Although I had a clear vision of how I wanted the birth to unfold and did everything in my power to bring that vision to fruition, I also went into the experience with the understanding that we can only control the inputs--not the outputs--of our lives. In a
letter to myself, I wrote:
If, at any point, the birth deviates from the plan, you will rest assured that you have done everything within your power. You will relax into the Universe’s intentions and embrace the expertise of your team.
At the very end of my pregnancy, my liver started to malfunction. It's a
rare disease of pregnancy, called intrahepatic cholestasis, that usually clears up right after delivery. However, it does come with an increased risk of still-birth, so as the days started to accumulate past Henry's due date, the midwife had many conversations with the back-up physician. He started to push for a "timely delivery of the baby." My midwife, Matt, and I were encouraged by my lab work and didn't want to invite the risks associated with induction into the experience.
Still, it was a scary place to be. We wanted to make the very best decisions for the baby, but the path was never very clear. We didn't want a tragic outcome and then have to look back and think, "We should have made a different decision."
Natural induction was always an option (like Castor oil), but any type of induction is still a potentially risky intervention (not to mention the fact that I really didn't want to go into labor with severe gastrointestinal cramping and diarrhea). Once I hit my due date, the midwife recommended that I start taking Evening of Primrose to help prepare my cervix. As we approached the second week past my due date, she recommended that I start taking a homeopathic remedy that would help "nudge" labor along but wouldn't be as drastic as Castor oil. Both of these approaches were very mild, since we really wanted to let the baby come when he was ready.
When my labor started Saturday night with contractions (at 41 weeks and 4 days), Matt and I headed to Whole Foods to distract ourselves and finish some last-minute to-do items. After we checked everything off our "Birth Day" action plan, we headed to bed around 11:30pm to try and get as much rest as possible.
Around 1am, the contractions got to the point where I had to sit up in order to really relax into them. I concentrated on relaxing my shoulders, face, and the rest of my body while I coached myself with messages like, "This pain has a purpose. My baby is coming to me." and "Open, open, open." I reminded myself to work with my body, not against it and tried to breathe deeply into every contraction to make it count. I welcomed deep, powerful contractions to make the birth as efficient and effective as possible.
At that point, the contractions were about five minutes apart. I was counting down the hours until I could call our doula. I didn't want to call her too early because I wanted to section the labor into discrete parts (Matt and I alone, us with the doula, all of us with the midwife), in order to help the time pass more quickly. She was actually the back-up doula because my original doula was at an out-of-town event (during which she got the flu and had to go home anyway).
The doula came in the morning, but she said I was still very early in labor and that we should just focus on resting. Since my contractions were coming consistently every 5-6 minutes, resting was not much of an option. She got me set up on the couch with pillows everywhere, but I still wasn't very comfortable. Meanwhile, Matt came down with something that seemed like the flu and was in miserable shape himself. We spent all day Sunday alone, trying our best to ride the waves of my contractions and his sickness. Getting in the shower helped a lot, as well as sitting on the birthing ball and leaning onto a pillow on the bathroom counter.
Late that evening, I asked the midwife to come over and check how dilated I was. Right as she arrived, my water broke, which was very encouraging to me. However, I was still only 3cm dilated. The midwife went home to rest, but the doula came back over to provide more support. While Matt tried to cope with his sickness through sleep, the doula helped me work through different positions. For example, I walked around a lot, swayed through contractions, walked up and down stairs, and sat on the toilet.
At various points throughout the process, she would hook me up to the fetal monitor to make sure Henry was handling the labor okay. Once we started nipple stimulation as a way to speed up the frequency of the contractions, the doula got worried about not seeing enough accelerations in Henry's heart pattern. She called the midwife who came right over. The midwife wasn't as worried by the results of the fetal monitor, but she stayed to support the rest of the labor.
We continued the nipple stimulation and then tried an herbal stimulant. Although my contractions were intense and painful, they were only coming about 6-7 minutes apart and I was only 7cm dilated. I did get in the birthing tub a few times, but the contractions seemed to slow down even more.
Around noon on Monday--after 40 hours of labor at home--the midwife suggested that we go to the hospital for some Pitocin. She explained that she was worried that we would run into problems during the delivery if we couldn't get the contractions any closer. For example, we might deliver the head but then need to wait a long time to deliver the rest of the body, which could put the baby into distress.
Although I was completely dejected by the idea of going to the hospital, I had complete trust in my midwife. I knew she would not recommend such an intervention unless she really believed it was necessary. Still, I was in a really bad place as we drove to the hospital. I was scared of what would happen there. I was frustrated with every painful contraction that I had to endure in the car during the long drive to the hospital (plus Matt missed the exit), since they didn't really seem to be helpful to me.
At the hospital, we had to go through a long check-in procedure. While my doula pushed me around in a wheelchair, a woman said something to me. My doula said, "Oh, how nice. I think she said a prayer for you." I said, "That's funny. I thought she was telling me to close my legs because my underwear was showing."
When we finally got into the room, everything I feared started to come true. I was immediately hooked up to an IV, which I had to stay attached to for more than 12 hours, even though I was already fully hydrated and nourished from drinking and eating throughout my entire labor. I was also hooked up to a fetal monitor for constant monitoring, as well as a contraction monitor, which was very tight and uncomfortable around my uterus. Then I had to wear a blood pressure cuff that seemed to deploy and check my blood pressure every minute and a half. When I needed to use the restroom, we had to wheel the entire IV cart with me.
My midwife asked the nurse for a birthing ball, but there were none. My midwife then called her husband to bring us a birthing ball from their house.
At that point, I tried to rouse myself out of my despondency and remind myself that I needed to do this for our baby. The nurse pretty much left my midwife and doula in charge of helping me labor. There are pieces of this part of the story that I hope time and distance begin to whitewash away, like being asked by the nurse to lay on my back through a contraction so she could insert her fingers and try to push back the lip of my cervix. I just kept telling myself that I needed to do it for our baby.
Throughout the entire process of labor, time went by surprisingly quickly. Every time I looked at a clock, hours had gone by. The nights turned quickly into the days. I endured very painful contractions (in my butt, since giving birth to a baby essentially feels like you are pooping it out), for 3.5 hours with Pitocin at the hospital. Then my back-up physician came in for the delivery. I pushed with all my might because everyone kept staring at the fetal monitor, and I desperately did not want to have a c-section. I knew I had to hurry.
I'm still not entirely sure how I managed to push a 9-pound, 4-ounce baby out of my body, but he came to us safely and perfectly. In retrospect, my midwife thinks his position was just slightly off, so that each contraction wasn't quite pushing his head into the cervix in a way that would help it dilate the way it needed to. The back-up physician thinks Henry was completely backwards (i.e., face-up), but that explanation doesn't really make sense, since the baby was never face-up in any of my prenatal exams, and I also never had any back labor. My original doula thinks the fact that the cord was wrapped around his neck twice led my body to undergo a slower and more prolonged labor as a way to prevent the baby from going into distress.
The hospital had a "no separation" option that allowed us to keep our baby next to us the entire time. He was never taken away to the nursery. We opted out of the newborn bath and as many tests/procedures as possible. For all the mandatory things, the staff came to our room. We checked out as early as we could the next day and quickly made our way back to the comforts of our own home.
At the end of the day, I am so thankful for the birth experience we had. If we had gone to the hospital any earlier, I probably would have ended up with a c-section because of hospital protocol around how long you are allowed to labor without making "adequate progress." If we had gone in much later, I would have run the risk of being too exhausted to put in as much effort as the pushing process required or the baby could have gone into distress.
I feel so, so grateful and fortunate and immensely lucky that all the choices and decisions we made took us down a path that had a safe and healthy outcome for our son, while maintaining as peaceful and natural birth as possible.
Image courtesy of goosedesigns
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