The facts: 15 hours of labor, 35 minutes pushing. Born ROA (right occiput anterior) with a nuchal hand and puffy feet. 8lb 2oz, 20 3/4 inches of perfection.
(Note: Andrew was born at 39wks3days gestation by our probable ovulation date, but at 40wks0days by his ultrasounds. We are using the ultrasound timeline here for comparison to future pregnancies.)
A long time ago, I went in for my 12 week ultrasound. Even though I was very sure of my ovulation date, and that date implied that my due date was May 2, the ultrasound technician was *sure*, based on measurements, that my baby would be ready to come on April 28.
A slightly less long time ago, I went in for my 20 week ultrasound with the same technician. She informed me that my baby was a boy, and said, "Didn't I give you a different date last time?" I nodded yes. "April 28?" Again, yes. "April 28," she said, with supreme confidence.
Sunday, April 10 (37 wks, 3days) - My mom had come into town for the weekend to help me prepare for the baby, and we worked hard. I was extremely fatigued by it, and lost my appetite for a couple days, for the first time in my pregnancy. There was some nausea and diarrhea to go along with that. I had some mild contractions, though nothing regular or timeable. This settled down by midweek.
Monday, April 18 (38 weeks, 4days) - After another weekend of "getting things done," I had mild, but regular and timeable contractions every 20 minutes apart. I also developed a headache very much akin to my menstrual migraines. After asking Dr. Google, I discovered that labor is preceded by a drop in progesterone, similar to a menstrual period. I was encouraged that things might be happening, what with more diarrhea and irregular contractions, but again, things petered out by midweek.
Tuesday, April 26 (39 weeks, 5 days) - I had had contractions when I woke up overnight, but none that woke me up. I was having regular contractions, very mild in intensity, but 5 minutes apart. I decided to work from home, in case this was early labor and I needed to rest. Nothing much happened all day - the contractions continued, but never progressed, and I felt less tired. I did get a lot of work done, though!
39weeks, 1 day
Wednesday, April 27 (39 weeks, 6 days) - I went back to work, because I couldn't really justify two days at home with nothing really progressing. I saw Sarah at my 39 week appointment at the birth center. She performed my first cervical check. I was 1 cm dilated, 50% effaced, and my cervix was completely anterior. Sarah offered to sweep my membranes in order to encourage labor to start, but I didn't want to be too anxious to get started. After all, we weren't even at my due date yet! Don't get me wrong, I had been doing all the silly things you are supposed to do to jump start things on your own: spicy food, walks, bouncing on the exercise ball, etc., but I didn't really believe that any of those things would make baby come before he was ready. We left the appointment happy that my body seemed to recognize that it was coming to the end of pregnancy, although when exactly that would all happen, we didn't know.
After the appointment, we ran a few errands, and then, as had become our thing following late afternoon appointments, we went out for dinner. This time it was the Dickey's BBQ off of Santa Fe in Littleton. We love going to Dickey's, but we had never been to this particular store before. I had the spicy sauce, the jalapeno beans, and the hot links, just to be sure. :o) We had a nice dinner, and a nice conversation, discussing, among other things, what was on the to-do list for the evening when we got home. Before leaving, I went to use the restroom, and after I was done peeing, there was a completely involuntary *squirt* into the toilet. My eyes flew open, and there was another *squirt* into the toilet. My water had broken! It was clear and had no odor, so that was great news. I spent the next few minutes hyperventilating and trying to figure out how to get out of the restaurant without looking like I totally wet my pants.
Armed with wads of toilet paper, I managed to get out of the bathroom and back to my husband. "Change of plans!" I said. "We're going to have a baby!" He looked appropriately confused, so I explained that my water broke. We spent the next few minutes in the parking lot in a giddy state of "what should we do??" panic. Eventually we determined that we should go home, as I was having no contractions yet. Also I should call the midwife on call and let her know. It was about 6:30pm
So I called the birth center, and Laura was on call. She said that I was to go home and rest until contractions started, which would likely be when the sun went down. If they hadn't started by the morning, I was to come in for a non-stress test and some options to kick start things, like herbs, etc. I also called Jessica, our birth doula, to give her the heads up, and a few of the "must call" list to let them know things were in process. We dropped off one of two cars at a friend's house, and as I was leaky, I sat on my fleece all the way home.
Once home, we got the car seat installed and staged the birth bags by the door, and then I went upstairs to nap and listen to`` my Hypnobabies Birthing Day Affirmations and Easy First Stage. I laid down at about 8:30pm. As I was getting relaxed and starting to drift off, my whole body felt like it was folding up on itself. My eyes snapped open and searched for the clock -- 8:45pm. That was definitely a contraction. A *real* one. I had spent the last three weeks of false or practice labor wondering if I'd know when it was real. Answer: yes. This was it. I was super excited. I closed my eyes to continue resting and focused on my hypnobabies techniques of deep relaxation.
Another came: 9:05pm. And then another, 9:25pm. And then a third: 9:35pm. I had only had three at 20 minutes apart, when they started coming at 10 minutes apart. I then had three at 10 minutes apart, by the clock, and they started coming way more frequently than that. I couldn't keep track. I was not getting any sleep, and I was extremely uncomfortable, so I thought it would be better to go downstairs and lay on the exercise ball, which would be a more favorable position, and from there I could get on ContractionMaster.com and time these puppies.
They turned out to be approximately 3 minutes apart, plus or minus, with durations ranging from 60-90 seconds, with an occasional 30 second "lite" one thrown in. I ate some toast at this point, wanting to buoy my strength for a labor that seemed to be coming on pretty fast. Within about an hour of this laying on the ball routine and trying to rest between contractions, they were strong enough that I had to begin to vocalize through them with low groans. I tried changing positions, leaning on the post of the stairs and swaying my hips. The contractions continued to intensify.
Laboring at home
Sometime around 11:30pm, I started to get a little nervous. It was *really* intense, really fast. There had been no ramp up, just bam! here we are in full blown labor. I didn't want to go in to the birth center too early (they like to see you show up between 5-7cm dilated), but we were a solid half hour away and I didn't really relish having the baby halfway down the canyon, either. I had Travis call the answering service and get connected to Laura. I talked to her a bit between contractions and expressed my surprise at the intensity of it all. She said she was already at the birth center, and that I should come in and she could monitor me for a bit.
Travis then snapped into action, pulling together the bags, loading up the car and calling Jessica to have her meet us at the birth center. I was pretty focused on contractions at this point, and internally worried about how I would handle the car ride, as I had read that it was typically one of the more brutal parts. I armed myself with Hypnobabies on my mp3 player, a fleece blanket, and a trash can, in case of hurling. On the way down the canyon, Travis spotted Toby the fox, and then more excitingly, a mountain lion, which actually got my attention and snapped me out of my trance for a minute. The car ride actually wasn't that bad, other than the parts where we hit a bump in the middle of a contraction, which was blessedly not that often.
Travis had me to the circle drive at the birth center by 12:30am. We waddled in, expecting to head to the tent room for the labor and birth, which of the three rooms, is the smallest. It turns out there was a laboring mama in the blue room, which is on the same side of the birth center as the tent room. While it's possible to share the center and split those two rooms, it just seemed logistically easier to maximize everyone's space and have us go to the log room. This turned out to be an awesome decision, as the log room is much larger, and even though it didn't appear that we were a large party, it sure was nice to have the extra space. Laura was there and so was Tiffany, the student midwife, and they let me come in and get settled. Travis parked the car and brought in our gear.
Very shortly after we got there, Jessica arrived. I smiled a tired smile at her and then requested a bucket as I headed over to the sink and threw up. I looked at Travis and asked if he was now glad that i had insisted on carrying the can in the Jeep. Luckily, I did not see the jalapeno beans again, it was mostly just water, but I still hate throwing up, under any circumstances. That over, I flopped down on the bed, and in between contractions, brought Jessica up to speed, still in disbelief that things were so intense, so fast.
Not long after, we heard the mama on the other side pushing. I was cheering her on - she sounded so good, so powerful. A few minutes later we heard the baby cry.- what a sound! Tiffany came in. The other mama needed to transfer to the hospital (found out later she had a fourth degree tear - yowza!), and Laura was going with her, so Tiffany checked my progress at arrival. I was 3 cm. It was 1am.
I lamented that we had come in too early. Jessica and Tiffany both reassured me that if things were this intense and moving potentially quickly, it was better to come in than not. In hindsight, I spent a lot of labor in my head. I had read *a lot* of books on childbirth, especially natural childbirth, and a lot of other women's birth stories. I spent a lot of time in labor checking my progress against my internal checklists, my knowledge of what should or shouldn't be happening, trying to anticipate what was coming next, trying to determine what I should be doing to help. What I didn't fully grasp was that my primary objective should have been to get my head out of the way of my body, to let my body and my baby work together and do what they were going to do to make it happen. That my head, for all its book knowledge didn't have information about what my baby was trying to navigate.
I labored on the bed for a while, moaning through the contractions, sipping water to try and hydrate. I buzzed my lips, and when that took too much air, I played with my lips with my fingers to keep them relaxed. Travis laughed at me, and Jessica smiled and said "sphincter law," and I smiled and said, "Hey, I read Ina May's Guide to Childbirth." (In my head - all that book learnin'.) At some point in there, I threw up a second time, which was discouraging (all that hydration down the tubes!) and made me ask in disbelief if I could be in transition already (in my head again - all my reading had said that throwing up was a sign of transition). Travis and Jessica helped with counterpressure on my low back. I liked Travis's hands better than Jessica's, because they were big, warm, covered more surface area.
Laboring on the bed in the log room, trying to hydrate
I tried a couple different positions by the bed - on my knees on a pillow on the floor with my elbows on the bed, on all fours on the bed, and then tried some other stuff. I went in the shower, and Jessica put the shower right on my lower back. I liked that, except that the tub was really narrow and i couldn't get my feet into a stance that I liked. I also walked the halls of the birth center, stopping and leaning against the wall with contractions, swaying my hips, trying to talk to the baby to get him to move down. Somewhere in here I insisted that Travis take a nap (he had not rested at all before leaving for the birth center), and Jessica helped convince him (she had slept from 8pm to midnight). So he crashed out on the bed for a few hours, which made me really happy, because I stopped worrying about him.
I finally found a position I really liked in the sling/hammock hanging from the ceiling. I would lean over it, supporting my elbows in the sling, with my head in my hands. It was here that I started singing. I sang a wide repertoire of stuff from old choir music, to praise choruses, to country, to pop hits. I would sway my hips when a contraction came in slow circles.
For most of this whole time I had the Hypnobabies Early First Stage track on repeat in the background. I don't remember consciously listening to it, but I do remember using the relaxation cues a lot. I said a lot of "Peace," "Relax," and "Open, open, open." I did a lot of talking to the baby, asking him what he wanted me to do, asking him to move down.
I really wanted to get in the birthing tub. Laura came back from the hospital, and came to check on me. I apologized for coming in too early, and she reiterated that if I didn't need to be here, she would have sent me home, and that this was the right thing. I asked about the tub, and she wanted to check me first. I was 4-5 cm, very stretchy, 75% effaced and baby at -1 station. It was 4:30am.
Unfortunately, that was not quite far enough along to get in the tub and be assured of not hindering progress, so back to the sling I went, more singing, more swaying. I watched the windows get light and whispered "Good Morning, Denver." I thought about getting ready for work, of being woken up at home by the woodpecker at my house. My contractions were coming in shorts and longs, and I could tell as they came on how it was going to be. "This one's a doozy!" I'd announce to the room, when it was a long, hard one. "Not so bad," I'd say on the short ones. I tried to give my helpers cues as to when they were coming and going and how they were, although mostly during them I could only get out a word at a time, which confused Travis greatly, as I would often just say "No!" and push his hand away, or "more!" or "harder!" or "stop!" and he would have to figure out from there which of the three things he was doing was good or bad.
The midwives' shift changes at 6am, so at that point Laura left (after a very long day/night, I'm sure), and Cassie came on. Shortly after Cassie came on, she checked on me and I tried to brief her on my experience. I told her I really wanted to get in the tub, but I wasn't far along enough yet, and that I understood that she shouldn't check me again just yet because my water was broken. She said that based on my progress, i was probably between 5-6 and that she was fine with me getting in the tub as long as the contractions didn't seem to slow down. (They never did.)
Extremely grateful, I slipped into the tub that was wonderfully warm. It soon felt too hot, and I ended up with two fans blowing on me in the tub for most of the rest of labor. I didn't find that the tub eased the contractions at all, but it went a tremendously long way to helping me relax in between contractions. I started out draped forward over the side of the tub with my legs froggied underneath me, but ended up flipping over and sitting on my bottom, my legs splayed out, my arms up on the sides of the tub to stay cool.
Finally in the tub, the sling in the foreground. And my fans.
It was here that we started the Dixie Chicks phase. At some point in my singing through various genres of music, I stumbled upon Cowboy, Take Me Away, and boy, did that seem to do the trick. I sang that song over and over and over and over during contractions, stopping only to buzz my lips when it got really bad to help my bottom relax. In between contractions, I fell asleep. For the first time in my labor, I felt like I had a rhythm. I felt like I had the hang of it. And I felt like I was effectively relaxing and letting my body do its thing. This lasted for several hours, and then I ended up in a pattern of short-short-looooooong contractions. The long ones felt like they were going to rip my body in half. It was then that Cassie began to suspect that my baby had spun around posterior. They didn't tell me this at the time - they merely encouraged me to take more favorable positions. But first Cassie checked me. I was 8 cm dilated, 90% effaced, baby at +1 station. It was 9:30am.
The contraction after that cervical check was ABSOLUTELY KILLER. Probably the worst one of the whole event. I screamed, "Cassie, what did you do to me???" It was not good. They had me get on my hands and knees in the tub, which I did for a while even though it was not the most comfortable position to take - I could have used a yoga block or something to bring my hands up. I breathed in some water because my face was too low and I was focusing elsewhere. I started to feel a little bit of pressure in my bottom at this point, and I kept saying, "Is this pushing? Am I supposed to push?" I tried to talk to the baby, and giving up, said to Jessica, "I just don't know what he wants me to do." Again, very much in my head. Jessica said that pushing contractions ended in grunts, and so I tried a few test grunts and test (voluntary) pushes at the end of the next few contractions - seemed pretty futile.
On hands and knees in the tub, with my awesome birth partner.
Jessica, by the way, was so awesome (Jessica Potter, http://birthbeblessed.com/). I could not have anticipated how wonderful it was to have the support of both a man (my man, *the man*) and a woman - a woman who had been there before. Jessica held my hand. When I looked at Travis, he would smile, and maybe give a thumbs up, but that wasn't what I needed. I looked at Jessica and she met my intense gaze with equal intensity, and she nodded. She knew. She knew exactly what was happening. The team of Travis and Jessica together was incredibly encouraging and supportive and though I'm sure that I would have made it through with just one of them, having both of them was beyond description. They were a dream team. Get a doula, that's about all I have to say.
Cassie and Nurse Kate (who had materialized out of the ether) came in and cleared the bed, and arranged it with chux pads and instruments at around 11:30. Cassie came over to suggest that I get out of the tub and try some other positions, and I pleaded with her, staring at the bed, "Don't tease me, Cassie." She said, "Mama, we wouldn't be getting it ready if there wasn't a baby coming here soon. We need to get you out of the tub." I grumped about it, but I knew they were right, that we needed to try different things to keep the process moving. So I went to the toilet and sat on it backwards. I labored there for a while but not too long, feeling increasing rectal pressure ("is this pushing?") Then Cassie suggested the birth stool, which I had wanted to try since I had been introduced to it in the prep class we took. Once on the birth stool, I had increasing pressure, and wanted to be pushing. I checked myself a couple times to see if i could feel baby's head, but he wasn't there yet.
Then it happened - my body pushed. My eyes flew open and I looked at Jessica. She said, "Yeah, that's it." After the first few pushes I decided that I didn't want to do that anymore, and every time a pushing contraction would come on, my consciousness would go, "No no no no no!" and try to resist. For all my preparation, this is not what you are supposed to do. You are supposed to surrender to the push - which I was able to do towards the end of each wave. But I was fighting them as they came on.
Pushing on the birth stool.
I was shocked by the power in my body at this point. Hypnobabies includes a "fear-clearing session" where you are supposed to deal with your fears about childbirth. I did this exercise, but it seemed like I didn't have too many fears - I felt prepared. It seemed like fears were for people who had had bad birth experiences in the past, and that wasn't me. It's amazing though, how in the throes of labor, things come up that you didn't even know were there. Looking back, it's hard to even describe what the fears were of, but they were there. One of those moments of fear, though, was when the pushing started. It was so powerful, it wracked my body. My body was compressing in on itself, as if approaching crush depth, and there wasn't a damn thing I could do to stop it. I wanted to say that I couldn't do it, that I didn't want to any more, but my head, my dear, blessed, rational head, said, "it's far, far too late for that." Travis sat behind me on a ball and pushed on my back. He whispered in my ear what a great job I was doing. As the pushes came, I gripped his thighs under his knees and pulled.
I was roaring, driving the pushing grunts low into my body, into my pelvis. I couldn't imagine being quiet. I was doing it. I kept reaching down - where was the baby's head? Not there yet. Cassie interrupted me. She looked me in the eye and said, "Your bum is very swollen because you've been sitting on this stool for so long. If the baby crowns, I'm afraid it will split you open." I looked into her eyes and knew she was right. After grumping at her and telling her I didn't want to take her suggestions all morning, I didn't this time - I immediately jumped up and went to the bed. She suggested hands and knees, which I tried, but a push came and I had no leverage, nothing I could actively do. She suggested side-lying, and so I flopped over like a sea lion, half on my back, my right leg in the air. Kate grabbed that leg, and Travis held my hands near my head as I pulled on him with each push.
I started to scream as he started to crown, forgetting to drive the vocalizations down. Jessica and Cassie grunted at me, and I grunted with them, lowering my effort. I'm not sure how many pushes it was, but he was crowning. I knew I was supposed to keep my jaw relaxed, but I couldn't help it. I bit down... on Travis's thumb. Then I decided that wasn't very nice and bit down on my own forearm, which resulted in a bitemark that stayed there for the rest of the day. I pleaded with them to just take him out, just pull him out if he was right there. I reached down and felt his head. Only one more push! But it was four or so more pushes, with everything I had. Cassie kept encouraging me, telling me how far he was out, there's his forehead.
Then Travis said, "And I see fingers! ...And a hand!" And even in the midst of the most intense pain and pressure I've ever felt, and amidst the collapsing of my body upon itself, my head, my beautiful, blessed, rational conscious self said, "Fingers? Don't shoulders come next?" But there was no time to contemplate. The next push came and I roared with it, and his head was out. (He did come out with his hand up by the side of his head, which perhaps is why it took so many pushes from crowning to birthing his head.) I was relieved! Everything I had read said that once the head was out, the body just slides out after. Not so!! It took me at least three more hard, gut-bending pushes to birth his body before I felt him slide out.
And then there he was, all slimy and warm on my belly. The cord was short, so he rested with the top of his head just under my breast. I covered him with my hand and welcomed him - "He's here!" I don't remember what all I said. Just that I couldn't believe that with that, we were done. It was 12:13pm
Except we weren't done. I needed to birth the placenta. Again, I was under the impression that the placenta all but falls out of you after the birth. They lied! I had to push - hard! eventually it came oozing out - the weirdest feeling ever. They put it in a ziploc bag and then scootched Andrew up onto my chest, while the cord finished pumping all of his blood back into his body. We could look at his handsome face then, and Travis and I were so in awe of his perfection. And he was so perfect. He had a perfect conehead, having presented just perfectly, other than the hand thing. He came out ROA. He had pretty much no vernix on him, and other than his hands and feet, he was immediately pink all over. He had no bumps, bruises or other birth injuries. We had been prepped for an ugly, squashed little creature, but he was so beautiful, our perfect little man.
But I was bleeding. I didn't know it at the time. It didn't hit me until later, even after they had said "hemorrhage." It was when I looked up that 1250ccs of blood that I lost is over 2.5 pints. Cassie stuck a syringe of Pitocin in my thigh, as Kate massaged my abdomen, trying to convince my uterus to contract. Unsatisfied, Kate put 3 Cytotec suppositories in me. And then to be sure, a dose of Methergine. They finally seemed satisfied. My uterus complied and shrunk down to a good size and a firm texture. I didn't want to have to be transferred to the hospital, and I'm glad in the end, that they were able to get it all under control.
Andrew was now attempting to make the "birth crawl" to my breast on his own. With a little help, he made it and explored it. He did latch on, but it was a little painful. I didn't realize it at the time, but this was a sign of things to come. Still, we nursed, as best we knew how.
I couldn't imagine ever leaving that bed. We luxuriated as the birth attendants ran around cleaning up and getting things ready. Travis had taken off his shirt and crawled in next to me to enjoy our son. After an hour or so, Kate clamped the cord while he was curled up skin-to-skin on Travis's chest and Travis cut the cord. They then took him away to be examined and I was stitched up. I did end up with a small 2nd degree perineal tear that needed stitching and a couple small skid marks. Cassie said that without the nuchal hand, I probably wouldn't have torn at all! I then had a relaxing herbal bath. Travis came and sat next to me, holding our new little boy as we called the grandparents.
Cutting the cord.
20 3/4 inches long.
The one item of concern was that his feet were swollen up - the left one a little bit, and the right one quite a bit. They wanted him to be seen by a pediatrician right away to be sure that it wasn't something that needed immediate treatment. So we rushed out of the birth center a bit, having stayed well past the 8-12 hours they say is a "normal" stay there, to catch the pediatrician during his regular office hours. He checked out the puffy foot and deemed that it had good circulation and profusion, all the proper reflexes, good color, and he wasn't favoring it, so we should just wait and see on it.
On the way home, we stopped at the grocery store to pick up some rotisserie chicken and take-and-bake pizza. I went in to use the restroom and it was quite the surreal experience to be wandering around the grocery store having given birth about 5 hours before. While daddy went in to do the shopping, we nursed a little more in the car.
And then we were home, a family of three, falling desperately in love with this little person who had lived inside me, with the face just like his grandpa's.
Laying there in bed post-partum, in a pool of endorphins and oxytocin, I told myself not to forget the pain of it. The powerful, intense pain that had me certain that I was going to be ripped in half. I commented to the room, that I can understand why people would elect non-medically necessary c-sections. (Nurse Kate protested about the long/arduous recovery from the c-section, and I will admit that, aside from a bit of a sore behind and some lightheadedness from blood loss, I was back to my normal self that very same afternoon.) I believe that if I had been at the hospital, I would have likely taken the offer of pain relief. Not because I would have *wanted* to or thought it was the best idea, but because it would have been available when I was vulnerable and worn down. I remember thinking during the back labor section, when we thought baby was posterior, that I would really like to go to the hospital and get an epidural, and the only thing that held me back was inertia - I didn't feel like making the two block trek over there. Obviously in the end, I am glad I didn't - I strongly believe it was best for my baby, if not for me as well, and the mellow, observant, attentive little boy I got was totally worth what I went through. I'm glad the option wasn't really on my radar
Going into this, I had felt as prepared as I was going to get. I had read many many books on childbirth, especially natural birth. I had read many many birth stories - natural ones, augmented ones, induced, c-section, emergency, home birth, fast, slow - you name it, I read it. I was intellectually prepared to give birth. But I guess what I forgot in all of it was that birth isn't an intellectual event. In fact, making it an intellectual event is what has the tendency to mess it up - we let our checklists, our expectations, our statistical analyses of what is "normal" get in the way of a natural, fairly random process. No, birth is a primal, instinctual event. Primal and instinctive are not mental places I'm used to being.
I have to say that I am skeptical of the Hypnobabies promise of pain-free birth. I'm not sure I believe that that's possible. Don't get me wrong, I loved doing Hypnobabies. I believe that it did me worlds of good in staying relaxed and positive throughout my pregnancy. I believe that it kept me calm and focused during my pre-labor in those last few weeks. And I certainly made a valiant attempt, with some success, at staying relaxed and embracing my first stage of labor. But I admit that I'm skeptical about it delivering a pain free birth experience, especially through the 2nd stage.
Let me be clear - this was definitely the worst pain I've ever experienced in my life. But it was productive pain. It was pain with purpose, not unlike the burning in your legs on a long run or burning in your lungs at high altitude when making a summit push. And because it's productive, purposeful pain, it seems, not that bad, somehow. It seems handleable.
Laying there afterwards I remember thinking that if I never did it again, well, that would be just fine by me. But it was just a couple short days later that I decided I *did* want to do it again. I want to do it again to get out of the way of it, and to marvel in what my body can do. I would like to stand next to that raging fire of power that was at the center of those pushes and surrender to it.
Birth Reading and Resources
Mountain Midwifery Center
Jessica Potter, Doula
Clara's Birth Story