{first baby, hospital birth}
A lot of people knew that we were hoping for a low intervention birth. I have no problem with women making their own decisions about pain management in labor, and I don’t think there is anything wrong with getting or planning to get an epidural. However, for a few reasons I was hoping to avoid one.
- A. I wanted to fully experience this unique life event,
- B. I had done a lot of research and knew that epidurals and other interventions could increase my chances of having a C section, which I really wanted to avoid*,
- C. It just seemed better overall for me and the baby to avoid as many drugs as possible, and
- D. I wanted to see if I could really do it (this is the worst reason, but I knew it would be an accomplishment like no other).
At Sarasota Memorial Hospital, their C section rate is around 42%, which is quite high and I did not like those odds. So we decided to go with midwives in a birth center. The problem with going with a birth center and planning to go “natural” is that everyone you tell your plans to will then tell you how crazy you are, how it didn’t work for them, their horror stories, etc. I had a woman at a nail salon tell me that I would be screaming and begging for the epidural. It’s really not helpful when everyone tries to scare you.
*I wanted to avoid a C section because it is major surgery, and a vaginal delivery has fewer possible complications for both mom and baby. I also wanted to be able to hold and feed the baby right away, and just in general the idea of surgery and its recovery scared me. One of my first thoughts after delivery was that a C section didn’t seem like such a bad thing anymore!
Spoiler alert: I did not make it through without pain medication. But I absolutely believe it is possible and that women are capable of doing it. I also believe that some things are out of our control, sometimes things happen for a reason, and ultimately it is about making the decisions that work best for you. I think it would be a lot easier to get through a short labor drug free than a 24+ hour one, though certainly the latter is possible too with the right support and circumstances. Ultimately, Sam and I ended up where we needed to be for various reasons, and I don’t really regret any of the decisions I made in the process. And I still feel a huge sense of accomplishment and amazement that I made it through and gave birth to our 8 lb 4 oz baby boy.
Since I was over 41 weeks pregnant and facing a possible induction at the end of the week, I was trying nearly everything to get labor started. I was walking about 1.5 miles a day, taking all sort of homeopathic supplements, eating spicy foods, acupuncture, reflexology massage, etc. etc. Of course all I could think about was “when is this baby going to come?!” On Thursday, October 24, my mother (who is staying with us to help with the baby) was ill all day, and in the afternoon, on the advice of her doctor, we decided she needed to go to the emergency room. As we were packing her stuff to go, I felt lightheaded and nauseous and crawled into the bathroom. I was then seized with the worst back pain I had ever felt (I still think it was worse than anything in labor, though my memory of labor back pain is all kind of hazy now, so I don’t know). I was freaking out and couldn’t do anything but lie on the floor and say over and over, “I don’t know what’s happening.” Adam was understandably shaken as well. This lasted maybe 2 or 3 minutes before I was able to move again. We called the midwife and decided we needed to make sure everything was OK before we could take my mom to the hospital. Baby was fine and we determined that it was just a freak back spasm. Looking back, I think it’s too coincidental that that happened the same day labor started, so in my non medical opinion, I think that Sam had moved into a position to get going and that put pressure on a new nerve (or something) in my back.
We headed back home and took my mom into the hospital. I was feeling pretty crampy all evening, but it wasn’t that unusual at that point, so I didn’t think much of it. I was way more focused on my mom and worried about what was wrong with her. She ultimately had a kidney stone, and while I don’t think she’d want to go through that again, I believe that her being ill and therefore taking my mind off of not being in labor is what finally got me to go into labor! My mom was admitted to the hospital around 9 pm and needed to have some tests done, so Adam and I headed home with the intention of returning once her results were in. We got home around 10 pm and ate some dinner. At 10:40 pm, I felt a pop and knew my water had broken. I immediately had a strong contraction. I made my way to the bathroom where I discovered that there was meconium in the water. This can be a sign that the baby is in distress, though it’s also not that uncommon in an “overdue” baby. Adam called the midwife, and we learned that both birth center midwives had come down with a stomach flu! They have some back up midwives, one of whom came to our house at 1 am to check me out, but given the meconium, they advised us to head to the hospital. At this point my contractions were pretty strong and coming every 2-5 minutes, and I was one centimeter dilated. We called our doula, Chantal, to meet up with us at the hospital, and we were on our way. Two funny things I remember from this time: I made Adam pull the car over for a few minutes before we entered the hospital so I could scarf down some graham crackers. I had meticulously packed some snacks for laboring at the birth center, and I knew they wouldn’t let me eat once I was admitted to the hospital, so damn it I was going to eat some of those snacks! Then once we dropped the car off at the emergency room valet, they put me in a wheelchair and the attendant literally started running me to the labor and delivery ward. I was like, “I am one centimeter dilated – I’m not having this baby anytime soon!,” but she said, “your water has broken, we don’t know how to deliver babies down here!” Poor Adam had about 4 bags of our stuff and pillows and had to run to keep up with us. I think that’s probably the last time I was laughing until I got the epidural 17 hours later.
For someone who really didn’t want a hospital delivery, I have to say, the L&D staff was fantastic. They gave us a great huge room with a shower, were totally respectful of my birth plan (as much as possible), let me wear my own clothes, and were so friendly and encouraging. The doctor on call was the same doctor we had seen prior for the past dates testing and another visit. He basically left us alone to labor as we wanted. As per the hospital’s policy, the baby and I had to be hooked up to the monitor for 20-30 minutes every hour, so I was somewhat restricted in my movement, but I was able to move around the bed, so it wasn’t too bad. I found the only way I could tolerate the contractions was to lean over something, either leaning on pillows on the bed, sitting on a ball and leaning over the bed, or standing up and leaning on the bed (eventually I think this contributed to my exhaustion from all my weight being on my legs). Chantal and Adam massaged my back and hips, which provided so much relief. For the first few hours we were there, Adam got a little sleep while Chantal helped me through contractions. I wasn’t expecting things to go quickly, but man did they go slowly. I made Adam take the clock off the wall because I felt like I was fixating on it. Eventually I decided to try out the shower, which was wonderful. The hot water helped me relax and provided relief on my back during the contractions. After the shower, they checked me again and I was still only 1 centimeter dilated. I told myself I wouldn’t be discouraged, but I was. I had been having strong contractions every few minutes for hours and hadn’t made any progress.
This is when things start to get hazy and I lost a sense of time. I know I labored for a few more hours, I threw up at some point, and eventually made it to 4 centimeters. I got back in the shower. While it was better than not being in the shower, I wasn’t feeling the same relief as before. I called Adam in and told him I couldn’t do it anymore. I even used our I-am-serious-now code word. I got out of the shower and discussed options with Chantal, Adam and our nurse. The nurse suggested Nubain – an IV drug that would help me relax, though it wouldn’t take the pain of the contractions away. I was willing to try anything, so I agreed. The Nubain allowed me to lie down and relax and even fall half asleep between contractions. I still had to get up and into a leaning position for each contraction, but it kind of made me forget about the contraction after it happened and not dread the next one so much. I dozed on and off for about an hour and woke up feeling somewhat refreshed.
Again, I don’t remember exactly what happened during these hours other than lots of contractions and breathing. By early afternoon I was at a 6-7, and I was thinking I could use some more Nubain! The nurse told us that if I was going to get more, it would have to be soon because if you have it too close to delivery, it can make the baby lethargic. So I got a second dose, and while it again allowed me relax a little bit, it did not help me forget the pain and anticipation of each contraction. The contractions were now very close together and taking on a new kind of pain. It felt like there was a huge ball of pressure deep in my stomach that I could not stay on top of with breathing. All I could do was whimper and cry when one of those contractions hit. They checked me again a few hours later and I was still at 7. I got in the shower again (in hindsight, while the shower helped so much, I think it also dehydrated me because I stayed in the heat so long and drinking fluids made me want to throw up). This is when I started to break down and cry to Adam that I really couldn’t do it, that I hoped he wasn’t disappointed in me (he was not, in fact he told me later that hours before he had started questioning why I was going through so much pain when there was the option to do the same thing without pain), and that I really needed the epidural. Looking back, I think that the pressure I was feeling was the beginning of transition – the hardest though usually shortest part of labor – but after so many hours of no sleep and constant strong contractions, I was unable to relax enough to get my body to progress. The Nubain was also making me feel like I was kind of hallucinating, like I didn’t know where I was and what was real. I know that it’s common for women to doubt themselves when they are in transition, but I feel like for me it wasn’t self-doubt as much as self-realization that I had really reached my limit. Adam and Chantal, bless them, knew how much I wanted to avoid the epidural and kept telling me how great I was doing and that I could keep going. But I had made up my mind. The nurses changed shifts at about 6:30 or 7 and my new nurse Diane introduced herself and asked me if I needed anything. I responded, “yes, an epidural as soon as possible.” I think this came out pretty sassy, but I was done negotiating.
One of the worst parts was then having to sit still through contractions for them to place the epidural. I knew they were placing a big needle in my spine and since my contractions were coming at least every 2 minutes at this point, I was terrified I wouldn’t be able to be still and I’d mess it up. Thankfully I did not, and within 10 minutes I had blessed relief. I think I said something like, “I have no regrets!” and I still don’t. Chantal said it was the first time she’d seen me smile all day. After not even an hour, I was almost fully dilated. The doctors’ shift had also changed, and the new OB came in to meet me. She seemed surprised that I had progressed to full dilation so quickly. She also told me that she has a time limit for pushing and wasn’t sure if I would be able to push the baby out because I was 42 weeks and he might be too big and get stuck. Behind the scenes, Adam and Chantal learned that this doctor was very C section-happy and usually goes straight for surgery if someone’s water has been broken for 24 hours. The next morning the doctor straight up told me that she had thought I would need a C section. I was not terribly fond of this doctor. However, our nurse Diane really advocated for us and I am so grateful to her for helping us achieve a vaginal delivery.
We all rested for an hour or so. We joked that the baby would be born on 10/25 at 10:25 pm. I wish. Pushing was my least favorite part of the whole labor. We ended up beginning the pushing phase around 10:30, and he was born at 12:46 am. It was a long time. I asked them to turn off the epidural so I could feel when to push. I was still pretty numb for the first 30-45 minutes and didn’t make much process (thankfully Diane kept the doctor away until I started making good progress). Then once I regained feeling I somewhat freaked out because I was afraid of the contractions and of coping with them on my back. I won’t go into much detail, but I do remember accusing everyone of lying to me for telling me I was making good progress, I started really hating Diane at some point for telling me not to make noise (though I have nothing but gratitude for her now), I snapped at Adam a few times for telling me to grab my legs, though I also gained a lot of strength from him to get through it. I remember being so so hot and they turned the fan off because it would make the baby cold (I still don’t understand why it couldn’t have been left on until he was born), and I remember screaming at the doctor to “just get this baby out of me!” It was not my finest moment. By the end it kind of felt like an out of body experience because I was in so much pain that all I could do was keep pushing without thinking. I didn’t even think about meeting the baby, all I could think was, the only way to end this is to keep going.
One of the things I was hoping for the most was that the baby would be placed on my chest right away after birth. We also hoped that Adam would get to cut the cord after it stopped pulsing. Well, because of the meconium (and even though Sam’s heart rate had been perfect throughout the entire labor), they called in people from the NICU to suction him right away and make sure he didn’t breathe in any meconium. In a way it was good they were there because once they showed up Adam assured me that the baby really was that close to being born, but it also meant we wouldn’t get to experience some of what we had hoped. Once Sam was finally born, what was the first thing he did? Sneezed. So much for getting him all suctioned. They carried him over to the warmer table with his butt up in the air, and I could see that he was a boy and got to make that announcement, so I was happy about that. I was also so relieved that I was done pushing and that I had really done it.
The rest of his first hour did not go nearly as planned, and it still makes me sad to think about. I couldn’t really see him at first over in the warmer, but I also couldn’t concentrate on him because of what was still going on with me. I was losing a lot of blood and my uterus was not contracting as it should (apparently it’s not that uncommon for it to be exhausted after a long labor). They gave me Pitocin in my IV and then a shot in the leg to try and get the bleeding to stop. At some point they put Sam on my chest, though they put him right in the middle so I couldn’t see his face, and then I had to ask Adam to take him because I couldn’t concentrate on him because of the pain. Once the bleeding situation calmed down, the doctor, you’ll recall not my favorite woman, started working on fixing me up. She apparently didn’t realize that my epidural had worn off, but I sure did. She asked me if I wanted something to relax me and take the edge off and I agreed – probably my only regret of the whole experience. What did they give me? More Nubain! The drug that does not take away pain. I didn’t want to be high, I wanted to not feel what was going on. When I complained that I was still in pain, they decided to give me another dose of the epidural, which worked great on my left foot and nothing else. At this point I started crying because I was still in pain, I could barely keep my eyes open because of the Nubain and blood loss, but most of all I could not hold Sam and I couldn’t even really concentrate on Adam holding him. I felt like a horrible mother because I couldn’t stay awake to bond with my precious baby. I still cry thinking about this. I think eventually I gave in and slept for a few minutes. Finally they finished working on me and set us up to be transported to the mother and baby unit. I held Sam on the stretcher and fought to keep my eyes open and snuggle him. We got up to our room where I scarfed down a turkey sandwich, called my family and then passed out. We were absolutely exhausted but also so elated that our beautiful baby was finally here. I wish that was the end of the drama of his arrival, but the next morning would bring some new unforeseen challenges.
When I look at him, not only do I not understand how he fit, but I still can’t believe I was able to push him out – and with minimal interventions. Even though I ended up needing pain medications, I still feel a huge sense of accomplishment for making it through an intense labor for so long and especially for pushing him out when I really wanted to give up. It’s the most amazing thing I’ve ever done, and while I am not in a rush to do it again anytime soon, he is so very worth all of the morning sickness, pregnancy discomforts, and labor pains. I feel very blessed. I also really believe that “natural” birth is very possible, and that women should support each other in whatever their goals are for their birth experience. Things didn’t go as planned for me, but it was still an incredible, life changing experience, and I don’t look back on it with horror but with pride and a new appreciation for my body and its capabilities.
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