Monday, August 24, 2015

Birth Story: The Long Version

Thanks to Emily for reminding me to get back to this. I'm typing without editing because I can barely remember parts of this anymore. Luckily I wrote out pages and pages of notes while in the hospital; that lovely day between arrival and departure when I didn't have visitors until the end of the day and just cuddled with my new baby. <swoon>

3/19/15, 11 pm
I'm reading in bed, too late (The Interestings -- a page turner!) when Tree Leaf kicks me hard and painfully -- a first. I feel a little trickle a couple seconds later. At first I think it's discharge, then I wonder if I'm peeing, then I hop out of bed and stand on the (small, washable) rug next to my bed and what feels like gallons of water pours out of me.

It just keeps coming and coming. I say, out loud, "Oh my god." I try squeezing my bladder muscles experimentally but nothing changes -- the fluid keeps coming. Eventually it pauses and I dash to the bathroom with my phone. I peel off my sodden pants, socks and underwear and perch on the toilet to call Chris, my midwife.

I had seen Chris for my weekly appointment just a few hours earlier. She had stripped my membranes at my request  but said she guessed I would go into labor sometime after my due date (I was currently 38w6d), since I had gone late with Calliope (induced at 41w2d), and planned to strip my membranes again at subsequent appointments. At my appointment that day, I was 1 cm dilated and 2/3 effaced, I think. Same as the previous week, though my cervix was had moved from posterior to anterior in that week.)

But instead... here I was, dripping in the bathroom. I was pretty sure, though, that it had been that violent kick from Tree Leaf that got things started and not the membrane stripping.

I called Chris and said shakily, "I think my water just broke." Even though I hadn't peed more than a tablespoon at a time in months, I was too afraid to call it amniotic fluid definitively. Not that I really thought I had just peed a gallon.

Chris said "really?" in warmly surprised tone. She suggested we stay in close touch and that I plan to meet her at her office sometime the next day for a sterile speculum exam, just to confirm that it was definitely amniotic fluid, though she didn't seem to have many doubts and neither did I. I don't remember her suggesting that I might start having contractions, though surely she must have? I remember dumbly asking if I would be missing work tomorrow, whether in labor or not. (She kindly said yes, and laughed.) My mind was still reeling from the shock of this unexpected development. I mean, I figured one way or another, I was definitely having a baby in the next day or two. Wild.

Next I called my sister in Rhode Island. She said she was too tired to make the drive that night but would set her alarm for 6:30 am and we would talk then. While we were still on the phone, my body started shivering uncontrollably. The phone kept chattering in my hand against my earring, no doubt making a racket for my sister. She kindly consulted Dr. Google and confirmed that this was a normal reaction to having one's water break.

After that, I called Salt Lick and we agreed that she would travel 90 minutes via subway to come over right away -- both of us would sleep better knowing that she was already here. (I think she ended up taking a cab.) I also called my doula at some point. She said she would sleep, and wait to hear from me again.

Finally I got off the phone and into a blissfuly hot shower. I think I had my first contraction contraction while in the shower. Not too bad.

I finally got out, dried off and dressed, and went to my computer. My mind was racing a hundred different directions as I rescheduled my grocery delivery from Saturday (two days away) to Tuesday and sent an email to our playgroup alerting them to a possible last minute change in location. I also emailed my boss to alert him that I would be out, alerted my temporary replacement that she had an updated start date!, and sent an apologetic email to my departing medical director that I wouldn't be able to make her farewell party the next day. I also wrote a note to Calliope, just in case I needed to leave before she woke up.

She had been asking for months when our baby would come and I always answered "she will come in the spring."

I had just finished the work at my desk when Salt Lick arrived. I chatted with her a few minutes then retired to my room to let her nap on the couch while I attempted to rest as per my doula's advice.

It's hard to remember but according to my contraction timing app, I started having contractions in earnest at about midnight, one hour after my water broke. At first they were every 5-10 minutes, lasting about 30 seconds. They were manageable, especially once I finally got my Hypnobabies tracks playing -- focusing on them helped remarkably well. I managed to doze in between contractions at times. The only hard thing about that was waking up in the midst of increasingly intense contractions was startling and unpleasant.

The frequency remained frustratingly inconsistent, ranging from every 4-9 minutes, despite the intensity continuing to increase. Or was it just that using the contractions time app versus an old fashioned watch makes the contractions seem more inconsistent?

Shortly after labor started, I stopped feeling the baby move. Chris told me to drink some juice but I didn't realize that watered down Vitamin Water didn't qualify as juice. When she finally realized my mistake, she firmly told me to drink some actual juice. Oops. I found some painfully sweet Shabbat grape juice in the fridge and gaggingly chugged eight ounces. I was on the phone with Chris at 3 am, making plans to meet at the hospital for monitoring, when finally, the baby kicked. Phew. Crisis averted. Back to laboring at home.

By about 4 am, I think, I couldn't lie down anymore -- too painful -- but sitting cross legged was okay. It seemed like I went to the bathroom after nearly every other contraction -- having anything in my bladder set off another contraction. But sitting on the toilet also triggered contractions, and made them even more intense -- a frustrating conundrum.

I called my doula and Chris by about 5:30 am, really done with laboring at home. Whatever the spacing was, and whether the frequency was regular or not, the pain was intense -- I needed to get to the hospital before it got any worse. I started thinking seriously about getting an epidural.

I also called my friend Amy, who lives two blocks away (we share a nanny) and asked her to come to my apartment by 6:30 am in order to definitely be there when Calliope woke up, even if I was still there. But only fifteen minutes later, Calliope woke up crying. She never wakes up that early (5:45) -- and she asked to sleep with me -- something she never asks. I wondered if she could sense the intense energy in the air, even while she was sleeping (she had white noise in her room and I was in my room with the door closed, so I knew she didn't hear anything).

Anyway, I went to her as soon as one contraction ended and did a pretty good job of acting sleepily normal as I kissed her reassuringly and firmly told her to go back to sleep... before rushing back to my room to prepare for the next contraction. As soon as it was over, I texted Amy and then called Chris again. She was on call for the birthing center and needed to call the hospital to prepare them for my arrival before we could leave, so I had to wait. I think I was now having contractions every 3-4 minutes, with intensity that was getting hard to manage.

Chris called back just a few minutes later, sooner than I expected, ready to meet us at the hospital. Then Amy arrived, and Calliope started to cry, so Amy went to her and kept her busy in her room, packing a bag (one of my child's favorite activities). All we needed to do was get the copy of my medical chart that Chris had given me the previous day, and put it in my bag. But we couldn't find it. And my contractions were so intense that I couldn't think straight. I think we spent a lot of time trying to figure out where it was (turns out it was in the bouncy seat, just a few feet from my hospital bag and hidden by a rack of clean clothes hung to dry the previous day by the cleaning lady).

Finally we abandoned hope of finding the chart, even though it was still really bugging me. Getting ready to leave was slow and torturous because at this point, I was in pain even between the contractions, which were all too frequent. I was really scared to have one in the lobby of my apartment building.

Amy quickly brought in Calliope to say goodbye to me, then left her with the nanny (who had apparently just arrived) to help us get downstairs.

Around 7:15, we slowly went downstairs in the elevator. A cab had been waiting for us for ages -- he had been pacified with promises of extra money for his time spent waiting. Amy helped carry the bags. As we were loading the car -- or rather, they were loading as I stood there -- Emily and Annabelle (SMC friend and her six year old daughter) came running over to say hello, clearly excited to see us (I had texted Emily the night before to let her know about my water breaking). I could barely muster up a "hello"for them now.

I carried my quilted "chux" pad to sit on in the cab. Thank goodness the doula had told me to buy "Depends" in advance -- I hadn't felt any any fluid leaking in a while but it picked up again in the cab.

The car ride was painful but mercifully short. It seemed like we hit every pot hole along the way. I kept my eyes closed most of the time but texted the doula that we were on the way (she was frustratingly unwilling to come earlier, and said she would meet us at the hospital). I also texted Chris to ask "can we expedite the epidural?" (I was thinking it would be fabulous if the anesthesiologist could meet us curbside.) She called me and explained that, no, we had to go through triage to confirm that I was at least 4 cm dilated (otherwise I wouldn't get a room and would have to walk the halls) and she had to do a sterile speculum exam to confirm that my water had broken. And then I'd need to do 20-30 minutes of tracings on the fetal/contraction monitor in triage. After that, I would get my own room, then vital signs and blood draws and a half a bag of IV fluid and only then could I get my epidural.

We arrived at the hospital shortly thereafter. I was scared of having a contraction in the lobby but desperate for the epidural, now, so I think I shuffled along pretty efficiently. Though I did have to stop once in the hallway for a contraction. I gripped the wooden handrail along the wall and tried not to moan. As soon as Chris saw me in the hallway she said, "oh yeah, we are getting a room." Thank god. I couldn't bear the thought of being told I wouldn't get a room of my own.

I felt lots of amniotic fluid leaking out, both in the cab and in the hospital hallway now, and was worried my Depends would overflow so Chris sent her wonderful midwifery student, Emily, with me to wait outside the bathroom for me. I had not one but two miserable contractions in the bathroom. I tried to moan quietly but barely resisted crying out to her -- I don't know why I refrained. As it was, I dropped my coat in the middle of the bathroom floor for her to pick up -- afraid of any unnecessary movement triggering yet another contraction.

We went into the triage room -- Chris, Emily, and I -- the doula (who finally appeared) and SL had to wait outside. I bent over the counter in the triage room with the next contraction and cried out, "oh, my back!" -- the pain was suddenly fierce in my back. Emily came to my rescue and pushed strongly on my hips for blessed relief.

The nurse was impatient to get me on the monitor but the thought of lying on that narrow hard bed seemed impossibly intimidating. Emily promised me that I could stand or sit next to the table for the monitoring and she would crouch under me, if necessary, to keep the monitor pressed to my stomach. Someone (Emily?) helped me step into the too-tight band of material that stretched over my belly as I shucked my clothes off and onto the floor.

Chris wanted to do the vaginal exam now and needed me to lie down on the table. That seemed totally impossible to me, too, but Chris was insistent that I had to do this before I could get my room and thus my epidural. So after the next contraction, still in pain, I somehow climbed onto the exam table.

Chris inserted the speculum mercifully quickly and painlessly and confirmed the presence of amniotic fluid. Then she removed it and said she would keep her gloved hand inside me for the next contraction. That sounded like a terrible idea, but apparently it wasn't optional. Then she announced that I was seven cm dilated! Hooray!

Emily continued pressing on my back with every contraction, which was amazing. I remember sitting on the end of the exam table for one contraction and Emily instructing me to hug Chris, who stood in front of me, while Emily stayed behind me to push on my back. It felt a little funny to hug Chris, because I think of that as something a labor support person is supposed to do, not a midwife, but it felt amazing, too -- so supportive.

Then they let SL into the room, to bring me my Hypnobabies, perhaps? and Emily told me to hug SL while Emily continued to press on my back. I was scared I would knock SL over as I draped myself over her tiny frame but she held up well.

Then the nurse announced she had a room ready for me and I immediately abandoned all my people and my belongings (except my precious Hypnobabies, playing on my Kindle), fixated solely on getting to my room and getting my epidural as I shuffled determinedly down the hall behind the nurse who waited patiently.

Then I was on the bed and the pain in my back was so cruel and punishing and someone was pushing on my back -- first Emily, then my doula, who reappeared mysteriously at some point. The nurse said again, rather impatiently, that I had to have my blood drawn and IV fluids started before I could get my epidural, so I clung blindly to the bed rail with my eyes squeezed shut and stuck out my right arm.

She got the bloods drawn and started the IV fluid and I guess Chris stepped out of the room then to go to a computer to start officially admitting me to the hospital. I think just a couple of minutes later the pain seemed like it was maybe dying down when suddenly I screamed and found myself pushing.

Chris was suddenly there again (apparently the nurse quickly left the room and went to Chris in the hallway and said "you'd better come" and when she came in, Emily mouthed "she's pushing" and Chris mouthed back, "good" -- Chris told me this later). Then Chris checked my cervix but told me she wanted to keep her hand inside for the next contraction. That sounded awful and I think I begged again for my epidural. But she insisted. And someone said, "it's too late for an epidural." And I wailed "No! I want my epidural!"

After that, Chris came to my beloved bed rail, which I still clung to like a life raft, and told me it was indeed too late for an epidural. I cried, "No! I want my epidural! Please, Chris! Help me!" I was heartbroken. The pain was so fierce. But there was no changing her mind.

Finally I gave in to the futility of arguing and decided that if I couldn't get an epidural, the only thing left was to get this over. So I pushed as hard as I possibly could when the urge came again.

I'm not sure exactly how long I pushed, a little less than 20 minutes, i think, but it felt like only a few contractions. It's only been a few days but already the memories have faded. At one point, early in pushing, I said, "I want my sister!" but I knew she was en route and wouldn't make it in time for the birth. I was thinking of my mother, wishing for her, too, but knowing she definitely wouldn't be there -- she died about a month before this conception.

I remember the awful feeling of the head in the birth canal -- it felt like she was crowning already, though she wasn't -- and screaming "get it out! get it out!" but Emily gently told me to feel the head myself and was still inside me. Dammit.

I think with the next push Emily said she could see hair. Chris told me that Emily would deliver the baby. They were at the end of the bed together. Then I think there was one more enormous push and it was burning and I was writhing and twisting my hips up off the bed and was I screaming on the outside or only on the inside? I dimly saw SL beyond the end of the bed and was glad she was out of harm's way, far from the carnage. Chris and Emily told me to lower my hips back to the bed. I wanted to know if the head was out yet.

Emily told me to push little pushes with the next contraction. It seemed like there was a little break, then, because I waited a minute then asked, "Wait, one big push, or little pushes?" She again said little pushes. The next thing I remember was the feeling of the body slithering out of me. Thank god. Relief. I could feel the umbilical cord still inside me and it bothered me but still, it was so much better.

Someone -- Emily? -- immediately laid this pink baby on my chest as someone else pushed my gown out of the way. There was no question of doing skin to skin care, and I dimly noticed and appreciated that.

SL appeared at my side and was flushed pink and sobbing as I stared wonderingly at the pink baby. A baby??? Wow. There really was a baby in there. Huh.

I was just so glad that the hard part was over. I didn't feel much about the baby beyond surprise -- with the very slow and uncertain start to the pregnancy, plus it being so close to my mother's death, I guess I was always scared to believe that there would someday be a baby -- so I was glad SL was crying. At least someone was emotional. We called my sister on the phone and I held the phone up to the crying newborn so she would know the news. I didn't get emotional until J arrived and I told her the baby's name, Amelie, for our mother Amy (named for her grandfather, Emil, so a lovely sort of symmetry).

It took a while to get my bleeding under control after the baby was born. The nurse kept pressing painfully, forcefully on my stomach to try to get my uterus to contract to stop the bleeding but instead, with each press, I could feel blood spurt out. Chris inserted a suppository to help with bleeding then said grimly, "I have to feel inside your uterus to make sure there's nothing left [that is causing you to bleed]. This will hurt." That sounded terrifying -- I couldn't imagine a hand inside a body cavity of mine -- so I moved to hand the baby over but Emily waved her away. So the baby stayed on my chest as I focused on my Hypnobabies techniques and magically, the exam didn't hurt, thank goodness, just felt like lots of pressure. Eventually the bleeding diminished.

The bed was beautifully soft and cozy, though I needed to be draped with tons of towels and blankets and sheets because I couldn't stop shivering. I thought I might just never get up again. But an hour later I was ready to use the bathroom and was shocked to find I could stand up and hobble to the bathroom without much assistance. What a difference from my last birth -- four hours of pushing, an epidural, an episiotomy, tons of stitches for a second degree tear and a gigantic postpartum hemorrhage that left me profoundly dizzy and anemic. Versus no epidural, no stitches, no tearing, twenty minutes of pushing and considerably less blood loss (more than normal but technically not quite a postpartum hemorrhage, and certainly not a severe one).

Post script, written at nearly 5 months:

That day of Amelie's birth, I announced to Chris, "I'm never doing that again," but two weeks later I sat in her office and confessed I wished I could do it again! As intense as it was, it was awesome, in the true sense of the word.

Thankfully, that desire has mostly faded again. My family feels complete. It didn't happen overnight, but I'm now completely in love with my little girl. The copious dark hair mostly fell out (everywhere except the nape of her neck) and has been replaced my fawn colored fuzz, and her newborn squints have been replaced by frequent grins and chortles of glee. Her tiny limbs have filled out and everywhere she has delicious rolls and dimples. Truly, I wouldn't change anything about my labor experience. Well, except for having my mom there to meet her namesake. Other than that, it was perfect.


  1. Thanks for posting. You sound like you are very strong and did an awesome job!

  2. I loved reading that. I have tears in my eyes. The photo of your girls is adorable!

  3. I loved reading that. I have tears in my eyes. The photo of your girls is adorable!

  4. What a great birth story! I loved reading it, and it brought back some memories of my own unmedicated birth when it became too late for an epidural!

  5. Thanks for taking the time to share this! Sounds like an intense yet beautiful experience!