again from zero, as my uterus might be building up a resistance.
Dr. P called and asked how much longer I wanted to go. It seemed like she knew a section was inevitable and was simply allowing me to retain the illusion that I would have this baby the way nature intended, but once I got over that, she would come in and cut me open. Yeah, I've been known to read into things a bit. Regardless, I did not want to see her. I decided to give it two more hours and let her come back at 10 to check me.
Melinda got me on the ball, knees spread far apart. I rolled side to side, front to back. After a while, I stood next to the bed and squatted with each contraction. Just as that started to get more comfortable, she had me on the bed on all fours, shifting my weight back and forth. She was a bit drill sergeant-esque, which I really needed at this time of the day. My contractions continued to be irregular, especially after they cut the Pit. I remember waiting 5-7 minutes between them for a while. Erich and I both started entertaining a small hope that I had made no more progress because some progress would prolong this nightmare and it might still fail.
It was a burden and a relief when Dr. P arrived. I didn't want the c-section, but I couldn't do this any more. She asked how I was doing. "Pretty miserable, actually," I replied. "You poor thing!" she said. That was nice of her to say, but I blamed her for my situation. I still feel that if my bag of waters were still intact, we could have just stopped for the night and tried again later. Lily was fine, I was fine. And, incidentally, and to the surprise of no one, I had not progressed any further. 2-3 cm. Maybe some improvement in effacement, but I don't remember. It didn't matter any more. It was time to have major surgery because all these artificial interventions did what statistics say they will do (or fail to do) 50% of the time. My body and my baby were not ready for birth, so they were going to be forced into submission with the scalpel.
I don't think anyone even said the word at this point. Through my tears and utter defeat, I simply nodded.