- 4 years ago
- Wedding: October 2012
My birth story begins with a Friday afternoon at work where I suspected my water had broken at 38w5d. I went to the hospital to get checked out, and long story short, it hadn’t broken. But since I was there, they of course took my blood pressure. Since it came back high, they took labs for preeclampsia. And those labs showed that I had a slightly elevated urine protein level (440, 300 is normal), which would indicate preeclampsia, which would call for delivery of the baby as a cure. So the attending on duty that night came in around 10 p.m. and told me that they wanted to induce labor that night. Given that I was hoping to have a natural, unmedicated childbirth, I basically refused. I asked him what our alternatives were, and he grudgingly said I could do a 24 hour urine protein screen to confirm these test results. I jumped on it–anything to be able to get out of that hospital that night without having to go “against medical advice.” So he allowed me to go home and collect the sample.
The sample came back with normal protein levels in my urine, but showed some other elevated signs for pre-e, so my regular doctor wanted me to move my appointment that week up one day so she could see me sooner. I went to see her on Tuesday at 8 a.m. At that appointment, my blood pressure was high, as it had been for several weeks, and baby girl wasn’t moving very much in her NST. Since I was past 39 weeks at that point, the doctor sent me down to labor & delivery to get more labs and likely to be induced.
We got to L&D around 11, and I had to get blood drawn. The nurse who came in to do it was very competent and personable, so I asked her if I would need a hep lock. She said if I was admitted to be induced, I definitely would, and she could do it to draw the blood as well, to save me a needle stick. My husband subtly nodded at me in the background, indication: this is someone we can trust–let’s get the hep lock put in by her rather than whoever the luck of the draw might match us up with when the time comes “officially.” Worst case scenario, we get sent home today and they take it out. That ended up being one of the best calls we made. The nurse did an excellent job, and the hep lock hasn’t been irritating or painful at all, other than to the extent I don’t like having something sticking in my hand.
The labs came back around 2:30. I spoke to the resident on duty, who reported that they planned to induce with pitocin that afternoon. I called my regular doctor, and she said they basically had 2.5 reasons for wanting to induce: 1. I had polyhydramnios, which means excess amniotic fluid, which made the possibility of my water breaking naturally at home very dangerous because it could lead to cord prolapse or placental abruption with the huge gush of water 2. I had gestational hypertension, for which the cure is delivery and 2.5. I had elevated “non-specific” indicators for pre-e, nothing conclusive, but still not good. I asked her why we couldn’t start the induction with Cervadil rather than pitocin, and she responded simply, “Because we want to get that baby out.” Cervadil means 12 hours of waiting to see if it takes effect, and my cervix was already 3 cm dilated and 50% effaced, so I was ready to be induced with pitocin.
Finally, I consented to the induction, and they administered the first dose of pitocin at 4:39 p.m., at 2 mu. I felt mild cramping, but nothing serious. Throughout the night, my husband and I just waited in the L&D room for something to happen, but aside from some additional light cramping, nothing really did. The dose of pitocin was so mild that it didn’t send me into immediate, violent labor, as I know can be the effect on some people. As I said, I barely felt anything but mild cramping. The worst part about the pitocin, and this remained true throughout the whole labor process, was being hooked up to an IV. It made it a huge hassle to do anything, and I hate needles, so I basically didn’t use my left hand for 24 hours. It also made it much more cumbersome to change positions to labor, to go to the bathroom, and to get other monitoring. But to be honest, being on the IV constantly didn’t impair my labor as much as I thought it would.
A doctor came in around 6 a.m., after I had basically a sleepless night, to check my cervix. She reported that I was 3 cm dilated and 80% effaced now. I found this extremely discouraging, as I felt like I’d been in the hospital for 12 hours for basically no reason. I started crying and told my husband I felt foolish for agreeing to be induced, that this was a huge mistake, I couldn’t possibly be in “labor” with pitocin for 12 hours with no progress and still expect to have the unmediated vaginal birth I desired. He was very encouraging, saying that the 12 hours on a mild drip was also what I wanted, not to have labor come on too quickly, that the doctors were trying to take the most gradual steps possible to trigger labor. Eventually I calmed down and was even able to sleep for an hour or two. During that time, they kicked my pitocin up from 2 to 4 and then to 6.
My pitocin was gradually increased throughout the day, and the cramping got stronger. A few hours later, my cervix was checked again, and I was at about 4 cm–some progress, which was encouraging. The doctors said they would come back in another couple hours to check my progress and possibly break my water, which would really get things moving. Because of the excess amniotic fluid, my uterus wasn’t able to contract like normal, so I wasn’t feeling typical “contractions.”
Around 2:30, my cervix was checked again, and this time I was at 5 cm dilated, so it was time to break my water. At that point, I was at 14 mu of pitocin. Having my water broken was a pretty scary experience because of all I’d been told could go wrong. The doctor had me lay down with my feet apart, and broke the water. I felt an immediate release of pressure in my abdomen, and of course felt a gush of water come out. It felt really great, actually. It was a TON of water. Oh and the process of the water being broken was completely painless–I didn’t even feel the “breaking,” just the gush of water. As the water was flowing, the doctor reported I was then at 6 cm and 100% effaced. Yes! One note is that I’m glad they broke my water in the afternoon–that way, my hard labor was in the afternoon/evening, rather than throughout the middle of the night, which probably helped me feel less exhausted overall and to have the strength to get through.
Once my water was broken, every contraction brought on a flow of fluid, for about the next couple dozen contractions. Same for if I stood up or shifted position dramatically. There were puddles and puddles on the floor. And immediately after the water was broken, my contractions began to increase in intensity and regularity. That was when we called in our doula, Nicole.
Nicole was awesome. In the beginning, when my contractions were still manageable, she massaged my swollen, achy feet which made it easier to walk around later. But soon enough, my contractions were intense enough that they required vocalization to get through them. She talked me through them and suggested vocalizations to do: a low “ohhhh” sound as opposed to a high pitched scream. She also suggested different positions. I spent some time sitting in the “throne” position in the bed, and some time doing the “slow dance” position with my husband. Neither of those were great. Lying on my side in bed was somewhat better, but not that effective at moving the baby down.
At one point, she suggested I get in the shower, which sounded great due to the warm water. At first, I got in there and just stood in place with the hottest water possible beating down on me. Then my doula suggested I get on a birthing ball, in the shower. I sat down on it, and that felt great! However, it wasn’t until a nurse came in the room and asked what all the water on the floor was that we realized: the birthing ball was covering the shower drain. Somehow, in helping me labor, no one had realized that the water had built up so much it actually spilled out of the shower, all the way across the bathroom, and halfway into the hospital room. Oops. Sorry, everyone! So my doula then had me get on the birthing stool.
The birthing stool was magic. It is basically an open-bottom seat, like a toilet, but about a foot and a half above the ground. Sitting on it, I was able to relax my pelvic muscles very completely, and I let my body just go with it. I had been shouting through contractions, but on the birth stool I entered kind of a zen place, where I just had my eyes closed and breathed heavily through the contractions, or maybe moaned or spoke words in a whisper to myself. I felt a little out of body, a little tingly. It was kind of weird, but again, I went with it because it was working. And the downward pressure in my pelvis let me know that it was working. I’m not sure how long I stayed there, but it was really great.
Eventually, I got back in the bed, as I felt I needed to rest my legs. We started working on filling up the labor tub. Here I’ll mention one of the worst things about a pitocin induction: the fetal monitor. Thank goodness, my hospital had wireless monitors, so I wasn’t tethered to ANOTHER machine in addition to the IV. However, the monitors had to be constantly on the baby, who of course was moving around. So probably ten or more times per hour, a nurse would come in to adjust the monitors. And when it came time to get in the labor tub, which felt SO GOOD because of the warm water and buoyancy, I basically had a nurse groping my abdomen the whole time, and I eventually had to get out after about two minutes because she couldn’t get the monitor to read the baby’s heart rate while I was in there. BOO!
By this point, the contractions were really painful. I had long since discarded any pretense of wearing the hospital gown and DID NOT CARE. I was stark naked other than the fetal and contraction monitor straps. I labored in the bed for awhile, and then a doctor came in to check me again. I was terrified to find out that after all that miserable work, I was only 7 cm or something, so I asked her not to say out loud what she found. So the doctor gave the report to Nicole and left. I had a few more really bad contractions and was getting upset, so Nicole told me, I really want to tell you what the doctor just told me because it’s GOOD NEWS. Can I tell you? I consented, and she said the doctor had said I was 9 cm and only a small lip of cervix in the front remained. I have to be honest, I wouldn’t have been “happy” to hear anything other than that I was 10 cm and it was time to push at that point. But Nicole seemed happy about it, and she immediately suggested I move into leaning forward positions to press the baby on that lip of cervix and move it out of the way.
Since the birthing stool had worked best of any position, I got back on it, only this time instead of leaning back and loosening my pelvis, I leaned forward into my husband’s lap. Here, I’ll say that my husband was absolutely amazing during my entire labor. He was completely selfless–anything I said I needed, he immediately responded to my cues. He didn’t make any stupid jokes about how weird I was acting, nor did he try to change my mood or make me “feel better” in some superficial way. He respected my feelings and my labor process absolutely. What an incredible gift. During some of the stranger moments of labor, I was in a near-delerium, laying on the bed wagging my head back and forth and murmuring phrases repeatedly like “I can’t do this, I can’t do this” or “please. please. please.” or “I need more information. I need more information.” Just totally crazy. Anyway, my husband also took over for my doula or added to her efforts, by massaging my legs or back, bringing me fluids, and reminding me to do low, deep “Ohhhhh” vocalizations when I started to shriek. He’s so physically strong, it was really helpful, and his love for me was evident in his every action.
So. I’m leaning into my husband on the birth stool. I kept asking Nicole, when will I know when it’s time, when will I know I’ve gotten the cervix out of the way. She kept telling me, when your body feels the urge to push that you can’t deny, your body will know what to do. She was right. At some point when I was on the stool, I felt the need to push down and told her so. It kept coming, and then I asked if I could move to the bed. She said yes. I went to the bathroom first, and I left a trail of bloody cervix on the ground (sorry). This was another sign I was completely dilated and it was time to go.
I laid in the bed, and I kept having the urge to push. Nicole urged me to start “blowing out” through every contraction, rather than vocalizing, as this would make it easier to hear when the pushes were happening. When I got into the bed, contractions slowed down a LOT and became very different. I had much longer breaks in between, or at least they seemed longer. I kept saying during the breaks, “I need a break, I need a break.” Nicole would say, “This is your break.” Ha ha. True. But I meant more like a 5 hour break. Not to happen, as it turned out.
Of course once pushing begins, doctors happen. Up to that point, it had just been me, my husband, and our doula. But I basically spent all 8.5 hours of labor with my eyes closed once it got intense–I wasn’t about to change that now, so I was just barely aware of who was in the room. The doctors allowed me to labor on my side as I had been for awhile. Then things started to happen. They actually removed the bottom part of the bed, and my husband and a nurse each held one of my legs. I’d read all about how being flat on your back with your legs in the air is a terrible position for pushing. Let me tell you, at that moment, I was in so much pain and so “out of it” that they could have hung me from the ceiling for all I cared. I was just trying to survive the next contraction. And what they also don’t tell you is that yeah maybe squatting or on hands and knees is the best position for pushing the baby out, but show me a woman who has the strength in her legs or arms after a long labor to do either of those, and I will shake her hand because that is impressive. Laying flat on your back, while maybe not ideal for pushing, is ideal for resting between contractions especially.
So the bed is prepped, and I later found out that standing around watching my birth were: an attending, a resident, an intern, a med student, a nurse, my husband, and my doula. Hi everyone! They were all SO SUPPORTIVE and awesome. With each contraction, I would get out 3-4 good pushes. The doctors and nurse were shouting, she’s so close, such a great push! At one point, someone said, “She has a LOT of hair!” I got excited deep in my subconscious because I knew that meant she was coming, though I tried not to consciously acknowledge it because on some level I knew that it didn’t mean I was close to being done and I didn’t want to frustrate myself with false hopes.
My pushing stage was sloooow. They say two steps forward, one step back. I was more like, two steps forward, 1.75 steps back. And having an audience made me weirdly apologetic. At the end of the contraction, sometimes someone would say something like “One last big push!” and I’d be like “I can’t, I’m sorry. I’m sorry.” And they were like, Don’t be sorry!! You’re doing so great! At one point, one doctor said she was putting oil on the baby’s head to help her get through, and I remarked breathlessly, “I appreciate it.” They all laughed at my congeniality despite being in the middle of the pushing stage of labor.
The baby was ALMOST crowning for maybe a dozen contractions. I could feel the anticipation building, building, and that everyone felt that surely THIS one would be THE ONE that would send the baby out, and then it just never was. When she finally did come out, we found that this was because 1. the umbilical cord was wrapped around her neck twice, so she couldn’t go chin down (but she was never in distress, thank god) and 2. her hand was up by her chin. As the baby’s head made its way out, the doctors kept urging me to look or feel. I was like hellllll no. My process with the labor was to take myself out of the moment as much as possible and just get through. So they kept being like look, look, and I kept refusing. I had a huge push, and suddenly, someone was like, no really, LOOK! They were putting my baby on my stomach.
I gathered her up to me and held her on my stomach/lower chest and just looked at her in shock. I was so tired and out of it, I hardly knew what to do. It was amazing to see her face to face. In what seemed like only seconds but had to have been a few minutes, the doctors were telling my husband it was time to cut the cord. He did so like a pro, and the baby was free to come up to my chest. I held her with her head on my right, near her father who was standing on my right. We just gazed at her. I asked if she needed to eat right away, and my doula said no, that she could take a little bit of time to be ready. Eventually though, she did latch on to first one side, then the other. She is an absolute latching pro–I feel so blessed. I obviously have no idea what I’m doing, as a first time mom, so it’s all her. If she’s hungry, she’ll latch on and eat. Feeding her for the first time felt great. My husband and I after the birth just marveled at our beautiful baby.
Meanwhile, below the belt, the doctors were massaging my uterus to get it to contract and to stop bleeding. I was obviously also still on pitocin at this point, which is supposed to help stop bleeding after delivery. They delivered the placenta, which didn’t hurt but felt more like a relief. Like the process was really, finally over. There was some cramping with the uterine massage but really, after labor, it wasn’t a big deal. They also had to check me for any necessary repairs. They marveled in disbelief that my perineum was completely intact. The only “tear” was from where baby’s hand came out next to her face and she scratched the top of my vaginal opening with her fingernail, for which they did one stitch to stop the bleeding but wasn’t really “needed.” I feel so so incredibly blessed, and I know that the doctors used oil, massage, support, and any possible method to keep damage to a minimum as I pushed out my baby. I also believe that the fact that I could feel every push and all the pressure allowed me to labor with my body naturally. The slow pushing process, though excruciating at the time, obviously allowed me to stretch gradually.
As the doctors were doing this, my husband asked if we could have a visitor. The attending was like umm maybe wait a few minutes for a visitor? Probably because I was still stark naked, splayed on the bed, with blood everywhere, my placenta still to be delivered, the baby covered in birthing goo, etc. My husband said, no trust me, this is a visitor she will want to see, referring to me. I was like WHO IS IT??? My mom had flown in from halfway across the country to surprise me! She had planned to come after my due date, and she was sad that she was going to miss the first few days of baby’s life, so her friend offered her a buddy pass to fly up early! It was SO WONDERFUL to see her–she was all smiles and so excited. And my mom is SO low key. She very much blended into the background as I figured out how to nurse our new baby, just taking pictures, offering congratulations, marveling at how cute the baby is. It was perfect.
I held the baby for about an hour, then when she was done eating, it was time to weigh and measure her. 7 lbs 12 oz, 20.5 inches. Smaller than I expected since both my husband and I were over 8 lbs. But thank god, because it was hard enough to push her out as it was! My husband got to hold her as they prepared the measurements, so that was a great moment for him and our baby. So sweet. Eventually, he went with her to the nursery to get more tests, and I went to the postpartum room to lay in bed and wait for them and recover. I have to say my hospital was amazing–I NEVER felt rushed or like I was inconveniencing the staff or doctors. All told, I was in my L&D room for about 30 hours. And they completely respected my space and my time and let me do what I needed to get my baby here.
Now baby is 3 days old, and we love her so much. Our parents have both been here helping, which has been awesome. Baby is very low key–she spends lots of time sleeping, and she eats fairly well. My milk has come in, so I’ve been able to breastfeed her pretty successfully. As for me, I am still EXHAUSTED. I got 2 hours, 4 hours, and 2 hours of sleep in the last three days, so I spent a lot of today napping. Physically I feel very good–I haven’t been in too much pain, the prescription-strength ibuprofen is doing the trick. I was slightly anemic after birth, so I’m taking an iron supplement. Oh and of course the question everyone wants to know: I gained 51 pounds during my pregnancy, and today less than 72 hours after birth, I’ve already lost 29 of it. So yes, water + baby + placenta can add up to a lot!
I feel so fortunate that I was able to achieve the unmedicated birth I wanted. There was never really a moment, other than that first morning where I found out how slow my progress had been, that I didn’t think I could do it. Once I was in the labor, it was a very challenging experience, but as my doula kept saying, “The only way out is through.” I just had to be in the moment, get through each contraction as it came, and do my best to cope with the pain. But as I kept reminding myself, pain goes away, it is temporary. So that helped a lot.
Moral of the story: induction with pitocin can still result in an unmedicated, vaginal delivery. I wish I had known that going in, but now I do. As I keep telling people, I’m glad I did it, but I’m not eager to repeat the experience any time soon! Give me a few months at least. 🙂