My (very long) birth story

Friday, May 21, 2021

In the last week before I ended up giving birth, my husband and I decided to binge watch the Harry Potter movies again just for something to do. We had already prepped everything we could, cleaned the house and since it's still a pandemic there wasn't much else to do. I was 40 weeks and 6 days so we had been prepped for this for awhile. On Monday evening John offered that we could push back watching the last movie until tomorrow, but I said no, we better finish tonight. That ended up being very fortuitous! I sat on my birth ball while we were watching because I was trying to stay angled forward as they tell you to do to help a baby be posterior facing. I started noticing Braxton Hicks contractions but they were fairly evenly spaced. I started timing them in my app just to keep track and they were about 8 minutes apart. They didn't hurt at all though so I thought nothing of it. I had had some Braxton Hicks contractions previously in the week, so I assumed this was just more of the same. 

We went to bed after the movie finished and I slept just fine until about 2am. I woke up to what I thought was a Braxton Hicks contraction, but one that actually started to feel like a strong cramp. I went to the bathroom, returned to bed and fell asleep again. 4am rolls around and again I'm awoken by another contraction. Now I'm starting to think that this might be the beginning of something. Never before had they felt even remotely painful, nor did I often wake in the night. I managed two more hours of sleep until at 6am I started feeling more strong cramp-like contractions and this time they were relatively frequent. I went to the bathroom to sit on the toilet and assess what was going on and to avoid waking John. By the time our alarm went off at 6:45am I was pretty sure this was real. I told John as he woke up and messaged my office to say I probably would be late if I came in at all. 

With the first really strong contraction I suddenly felt like I was going to be sick. That sweaty upper lip, queasy stomach sensation. Luckily I wasn't sick, and the feeling never returned, but from that point on, early labor went really quickly. I asked John to get my birth ball for me to sit on which he got right away and I promptly ignored entirely. I spent most of my time either leaned over the bed, on the toilet or, eventually, standing under hot water in the shower. By 10am I asked John to run the contractions app because I couldn't anymore and to tell his work that he needed to leave. While I was standing in the shower he did my Duolingo for the day (Priorities -- gotta keep that streak alive!) and called the midwife. I had already been having contractions about 3-5 minutes apart for over an hour. I couldn't believe that it could have progressed from hardly anything to needing to head to the hospital in under 4 hours, but they told us to come in anyway!

By the time we finished packing the hospital bag (with completely unnecessary stuff as it turns out), texted our doula and got everything ready to go, it had almost been another hour and I was now having contractions 1-2 minutes apart. It took me several contractions to get down the stairs, and several more to put my shoes on. I remember yelling at John to hurry up (something he's absolutely terrible at) because they were suddenly coming so fast. We took what seemed like the longest drive over an absolutely pothole riddled route to the hospital, parked and I made a beeline to the labor wing. While walking down the entrance hallway I was so laser-focused on making it to the elevators that we blew right past the Covid checkpoint, I refused offers to go get a wheelchair while I waited through contractions leaning against the wall because I knew it would only slow us down and I barely remember the elevator ride up or the check in process.

I was put in a room to assess if I could be admitted. They had to monitor the baby for 30 minutes and do a cervical check. Despite my contractions being really intense already and very close together I was convinced I would only be a few centimeters dilated. Instead, when my midwife was checking me she chuckled to herself and said, "You definitely won't be going home." I was already 7cm dilated! They immediately started running water for the tub because I was interested in laboring in the water. As soon as the monitoring was done and I was free to walk around I stripped down to only my bra, losing any sense of modesty immediately. They asked me to try going to the bathroom first, joked that I should be careful not to have a toilet baby, and then into the tub I went. I labored in the tub for about an hour but was surprised that I didn't find it as comfortable as I thought I would. There was really no good way to relax because I couldn't lean back and there wasn't anything to hold onto really. My knees got tired from kneeling on them and I wasn't in enough water to float. They really should get themselves some bath pillows or foam boards! They gave me nitrous oxide while I was in the tub. I didn't like how hard I had to push the mask against my face to get it to actually seal when I inhaled, and I didn't feel like it was doing anything. Turns out, the tank had been empty the whole time. Super helpful. They replaced the tank, but even after that I still didn't feel like it was doing a whole lot for me.

After laboring in the tub for awhile they asked me to try to go to the bathroom, do another cervical check and try some new positions on dry land. I was 9cm dilated at the check, with only a lip of my cervix still present. I did some side lying and hands and knees for awhile positions, moving about every 30 minutes. I remember that every time I moved to a new position the first contraction in that position was really unpleasant, so I wasn't super keen on all the moving they were having me do. At some point during these didn't positions I felt my water break. It was only a tiny bit of water, but it was clear. Eventually I felt my body do a tiny little push of its own. By this time I had totally given up on the gas because it was so annoying to have told hold and press on my face and it just wasn't worth it when I didn't feel any different. My midwife checked again and the lip of my cervix was still present, so she manually moved it aside during a few contractions which wasn't the most pleasant thing ever. It paid off however because then it stayed aside on its own and I was cleared to start pushing.

This is when things slow down quite a bit. I started pushing on the birth stool. The stool is appropriately named because boy does it make you pass a lot of your own! Luckily because of Covid everyone was wearing masks except me, but I was honestly jealous. They always tell you that nurses will just happily wipe the poop away and say nothing of it, but in my case they just left it on the chuck pad below me and I wished they would have cleared it away faster! Anyway, enough of that gross detail. When I first started pushing, my noises were a lot higher than they were supposed to be and my pushes weren't quite strong enough yet. It was pretty clear I wasn't fully in the thick of things yet. After the birth stool I moved to hands and knees, side laying, even on my back. I was in so many positions I can't even remember them anymore. My midwife kept disappearing and in hindsight I think it was to fend off the attending physicians because I had been pushing for so long already. At one point they asked me to try going to the bathroom, but absolutely nothing would come out even though I had drank enough water that there was definitely pee in my bladder. 

Eventually I started making much lower noises and my pushing got a lot stronger and my breathing a lot more in sync with what they wanted while pushing. I was honestly surprised that they were telling me to hold my breath and bear down because the hypnobirthing class I took had advised against doing so. In the end I didn't really care -- my heart wasn't set on any one approach -- I was just surprised that this is the one thing my midwives differed on from the approaches I had seen promoted in the more "natural" community online. Up until now the pain wasn't really something that I had thought about too much. It was present, but it wasn't at the forefront of my mind. When I started pushing it was nice to be able to utilize that pain and do something productive, but for some reason the pain was the worst for me when I was inhaling during a contraction. Exhaling and pushing? Fine. Inhaling? Very unpleasant. I never thought to myself that I wanted pain medication, but I did start to dread having to stop holding my breath after a push. I didn't really make any noise while pushing or in pain though -- I spent almost the entire time I was in labor with my eyes closed and silent. My midwife and doula actually had to coach me to make the low groaning noises when having a contraction or pushing. 

After about 2 hours of pushing with little progress, my midwife suggested that I get an IV and start fluids so I could would hopefully have a little more energy. I honestly couldn't tell you if it helped or not. I hadn't felt particularly fatigued to begin with. What I did feel was more of a mental fatigue. I just had this feeling that none of my pushes were doing anything at all. I obviously had no idea what progress during pushing would actually feel like, or if I should be able to feel anything at all, but in my head I just knew that I was getting nowhere. I pushed for another hour after that, again with very little progress, and so my midwife asked me to get an epidural. In hindsight I think she knew I was going to have to have an epidural for one reason or another when she asked me to get an IV because you have to run fluids for a certain time before administering the drugs. I think she might have just been preparing but trying not to scare me. Her reasons for me getting an epidural were twofold. First off, she wanted me to actually rest. Secondly she was hoping that my pelvis would expand a bit if I wasn't able to feel anything or control my muscles. 

I don't actually remember the feeling of the first local anesthetic that they administered while getting an epidural, but I do remember how hard it was to remain completely still during the middle of a contraction. I remember how close both my doula and my midwife were and how hard they were trying to coach me to breath through the contraction and assure me that I was doing well. They actually require that your birth partner sit in front of you, and I remember how scared John looked while it was happening. He was probably more scared than I was because at that point I just wanted something, anything to change from what we had been doing previously. I remember telling my doula that I just didn't feel like she was going to come out of me on her own and I appreciated that she actually relayed that to my midwife and that they actually considered my instinct seriously. Once the epidural was administered I initially couldn't feel any contractions at all. I actually opened my eyes and was talking for the first time in many hours. After a few minutes I started to be able to feel contractions again and my feeling was getting stronger with each one. They brought the anesthesiologist back and I was given a booster dose. Feeling started to mostly go away again, but I could still feel them a bit, especially in the right side of my pelvis. I was then given another booster and they rolled me to my right side to try to get rid of the hot spot. As soon as they did that the baby's heart rate slowed and out of nowhere there were nurses all surrounding me and they all flipped me back over and waited to make sure her heart rate stabilized again. Shortly after that my blood pressure dropped (a side effect of the epidural) and so they had to give me medication through my IV to help stabilize me this time. Eventually things calmed down and I was able to rest for an hour despite being really cold from all the fluids they had to have running through my IV.

After resting they did another cervical check (which I didn't even know they did because of the epidural -- so weird!). She had moved down an inch which was great news. My midwife talked to me and said we would try pushing with an epidural for another hour, but that she was going to ask the hospital physician that's especially skilled with forceps to be ready to come in if we hadn't delivered her yet. She told me the doctor could do a forceps delivery if I wanted to and she thought it was safe and possible to do based on baby's position or I could go straight to a c-section if I didn't want to try forceps. She warned me that even if we try forceps that it may not be possible and I may end up having to get a c-section anyway. This was the moment I was very glad I had taken the birth classes with our doula because I felt like I knew what the risks and benefits to each option were already and I wasn't scared. I just wanted her out! 

We began pushing with an epidural in the classic stirrups position. My midwife told me she wanted me to hold a mirror and I immediately looked horrified and said "MUST WE??" Clearly I was not interested in seeing whatever was to be seen down there. Thankfully the mirror never made an appearance. The entire time I was in labor I had been having an irregular contraction pattern where one contraction would be weaker and less than a minute and the next contraction or two would be up to three minutes and really strong. It hadn't been a problem until we got to this stage of pushing and they noticed that during the long, strong ones baby's heart rate was decelerating. I was given oxygen to help it pass on to her and I was told to stop pushing on every other contraction so she would have a chance to recover. Luckily it never got any more serious than something that could just be monitored and mitigated naturally.

I pushed for another hour and again there was no progress made so the hospital doctor was called in. My midwife and doula spent a lot of time assuring me she was the best in town with the forceps but that she was very direct and didn't have the best bedside manner, but as a person that grew up in a family of direct, assertive women I thought she was perfectly nice and that she took her job very seriously (thankfully)! I already had an epidural so when she arrived we were ready to go straight in. She told me that she did think she could attempt a forceps delivery but again, we might find out it wasn't possible and have to go into surgery relatively quickly for a c-section. Then she told me she would get her tools in place, wait for a contraction to start and that I was to wait for her to tell me to push and no one else. It took her no time at all to get the forceps inserted. I didn't see them, but John did. Later he said they kind of horrified them because they were huge metal hockey-stick looking contraptions. On the first contraction she had me push a total of 4 times. After the third push her head was out and suddenly all the difficulty was made clear. She was sunny-side up and her eyes were staring straight up at us! Normally they only have you push 3 times per contraction, so the nurse tried to tell me to rest but the doctor was very stern and said "No, push again, push again!" On the fourth push she was out! 

Things were moving at lightening speed by this point. I had wanted to have delayed cord clamping and immediate skin to skin, but I knew that something wasn't right because as soon as she was out they called John over very quickly to cut the cord and then she was taken straight to the NICU station in the corner of our room. She was not crying yet and she was completely brown from meconium. It turns out the water that broke earlier was just the outer sac. Her inner sac had remained intact and was completely filled with a ton of meconium. Even though she was taken away so quickly, I was oblivious to the idea that something could be wrong. I just assumed this was the way things had to be due to having an instrumental birth. John however was more clued in and stood halfway between me and the warmer, not sure if he should comfort me or make sure she was okay. They ended up having to suck fluid from her stomach twice before she cried, but after that she was perfectly healthy. They gave her oxygen for a little bit just to make sure she was okay, but her coloring was great and all her vitals were completely normal. The nurses said later that she had swallowed so much fluid that they were surprised she was able to stabilize as quickly as she did and not have to go to the NICU and for that we are very thankful.

While this was happening and I was just laying there waiting, the placenta was delivered. I had no idea it had happened so quickly because of the epidural and I had assumed it was something that I would have to push for. Apparently not! The medical team stayed for another 45 minutes or so stitching me up because I had a 3rd degree tear (which they told me later) and some unexplained cervical bleeding. My epidural had started wearing off so I kept having to say that I could feel what they were doing. I ended up getting two shots of local anesthetic and fentanyl in my IV line while they were working. I was never actually told how many stitches I received, but my doula and midwife both told me that the physician was very meticulous about her stitching so I'm sure it was a lot. To help stem the cervical bleeding they inserted this very long gauze strip, probably at least three feet long, into my vagina to sop it all up. When they were doing inventory of the sponges, gauze and tools, etc after they finished stitching me they found that they were missing a sponge. They used a sort of metal detector thing to try to locate it (apparently they have chips in them) and they heard it beep while holding it over me and thought that it must have accidentally gotten wrapped up in the gauze they had put inside me. They took it all back out (I felt a bit like a magician pulling a colorful scarf from her sleeve), looked for it in the gauze, didn't find anything and the subsequently realized that the sponge was just under me, not in me. Still glad they checked though!

While this was all going on they had returned the baby to my chest for skin-to-skin time. They warned me as they brought her to me that she had a very misshapen forehead because it had been hitting against my pelvic bone for the entire five hours we were pushing. The bump on her forehead was huge -- probably about two inches tall! Amazingly this was completely gone by morning and you couldn't tell it had been there at all. The combination of the bump and the fact that she wasn't in the birth canal for more than one contraction meant that her head was in the 95% percentile for circumference. My vagina says yikes. I also wonder now if her head pressing on my pelvic bone is why I had that hot spot with the epidural. I'm far from being a doctor, but it seems like a pretty plausible explanation to me. She stayed on my chest for about an hour before she started crawling to my breast on her own. It was truly insane to see such a new little creature already know where to go. She latched on and we were able to breastfeed for a little bit. We were left alone, just the three of us, for about two hours to hang out and bond. In reality we just sat there a little stunned at the fact that she was here and real and everything was okay.

After we had time alone, they came to try to move us to the recovery room. No one had told me yet, but I had officially lost around 1.5 liters of blood during labor, so I was classified as having had a postpartum hemorrhage. When they sat me up to get out of bed I felt a little light headed, and when I stood I got very pale and light headed. They took one look at me and told me we'd be spending the night in the delivery room to rest some more. Unfortunately for John that meant sleeping on a hard couch instead of in a double wide bed that they have in the recovery rooms. We stayed until around 6am when someone came to take my blood so they could check my hemoglobin levels. They did this several times a day and yet I still had no idea that I had lost so much blood. I just assumed it was normal post-delivery procedure. It wasn't until they told me that my hemoglobin levels got down to 6.8 and that I officially qualified for a blood transfusion that I understood why. This was on the second day in the hospital, around late morning. It wasn't until mid afternoon that it was finally cleared and I was hooked up to receive a unit of blood. They had to run a bunch more fluids through me first which added to my already very swollen state from the fluids I received in labor. So much so that I had to remove my bracelet because it was getting too tight! A few hours and a very bruised arm later (blood transfusions are a very strange sensation) I was on my way to getting my hemoglobin back. After my last hemoglobin test after the transfusion, my levels were back up to 8 and I was cleared to go home. We raced to get everything packed up before the pharmacies closed for the night and headed out for the first time as a family of three!

My birth story is absolutely nothing like what I thought it would be. It's not a very nice story on the surface, and it was especially hard for John to process as someone who had to watch it all from the outside. I am lucky that I didn't feel particularly scared or upset during any of my labor. I was just happy that things were progressing after so many hours of no changes. I didn't even consider the gravity of the situation until well afterwards. I am incredibly grateful that everything turned out okay for both me and the baby, and that we had come into labor incredibly well informed from the birth classes we took and supported by our doula and midwife. To anyone preparing for the arrival of their baby, I hope you take time to consider how you want your birth to go if things don't go exactly as planned. You'll be grateful you're not scrambling to make decisions or understand a procedure in the moment. I hope that hearing my less-than-ideal story that still ends happily has provided a little reassurance that even if things don't go how you thought they would, it can still be a positive experience. And remember, birth trauma is real. Seek help if you're having a tough time coming to terms with your own birth story!

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