My baby boy is turning 3 in less than a month. His birth made me a mother and was a defining moment in my life. I wrote his birth story within weeks of his birth, but I’ve never shared it before! Please don’t read if you don’t like graphic birth details . . .
On May 1, I was 1 week overdue, so our Midwife, M scheduled us to have a non-stress test and ultrasound on May 2 to check up on baby’s heartbeat and welfare and to check my levels of amniotic fluid. Matt and I went to the test together and after baby passed the non-stress test with flying colors we had the ultrasound. It was very exciting to see our baby again on the ultrasound screen. After the exam, the ultrasound technician let us know that the amniotic fluid index (AFI) was low at 3.86 and that the doctor would speak with M and maybe we would be “making a plan today.” Matt and I knew very little about low AFIs, so as soon as we got home I called our Bradley instructor, who basically said not to worry about it because low AFI’s were normal and that my baby was making amniotic fluid all of the time. I checked the internet as well, but pretty much every source said that babies over 37 weeks with AFI’s below 5 would be induced. I was pretty anxious by the time we received a call from M. One of the first things she said was that I was risked out of home birth due to the low AFI. Her biggest concern was that the low fluids indicated some kind of problem with my placenta and that although Baby was fine now, he would be negatively impacted if he wasn’t born soon. She planned to stop by the house this evening to talk about our options—her preference being that we would try sweeping the membranes that night, May 2, in the hopes of starting labor. If labor did not begin, we were to meet M at Memorial Hospital at 10:30am on Tuesday May 3 to begin ripening the cervix.
That afternoon, Matt and I tried to process the change in plans. We were pretty devastated, especially Matt who hates hospitals and had been planning to not need one. We visited Memorial Hospital and learned how to get there, check in, etc. We talked about what we would need to pack if we were going to be at the hospital for such a long time and we took time to be sad about no longer having our home birth. M arrived at the house around 7:30pm. We talked about the pros and cons of different options, including not doing anything and continuing to wait for Baby to arrive naturally. Despite our protests about wanting to avoid induction, we were strongly discouraged from waiting any longer and given a very hard sell on the induction.
We also talked about what labor at the hospital would be like. Because of my diagnosis of low amniotic fluids, we knew that I would be continuously monitored and that I would have a hep-lock, iv port the whole time I was there. Ultimately, we decided that I should submit to a cervical exam—my first the whole pregnancy—and then discuss sweeping the membranes. M examined me and found me to be about 1.5 cm dilated and I forget how much effaced. She then went back in to sweep my membranes which hurt and caused me to bleed. Afterwards, she said that she thought I was about 2 cm dilated. After she left, we made some phone calls. I told my mom and sister about our plans to go to the hospital tomorrow. Everyone sympathized with our sadness about losing the home birth but everyone was excited that Baby’s birth was getting closer. That night we went to bed around 10 and although I had a little bit of cramping that night, I slept very well and woke up disappointed that I had not gone into labor—which would have allowed me to at least labor at home until going to the hospital.
Matt and I finished packing our bags for the hospital and even did a load of laundry before leaving the house. We left about a quarter after 10am on May 3. We hoped that next time we came home it would be with our new son or daughter. We arrived at the admissions window around 10:30am but it took some time to be admitted to M and to answer all the questions about insurance. We got up to maternity close to 11:30 where we were brought to the tiniest labor and delivery room. We were definitely disappointed by the cramped quarters, but I told Matt not to complain, because I really wanted to get along with the nursing staff. One of our first nurses was Ashley, who had shown us around the day before which made things feel a little more familiar. Once I was in the room, I changed into my cotton dress I had brought to wear instead of the hospital gown. Then I got my first heplock put in onto my left hand and had some blood drawn. I also had my monitors placed around my stomach—one to measure the baby’s heartbeat and one to measure contractions. I also learned that I would have to pee into a “hat” a plastic container placed into the toilet so that the nurses could measure how much I was passing. As we waited for M to arrive at the hospital a nurse went through a lengthy admissions questionnaire about my health, etc. I also was able to order and eat a lunch of grilled cheese with tomato and soup.
By around 1pm, M arrived at the hospital and we discussed our next step. M gave me another ultrasound, in which she determined that my fluids were still very low. We decided to try to ripen the cervix with Cervadil—a shoelace like medicine that would be inserted into my cervix and then left in for 12 hours. Right before I started to chug my Gatorade, I was informed that once the Cervadil was inserted, I would need to remain lying down for 2 hours and if I needed to use the bathroom during that time, I would have to pee into a bedpan. Needless to say, I stopped drinking immediately, but promised M that I would resume fluids as soon as the Cervadil’s 2 hours was almost up. At 1:55pm M inserted the Cervadil and told me that I was about 3 cm dilated. For the next two hours, I laid in the hospital bed. Matt and I read our books and talked and I started having contractions. Then Matt went out to get something to eat for lunch because the hospital cafeteria was closed. Matt came back with a cheesesteak from D’Angelos . At a little after 3:55pm I was allowed to get up and use the restroom. By this point, I was having a lot of contractions which were painful, but not much more painful than bad menstrual cramps. Matt and I played a game of Mille Borne, watched T.V., read and talked to pass the time. At dinner time, I was brought up a tray of food from the cafeteria. I was still having contractions that were rather close together, but they weren’t too strong and, although uncomfortable, weren’t too painful. We decided to get hooked up to the telemetry unit so that we could walk around the wing and possibly help the contractions get stronger. The nurse told us to avoid one part of the floor because “something was going on.” As we walked around, we could hear a woman making laboring sounds. Soon, we heard a baby cry, I almost cried to think that soon I’d be hearing my own baby cry. I felt very excited, but also very scared at where this road of interventions would lead us. The walking helped to break up the boredom, but was kind of annoying because we had to keep returning to the room to get the sensors adjusted by the nurse. The telemetry units don’t work too well!!!
After the walking, I laid down for a bit. Matt got a cot put into the room so that he could sleep next to my bed. A new nurse came on for the evening shift. We chatted and learned that her husband was an actor who now taught at Trinity Reparatory Company. Eventually, she and M discussed that my contractions were spacing out—probably because I was lying on my side. I decided to get up on the bed to try to make the contractions stronger. I spoke with family, but by 8 pm, as American Idol played in the background, the contractions were strong enough that I didn’t want to talk to my sister. I listened to Idol and then listened to my iPod for a while. Soon, the nurse came back and told me that I was some medical term, meaning that I had had 6 or more contractions in a ten minute period. If this level of contractions continued, the Cervadil would be removed. She advised me to lay on my side, which I did. The contractions eased up a bit and I dozed. At some point, I heard M and the nurse consulting out at the nurses’ station because the base rate for the baby’s heartbeat appeared to increase from the 130s to the 150s. I could feel the baby moving a lot so I knew that the baby’s activity was the real reason for the change, but nobody asked me or talked to me about it. Around 2 am, M came in to remove the Cervadil and check my progress. By this point, we had another nurse, Barbara, who would be my favorite nurse of them all. Removing the Cervadil hurt, as did checking my progress. M said that I had a very low threshold for pain, but I just think it hurt. I didn’t complain, but I did groan and writhe around during the exam. I thought she seemed kind of annoyed about it. She said that I was about 3 cm and 80% effaced. She decided that it would be best if I rested through the rest of the night, then ate breakfast and started Pitocin in the morning. Nurse Barbara moved Matt and I to the much bigger and much more comfortable labor and delivery room 4—which had a rocking chair and a private bathroom. It had so much more room!!! The move was through by 3:30am and then Matt and I slept until about 7:30am. After I woke up, Nurse Barbara encouraged me to take a shower and left my monitoring off for at least a half hour. The shower was refreshing, and after it was over, I laid down on Matt’s cot with him and cried a little bit because I was so scared of what the day would hold. After Matt and I had breakfast from the cafeteria, I called our doula, Stacie, to tell her about the Pitocin and ask her to come to the hospital when possible. I wanted her to be there if things got hard because I thought it would make me feel safer to have her there.
At 9:30am on Wednesday May 5, I was started on Pitocin. My nurse for the first part of the day was Beverly, and first thing she had to do was put in a new IV line because the other one (which was never used) was no good. The one she put in was in a slightly different position on my hand—in between the index finger and thumb—which was much more comfortable and lasted for the rest of my time at the hospital. At 9:30, the level of Pitocin was 2 and I was to increase by 2 units every hour until I hit 20. At this point, I wasn’t feeling any strong contractions and was just lying in bed, reading and playing Mille Borne with Matt. At 10:30, I was increased to 4 and at 11:30 to 6 units of Pitocin. Stacie arrived around 11:30 as Matt and I were finishing our card game (he won). Stacie had been our “back-up” doula because the doula we had chosen was away at The Farm for a midwife assistant’s training. We had met her once, but didn’t know her very well. We spent the next several hours chatting about our fears and getting to know each other better. Around noon, I ate lunch which would be my last meal until the baby was born, although I didn’t know it at the time.
At 12:30, Pitocin was increased to 8 units, at 1:30 to 10, at 2:30 to 12, at 3:30 to 14. The pads I was sitting on kept showing a mucous discharge that was yellow which I knew was a good sign, but the contractions were even weaker than the ones I had with the Cervadil. Around this time, I began discussing with Matt what to do if there was no labor by the time I reached 20. Despite the worry of complications to the baby, I thought that if the Pitocin didn’t work, we should consider going home to rest and regroup for a couple of days and then reevaluate. We were in agreement about this possibility and I began to feel hopeful that I would be going home soon. I wanted the baby to be born but I was also afraid. Stacie began applying pressure to pressure points in my ankles and wrists. M came in to check on things and suggested that I try to squat during contractions or at least stay upright in order to encourage them to get stronger. For the next bit, I squatted while holding on to the bottom of the hospital bed during each of my contractions. At this time, I had my least favorite of all of the nursing staff—a nurse named “Chris” who had never had children and competed in fitness competitions. I really grew to dislike her because she took the least amount of care in the little details that made the hospital bearable. For example, she often let my cords get tangled when I needed to go to the bathroom, and she routinely left the toilet seat up when after she measured the amount of urine I left in the hat. She seemed annoyed by my frequent trips to the bathroom. At 4:30, the Pitocin was turned up to 16. I encouraged Matt to lay down for a short nap because he looked tired and I knew that we still had a long way to go. Shortly thereafter, I went to the bathroom, and as I peed, I felt a large plop and swish of liquid. I was scared that my water broke so I waited for the nurse to leave and then almost whispered to Stacie that I had felt something fall out. She smiled and said that that was good and it was probably my mucous plug. When the nurse came back in, Stacie let her know that I thought my plug had fallen out. [Note: I now believe this was my water breaking.]
Then, things began to happen quickly. By 5pm, I began to feel very strong contractions that hurt a lot. Matt woke up and came to my side where he would stay almost nonstop for the next 12 hours. The rest of the labor is difficult to recount because it all runs together, but here is how I remember things.
As soon as the contractions got hard I became filled with doubt. I had really hoped that nothing would happen and that I would be able to go home, so it took me at least an hour to accept that I was going to have my baby and I needed to deal with the pain. The pain hit so hard and fast in my mind that I was really scared that I wouldn’t be able to handle it. In my mind, I began telling myself all kinds of things—like that I would never do this again (have a baby without meds), that no one would blame me for getting an epidural because of the pitocin, and that I couldn’t do it. At 5:30 the Pitocin was turned up to 18 and at 6:30 it was turned up to 20. During this time, I tried many different positions at Stacie’s recommendation. Every time she would suggest something, I would be afraid to try it because if I didn’t relax completely during the contraction or if I tried to move it would hurt so bad. I tried sitting in the rocking chair, which was ok early on, but soon too uncomfortable. I also sat on a huge birthing ball and held onto the bed but I felt like I would fall over. I did slow dancing with Matt which was ok, but it was difficult to relax my legs and abdomen enough while standing up. All of the standing made me tired but when I tried sitting on the bed in between contractions to rest, I often wouldn’t stand up quick enough and then moving to stand during the contractions would kill!!! I believe it was during this point that I said to Matt and Stacie that I didn’t think I could do it if the contractions got worse and that I would need an epidural. I knew that I had made Matt swear not to let me get one, but I was feeling desperate. Both of them gave no reaction and just suggested that I focus on each contraction one at a time. I remember spending a bit of time propped up on the bed with my legs kind of pulled back to rest. At some point, I also remember dozing in between contractions during which I would have imaginary conversations with Matt and Stacie. Then I would wake up and realize that I hadn’t said anything. When the pain got really bad during the height of the contractions I would try to distract myself by thinking of Hawaii—especially swimming with the turtles. A few times, I also thought of the black sand beach, but then would remember that we had a fight there, so I tried to focus on the turtles. Sometimes that little bit of distraction made the pain a tiny bit more bearable. I also would try to glance at Matt’s face and look into his eyes which also provided some relief. Matt would stroke my arm or my hand and if I didn’t like what he was doing, he would stop and try to do exactly what I needed. At this point, whenever I went to the bathroom, I had Matt come in with me and stand in front of me on the toilet so I could hold on to him if I had another contraction. Having him there made going to the bathroom so much less scary. When I could remember, I would try to imagine my body opening up.
At 7:40pm, M checked my progress and found that I was 5 cm dilated and completely effaced. I don’t remember this check at all, but I do remember M turned the Pitocin down to 10 (at my insistence) because I wanted to see if the contractions would continue in a more manageable way because they were very close together. I remember laboring on the birthing stool at this time, moaning, and swaying, and deep breathing. At this point, I remember feeling pretty positive about the labor. I was going to have my baby!!! I think that it was around this time that I realized I had been listening to the same music—a CD of nature sounds and pan flutes that was super cheesy. I said to everyone, “ I’m totoally digging this music.” M said, “We can change it,” I think because she thought I was being sarcastic. I said, “NO! I’m totally serious. I need to buy a copy of this shit!” I don’t know why, but I couldn’t bear to think of anything changing. Around 11pm, I begin to feel nauseous. M and Stacie encouraged me to throw up thinking that it might help labor to continue. Despite the urge to throw up, I just couldn’t do it. M was dozing in the rocking chair and said nonchalantly, “Drink some water, you’ll do it.” I drank some more juice and water and basically forced myself to throw up around 11:35pm. Throwing up during a contraction was one of the best feelings. For once, the contraction didn’t really hurt. I knew Nurse Barbara was back and she said something about throwing up would make me be at 10cm.
At midnight, M turned the Pitocin off to give me a rest for the hard work ahead. I don’t really remember this time, but I was allowed to labor on the toilet for about a half hour without being monitored thanks to Nurse Barbara. At 12:30am on May 6, M found me to be 7cm dilated. She discussed turning the Pitocin back on because the contractions had spaced out a bit, I knew she was right and was happy to have the Pitocin turned back on so I could get my baby born. I believe I laid down to rest at some point during this time, I think after trying to stand supported by Matt but not being able to stand at all during the contractions due to the pain. The pain during this period was intense. I remember lying on my side and feeling huge pressure in my lower abdomen and pain in my lower back. Matt got out a tennis ball and massaged my lower back while I writhed in pain. In my mind, I wanted to shout out for an epidural but I figured that it was too late and it would only make me look weak to ask. Around 1:30, I started to feel an urge to push. I kept saying it over and over to Stacie with each contraction. She told me I would know when to push and to listen to my body. After a particularly hard contraction followed by strong pushing urges, she asked the nurse to page M who had left to rest herself before the big work ahead. M checked me to find me mostly dilated with a cervical lip at 11 o’clock. She put her hand up inside me and coached me to push when I felt the urge while imagining the cervical lip melting away.
By 2:30am, M tells me that I am fully dilated. It is now time to push! Pushing felt so good! While pushing, I didn’t feel pain during the contractions, but once the cervical lip was gone, I didn’t feel a very strong pushing urge but instead just pushed when I thought I was at the height of a contraction. I pushed in many different positions. At different points, I was up on my knees facing the back of the bed, with my feet on a squat bar, pulling on a sheet, and side-lying. Very early on in pushing, I felt so hot and I wanted to be ready for the baby to go on my chest, so I whipped off my cotton dress and went naked for the rest of the time. Mostly, I remember being on my back with my legs pushed back by either M, Barbara, Matt or Stacie. M would tell me to push farther than I’d ever gone, over and over. She kept telling me to relax my legs, which was difficult. In my mind, I often thought, I can’t do it, it’s too hard, but I knew that there was no turning back now and that if I didn’t push out the baby soon it would be bad for both of us. To combat my negative inner voice, I would coach myself out load saying things like, “I’m going to have an awesome push, I’m going to move the baby down, I’m going to push the baby out.” Matt stood near my head and gave me an oxygen mask to breathe from in between contractions to make sure the baby was getting enough air. It was such hard work.
While pushing I remember worrying that I wasn’t doing it right or fast enough. Around 3am, I asked M how much longer it would be. She said about another hour and a half, and I asked, “Why not an hour?” She said to prove her wrong, but in the end, it was her who was exactly right about how long it would take. I also remember Nurse Barbara standing at the foot of the bed and smiling and nodding during my pushes. Seeing her made me think that I was doing what I needed to do. Eventually, Matt went down and looked inside me to see the head and M had me reach down and feel the head for myself. It felt slimy. At some point, a large mirror was wheeled into the room so I could see the baby’s head coming down. I also noticed that I had HUGE hemorrhoids!!! Needless to say, I was happy when they wheeled that mirror away!
I was having trouble getting the baby’s head out through the narrowest part of the pelvis. Then I felt the baby move in my abdomen. M said to relax that the baby was trying to move into a better position. The baby moved so that its head was face down. With many more pushes I was able to push the baby through the narrow part. During the pushing phase, as he began to see the baby’s head moving down, Matt became very emotional and told me often how awesome I was doing. I remember thinking that I wasn’t sure whether he knew whether things were going awesome or not. I was afraid because they wanted me to breathe the oxygen and just wanted to get the baby out so I would know that the baby was ok. Eventually, M brought in a big tray of stuff near the bottom of the bed and began to put on a surgical gown and gloves. I began to get excited to think that the baby’s birth was finally getting close. Then I noticed that another person had entered the room. It was a medical resident OB. M said that he would be there during the birth. I kept pushing as hard as I could during the contractions. I tried to give powerful pushes, but sometimes felt disappointed with myself when I felt like I gave a less powerful push because I wanted the baby to be born.
When I saw M ready with all of the equipment I kept expecting to feel a “ring of fire,” but it never came. Eventually, M coached me to give a few small pushes. I only knew the baby’s head had crowned when M said, “give me another big push to get the shoulder out.” I was so happy to know the head was out. Matt was crying and I pushed out the shoulder. Then M said, “Matt, get down here.” Matt said, “What do I do? What do I do?” M said, “Pick up your baby.” The next thing I knew, Matt was putting our baby up on my chest and at the same time saying, “It’s a boy!” I was so excited to see my baby boy. Someone suctioned out his nose and mouth with the bulb and rubbed him with a towel and he started to cry. Eventually, I heard Nurse Barbara say the time and the resident echoed it—4:31am. The resident examined Peter and gave him a 1 minute APGAR score of 9 (out of 10). I could sense Matt next to me and see his arm, but I had eyes only for Peter for the first 30 minutes or so. Peter looked at us with wide awake eyes. We all marveled at how much hair he had. After a bit, the umbilical cord was clamped and Matt cut it. Then the resident “delivered” the placenta. Meanwhile, Peter latched on and nursed for a good half an hour. While Peter was still on my chest, another Nurse came in and told me that my mom had called around 5. I felt so bad because when contractions had started I felt like I couldn’t handle me or Matt making any calls. Everyone forgave us because we got to deliver the great news . . . It’s a boy!!! After a few hours, Peter was weighed—8lbs, 10 oz.