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Here was my plan for giving birth: I have an excellent midwife, Charlotte, with over 20 years of experience and over 2500 attended births to her name. I was planning on giving birth in her clinic, where she has a couple of rooms set up nicely for birthing, with their own big beds, couches, and private bathrooms, and the main one even has a Jacuzzi tub for water births. My husband was going to be there; I knew he’d be an encouragement and a physical rock. My sister-in-law Brandi was going to be my doula. She’s even worked with my midwife and used her for her own children’s births. And my mom was going to be there, with a camera. I didn’t know how much I wanted her involved beyond taking pictures; my family has always been fairly private, so I wasn’t sure how comfortable I’d be with what level of involvement with her. I wanted no drugs. Completely natural. No hospital unless medically necessary for me or the baby. I expected, pretty much, a typical birth. It’s my first baby, so I expected labor to be on the longer end, but since he was head down and in a great position, I expected it to take no longer than a day at most once contractions started.
Here’s how it ended up going.
I was due on February 25th, according to a 7 week ultrasound, which is more accurate than a gestational due date. I’d been 2.5 cm and 50% effaced at my last check.
At 12:18am on Monday, February 24th, I started having contractions. I hadn’t even gone to sleep yet. The last time I’d eaten was my pulled pork dinner late in the evening.
The contractions started right off at 5-6 minutes apart and noticeably more painful than Braxton Hicks or even the false labor I’d had the previous Monday. After forty minutes or so of that, I woke Steven up to let him know that I was pretty sure I was in labor, and then called Charlotte. She was at another birth and had a woman whose water had broken a few hours before waiting for her at the clinic, so she told me to labor at home for now and have Brandi come so that Brandi could keep Charlotte updated and help Charlotte decide when I should go to the clinic. The hope was that the birth she was at would be done before I needed to go.
So then I called Brandi and my mom, and both headed to my apartment. Mom arrived first, since she lives 20 minutes or so closer, and by then contractions were painful enough to make my throw up and getting closer together. By the time Brandi arrived, they were anywhere from 2-4 minutes apart. I thought we’d have to go to Charlotte’s pretty quickly with how close contractions already were, but not actually knowing how things usually go since it was my first time, things were actually going quite as quickly as I thought. Brandi kept in contact with Charlotte every hour or two so they could update each other.
I had a lot of back labor. It wasn’t completely not in my stomach, but my hips and lower back were where I felt the worst of it. Brandi helped me figure out the best way to breathe through contractions–in through the nose out through the mouth, making low noises if I needed to make noise, which I often did. High pitched noises work against the contractions; low noises don’t. That’s why high pitched screaming is not a good idea during labor.
The most common way I got through the contractions at home was to lean on one person and have another press on my hips. Occasionally we’d do pretty much the same thing, but on my exercise ball instead. We tried a few different positions for contractions, but anything that had me bent over or on my side hurt more and often made me throw up. I couldn’t keep any food or liquids down, not even a popsicle or water.
Brandi put my hair into a French braid — which she’s amazingly fast at — so that I didn’t have to worry about hair in my face or a tight ponytail. I was wearing sweats and one of my husband’s shirts, and when I wanted extra warmth I’d put on a bathrobe. I liked having the comforts of my own home, but I was also anxious to get to the midwife’s. I wanted to be where I was going to have the baby.
We slept a bit, when we could. For me, that meant very short naps between contractions. The other three took turns with who would help me get up and get through the contractions, and who slept. Mom and Brandi let Steven sleep the most, because they wanted him to be awake when I got nearer to the end and needed his strength and support the most.
Occasionally, I would have contractions back to back. Those sucked, because I didn’t get a breather in between. I’d just be feeling the relief of a contraction being done, and suddenly another would start building. I think the worst was five in a row. Usually they were 2-4 minutes apart, though. By the time the morning was done, my teams’ arms were getting tired. Mom’s were so tired, she couldn’t even effectively press my hips for me during contractions anymore.
After twelve hours, almost exactly, Charlotte was finally on her way back to the clinic and we were loading up the car and heading there as well. I was really not looking forward to the 30 minute car ride with contractions being so close together, but I was excited to be going to the clinic finally. The car ride was difficult, but do-able. I just held Steven’s free hand and breathed through each contraction.
The other mom whose water had broken the day before was still in the main birthing room, so I went into the other one. Charlotte checked me shortly after I got there. I was only at 3cm, but I was almost completely effaced, and they guessed that once I got to 4cm, the rest of the labor would go fairly quickly. Just getting to where all I had to do was dilate was what had taken so long so far. Brandi had actually told me earlier that she’s noticed that one of two things usually happens with first moms: either they take forever to get to about 4cm and then the rest will go fairly quickly, or they stall for awhile at 7cm and then the rest goes smoothly once they get passed that. Apparently I was going to be in the first category.
My water broke on its own as I was getting checked, too, which was also a good sign for the rest of labor progressing fairly quickly from there. Everyone was optimistic.
At this point, my mom gave Steven a stuffed velociraptor. He’d been saying that’s what our baby would be all pregnancy, especially before we learned the gender and people were asking us often what we thought we were having. We thought that he should still get his velociraptor.
Unfortunately, they soon found that my blood pressure was up way higher than it should be. Charlotte told me I had to lay on my side. I literally begged her to let me stay upright because labor hurt so bad on my side, but she told me, “I’m really not trying to be mean, I literally have to have you lay on your side because your blood pressure is just too high. We have to try to get it down.”
Laboring on my side was really difficult. Brandi prayed with us multiple times through the labor, but the most was probably during that time. It was the first time I said, “I can’t do this,” during contractions. They kept reassuring me that I could do it, and pointing out that I was doing it. I kept thinking, “But I don’t want to keep doing it!” They kept encouraging me, though, so I kept going and getting through each contraction.
My blood pressure just wouldn’t go down. Charlotte considered trying IV fluids to see if it was just dehydration from throwing up so much that was causing it to stay high, but she finally decided not to because, if it wasn’t that, it could detrimental to wait that long to send me to the hospital. Very disappointed that she had to make the decision, she said that I needed to go to the hospital. She only has a 2-3% transfer rate, so I knew that she didn’t make that choice lightly.
Then it was just a matter of making a couple of decisions. Providence or Seattle U? Providence; it’s closer, and I’d had a good experience there when I’d been hospitalized for a few days a few years before, so I felt I’d receive good care. Car or ambulance? Ambulance might take me to the hospital in town instead, which I didn’t want, and I didn’t require an ambulance, so we’d go by car. Would Charlotte go with me initially and then leave since she still had to attend the birth that was going on in the other room, or would her assistant, Heather, go with me and not have to leave? I wanted the constant care and advocacy of someone who was supportive and knowledgeable about natural birth, so I chose to have Heather come, especially since she’s an experienced midwife, having worked as a midwife in another country, helping poor women receive good maternity care, for a few years. Who would take which vehicles? Mom and I would ride with Heather, and Steven and Brandi would take their vehicles. Mom would pick her car up after the birth.
And so we were off to the hospital. Charlotte called ahead to let them know we were coming, and got the midwife on duty as my provider insteas of an OB. After a little bit of confusion about where to go to get into the right part of the hospital, I was admitted and brought to my room, where I was put into a hospital gown, strapped into monitors for contractions and the baby’s heartbeat, and given an IV — all the while still leaking amniotic fluid occasionally, which was very annoying. My blood pressure was still very high. The midwife had me put on some blood pressure medication, and ordered blood tests to check for preeclampsia. The good news was that the car ride had effectively gotten me to 5cm and contactions were still pretty regular, so things looked good.
The hypertension medication was not effective enough, I’d started swelling badly, and the blood tests showed that I had developed preeclampsia, so an OB-GYN had to take over my care. I had not had preeclampsia earlier in pregnancy. I’d never had more than trace protein, and while we’d had a few higher readings (most not higher than 140/90, just high for me) for my blood pressure in the last couple of weeks, it seemed that part time bed rest and supplements were controlling it, and my blood tests had come back normal. It was very disappointing to have it now, and the only thing that will cure preeclampsia is to have the baby.
At the same time that I got an OB, I got a new nurse as well because of shift change. Her name was Electa, and she was amazing. All the staff were understanding of my desire for minimal intervention and that the hospital had not been in my plans, and not only was Electa friendly and good at her job, she did her best to help minimize interventions. She was also not at all pushy about me getting pain medications; she just did her best to help me keep going with the labor.
I wasn’t standing for contractions anymore, but I was able to be upright in bed. I held onto people’s hands and focused on something — preferably Steven — to get through contractions. Apparently the staff was impressed that I was handling my first labor so well, especially without pain medications, but I was just handling it the way Brandi had coached me to at the beginning.
I was put on magnesium to prevent seizures, which is what happens if preeclampsia progresses to eclampsia. Unfortunately, since magnesium interferes with the nervous system, it often slows labor as well. Late in the evening, they thought I was getting close to delivering. They thought I was at about 8cm, and I was feeling the contractions through my tailbone, almost like I had to go #2, which is often a sign that pushing isn’t too far off. Soon after, though, contractions slowed to 15 minutes and progress stopped. I was tired enough that I liked the break, but we needed progress or I’d be put on pitocin. They couldn’t allow labor to stall too long. We tried natural ways to induce contractions for a couple hours, with the doctor’s blessing. Heather and Brandi were able to get contractions back to five minutes apart, but there was no further progress, so sometime around 1am-2am, we started me off on pitocin at a 2 (I’m not sure what measurement that was in).
Pitocin contractions suck. Let’s just put that out there right now. I had not wanted to be on pitocin for a reason. The contractions tend to be longer and harder, and are more likely to put the baby into distress and cause a c-section to be necessary. I understood the need for it in my situation; with preeclampsia and my water having already broken, delivery needed to happen as soon as possible, and letting labor slow or stop for too long increased chances of infection or of complications from the preeclampsia, some of which could be life-threatening to me or to my baby. But knowing all of that didn’t make the contractions caused by the pitocin any easier, especially when we got up to a 4 and started trying different positions to help things along. It was the first time I threw up again since we’d left my house, and the contractions in certain positions were even worse than when I’d laid on my side at Charlotte’s.
I said “I can’t” during a contraction again. The staff — I think the doctor happened to be in the room at the time — immediately asked what I meant by that. I told them I was just reacting to the pain. That response was good enough that they didn’t offer pain medication, but I know they’d been ready to do so.
My birth team was tired. Mom, Brandi, Heather, and even the nurse had gotten teary at times through the labor, especially after I was on pitocin. Part of it was definitely fatigue, but they also all were impressed and moved by how hard I was working to get through it even with everything that had been going differently than I had originally planned for the labor and birth. I don’t know how many times Brandi called me a rockstar through my labor.
By early morning, I was coming up on two days without any real sleep, a day and a half without food and fluids mostly by IV, and about 30 hours of labor. I was exhausted. I couldn’t even keep my eyes open through contractions half the time, although I couldn’t really sleep either, since they were back to 5 or less minutes apart. Steven was encouraging me to keep going like I was, but I eventually hit a point where I knew that I probably wouldn’t be able to push if I had to do a few more hours like that. I’m actually not sure I could have even pushed at that point, in retrospect. My nurse realized that at about the same time, and pulled Heather out into the hall to express her concerns and ask her to be the one to remind her that I did have the option to try pain medications.
I don’t remember everything Heather said, but I asked for the epidural once she talked to me and she and Mom reassured me that it really was okay to change my plan at this point.
I got the epidural at about 8:30am, after 32 hours of labor. My mom stayed in the room with me while it was put it, and everyone else stepped out. The relief began within two contractions, but my legs soon felt ridiculously heavy as well. Later on, Charlotte told me that the later in labor an epidural is begun, the less likely it is to cause a c-section due to stalling progress, so holding off as long as I did was good. One side effect of epidurals can also be lowered blood pressure. Normally, that can be bad, even sometimes causing brain damage to babies, but in my case it caused the only normal blood pressure readings I had at the hospital.
I got a new nurse at the same time, Emily, who was also very wonderful and involved in helping things go as well as they could, and a new OB, Dr. Moi, who was very personable. Unfortunately, they found that I was actually only at 6-7cm instead of 8cm like Electa and the other OB had said the night before. They didn’t seem to think the progress had actually reversed, just that they’d measured wrong or something like that. It made me grateful that I hadn’t tried to get 4cm more instead of 2cm more without pain medication while on pitocin, though.
Emily helped me get into a position in bed that would help things progress as quickly as possible, and the pitocin was set all the way up to 16. The medication allowed me to sleep through contractions, as they were now at most just a feeling of pressure in my stomach. No more back labor. They also put pressure cuffs on my feet to help with the swelling, which was very uncomfortable. I slept, with Emily helping me turn to my back or other side about every hour to help things along. Heather and Brandi both left for a couple of hours, Heather to Charlotte’s clinic to catch a little rest and clean up a bit, and Brandi to shower and feed her 10-month-old. Steven and Mom slept while I did. I even slept through Mom being given a mattress pad to put on the floor so she didn’t have to try to sleep in the armchair, since Steven had the couch.
When Heather returned, she had Charlotte with her, which was a nice surprise. The other mom, whose labor had also been long, had delivered a few hours before. Charlotte was very glad she’d been able to make it when she did, so that she could be there for the actual birth.
At this point, I was starting to feel signs that it was getting near time to push. I was also on oxygen, since there wasn’t as much variation in the baby’s heart rate in response to stimulus as they liked to see, and the oxygen helped. The heart rate should stay within a certain range, but they like to see some variation within that range.
Emily started asking me every now and then if I wanted the doctor to come check me and have me try a push, since I was feeling pressure in my tailbone more and more. I held off because I didn’t want to do any pushing before it was definitely time, but I asked for the epidural to be dialed down just a little so that it wouldn’t interfere with the urge to push and so that I could fully control my legs again. I could tell they didn’t get that request often. When Emily called the anesthesiologist, I heard her say, “She wants her epidural down a little. Yes, down.”
Then I was feeling the pressure even between contractions, so Emily called in Dr. Moi, who checked and said I was ready. The timing went really well. They got me all ready, with my calves in the stirrups. I was happy that the stirrups weren’t set up like they are when you go in for your check up at the doctor, where they’re all the way at the foot of the bed and you put your heels in them, which isn’t good for pushing. These stirrups were up at about knee level and my calves rested in them. The bottom of the bed was removed to make room for the doctor, who told me that she’d want my hands on my thighs so that I could hold them and curl around my stomach for pushing. Brandi stood at one calf and Charlotte at the other so they could push my legs back for me while I pushed, and my mom stood behind my head to help me lift my head and shoulders. It’s actually not a bad position for pushing.
Steven was at my right side, to encourage me, Heather between Brandi and the doctor, and the nurse on my left side by the monitors. A few people from the NICU also showed up, since there had been meconium in the amniotic fluid and the magnesium would effect the baby too, so they needed to suction and check him when he was born. It was a full room, but I didn’t have much room to notice.
I started pushing at 3:50pm. I was definitely ready to when we started. Dr. Moi was a surprisingly good coach, able to give me instructions very clearly to help me maximize the effectiveness of each push, and the rest of the birth team gave wonderful encouragement. The standard is usually three pushes per contraction, but I went with what my body told me, and did four sometimes. Apparently I’m a good pusher. I was very much in a zone, very much inside my own body and everything I was feeling.
Riley was born at 4:48pm on February 25th; his due date. All of the medical interventions that I had gotten despite my original plans were necessary, but the only one I regret is that he was not able to stay on my body and that the cord could not finish pulsing before it was cut. I feel that the first moments of bonding were hurt by that, and when he was with me again, it took some time and skin-to-skin contact for it to really feel real that this was my baby. The cord was cut and he was brought over to the NICU team a few feet away.
I looked at Steven and said, “I did it,” a few times, elated that I’d finally birthed my baby boy naturally despite everything that had happened. Elated that it was over.
After a moment, I realized I hadn’t heard the baby yet, and looked over there, but I couldn’t see anything with people in the way. I said, “I just want to hear my baby,” and almost immediately he cried. Someone, I’m not sure who, said that sometimes they just need to hear their mom’s voice.
They wrapped him up and gave him to Steven to bring to me to hold for a moment, but he was very pale even though his vitals were fine, so they wanted to take him to the NICU to monitor for awhile. The NICU doctor told me that, if he improved well, he’d be back to me within a few hours, and that once I was recovered enough I could come in a wheel chair to see him. If he didn’t improve quickly, he’d be kept in the NICU until he was healthy enough. Steven and Mom went with him.
I had just a little extra bleeding — not nearly enough to be a hemorrhage — which they were able to take care of quickly with a couple of shots and kneading my stomach (ouch). I was also very grateful to have not torn badly, so healing up wouldn’t be too bad. I was soon settled in and covered up again.
My dad showed up shortly after I was decent again. He came to see me first, and then Mom came up to get him and let me know Riley was doing well, so he went to meet his grandson. I had thought he’d cry — he did when he gave me away at my wedding — but he didn’t.
Brandi, Heather, and Charlotte soon left so I could be with my family, and so that they could go home and rest. Heather wasn’t gone long before she showed up again, though, because she just had a hard time leaving me. She hadn’t felt like the birth had quite had closure yet, and wanted to stay long enough to feel that it had. It was very sweet. She didn’t stay more than an hour or so, but she did help me choose and order my first food in two days: Greek yogurt. It was very nice to eat again. At some point someone also brought me Riley’s measurements. He was 5 pounds 13 ounces and 19 inches long. Although I hadn’t expected a large baby, I had expected him to be in the 6-7 pound range, so for him to be a few ounces shy of 6 pounds was surprising. He was so tiny.
Riley recovered quickly enough that he was brought back to me at about the same time I would have been ready to go to him in a wheelchair. It was so good to have him with me. It made the whole experience far more real than it had been with him gone, especially since I’d had so little time with him when he was first born and no skin-to-skin.
We were brought to the room we’d be in for the rest of the stay. I couldn’t walk to the bathroom without two people helping me; I didn’t even feel strong enough to hold him while they brought me in a wheelchair to the new room. I only felt secure holding him when I was in bed at first. He had a bassinet that stayed right beside my bed, and that first night, I soon got him out and unwrapped and slept skin-to-skin with him for a few hours.
Steven had to go back to work the day after he was born, but spend the evenings and nights with us, while my mom spent a lot of the day with me. I had to be on magnesium for 24 hours after the birth, and then monitored for a bit longer after that to make sure my blood pressure wasn’t dangerously high anymore, so I wasn’t discharged from the hospital until nearly two days after he was born. We spent a lot of time bonding.
My blood pressure went down, not back to normal, but no longer dangerous. And thank goodness, the swelling started going away quickly too. I hated being swollen. We went home the afternoon of the 27th.