Pax's delivery - what to expect when your labor is induced?

It has been over three years since Pax was born. I often say that I haven't bothered to write an entry about my second birthing experience given how arduous it was that I can hardly remember a thing. I was lucky I was able to deliver Pax naturally still, without epidural. But I did ask for epidural at some point, I recall, but re-considered given the rapid progress of labor. The nurse instead gave me Entonox (laughing gas) and it certainly helped me manage the intense pain. Given what I went through, I would never allow myself to be induced again. N-E-V-E-R again, spell that out! (Meaning, if I can avoid it, I certainly will!) It was my ignorance about the effects of labor induction that put me in that agonizing situation.

But I am surprised to see in my drafts that I was able to jot down the main points about my second delivery. I have cleaned the draft a bit, but nonetheless remained faithful to an earlier (and thus, more reliable) personal recollection of Pax's entry into the world.
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Pax arrived two weeks earlier. His EDD was supposed to be on the 24th of January 2015. He was born on the 13th of January, a Tuesday, at 12:39am.

Childbirth, the second time around, was no way easier than my first.

My water bag broke at around 5am on Monday. Rene and I headed straight to Mt. Alvernia Hospital, afraid that contractions will start sooner than I can turn over my work to my bosses ('coz I was still planning to report to work that week). But mild contractions only started in the evening at around 7pm, after a dose of prostaglandin in the morning and oxytocin in the evening. Because labor progressed very slowly, my OB suggested over the phone that we opt for a C-section. I already had an inkling that this option might be raised while Rene and I were still lingering around the hospital corridors earlier in the day, waiting for labor to start. I just did not want to entertain the idea as I had no plans of going through a major surgery.

Hearing the OB suggest a C-section was hard to swallow for me, and Rene understood that. So we asked our OB to re-assess the situation when she would arrive at the hospital. Rene and I prayed hard for a miracle. No C-section please. What if something goes wrong? I feared of death and the thought of leaving my lovely kiddos and husband behind.

Miraculously, when the OB arrived at the hospital about an hour later, her vaginal examination (VE) indicated that I was already about 5cm dilated and that there was actually no need of a C-section at that point. We realized that the nurse or mid-wife who had been attending to me earlier did not ask me to pee every time she did the VE. And that made all the difference. Apparently, when your bladder is full, the cervix could appear less dilated. I can imagine the enlarged bladder taking the space of a supposedly wider cervix, causing erroneous measurements.

Labor did progress minutes later. But I was taken a back at how the contractions suddenly became excruciatingly painful. It was not supposed to be that way; from my experience with Umi and what Rene and I learned from the childbirth class we had attended, the pain intensity was supposed to build up gradually. However, this one was rather highly accelerated (this is an understatement!). I soon got so tired from bearing the pain that I began asking for epidural. However, the nurse told us that it would take 0.5-1 hour to get the anesthesiologist. So she offered me the laughing gas instead. The laughing gas turned out to be a real blessing, I survived the whole ordeal without an epidural!

Inhaling the laughing gas during contractions helped ease the excruciating labor pains. It also made me groggy and I felt that my body was beyond my control. I heard Rene's voice and felt at peace that he was with me at that moment. I thought, 'maybe, maybe you truly love the person when you still want to be with him during the toughest point in your life' (naks!). The gas was definitely helping me manage the pain...and making me hallucinate, too? 

Then the time to push came. The nurse took away the gas from me so I can be alert to push with every contraction. Looking back, the gas was actually a way to conserve my energy for the unimaginable effort required to push out the baby. 

The pushing stage seemed to last forever. I wanted to give up but there was no turning back. After what seemed like eternity, Pax came out. He was beautiful. My Pax, our Pax. 

The gas was again offered to me during the delivery of the placenta and during stitching because of the episiotomy. 

After Pax was cleaned, he was brought back to me on the bed. He was lovely. He seemed to want to talk, as if he wanted to tell me about the tough time he went through to see this world. (He did actually look like the world had treated him terribly, only to find out later on that this is another bungisngis kid of ours!) Our encounter, however, was cut short when the nurses informed me that Pax had to be brought to the NICU (neonatal intensive care unit). Pax apparently had difficulty breathing. But after a few more checks, we were told that his condition was stable and that we didn't have to worry. 

Rene and I celebrated this another feat of ours with toasted bread and warm Milo. As there was no available 1-bedder at the hospital that night, I was temporarily placed in a 2-bedder. That meant that Rene cannot stay with me. So he went home shortly and slept with Umi instead.  

In my room, I tried to sleep but couldn't. My emotions certainly hadn't calmed down from what just transpired. I passed the time by searching the internet about Pax's breathing difficulty and found out that it could be due to the synthetic oxytocin that was used to induce labor. Thankfully, that initial breathing problem did not interfere with his ability to feed from my breast, and that Pax and I had a wonderful breastfeeding relationship. 

Pax at 6 weeks old. Still looking like the world owes him a great deal! Hahaha!

That bungisngis chubbikin at 6 months old with his Papa and Ate Umi

Oh, this mischievous boy now! At 3 years and 4 months.

Postscript:

Risks of labor induction (from Journal of Perinatal Education, 2006)

Induction of labor alters the process of labor and birth in significant ways. The cervix often needs to be softened before pitocin (synthetic oxytocin) will be effective. Pitocin causes contractions that both peak and become stronger more quickly than naturally occurring contractions. The result is a labor that is more difficult to manage. In addition, the uterine muscle never totally relaxes between contractions, increasing stress on both the uterus and the baby. Because of the increased potential risks for the uterus and the baby, continuous electronic fetal monitoring is indicated. The fetal monitor and intravenous line make movement more difficult. The hormonal orchestration of labor is disrupted. Pitocin does not cross the blood-brain barrier; therefore, endorphins are not released in response to the increasingly strong and painful uterine contractions. Laboring women do not experience the benefits of endorphins as they try to manage their contractions. Additionally, without the help of endorphins, they are likely to require an epidural. The epidural alters the course of labor, prolonging the length of both first- and second-stage labor and increasing the need for the use of instruments at birth. Without high levels of naturally occurring oxytocin and endorphins, catecholamine levels do not surge at the time of birth, and the mother and her baby are less alert and able to interact in the moments after birth.

Elective induction increases the risk of giving birth to a baby that is near-term (born between 35 and 37 weeks, even when it seems the baby should be 38–40 or even 42 weeks by dates). In spite of their physical appearance, near-term infants are physiologically and developmentally significantly less mature than full-term infants and are at increased risk for mortality and morbidity in the newborn period (Wang, Dorer, Fleming, & Catlin, 2004). The near-term infant is at increased risk for temperature instability, hypoglycemia, respiratory distress, apnea and bradycardia, and clinical jaundice (Wang et al., 2004). The baby's difficulty in coordinating suck/swallow and breathing abilities contributes to problems with feeding; subsequently, poor feeding adds an increased risk of hyperbilirubinemia (Sarici et al., 2004).