(I think it goes without saying, there will be discussion of lady parts in this blog post.)
The big difference in this pregnancy and my last pregnancy was definitely in prenatal care. Now, obviously, Cora required a lot more prenatal care thanks to a congenital lung defect, sophisticated prenatal surgery, and whatnot. Thankfully, none of that craziness went on this time. I was, in fact, surprised by how not-invasive prenatal care is when you aren't high risk. Like, I only have to go to the doctor once a month? I don't have to pee in a cup each time? No weekly ultrasounds, no weekly non-stress tests? But also I got to go to a private OB/GYN practice, and delivered at the private hospital. No three-hour average waits to be seen, no sitting in the waiting room with the lady prisoners, the crack-moms, and women so rough I'm pretty sure they could kill a bear with their hands. Just waiting about 10 minutes or so with some old ladies and some unremarkable preggos.
But there were definitely differences in delivery. Now, I'm sure if I hadn't been the problem child last pregnancy, they would have sent me home when I went in the night before my insurance final, believing my water was leaking. In fact, if the attending hadn't been there, they would have, but she said she wanted to keep me since they expected I would go early (something they'd failed to mention to me). So, I wasn't real concerned Sunday when I started having irregular, although painful contractions. Not pleased about it (or pleased that the Husband was passed out on the couch instead of paying attention to the fact that I was in pain) but I knew if I went to the hospital, I'd just be wasting my time. Then I started having more intense, regular contractions. I waited until they were 4 minutes apart, 1 minute in length, for an hour, like my instructions said, and we went to the hospital at 1 a.m. (Fortunately, we have a live-in manny, so we didn't have to get anyone out of bed to come stay with Cora, or drag her out of bed to take her with us.)
They took me in and hooked me up in the recovery room, which had three beds separated by curtains, because they were full that night. Although the contractions were now coming 2-3 minutes apartment, I was not dilated any more than I was at the appointment on Friday (when I was told I wouldn't be birthin' any time soon). So, at first they wanted me to go "walk around" and come back later. I'm like, WTF? I'm doubled over in pain from frequent contractions... you want me to do what? I want a damn epidural, is what I want. Then they made the call to hook me up to an IV because they thought I might be dehydrated (I wasn't) because the baby's heart rate was high and dehydration can bring on contractions. Two hours of drug-free contractions later, the baby's heart rate is back down but I'm still contracting at the same rate. They finally give me some drugs, which made me itch. Then they gave me some benadryl, which made me unconscious. Which was good, because they brought in Hillbilly Brigade into one of the beds, waiting for a c-section, and I was getting tired of listening to them. It was like being in labor in family court, holy hell. (I guess it was still better than being at University of Cincinnati, where I thought the screams down the hall was from ladies being in labor, but it turns out they were actually from pregnant women going through heroin withdrawals. Awesome.)
As an aside, the fun thing about being in "the city" is that for certain events, the hillbillies flock in. One of those events is for birthin'. There were several run-ins with the hillbilly kinfolk that day. At one point, Husband watched with amusement as two old biddies tried to figure out the door to maternity. (You have to push the button to have them buzz you in, then you pull on the door.) They buzzed in, but missed the "window" of getting the door open before it locked again, and couldn't figure it out. Finally, after watching one push on the door for awhile in confusement, Husband reached around her to swipe his security badge which unlocked the door. The old biddy apparently missed that and at that moment realized she needed to pull on the door, and pulled really hard at the now unlocked door... and hilarity ensues as said old biddy goes flying backwards with the door. The old biddies were grumbling about the defective doors, still having no clue what just happened.
Finally at 11:00 a.m., they got me into a room of my own. My OB came around about 1pm, and examined me. My contractions had pretty much stopped, but finally, I was dilated to 6cm. She said she didn't want to send me home just to have my contractions start again, so she made the call that it was time, broke my water and ordered Pitocin. I wasn't too concerned they hadn't gotten my epidural in yet, because the last time I had Pitocin it took forever to kick in. Yeah, not this time. It totally sucked. I had horrifically painful contractions for what seemed like an eternity and "slow deep breaths" don't do shit. So, I had plenty of "natural child birth" experience this time, and seriously, fuck that noise. Finally I got my epidural, and was able to get some sleep because I wasn't waking myself up with my own screams.
At about 6pm, the nurse woke me up and asked me if I was feeling that "pressure" that I should push. I was a little bit, but she checked me and I was 8cm. So, she left, and right around shift change, I'm definitely feeling it. Like, I'm clenching, trying to hold stuff in, because I felt like if I didn't, I'd be pushing the catheter out (I kept thinking about this awful med mal case we had where the doc left the catheter in during delivery, and the damn thing came shooting out still inflated, ripping up this lady's urethra... yeah... no way.) And totally awesome, the epidural was starting to wear off, so that was fun. Anyway, finally the nurse comes in and calls for the nurse midwife on call, and they're like, hey, the show's starting. The midwife asked me if I wanted to reach down and feel the head. I'm like, fuck no, I'm going to my happy place now, get this thing the fuck out. With only pushing through three contractions, I popped the baby out. (Fortunately she has a small head.) Then I was like, seriously, get me some damn food and caffeine. A bagel and a Dr. Pepper later, I felt human again.
So, that was my birthin' experience. Definitely a significant amount more pain this time, not pleased about that. These folks were not on the ball with drugging me up. As soon as I got admitted the last time, I got my epidural, and until the Pitocin really kicked in, I never felt a single contraction, and pushing wasn't a big deal either. I was much more exhausted afterwards (probably due to all of the emotional turmoil) and passed out for awhile after they scooted me off and we found out that Cora was pink and not blue. This time, there was a lot of pain. But I think there was more adrenaline this time, from excitement and happiness instead of fear, and I felt great after it was over. Like, hell yeah, the baby's out! Also, there was significantly less damage to my girl parts this time. Cora had to be popped out with forceps there at the end because her heartrate started dropping. At least this time around I don't pee myself whenever I sneeze.
Anyway, we had to wait around to get into a room and they took Violette to the nursery to check her out and suction goop out of her and all that good stuff. The staff were all very nice and friendly, but there were certainly a lot more interruptions this time. Last time, I had a NICU baby, so I guess that might be the difference. But, geez, this time, I swear, there was someone in my room every 20 minutes doing something. Usually a teaching hospital is more intrusive. They're sending in med students, nursing students, residents, fellows, proctors, who knows who else. When Cora was born, there was a whole room full of people, I didn't even know who most of them were. Maybe they were there because of the anticipated medical complications. But when Violette was born, it was me, Husband, the nurse midwife and the nurse. A few other people came in after she was out to do the whole baby warming thing, while the nurse midwife finished me up and did the whole placenta thing. But then postpartem, everybody and their brother is up in my room for something.
Other differences between the university hospital and the private hospital: Food sucks at the private hospital. We have a kick-ass catering company at the university hospital. Like, we have even have sushi in the clinic cafe. The stuff they serve in the patient rooms isn't 5 star or anything, but it's on par with like Applebee's or O'Charley's, and that's significantly better than what the private hospital is serving up. The private hospital calls their department "nutrition." Yeah, it's not. It's pretty gross.
I was a little weirded out by the morning and evening prayers over the intercom. Definitely not used to that. And we were pretty surprised when the lady from billing came in to ask if we wanted to "take care of our bill" that day (and dropped that we'd get a 10% discount if we did). I can't even get our billing lady to return my phone calls at the university hospital when I'm trying to help them get paid.
So, there you go. Overall, I'm happy with the care that I got, and if we decide to go for a third kid, I'd definitely go with the same group and happy with the care in the hospital. However, if I were high-risk, I'd want to go back to the university, I have more confidence in their abilities to manage complex cases, even though it is a horrible inconvenience. We still take Cora to the pediatrician at the clinic (not my department, but the internal medicine/pediatrics department), and we took Violette there today. I don't go to them because they're impossible to get an appointment when you're sick and would like to be seen that day or the next day, not the next week, but for the kids, we have an after-hours pediatrics clinic (which is where my office is) which is like urgent treatment for kids, but with a regular doctor visit copay. So, I'm not too worried about not getting in for a scheduled appointment. Our docs staff that clinic in rotation, so same folks.
Baby out. Birthin' done.