I want to start by saying that we had planned for a "natural" birth. I'm not into holistic medicine or against pharmacology. I'm a medical professional myself, and I happen to work in a field in which we use a lot of pharmacology. The drugs we regularly use tend to be somewhat controversial. So I'm no stranger to modern medicine, and I "believe in" the power of pharmacology. But I am the kind of person who doesn't take any drugs I don't think I really need. And I do believe that my body was designed to bear children. I wanted my body to do what it was meant to do naturally. Of course, being a medical professional, I also know that you can't "plan" your labor and delivery, and you can't control everything, so we just made a list of what we hoped for and called it our "birth wishes," not our "birth plan." Yet I fantasized, throughout the whole pregnancy, about giving birth to my daughter in the "natural" way, and holding her in my arms immediately to comfort after she entered this strange, new world, enjoying the quiet, alert time she would have immediately after the delivery, getting to know her, and nursing for the first time in that first hour of her life. I didn't think it was likely that things would go awry during the labor. I had had a nearly-perfect pregnancy, other than the baby descending into my pelvis and having some cervical dilation several weeks early. In the end, we didn't get what we wished for, partly because of things that were beyond our control and party because of decisions I made in the process.
On February 25 (which was actually our due date based on an early ultrasound at 8 weeks gestation, though our provider at that time was using February 23 as the due date based on last menstrual period), my husband Everett (again, not his real name) and I were planning to make a trip to the mall. We thought spending some time walking would help bring on labor. Yes, don't you know? Everyone says you can start your labor by walking, having sex, or drinking castor oil. In truth, having sex is the only one that has any clinical evidence behind it. We did that too, a few days before. I thought I was going into labor that night because I had tons of painful contractions, but it had subsided by the next morning (but only after I was up most of the night in pain). It was not meant to be.
Apparently it was meant to be on February 25. As we were getting ready to leave the house that day, around 1:30 PM, I noticed I felt some fluid leaking into my underwear. Anyone who has been pregnant before knows that the 3rd trimester of pregnancy is a blessed time when you could feel fluid leaking into your underwear 90% of the time, whether it be the copious vaginal discharge or the urine leaking from your bladder (which is being squeezed by the comparatively immense weight of your baby). This felt different, though. I went into the bathroom and checked but couldn't find any clear evidence of amniotic fluid. Anyone care to guess how I checked? If you've been through labor, you probably know. Anyway, I wasn't entirely sure my water had broken. It could have been normal discharge. I decided to lie down on the couch for a minute to see if fluid would pool and then gush out when I stood up. There was no gushing. So I decided we should just go on with our plans. Maybe it's nothing, I thought.
At the mall, I felt some contractions, but I thought they easily could have been Braxton-Hicks, and I only had 3 in 45 minutes, so it didn't really feel like labor as far as I knew. While at the mall, we decided to get some lunch. We went to the food court and got some Chik-fil-A. As I started eating my sandwich, seated at one of the tables at the food court, I felt a big gush of fluid. My eyes grew wide as I looked at Everett and said something like "Ok, that was definitely amniotic fluid." I felt really excited and nervous all of a sudden and rushed to the bathroom to put on a fresh pad. I didn't see any other signs like the "bloody show" some people talk about, but I didn't really need to. I was pretty sure. We left the mall and headed home. I wasn't really having any contractions at that point. I called our doula on the way home, and she told me that I did not need to rush to the hospital and that I should try to stimulate labor if I was not having any contractions. She suggested nipple stimulation and brisk walking. We did some of both at home. I still remember walking quickly with Everett through our mildly hilly neighborhood in the cold, crisp February air. It was a very sunny day, and I could see my breath in the air. Pretty soon, contractions started.
I couldn't quite tell if there was much of a pattern. They seemed irregular. So I turned on a contraction counter from a website I had used throughout the pregnancy, thebump.com. I recorded frequency and length of contractions for about an hour, and we finally realized that there was a pattern. They were happening about every 10 minutes at first, then increasing in frequency. They became progressively more painful, until I got to the point at which I had to stop and kneel down with every contraction. Once they reached 4-5 minutes apart and about 60 seconds in length, we decided we should head to the hospital shortly. It had been our goal to labor at home for as long as possible to avoid any unnecessary medical interventions (the rate of which increases if you go to the hospital too early in your labor).
We had almost everything packed way in advance (as I had been expecting an early delivery, in fact), so we just put everything in the car. We called before we left, and the triage nurse on the phone did encourage us to come in. I knelt in the backseat because it had gotten too painful for me to sit upright in a seat in the car for the entire car ride (which is only about 15 minutes). When we arrived at the hospital, we discovered that the parking ramp closest to the L&D unit was full. How convenient. We parked in another parking ramp and got me a wheelchair, as it was a little bit of a trek from that area of the hospital to L&D. We had to keep stopping so I could bend over the chair during my contractions, as I couldn't tolerate sitting through them.
They didn't send us through triage on arrival. They just put us in a room. I remember looking at the clock and seeing that it was about 9 PM. Nursing staff came in and asked some intake questions. I answered their questions in between my kneeling, rocking, and groaning during contractions. It seemed like quite a while before the Ob/Gyn resident on call came in to check my progress. I told him the story about the gush of fluid and the contractions starting and gradually increasing in frequency and strength. He said it sounded like "a pretty good story," and checked my cervix, announcing that I was 4 cm dilated and 80% effaced. He enthusiastically said that was "a good start!"and probably told me something about coming in to check on me periodically and such. They did some kind of general informed consent, telling me it was best to do it ahead of time rather than in the throes of late labor, in case I needed to have a C section or anything like that. I signed it, but I thought to myself I was certainly not expecting it to come to that.
After that, I just remember a lot of kneeling and breathing and rocking and trying to mentally escape from the pain. I remember a few specific things that happened amidst the seemingly unending contractions. One was realizing I was kneeling alone on the floor and could really use some assistance. At that moment, I became aware that my husband was sitting in a chair in the room texting on his phone. Of course, he was probably informing people of what was happening. Of course, he probably didn't really know what else to do (although, isn't what we took that stupid childbirth education class for anyway?). Of course, I was in too much pain to concentrate enough to even tell him what I needed. Not that he asked. But he probably thought the last thing he needed to do was open his mouth. I remember the attending Ob/Gyn on call that night coming in to introduce himself and try to chat with me. He was cheerful and somewhat loud, in my recollection. I was on my knees on the floor, leaning over a balance ball and rocking back and forth, and couldn't even look at him. I don't remember much of what he said, other than calling me a "trooper" and saying something about how labor is really "intense" when it starts with your water breaking. He also made some comment about how they could "help" me with the pain if I wanted. No shit, dude. I tried to be polite but was thinking to myself that he should shut the f- up and get out because I couldn't focus enough to have a conversation with him. There was also an anesthesia fellow who came in to talk to me about pain control options. Similar situation, though he was not quite as loud, and he resorted to talking to Everett when he realized that I couldn't really pay attention to him or answer his questions about my medical history. I remember when our doula showed up, and I felt her hands apply counter-pressure to my lower back as I went through a contraction. I remember feeling relieved (emotionally) that someone who knew what to do was there. I was also grateful that we had chosen someone who had a calming, quiet way about her, who could help tremendously without even speaking a word.
Things seemed to progress very slowly from my perspective, but it was not quite midnight before they announced I was at 8 cm and 100% effaced. They brought in the "baby warmer," and it seemed like everyone was expecting things were going to happen soon. I was becoming less and less focused and more and more distressed about my pain, and our doula decided to have me move into the tub. This is supposed to give you some pain relief when you reach a critical point. I'm not sure if it helped my pain. It was a change of scenery anyway, but, at that point, I felt like all I was doing was writhing and yelling and fearing the start of the next contraction every time one of them ended. They were so close together at that point that I hardly had a chance to brace myself for the next. I don't know how long I was in the tub before I started saying I just really needed some relief and was afraid I didn't know how much longer I could take it. I think my doula was telling me to try to take it one contraction at a time, but all I could think about was how there could be so many more and it could go on for several more hours, which seemed like an eternity. Feeling like I got no help (no suggestions for what to do next) when I was asking for it, and also feeling like someone was stabbing me in the abdomen and the lower back, I eventually announced I wanted an epidural. I had intended to go without. Months before this, I had told both the doula and my husband not to argue with me if I said I wanted it. I felt so confident, at that time, that I would not speak the words if I wasn't utterly sure. It was wrong of me to think that, but how was I to know?
During my labor, I was thinking about the epidural long before the words ever came out of my mouth, but I wanted to hold out. I held out and held out. And then I just felt like I couldn't hold out anymore. I needed something. My brain didn't even think to ask for something like Nubain alone first to see if that would take the edge off long enough for me to hold out through transition. Or maybe I just needed a different kind of encouragement but wasn't able to ask for it.
So I held myself still (somehow) through a contraction in the tub while a nurse came in and placed an IV, as quickly as she could. Then they helped me out of the tub, and I shuffled over to the bed so the anesthesia fellow could place the epidural. I had to stay absolutely still. I began to shiver violently as this process began. I had really hit transition. My body was releasing all kinds of chemicals intended to help me get through this process. They gave me some Nubain, and I barely felt the contraction that was happening as they placed the epidural. At that moment, I was already questioning myself. Should I not do this? I seem to feel better already. Was it the Nubain? Was it my body getting ready for the big moment? I didn't know. I was just afraid of the pain coming back and lasting for 2-3 more hours or longer. Plus, I knew they had already started the process. So I let them place the epidural. To this day, I question this decision. Perhaps I changed the entire course of this labor and delivery by making this one choice that I had always intended not to make.
Anyway, it happened. I had relief. For a little while. About an hour after the epidural was placed, it stopped working on one side of my body, and I started to feel the contractions again. The worst part, though, was that starting the epidural had put a damper on the momentum. We had been rushing head on toward delivery, my labor being practically precipitous for a first-time mom. And suddenly it stopped. Contractions decreased in frequency and strength. Everyone went to sleep, except me. I lay there in the dark for 8 hours, anticipating, wondering when I was finally going to have this baby. I rocked back and forth in pain. I could not sleep. I couldn't get up to walk or anything to pass the time. I called the nurse in a few times to help me reposition myself to deal with the pain on one side of my body, only because I was too numb to move my muscles myself. I was so thirsty. I felt very alone. I was upset that everything seemed to have stopped. The doula was asleep in a chair, and my husband was asleep on the couch. I didn't even have a hand to hold. I tried to wake my husband a few times. I was successful at one point, and he got me some water and held my hand for a little while. Eventually, he lay back down on the couch while holding my hand and fell asleep again. I figured he might as well sleep and thought to myself that I should be doing the same, if only I could.
We had called our birth photographer earlier in the night, and she showed up at about 3 AM and sat quietly in the room for a while before retreating to the waiting room, telling us to let her know when we were ready to push. I wanted to be ready to push right then. I really did. I felt helpless.
Everyone else started to wake up as the sun was streaming into the hospital room the next morning. Around 8 AM, our doula brought me my toothbrush with some toothpaste and a cup of water so I could brush my teeth in bed. She also brought me some facial cleansing cloths I'd packed in my suitcase so I could wipe my face. It was slightly refreshing but not enough to make me feel really invigorated. I felt so tired already.
Corinne held out like a champ through all of it. There was one point at which she must have looked to be under a bit of distress on the monitor, as they put some oxygen on me, but it was only for a few minutes. Overall, she did very well.
The Ob/Gyn team came in again and told me they were concerned that I had been ruptured for so long and had not yet delivered. They had to admit, however, that she was moving downward in the birth canal. She just...hadn't made it out yet. They offered me some options, including starting some Pitocin to strengthen my contractions and doing a vacuum-assisted delivery. Our doula said that it would be possible to exhaust myself trying to push more on the Pitocin and perhaps not be able to take the vacuum-assist option after that. Not wanting to take the chance of continuing to push to no avail on the Pitocin, I agreed to vacuum-assist. But, when the resident checked the baby's station, she said she felt the baby was still a little too high for them to attempt it safely. So she told me she "would offer [me] a C section." I don't know what else she said because I sort of stopped listening after that. I just looked at her face and watched her mouth moving and thought to myself that there didn't seem to be anything else I could possibly do. What other option did I have? I felt defeated. I did not feel like I could keep pushing and manage to accomplish anything. I started to cry. I could not hold back the tears.
I said something to the effect of, "Well, if that's what we have to do, I guess that's what we have to do." She said something to me about how it was "nobody's fault." I just nodded. It was about 2:30 PM. My sisters, who had been waiting in the waiting room for a while, came in to see me before the C section. I felt emotionally and physically ravaged. I felt afraid. It was a relief to have my family there. I should say that we had decided ahead of time we didn't want anyone in the delivery room while I was laboring. I didn't want anyone else to come in until after the baby was born, so they had been made to wait in the waiting room. I knew they wouldn't like it. My family, being very enmeshed, is not used to being held at a distance. And Everett and the hospital staff had to keep them in the waiting room for me, though they were anxious to get in to see me. I obviously could not go out and tell them to their faces that I needed them to give me some space. I felt guilty about it, even at the time, but I didn't want them to see me that vulnerable. 2 of my sisters have had children of their own, but neither have been through labor, just C sections that were either planned or done in an emergency situation. I also didn't want to be distracted when I knew I would be dealing with a lot of pain and would need all my energy to cope with it. Maybe it was something I should have told them ahead of time, but I didn't know how to say it.
But, when the decision was made to go to the OR, I wanted them there. I needed that. As I waited nervously to be wheeled out of my hospital room, still rocking back and forth in pain during my contractions, one of my sisters stroked my hair and told me it was going to be ok.
It was a while before they wheeled me into the OR. They would not allow the doula or the birth photographer in, which was very disappointing. I did know that Everett would be coming in before they started the procedure, though. He was waiting outside in the meantime.
I was shivering again. I felt so defeated and tired that I didn't even want to look at anyone, even though the Ob/Gyn resident assisting came to talk to me before the procedure and was very kind. They placed a spinal, choosing not to use the epidural that had already been placed when I told them it stopped working on one side of my body about an hour after it was started. They put something cold (an ice cube, maybe? I couldn't see it) on different parts of my body several times, asking if I could feel it. The sensation gradually decreased as they kept checking, but it did not go away. I figured, since it was decreasing, it should be fine by the time they started the procedure. It was not. I could feel them cutting into me with that first incision. Of course, I didn't feel all the pain. It was duller than it would have been without the spinal, but it still felt sharp, and it did hurt. It's scary to know you are going to have major abdominal surgery and to feel that first incision. I told them I could feel it. I felt more cutting and painful tugging. Of course, you do feel tugging, and that's normal, but you should not feel sharp pain. I yelled out. The anesthesiologist, seeming nervous, decided to give me some nitrous by mask, which just made me feel like I was floating and couldn't breathe for a little while. Then I must have pretty much lost consciousness. Or maybe I was so drugged up that I just have no memory of the rest of it. Everett was taking pictures with my camera, for which I was so grateful. He captured the moments of her birth. This is a big deal because my husband doesn't like taking pictures and usually has to be coerced to do it. These were some of the most important pictures ever taken, in my opinion, especially since I have no actual memory of it. I "woke up" when I first heard her cry. Everett brought her over to me. I have a vague memory of touching and kissing her little face as he held her next to mine. The anesthesiologist took some pictures of the 3 of us together. It all felt very fuzzy and dream-like. It was about 3:30 PM.
Then Corinne and Everett disappeared, and I was closed up and taken to recovery, where I waited for until past 5 PM before I got to see my baby again. When the anesthesia wore off, I was in so much pain that all I could do was lie there with my eyes closed and breathe deeply, trying to breathe through the pain. They gave me extra morphine, which seemed to have no effect whatsoever. (So far, in my experience, opioids aren't that great for pain relief but are great for making me feel nauseated and headache-y.) Finally, they gave me some Toradol, which is a lovely non-steroidal anti-inflammatory drug, and I felt better. My sisters dropped in one by one, some bringing me gifts. A couple of them left before the baby had come down to the recovery area, but one stayed to see my little darling before she took off. I lay there thinking about how my little one was probably scared and needed her mommy. I tried to console myself by reminding myself that Everett was with her, but it still was devastating to me that we were missing those first moments after her birth when mother and baby are supposed to bond. It was even more heartbreaking when I later saw the photos the birth photographer was able to capture. They were photos of her in the NICU in a warmer, wearing just a diaper and a knit hat that the hospital provided, with a pulse oximeter on her foot. She was crying in some. In others, she was sucking on a gloved finger, which was all that daddy was able to offer her for comfort. Everett looked like he was going to cry. It made me so sad to think that my tiny baby had to lie in a warmer with just a gloved finger for comfort, when she just really needed mommy. The birth photographer later shared 2 of these photos on Facebook, as a "sneak peak" of our birth photos. Everett and Corinne looked so vulnerable and sad that I could not bear to share them with anyone at the time. Here's one of the less-upsetting ones:
I remember when they finally brought my baby to me and put her in my arms. At last, we were reunited and I could envelop her in warmth and love. I didn't feel any pain at that moment. What I felt was a mixture of pride, relief, and deep love. I felt such a great connection to her. Like we had survived something harrowing together. Like we were part of each other. I kissed her beautiful little face. I looked at her little features and her little body, touching her tiny fingers and holding her hand in mine. She was perfect, in my eyes. Her sweet little head was swollen from the long labor and all the pushing, and it was obvious that it hurt because she cried when it was touched. She had a few scratches on her head and face and little indentations in her forehead, just above her eyebrows, which seemed to be from where she had been lodged in my pelvis, pressing up against my bones. I didn't notice those things at that moment. I wouldn't notice until later. It would all resolve with time anyway. She nursed for the first time. I quietly told her I would always take care of her and love her. I felt I could "love away" any part of this that had hurt or was scary. This was what I had been waiting for for so long.
I later learned she had gone to the NICU immediately after delivery, just for a couple of hours to be monitored, because she had had some nostril flaring and grunting after coming out. She had great APGAR scores, though. The pediatric resident who had made the call later told me she didn't really want to send her to the NICU because she didn't think it was necessary but knew the nurses in the newborn nursery would get nervous about the grunting and would end up sending her anyway. If she had not gone to the NICU, I would have been able to hold her as soon as I got out of the OR. Instead I had to wait far too long, in my opinion, to finally hold my little one in my arms.
This really isn't a story about failure, though it has been hard for me to avoid seeing it that way for a long time. I was caught up in what went "wrong," which I attribute partially to the "baby blues" but also partially to an event that occurred almost immediately afterward that made me feel very disconnected from my family, who have been my major social support in recent years. The days and weeks after having a new baby are a very sensitive time. There is a lot of pain, lack of sleep, learning, and adjusting. Sadness is normal for a lot of new moms too. What you need is love and support, not criticism. But I'll save more about that for another entry.
I could also tell you where I think I made mistakes. I've replayed it in my mind over and over again and thought about what I'd like to do "next time" to increase the likelihood of achieving that "natural" birth for which I had hoped. There's really no point in doing that, though.
What I really want to say is that this is a story about new life and about meeting my child for the first time. For that, it is amazing. For that, it is a story that defines my life. It's the most incredible thing that has ever happened to me, and that's what I want to remember about it.
On February 26, 2012, my beautiful baby girl came into my life, and I love her more and more every single day.
*Photos by Laura Eckert, New Creation Photography & Design
