Sunday, December 4, 2011

At Long Last, The Ridiculously Long, Nineteen Page Saga of My Birth Experience

Note: I really, really tried to write this for myself, and not for my audience. Of course, knowing that you all are going to read it (maybe, if you don't have a lot else going on!), and now my midwife wants to read it as well... of course that impacts me. But I tried to stay true to myself. So I'm trying not to apologize for how self indulgent this all my sound. Feel free to stop reading any time. 

And sorry it's so damn long! But I couldn't bear to edit it any longer. And it was a very long experience! Anyway, it's partly Scott and Salt Lick's fault -- they took such amazing notes with such detail and I couldn't bear to leave any of it out. 

The first part was written in the first ten days after Calliope was born. The second half, about twelve weeks later. 

(I don't know why there's a giant white space below the photos. It's not showing up in my draft. Sorry about that!)

Bright eyed, despite the epidural drugs
Checking out my miracle, and oblivious to the action below

Getting suctioned by the pediatrician, moments after birth

My little peanut! (The string is the internal fetal monitor that had
been screwed into her scalp.)

Scott and me, during the peaceful epidural phase. (PS having my own
pillow was AWESOME! I highly recommend it to the pregnant gals.
Also, bring the My Br.est Friend to the hospital. Invaluable!)

My precious little girl is asleep on the big bed, with me all the way in the other room. This is the first time I’ve left her alone in another room, and I’m not at all sure it’s okay… but I’m thinking it might be?

So I am seizing this moment to jot down some memories of the birth before they flee. It’s incredible how fleeting they are. I assume this is some effect of the medications?


Sunday morning, 41 weeks, 1 day, my friend Salt Lick and I saw the midwife together. I drank a mix of castor oil, vanilla ice cream, mango juice, and a shot of rum (the midwife's personal recipe: the ice cream helps mask the taste better than juice, and the alcohol helps prevent cramping). It wasn’t too bad! And I didn’t have any cramping! I had some not-too-unpleasant diarrhea, and mild contractions for a while, which eventually petered out, much to my disappointment. Salt Lick stayed with me that night.

Monday morning we arrived at at the hospital at 8 am, as per my midwife's instructions. I got admitted to the Antepartum wing of Labor and Delivery. The hospitalist midwife (who I also know a little as a colleague through the union – she’s the one that did my off-the-books ultrasounds when I had little freak-outs about the baby not moving during my pregnancy), met us there and inserted Cervadil at 10:40 am. The Cervadil looked like a shoelace, all crumpled up in a ball, and it hurt when she put it in. She fiddled with it for a little bit, trying to get it just right.

Salt Lick and I hung out all day. I had a heplock (IV site) placed, just in case I went into labor. I don’t think I got any IV fluids. I think I had a CBC drawn at the same time that the IV was being placed. I was trying to not pay attention by chatting with the hospitalist midwife, who is upbeat and funny. I think I had some mild contractions for a while, but they petered out after a bit.

Mid-afternoon, Salt Lick brought me half a roast chicken, rice and beans, and platanos maduros from Coco Roco. They were delicious! I was starving. I had some more rice and beans for a mid-afternoon snack, along with a half a Twix bar that I was craving for some reason. It was delicious, too! (As was my pregnancy tradition, I skipped dinner.)

Then my friend Emily met Salt Lick outside and handed off three year old Annabelle to Salt Lick so that Emily could come up and visit. That was nice, as it was boring and weird to be stuck in a hospital as a well person with absolutely nothing happening! Emily was distracted and checking email because she had childcare issues to solve for the first week of school.

After Emily left and Salt Lick came back, I encouraged Salt Lick to go home and get some rest. It was unclear but there was a chance she could have stayed over, even though it was against hospital policy. But she had been with me since Sunday morning, and I knew Tuesday would be a long day, possibly with no sleep well into Wednesday. I figured I needed her rested the next day far more than I needed her entertainment that night.

We talked about it, and tears welled up in her eyes for a moment. I was sympathetic, remembering how hard it was to leave my dad in the hospital (I think it’s harder to leave than it is to be left). But I also knew she was tired, and hormonal (she told me she had PMS), and that we would both be better off if she left. She left around dinner time.

My midwife came to see me around 9:30 pm. She did a cervical exam, and took out the old Cervadil. I think the dilation was unchanged at 1 cm, but I remember that she was pleased with the effect of the castor oil plus round one of the Cervadil – I think my cervix was noticeably softer and the baby’s head was lower. She inserted a second dose of Cervadil at about 10 pm, taking care to make sure that it was in a posterior position. I remember that she felt that was important.

The midwife also recommended that I take an Ambien. I was nervous since I had never taken it before, and worried that it would make me groggy in the morning, but admitted I wasn’t sure how well I would sleep, given my excitement and the fact that I was in a hospital bed. She countered that the benefits of being well rested for the Pitocin induction in the morning outweighed the risk of morning grogginess, but left the decision up to me. She said I had to decide before 12:30 am, though, so that the effects would be worn off before the Pitocin was started… I think that was scheduled for 10:30 am the next day. She planned to arrive an hour before that, after dropping her son at day camp, to remove the second Cervadil.

At 11:30 pm, I opted to take the Ambien, and fell asleep.

This is where things get very fuzzy indeed.

According to Salt Lick, I woke up at about 1 am. Apparently I was having contractions but also I was feeling very weird from the Ambien. I called Salt Lick to tell her… something. She says that I was discussing with her whether to call my midwife or my doula. I sort of remember this, and deciding that the midwife was the more appropriate person. My midwife told me that I called her to tell her that I was worried about how I was feeling, but I have no recollection of this (but my phone log shows that I called her just before 2 am). I don’t remember calling Chloe, my doula, at this time either, but my phone says that I called her at 1 am and that we talked for 39 minutes. I’m not sure why I called Chloe first if Salt Lick and I had decided that I should call my midwife.

Sometime around 3 am, I called Chloe again. I was definitely having contractions at that point, and feeling them in my back. I think we were on the phone for about 45 minutes. I was very conscious of the fact that I had no ability to attend to what she was saying. I remember listening to the sound of her voice, but not what she was saying, as I gazed around the room at giant balloons and teddy bears on the walls… which I knew I was hallucinating.

Pretty much the only thing I remember is that she said she had another client who might be going into labor, so that she might not be able to join me, but that she had a colleague who could come join me if that were the case. I remember wondering how she would decide which of us to be with, but thinking I shouldn’t ask because I wouldn’t necessarily be able to phrase it diplomatically with everything else going on in my brain, and also thinking that maybe the other woman would deliver quickly, and Chloe would be able to be with me afterwards.

I think Chloe’s colleague, Tymaree, called me just a couple of minutes later. I remember that I was having some trouble with the contractions – they were really hurting my lower back. She coached me on getting up on all fours during the contractions, and swaying my hips back and forth to ease the pain. She asked me to focus so that I would recognize as soon as the contraction started, and have time to get my body in the right position before the worst of the pain struck. Apparently we decided that I didn’t need Tymaree to join me yet, but that I would call Salt Lick and ask her to come now to give me support.

Then I called Salt Lick. I don’t remember this conversation, just the fact that I was putting the phone down during contractions to focus on my all-fours position and my swaying. According to my phone log, this call was a few minutes before 5 am. I told her that I needed her to come, and she said she would get a car service. I think she called me a few minutes later to tell me that she was in a car and on her way. I remember being very conscious of lying the phone down during contractions; this felt very different than something I would normally do – not even asking permission, or asking her to hold on, just stating that I was doing it. My contractions at that time were every 5-10 minutes. She started taking notes at 6 am, so I reckon that’s when she arrived… but I have zero memory of her arrival. At that point, the contractions were every 4 minutes.

My phone says I called Tymaree again around 5:30 am. Apparently that was when I told her I needed help, and asked her to come to the hospital. I remember that there was some confusion on her part about how she would get there, whether she would ride her bike or take a cab, and that ultimately she decided to take a cab to get there faster.

Around 6:30 am, I apparently told Salt Lick that it “fucking hurt” and asked, first, for hot pads to be applied to my back, and then first asked for an epidural. I was told that I had to wait for my midwife. I remember feeling like the all fours position and the swaying were no longer helping me. They had helped initially, but now I just felt like I was swaying and in pain. The pain was in my lower back, and it was searing. Apparently I called my midwife at 6:24 am. I don’t remember what we talked about, except that she told me that I needed to be moved to a labor and delivery room. This is what my text message log shows:

Me: I want an epidural. (I love how this is said so flatly, no explanation, despite my previous hopes (not plans!) for no pain meds.

Midwife: I’ll come over. Be there soon.

Me: Ok.

Me (some short time later): Hurry please.

According to the notes, Tymaree arrived around 7 am. Again, I don’t remember this. But I do know that I took one look at Tymaree and my nervousness about working with a stranger instantly eased – I was totally comfortable with her from the first contact. She began to press hard on both my hips with every contraction. The relief this brought was magical. I instantly, fully, understood why we need doulas as well as our loved ones at our births – this was not intuitive knowledge that she had that told her to apply this amazing pressure, but from direct experience and training. And what an enormous difference it made.

The midwife arrived around 7:30 am. I remember that her hair was still wet, and thinking that she must’ve had to make alternate plans to get her son to camp. It’s funny what you focus on in these situations! I felt very distant and detached from most things. According to Salt Lick’s notes, the midwife did an exam at that time and said I was 4-5 cm dilated and 100% effaced. I don’t remember this at all. Strange, because I am sure I must’ve been excited to hear of this fairly rapid progress.

When my midwife arrived, she asked if I wanted to try using the hot tub before getting the epidural. I wished that I could’ve had both, but I knew that if I said yes to the tub, that would’ve meant a longer delay for the epidural, and I couldn’t risk that. The pain at that point was intense – I remember praying that each contraction was the last one before I got the epidural… and then another painful contraction would roll in like a wave, crashing over my lower back. I didn’t know how I could keep withstanding the pain each one wrought. The anesthesiologist and anesthesia resident were in the OR doing a C-section, and we had to wait for the anesthesiologist to leave the OR – he (or she) wouldn’t leave the resident until after the baby was delivered, but before the repair work on the mother began.

I remember various people would leave at regular, short intervals to go and check on the availability of the anesthesiologist. I know I asked them to do this a couple of times, but a couple of other times they went on their own accord. I was very grateful for this kindness as the pain was unbelievable. It took all my strength to survive each contraction. I was sitting on the birth ball at this point, leaning my forearms on the bed in front of me with Tymaree behind me. I rested my face on the bed between contractions, and didn’t turn around to attend to the conversations behind me.

Finally the anesthesiologist (plus medical student) arrived at about 9 am. They made Salt Lick and Tymaree leave the room, which I had expected. I remember that I had to sit on the bed, and not move – this was hard. I heard the anesthesiologist say to the medical student, “there, did you hear that crunch [as the catheter enters the epidural space]?” Afterwards, I remember joking with my team that I did not relish hearing that particular “teaching moment.”

(the rest of this was written November 15, 2011)

The anesthesiologist seemed to take forever to tape all the various bits of tubing in place. I remember silently begging (in my mind), “please, oh please, won’t you give me some medicine first, before all the tape??? I PROMISE not to move!” But she (I think) was merciless (in my opinion) and I think I suffered through a couple of more contractions before I received any relief.

The epidural helped a lot once it was started… but unfortunately, there was one area of my sacrum where it didn’t work. I was told that this was a “window” – an area where the epidural wouldn’t take hold for some reason. They (the voices of authority in the room – I had my eyes squeezed closed and can’t really remember who was talking) kept having me roll heave my body from one side to the other, to see if that would help. It didn’t. It was so hard to move. I still know exactly where that fiery pain was. I think it subsided some hours later, but it took a long time. My blood pressure was at 121/82 prior to the epidural and dropped to 94/60 afterwards – apparently this caused the nausea I felt at the time. Apparently I also felt very sleepy, and asked why the baby was so active when I was so tired and wanted to rest, and then commented “welcome to parenthood.”  

With the epidural came a urinary catheter. I remember being very nervous about that hurting, but I don’t actually remember what the insertion felt like, only that it was over very quickly and wasn’t as bad as I had feared. What was bothersome, though, was that with every single contraction from there on out, I felt the unbearable urge to pee. The catheter keeps the sphincters of the bladder dilated, so this is a normal feeling to some extent, I gather, but I don’t know why my contractions made the feeling so incredibly intense. Finally I started bearing down, as if to pee, during each contraction. I was worried that this could cause a problem, but I couldn’t not do it. It helped just a little.

At 9:42 am, I was 7 cm dilated. According to the notes, my midwife commented “your bag of water is bulging. 
That’s why you feel so much pressure.”

Apparently (I’ve been told) I was rather jovial once the epidural kicked all the way. I sort of remember being told to rest, and declining. Tymaree told me that that was when we got acquainted. I don’t really remember any of that, except for finding out that she was a massage therapist. I suspect if I was reminded of the rest of the conversation, I would remember more, but as it is, I am a blank slate. I believe that my friend Scott arrived sometime during this peaceful late morning. I wondered why it had taken him so long to get my messages to come, but being glad that he hadn’t arrived when I was in so much pain. Apparently I told everyone about my Ambien hallucinations – I saw balloons and giant teddy bears and people in the room, but none of it was scary. I told Salt Lick to go out and get herself some food.

At 11:17 am, I commented that I felt pressure on my perineum. I had a conversation with the other midwife:

Me: “Is it going to hurt when I push?”

Her: “Do you really want me to answer that?”

Me: “No, just lie.”

Then we had a conversation about Brad Pitt and Dolly Parton. I can’t imagine (or remember) what that was about! 

At 11:41, according to the notes (again, I don’t remember any of this), I talked to my mother on the phone and said, “Apparently they are pretty confident that I am going to have this baby before 4 pm. My contractions are 5 minutes apart. The midwife may break my water. But I still have to push the baby out. I’m disappointed about that. Couldn’t it just slip out? ”

I also said, “I had never heard of doing two Cervadils before. But it seemed to do the trick. I’m happy I don’t have to take Pitocin. I’m sorry about the epidural but the tub wouldn’t have worked. There was so much pressure in my hips. So I have no regrets. I wouldn’t say I’m comfortable, but compared to before, it’s heavenly.” 

At 11:49, I told my midwife that I felt “oozy” and asked “is there blood down there?”

When my midwife said yes, I asked, “is there a chuck? I don’t want to make a mess.”

Then she told me that the baby’s head was still high, and that she was going to start Pitocin “so the head will come down and out.”

After the Pitocin, the contractions quickly became closer together.

I then talked to my sister on the phone and told her it was probably better that she wasn’t here because, “it was kind of a shit show this morning. I was beyond miserable. I have no regrets about the epidural: with every contraction, I thought ‘I can’t live through this.’” (My sister was flying to Florida and her new home with my nieces that day. She had stayed with me in Brooklyn for 12 days before this, hoping to be present for the birth… but it was not to be.)

Scott then took over the notes so Salt Lick could go get a snack. He commented that the contractions were now coming very close together so they turned down the Pitocin. Meanwhile, I was complaining of increased pain and the providers discussed which side to try turning me towards. The midwife told me that I don’t have to push until she can see the head, which apparently pleased me. I complained again about bladder pressure, and said, “the thing I am looking forward to the most about this being over is peeing.”

My hip was really bothering me, and since I was already lying on that side, they didn’t think it would help, but I was instructed to heave myself to the other side to see if that will help. It doesn’t.

My midwife checked my cervix and according to the notes, told me, “it will be 10 cm once the head comes down. But with nothing pressing on the cervix, the cervix is ‘just hanging there.’”

At 1:22 pm, Salt Lick returned (and assumed note taking) and records that I am now 9 cm dilated.

At 1:28, I stated that, “something feels different, like more vaginal, like the bag of water is coming out. Why is she (the baby) moving – this is not a good time (for that). Get the midwife.”

1:34 From the notes: “It’s coming. Put the head of bed down. Turn the Pitocin off. Heart rate (presumably the baby’s) is up.”

Abby: “I’m scared.”

Midwife: “The baby is coming down. There’s lots of fluid holding things up.”

Then there was a big commotion and a big ultrasound machine got wheeled in.

Apparently something happened so that it looked like the baby’s heart had stopped, and so the OB residents, watching from the nurses’ station, came racing in. According to Scott, the two midwives came racing in right behind them, determined to keep the residents from interfering. One told me later she had been confident that the monitor had just lost the baby’s tracing, because the baby’s heartbeat had been perfect and strong until the moment before they lost it – apparently there would’ve been signs of trouble before now if there truly had been a problem. But because of all this, it was decided that she would break my bag of water. If she was so sure that all was fine, I don’t really understand why she decided this. But she told me of her decision, and I was game, though nervous about a sudden rush of pressure with the release of the amniotic fluid.

But the breaking of the water (at 1:40 pm) turned out to be a wonderful development, because for some reason, it stopped the feeling of pressure on my bladder! Hooray! The gushing amniotic fluid felt sort of nice, too, a big release.

I remember being told that I had had several contractions in very close succession, “right on top of each other,” and that the baby hadn’t responded well to them. So the Pitocin was then stopped.

The hospitalist midwife joked, “Because she’s a Leo, she decided to add a little excitement before she came out. Drama queen!”

My midwife explained, “you had three contractions in a row and she hated it. There’s a little meconium.”

I asked, “does that mean they’re going to take her?” (Meaning would the baby have to go to the NICU with the pediatrician when she was born?)

“No, if she looks good, we’ll keep her.”

Sometime later, I remember my midwife holding up a used chuck (the absorbent pad put under patients in hospital beds) and showing it to me, saying, “Look Abby, see it’s just light meconium?” I was glad and also amused that she remembered that the clinician buried somewhere within my laboring self would want to see this, and would be reassured by this.

During the next hour, I started to feel the urge to push, but was told to wait. I told her that it felt good when the amniotic fluid came out with each contraction, like I was peeing, she commented, “your bladder is living vicariously right now.”

Scott writes in the notes that at 2:40 pm, I apologized to everyone, but he didn’t know why.

At 2:45, I complained of a very painful contraction and say, “I don’t want to do this anymore.” Catherine went to find the anesthesiologist to ask for a little more pain medicine. The anesthesiologist came a few minutes later and says, “we are playing catch up.” Apparently I should’ve been getting more pain meds? She instructed me to use the PCA (patient controlled anesthesia) button and press it as many times as I wanted.

Apparently I got very quiet with this new medicine, and just moan quietly with each contraction.

At 3:05, I complained of the fiery hot sensation enveloping my body, the horrible sensation I get when I am about to faint and ask for a C-section. Catherine says, “you’ve come this far. Let me check you.”

Then Catherine says, “She’s much lower; she’s flexed. She’s doing everything right. There is just a little bit of cervix on the right side.”

At 3:15, Catherine tells me, “A C-section is not the answer. Give the new medicine ten more minutes to work.”

3:36 pm, Scott writes, “Heart rate slower. Abby hears it.” (I could hear the fetal heart rate dropping on the monitors -- my neonatal ICU days have the sound ingrained in me forever, I think -- and although the folks in the room always reassured me, I knew that they were lying sometimes when they told me that the heart rate was fine. I mean, she may have been recovering just fine, but I knew each time it dipped!) 

3:38 pm, “Head is pretty much down. Cervix is about gone.”

Abby: “how much longer?”

Catherine: “I won’t tell you because I don’t know.”

Catherine tells me to push when I feel the urge, with the contractions.

At 3:40, Elissa says, “let’s have this baby.”

Abby, “I’m scared. It’s so overwhelming.”

3:41 Scott writes, “this is hard to watch. Abby is yelling, ‘help me.’

Abby: "I can’t."

Elissa: "You can."

Elissa: "It’s going to be pretty overwhelming. You are going to be able to do it."

3:45, Catherine, “push my fingers out of your vagina. Good. Do it again.”

I’m told to put my hands under my thighs to push. Scott writes that I turned very red with the last push.

3:56 Catherine wants to re-start the Pitocin. I say I want to wait two more contractions. I am very quiet between contractions. I'm very afraid of what the Pitocin will feel like, how my contractions will get even more intense and also closer together.

Scott writes, “Here is another. Oy. Face very red."

4:03 “Damn alarm keeps going off. No one knows why.”

“It was me (Scott). I unplugged it (accidentally, by standing on it).”

4:07 Abby, after pushing, “I feel like I am going to turn inside out.”

Scott writes, “Abby’s contractions/pushes are coming every two minutes now. She is getting more confident , though not more happy about it.”

4:20, Scott writes, “Abby is in the zone now. Quiet. Pushing hard. Gaining confidence. Though she just commented, ‘It’s uncomfortable.’”

4:27 “Good push.”

4:36 “Still pushing good. Abby is strong and tough.”

4:45 “Catherine now getting Abby to put her hands under her legs and pull while she pushes. Abby wouldn’t do it before but now she will.”

4:47 “Abby, ‘It must be terrible to be constipated.’”

Scott writes, “Abby is calmer now. She is scared but she sees the finish line in sight. Abby asks Catherine why she is getting out gloves.”

5:10 “A huge push with Catherine’s fingers inside. When done, baby’s heart rate dropped way down. So we skipped pushing for one contraction and the heart rate came back up.” (Note: I remember how much I didn’t want to push, and yet, how impossible it was to not push, anyway.)

5:20 “Abby is turned on side to push.”

That’s where the notes stop until the birth, so here’s what I remember.

I wish I remembered that moment when I started to push. It’s all so murky in my brain! I do remember thinking, okay, great, Elissa is here until 4 so let’s see if I can’t push this baby out before her shift ends.

Elissa told me later that I had told her, “oh, this pushing thing isn’t so bad,” and so she knew that I wasn’t pushing hard enough that there was any chance that the baby would be born by 4. At 4:05 I remember solicitously telling her that perhaps she should go home. And she, knowing far more than I, namely that I was still far from delivering, agreed and said goodbye.

I had expected that the epidural would keep me from feeling the urge to push. I think it must’ve, initially, during that time that Elissa was there and I was reporting that pushing wasn’t so bad.

But oh, at some point, it became very, very bad. I didn’t expect this.

But honestly, what it felt like? Like vomiting, only out of my vagina.

You know that powerful… what’s the word… that powerful set of contractions you feel in your stomach when you vomit? And it’s so strong that you absolutely have to heave, even though you don’t want to? And those horrible noises that your voice makes, because it’s heaving so hard? (For the record, I am absolutely phobic about vomiting.)

That’s exactly what it felt like.

This just unbelievably powerful GAAAAAAAAAAH forcing me to try to push my insides out, even when I didn’t want to, even when all I wanted in the world was to rest. And then, on top of that, I had people yelling at me to push. Catherine insisted that I curl up into a “C” with each contraction and grab my legs and PUUUUUUUUUSH. I had to push at least three times per contraction. She wanted more, but that was all I could bear. I remember that contraction after contraction after contraction, I grabbed my legs wrong. Someone would correct me, I would move my hands to the correct position, and then with the next contraction, I would forget and put my hands in the wrong place all over again.

At some point, I was so tired that I whispered to Tymaree, on my right, “you have to hold my head up. I can’t hold my head up anymore.” She somehow cradled my head with her left arm, like a newborn, while also holding my leg with her right arm.

Salt Lick was on my left side. I had trained her in the Hypnobabies “finger drop technicque” in which I would drop one finger to enter hypnosis. Well, with Chloe being at another birth and me entering labor while hallucinating, Hypnobabies was nearly instantly forgotten. However, I used the same finger drop to signal Salt Lick that another contraction was starting. Others were often chatting or looking away, but she never once failed to notice my signal that another contraction was starting. She would then rally the others into position. That was a godsend, that she could get everyone organized and into position to help me before the worst of the contraction was upon me.   

Scott was in the far corner of the room, sort of hiding next to the infant warming table, up above my head. I could tell that he was freaked out. But at one point he came closer and snaked his fingers through the openings in the bed rail and squeezed my hand. He whispered to me, “remember that time in the [NYC] Marathon, where you thought you had nothing left, that you were done? And then you came up from behind me and passed me, and when I yelled, ‘what just happened? Where are you going?’ and you yelled back, ‘I don’t know what is happening! My legs just took over!’ Find that strength that took you across the finish line, even when you thought you had nothing left.”

That was great. That really inspired and helped me.

Then he started to whisper to me about our house in upstate New York, and how I should imagine myself walking through the rooms there. Trying to envision rooms there just felt like a lot more work. So I let go of his fingers and said, “No more” and focused on the task at hand once more.

It seemed to go on forever. Long past my point of total exhaustion. At some point I asked someone to go get Catherine from the nurses’ station. I pleaded for a C-section. I told her that I had absolutely nothing left.

She said no.

It was heartbreaking.

Salt Lick was getting excited, yelling that she could see the head, that I was “almost there.”

I asked if I could feel the baby’s head. I wondered if I was close, and asked if I was crowning. They told me to wait for the next contraction to feel her head, so I would feel it at its furthest most point. During a contraction, they grabbed my fingers to guide them to the baby’s head. That was horrible because during a contraction, I didn’t have the resources to think about anything but surviving – experiencing the sensation of the baby’s head on top of everything else was overwhelming.

Plus, my heart sank when I felt it, because I realized I was nowhere near crowning. Only a small portion of her scalp showed during the contraction; the rest of her head was still buried deep within me. And all of it disappeared from sight when the contraction ended. Salt Lick was excited because she thought being able to see the head meant that the end was near. Having been to a number of births, I knew better. First time moms can spend hours with that bit of scalp in sight. But I didn’t have the energy to explain, though I think I did yell at one point, “No I am not almost there.”

What I would say to her now is, “telling me that I was ‘almost there’ is like telling a marathoner at Mile 20 that they are ‘almost there.’ You just shouldn’t do it. It’s wrong. Terribly, terribly wrong. Having run a marathon, she would understand that!”

But I knew it came from a place of love and excitement and joy.

I remember looking up at her and Tymaree, feeling sorry for them that they had to see this horrible spectacle. I had enjoyed being at other peoples’ births in the past, but now I knew that it was more of a war scene than anything beautiful. (Luckily, they didn’t seem to feel this way.)

I pleaded again for a C-section, for help. I just knew I couldn’t do this. I was beyond spent, beyond exhausted.

Catherine suggested turning the Pitocin back on. She said that I needed to have the contractions closer together in order for them to be more productive.

I cringed. I refused. I couldn’t imagine them being any more intense. It already felt like my insides were coming out with every contraction. More of that… I couldn’t survive it. No way.

Periodically she would urge me to turn it back on, and I, terrified, would refuse. (To be honest, I was surprised she was offering me the choice. If she had turned it back on without giving me the choice, what could I have done?)

I was pressing the button on my epidural to release more pain meds with every contraction, but it didn’t seem to help with the intensity of the contractions.

The occasional contraction wouldn’t be so strong, and I might even be able to withstand the urge to push. Others I was able to push but not quite so hard. But then the next one would come crashing down over me and be so overwhelming that I simply had to push my guts out, even though I didn’t want to. But not pushing, which they told me to do a couple of times, was simply, entirely, impossible at times.

I was so frustrated because even those times where I didn’t push with 110% intensity, I was working really hard with every push, but I remember Catherine only praised me on those all-out pushes. I wanted recognition from her for every push. I wanted her to know how hard I was working. I was very aware of needing her approval.

Finally at some point, Catherine offered me the option of having a vacuum extraction. I gladly said yes.
But then, while she was waiting for the OB to arrive to do the procedure, I got scared. What if the extraction felt even more intense than what I was already enduring? Surely that would be too much to bear. I couldn’t imagine any more intensity than I already was feeling and completely overwhelmed by. More intensity would surely do me in.

And so, secretly, with the next few contractions I dug deep and pushed harder than I thought possible.

And secretly, I was relieved when Dr. Bizovi arrived and it was announced that I was too far along for the vacuum extraction after all.

I remember croaking out at one point, “don’t you have to break the bed?”

No one heard me except for Salt Lick, so when Catherine asked what I said, Salt Lick said, confused,
“She wants to know if you have to break the bed?” Salt Lick had no idea what this meant.

But Catherine and Dr. Bizovi and the nurse laughed about how it was funny to have a medical provider in labor because I knew the terminology and was asking such particular questions in labor. (“Breaking the bed” means taking the bottom half of the bed away, to make it easier to catch the baby.) Catherine then told me that she never breaks the bed. But at some point she changed her mind and did, indeed, break the bed. And I remember her commenting that it felt strange and oddly convenient to be so much closer to the action than she was used to.

Finally, at some point, Catherine told me, “Okay Abby, three more good pushes and you’re done!”

Fearfully I asked, “do you promise?”

She laughed and said, “No, I can’t promise you that!”

I dug deep, so deep, and pushed with everything I had. And three pushes later, the baby was still unborn.
More pushing, again and again, going far beyond what I thought was possible, far beyond my energy reserves. Each push was so deeply, totally, completely draining.

Eventually, Catherine broke me down and got me to agree to her turning the Pitocin back on, just a tiny bit, by telling me that that was the only way out. Terrified, I agreed.

The exhausting work continued. Inside my head, I had a conversation with myself.

I told myself, “Imagine there was something wrong with the baby, and her life absolutely depended on you getting her out now. Could you push any harder if your baby’s life totally depended on it?”

I knew that was the only way I could summon any more energy to push. I forbid myself from thinking about how tired I was. I knew that such thinking was deadly. I tuned everyone out and focused entirely on gathering whatever energy I could possibly find.

Catherine asked me if I wanted a episiotomy, to help things move more quickly. We had discussed this during my pregnancy, so it wasn’t a surprise, and I readily agreed. I yelped, though, when she started to cut, and so she stopped and injected me with some lidocaine. I was surprised that I was able to feel any more pain than I was already feeling, but there you go – the sting of the scissors was a different sensation and I was absolutely able to feel it (supposedly the pressure of the baby’s head on the perineum numbs the skin there so that local anesthetic isn’t necessary, but clearly this wasn’t the case for me.)

Some time after that, perhaps not long after, she again told me, “Okay Abby, three more good pushes and you’re done.”

Again, I asked, “Do you promise?”

And this time, she laughed and said yes.

I remember those pushes. The first two, I pushed with every last bit I had. With energy I didn’t know I had. I saved nothing. And so by the third push, I had almost nothing left to push. I tried to push, but I was so tired it was all I could do just to gather my breath. And so that last push was feeble.

But it didn’t matter.

It felt as if with that last push, Catherine grabbed the baby and helped. Perhaps it was just gravity, or I had done enough with the previous push? I don’t know.

But I felt her body slide from me. A great release. At last.

As I dropped back against my pillow, Catherine quickly grabbed the baby and laid her on my abdomen and suctioned her with the bulb syringe (I could hear the sound, but was too exhausted to open my eyes to watch). I could feel the baby’s wet and steaming body against mine. The steaming hot sensation surprised me, but of course – she had just come from the inside of my body, where it was very warm, indeed!

I could hear Catherine saying to me, several times, “Just a minute Abby, just a minute.” She wanted to me wait, but I didn’t understand what she wanted me to do. I had my hands cupping the baby – I suppose my hands were in the way? But even with my eyes closed and my total exhaustion, I didn’t want the baby to fall.

Then I heard Catherine say, “wow, Abby, look at this puny umbilical cord.”

I looked up to see, indeed, the cut end of the skinniest umbilical cord I had ever seen. And I knew what it meant that she had cut it that fast. Midwives normally wait for the cord to stop pulsating. If she had cut it that fast, there was a problem with the baby.

I asked hoarsely, “What is it? What’s wrong with the baby?”

And then Catherine explained that the baby was having a little problem breathing and needed help getting cleared out. The baby was handed to the pediatrician, who had been waiting by the warmer in case he was needed. He had been present because of the meconium staining earlier.

The pediatrician worked on the baby while I craned my eyes over the bed railing to see what was happening and Catherine worked below. I paid no attention to what was happening to the lower part of my body – it seemed like another country, not related to the rest of me.

I could hear the baby crying, and knew she was fine. I was so happy. Mostly just to be done with labor. Thank god. But also very pleased to have a daughter. Not ecstatic, just very pleased.

Before too long, Calliope was brought over to me, all swaddled up. I immediately unwrapped her and laid her, skin to skin, on my breast. I looked down at her beautiful little face and she looked up at me, bright eyed.
She latched onto my nipple within a few minutes, and I remember Catherine asking at some point, “you mean that baby has been nursing this whole time?” She was impressed, as I was, with Calliope’s ability to breastfeed right from the get go.

As Catherine continued to work on me, she informed me that I needed a few stitches. I waved happily in her direction, “sure, no problem.”

Now that I was done with labor, I didn’t care. She could do whatever she liked.

During the repair job, I magnanimously offered up the baby to Salt Lick to hold. I remember being impressed with my own generosity – I had imagined I wouldn’t want to give the baby up to anyone.

But actually, it was beautiful to see her being held, first by Salt Lick, then Scott. It made me so happy to see them already loving her.

 At some point, I heard some comments about Catherine being totally drenched, but not really understanding or paying attention. I found out the next day that she was, in fact, drenched in my blood. She wasn’t impressed by my bleeding at the time, apparently, but surprised the next day my blood counts were signifincantly lower than when I was admitted (hemoglobin of 13.1 when I was admitted, and 9.5 by the next day). The day after that, Elissa called me on the phone in my hospital room and told me that my hemoglobin was down to 7.5, and casually offered me a transfusion. That completely terrified me! I mean, I had never been offered a transfusion before. The fact that I might need one was scaring me pretty badly, and the fact that it was up to me to decide if I needed it was totally bewildering, especially in my weakened state.

Anyway, finally, Catherine was done with her repair work, and went to change clothes. We made arrangements for Scott to smuggle the placenta out of the hospital and to his apartment so that I could have it encapsulated later (Catherine told me about this when I expressed concerns in a prenatal visit about postpartum depression – apparently having your placenta made into pills that you take every day can really help with PPD as well as getting your energy levels back up after birth). The catheter must have been removed, because I remember needing to pee, and someone bringing a bedpan to me. There was absolutely no way that I could’ve made my way to the bathroom.

When it was time to bring me upstairs to postpartum, I was terribly, terribly dizzy. They helped me into a wheelchair and I was sure I was going to faint. I tried to hide how bad I was feeling because I was scared they would take the baby away if they knew how dizzy I was, but finally I admitted it.

The nurse cheerfully assured me, “Oh, don’t worry, that’s normal!”

I was sure that I wasn’t quite right. I felt so terribly dizzy that it felt like a miracle that I was even upright, even with support from the wheelchair. But again, I didn’t want to argue because I was scared they would take the baby to the Nursery if they knew how terrible I felt.

Even when they checked my blood pressure and it was 84/54, no one seemed concerned. And so they tied the baby to my chest with a bed sheet and I kept silent, figuring that surely the sheet would keep the baby safe even if I did faint? Surely I wouldn’t be the first to faint, if it did come to that?

I barely made it into the bed upstairs, even with the nurse helping me – I was sure I was going to faint – but I made it. When I needed to pee again, I rang the bell for the nurse and partway up, just sitting on the edge of the bed to acclimate to gravity, I knew there was no way I could make it to the bathroom, even with someone holding on to me. I’ve fainted before, and I was sure to faint again if I tried this.

Luckily the urge to pee wasn’t overwhelming, and so I lay back down again. Eventually I felt strong enough that I was, just barely, able to totter over to the bathroom with the nurse’s strong arms clenched tightly around me. I’ve never peed with someone assistance before! But she very kindly squirted my perineum with warm water for me as I fearfully peed. No pain, phew!

Then I collapsed back in bed and arranged the pillows on either side of me and took my tiny daughter in my arms.

I tried to eat something, since all I had had all day was one hard candy and some IV fluid. But I couldn’t eat anything. I had struggled with eating late in the day throughout my pregnancy – dinner was hard for me the entire nine months – and so, after a couple of bites of pretzel and a few sips of coconut water, I gave up, much to Salt Lick’s concern. I was just too broken down to even have the energy to eat.

We soon turned out the lights and went to sleep. Salt Lick got up during the night to help with the baby as I really couldn’t lift her very well and certainly couldn’t carry her safely. I tucked pillows on either side of me, against the bedrails, to keep her safe.

I was sure that someone would tell me I wasn’t allowed to sleep with the baby, and so I kept my breast bare the whole night, so that I could tell them that I wasn’t sleeping with the baby, I was just breastfeeding her! But no one bothered us. And I spent the whole night with that lovely warm bundle cuddled against me. It was amazing to me that even that first night, as completely spent as I was, I was able to wake up to care for my baby. Adrenaline and pure joy had kicked in for sure, despite the physical feat I had endured.

So what, about this experience that ended in a healthy baby, left me feeling so sad and also brutalized?

A number of things.

One: going into labor while “under the influence” of Ambien. I felt like I never got a chance to get mentally organized for labor. I didn’t get to get my Hypnobabies CD’s out and use them. I felt like I got woken up by being thrown in my slumber directly into a deep body of water, and woke up already sputtering and treading water just to catch my breath. I wish I would’ve been eased into things a bit more. Even if labor had started dramatically, just being in my right mind would’ve helped so much.

Two: Not getting the approval/praise I felt I needed from my midwife. I was aware of this need while I was still pregnant, and in fact, had discussed it with my doula. It was something I was worried about ahead of time. I’m the kind of person who is motivated by lots of positive feedback. I should have told Catherine about it ahead of time, but of course, it sounds silly, “Um, listen, I’m going to need you to cheer for me a lot, okay?”

So when I didn’t get the praise I needed during labor, I felt criticized.

It didn’t help that I talked to Scott about this on post-partum day three, and of course, like a stupid male, he felt the need to be honest instead of telling me what I needed to hear. He told me, “yeah, she was really annoyed with you.”

This, of course, reduced me to tears and overwhelming sadness. My first day home, limping through my home with my tender parts, hormones raging, and I’m being criticized for my labor?


Luckily I did talk to Catherine about this when she came over to encapsulate my placenta, and she eased my concerns somewhat. And now, months later, I can see that it doesn’t really matter what she thinks, of course! I know now that  I am strong, and that I did work harder than I could’ve imagined possible. And that I got my little girl safely into the world. And that is all that matters. Certainly anyone else’s opinion of how I “performed” in those circumstances is irrelevant.

But at the time, it really hurt.

Three: the pushing. The “window” with the epidural was bad, but I survived it. And technically, of course, you could say that I survived the pushing. But mama, I must say, it left some serious scars. It was so, so much harder than I expected. Having to pretend that my baby's life was in imminent danger in order to get her out was brutal. 

I think of myself as pretty strong, and pretty tough. I thought running multiple marathons, one with three stress fractures to boot, and all those years of working nights while going to school during the day… I thought that I knew how to work hard. And I felt like the pushing proved me wrong.

And that hurts.

And thinking that Catherine might think the same, that she might agree with my fears, makes me hurt worse.

Yet. I have my precious, precious girl. My miracle. My dream come true.

Was it worth it?


Will I do it again?



Thinking about enduring the physical and emotional exhaustion of pregnancy again… the agony of waiting for the heartbeat ultrasound, the nuchal scan, the anatomy scan… and then the total exhaustion of first trimester, the enormous ankles and unbearable weight of the third (okay, that was really the last month… but it’s hard to remember anything besides that last month!) …And I had an easy pregnancy! With relatively little weight gain (19 pounds), no health problems, exercising until two days before I was admitted to the hospital, stopping work at 35 weeks (a lucky break that I don’t work summers)…

So take the experience of pregnancy, which is almost impossible for me to imagine enduring again, and then adding on labor and delivery? Which I wasn’t afraid of before, truly I wasn’t, but now I am, already, terrified of experiencing again?

I will take my hippy-dippy, organic-eating, nature-loving, health-care-provider, exercise-addict’s self to my OB and ask if she would consider an elective C-section.

If she says no, yes, I suppose I would still have another child. But even working in pediatrics and even knowing the benefits to the child of a vaginal delivery, and knowing all the reasons not to have a C-section… if I had the option, I think there is a very good chance I would choose to have a C-section next time.

Even though my daughter was absolutely worth it, and even though nothing went seriously wrong – I know I’m lucky! – something about that delivery scarred me.

This must sound terribly self indulgent. But this is my story. And my experience. I’m trying to write only for me. And that is what happened for me.

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