V's Birth Story Part 4 -- Delivery

Continued from Part 3: Labor Intensifies (or start at the beginning).

It was around 11:30 AM. Doula K and Doula J stepped out, as they were not allowed in the room while the anesthesiologist was there, per hospital policy. As it turns out, the anesthesiologist didn’t care if they were in there, but I let them stay away so they could grab some lunch. Realizing that I was selling out the vision of a med-free birth that I’d had since I was a teen, I started crying before the epidural was placed. The anesthesiologist was trying to be nice but made some sort of jerky comment about how lots of women think they can do it on their own and then he gets called in. It was so demeaning because in my heart, I felt this was a medically advantageous decision and not one that was about eliminating labor and delivery pain. I had made it through 50+ hours of labor without meds, a true ultra-marathon—triple the length of an average first-time mom’s labor—and now I was reduced in someone’s eyes to just another  compromising woman who couldn’t actually hack it. It felt like just lonely me against the world to the point that I still have no recollection of Dave being there (though he assures me he was).

After that team left, I worked toward getting in the side-laying position. Dr. M had said that even with the epidural it would be uncomfortable and most women could only manage a few minutes. I was resolved to make it work, no matter how long it took. We put on relaxation music, darkened the room, Dave and the doulas were quiet, and I focused on my breathing for as long as I could bear the pressure in my belly. I made it lying on my side for an hour, much longer than Dr. M had ever had a patient do before.

Dr. M checked baby and found that he had indeed moved, but he had moved occiput transverse, an even less desirable position. We tried the fluid and manual rotation of baby tactic, which was not successful. I think it was at this point that she discovered I had meconium staining. The presence of meconium didn’t stress me out, as we’d covered this as a normal variation in Bradley classes, but Dr. M again insisted that a c-section was undoubtedly the road ahead.

Yet, our little labor team kept plugging along. The environment looked very different than dreamed with me in bed with an epidural and constantly on the monitor, but it was dim, quiet, and relaxed, and eventually I reached full dilation. At some point in there, I was emotionally done and the pain was intense and for the first time I wanted pain relief for the sake of pain relief. I didn’t know that I could push the button to get more medicine, so I let the epidural wear down. By the time I brought it up to someone, it was too late to settle in for pushing.  So, they offered a shot of lidocaine. I’m guessing that was at transition, but I don’t really have much recollection of that time. Medical records also are of little help.

During the considerable unmedicated portion of labor, the records talk about my mood, how I managed pain, etc. The records share lots of “breathing well through contractions” comments and some notes about me being pleasant but refusing things. After the epidural, the records are completely impersonal—just numbers from a monitor and quantities of drugs. I could talk for hours about what this implies in terms of the overall medical model of birth versus midwifery care, but that would get us off-track from an already lengthy story. Feel free to ask me about it, though.

Anyway, back on track: I started to have the urge to push, so I did some practice pushes with the nurse. Pushing was the part of labor I felt like I knew the least about, but I knew that my body would guide me. Albeit, now with an epidural I did worry a bit that my body might not be able to tell me what to do. I let the contractions guide me and I pushed to the point of comfort. At some point in this, baby’s heart started to have some decelerations. This seemed part of the deal to me: I was pushing, I’d had an epidural, it made sense. (Thank you, Thinking Woman’s Guide to a Better Birth.) But, Dr. M came to talk to us about it. She referred to the decelerations as “dippy doos” and encouraged me that it was time to get baby out. With her small frame, girly voice and baby talk, she reminded me of the Dolores Umbridge character from Harry Potter: utterly charming on the outside with a voice as sweet as honey that was used for spewing nastiness. She left and I continued to push to the point of comfort. When Dr. M returned, she was more adamant that I get baby out. She said I had thirty minutes or I would need to get wheeled down the hall for a c-section. I continued to work on my pushing and invited nurse Lara to coach me because I had lost all urge to push on my own.

We worked for a bit on it when Dr. M returned to check on me. This time, it was pure nastiness. She asked me if I had even been trying and told me I wasn’t doing a good enough job. I invited her to coach me through some contractions herself. She encouraged pushing hard and long, to the point I thought the blood vessels in my eyes might burst. I needed oxygen to make it through. It felt so wrong, but I knew that she could call it done at any moment. We were well past the thirty minute deadline she’d set. The doulas and Dave took turns holding my hand and legs. Doula J was amazing and whispered gentle encouragement to me. Dr. M yelled at me, used sports metaphors, berated me. I think she meant well, she was genuinely concerned for my baby and was trying to find something to motivate me. But, all of those were the wrong thing for me. I had prepared for a gentle birth guided by my intuition. I thrive off of positive words. Eventually, she said something about getting mad that resonated. The idea of getting mad at a pain was something I recalled from Bradley class. I focused on that. I am not an angry person, so I tried to focus on things that make me mad. Dr. M was one of them. I was mad at her and her infuriating approach. The other things I could think of were social injustice: rape, starvation. But, those are not things to think about during birth, so I summed it up as evil, as Satan. So, that was my focus: anger at Dr. M and at Satan.  If I could push harder to get her to shut up, then it was worth the anger.

At some point in there, they got the mirror in place for me to see baby’s head and I got to feel it. It didn’t mean much. I couldn’t really see in the mirror or feel much. All I knew was that focusing on those things was taking my concentration away from pushing. So, I had them remove the mirror. Later, I was sad to not have been able to see the actual delivery, though I am told that Dr. M would’ve insisted on it being moved.

Finally, after all of that it was time for V to come out. Dr. M was shocked that it was going to happen. She was still telling me that I couldn’t do it. Yet, he was coming, really coming. The final moments were faster than she’d thought since she just didn’t believe it would happen. I was told to stop pushing while the resuscitation team assembled. (I don’t think I listened to her to stop pushing—ha!) We knew by then that they would take V immediately to the table in the room because of the decelerations and the meconium. We agreed that Dave would go with him. So, when I pushed him out, I was happy and surprised that she laid him on my torso for a moment. I remember him looking wet and grey. He was silent. I wasn’t worried; I was just taking it all in.  I saw the cord for a brief moment. Then they moved him to the table and he made his first cry—small with a squeak at the end.

I wanted to know how his spine looked, as we’d been concerned about a neural tube defect.  It looked fine. V was born at 4:56 PM and weighed in at 6 lbs 12 oz and 20 in long. His first APGAR was a two, but by five minutes he was at a nine. The second stage of labor (pushing) had lasted 3 ½ hours.

Dave and Doula K were at the table with V. Doula J might have stepped out. During that time, Dr. M continued to work and I felt strange sensations. I felt like I was going to have bowel movement. When I asked her what was going on she laughed at me and told me it was the placenta coming out. Records indicate the placenta was delivered just three minutes after V’s birth, so I suspect she was pulling it out, despite our wishes to the contrary.  I got distracted with what was going on with V and the cord and placenta were gone before I could ask about them or see them. I later learned that Dr. M has a reputation of thinking placentas are gross and disdaining patients who don’t share this sentiment. She also told me that I was facing hemorrhage and needed to have Pitocin. I asked her to wait, but very quickly she brought it up again. There is nothing in her records that indicate a hemorrhage, so I suspect it was just another case of her doing things her way. She never said anything about stitching me or if she administered medicine to do so. But, she did tell me that I had torn because not only had V been born in the very challenging OT position where the largest part of his head was coming first, but his face was to the side with his hand by his head (nuchal hand). At some point, I learned that it was a third degree tear plus a partial. Only months later would I also learn that the nerves in my pelvis had been damaged.

After a few minutes, Dave brought me our V. He was calm and very alert and I could admire his dark blond duck fluff hair and his big, round eyes. They were either hazel or very dark blue--it was hard to tell then.

He had long, scraggly fingernails and his feet were dried out and wrinkled like an old man’s. His ear was folded down from where he’d been touching it on his way out. We did the breast crawl, something I had long dreamed of seeing. Babies are born with such incredible intuition!

We were enamored by this little boy—an answer to prayers, a bringer of joy. I had long felt like a mom who just didn't have a child of her own, but now I finally did.

Family Photo

A well-deserved rest

V's Birth Story Part 3 -- Labor Intensifies

Continued from Part 2: The Hard Work of Progress

I went home physically and emotionally exhausted. It was at this point that fear and anxiety set in. I had always—well, from my late teen years when I heard about the Bradley Method through a family I babysat for— truly believed in my body’s ability to birth a baby of its own accord. But here I was, feeling that I’d read my body’s signs wrong, or that they had misguided me, and it was emotionally draining.  The length of the labor wasn’t the bad part—I had just told nurse that we'd waited 2.5 years for this baby, we surely could wait a few more days—but the beginnings of the realization that my body might not just make this work had set it. Thankfully, I was still largely a believer, just a believer with some innocence lost. And, I kept on going. I called my Bradley instructor and she was encouraging. At about 3 PM, I started having contractions again. They continued to be painful back labor contractions. I sat in the living room on the ball and watched Netflix to pass the time.

Friend Kelly brought us California Tortilla for dinner around 6. Nachos for me! I was sitting backward on a folding chair in the living room processing through regular, intense contractions again about 5 min apart. Later she shared she could have sworn from my contractions and my reactions that baby was coming very soon, like concerned-we-were-still-at-home-soon. 

I decided that I wanted to labor in the tub again since it had felt so good at the hospital. Dave prepared a bath for me and kept me company. It was there that he told me we could name the baby V. We’d long been debating between V and another name. Dave wanted to meet the baby before deciding, whereas I was ready to commit, as I just knew it was the right name. What a great gift to give me a labor boost!

Dave was getting tired so he asked if Jill could come over and help while he slept. She came and kept me company while I continued to labor in the tub. A mere 15 minutes after Dave went to bed, my contractions started to increase in frequency and intensity again, to the point where they were two minutes apart, lasting for almost that whole time, and too painful to talk through. Jill was adamant that it was time to go to the hospital and woke Dave, who took a more relaxed speed in calling Doula K and the Kaiser nurse’s line despite Jill’s continual prodding. We learned that Doula K would not be meeting us at the hospital due to a family issue, but could send her backup doula, who we had never met. That was a big disappointment. We had debated a hospital versus center or home birth until I was about 30 weeks pregnant, and having a doula who was a good fit was key in my agreement to a hospital birth.

We made it back to the hospital at about 10:30 PM and ended up back in the same room as before. Jill followed us in her car came up to the room with us.  This time Dr. V was on call. I had seen him a few times during my pregnancy and I knew he was a fairly low-key guy, like Dr. S.  We got settled in again with a monitoring strip and another painful heplock. I wanted a progress check and this one showed I was 4 cm and baby was at -1 station.

I was ready to get back into the water. But, Dr. V was against it because I had been in labor for so long. He claimed my water might break and I wouldn’t know. I felt this was a bogus rule, so I drew the bath anyway. But rule follower that I am—I just could not relax in the bath knowing that I was violating his orders. So, I got out of the water and labored on the exercise ball in the room.

Backup doula Doula J showed up and Jill headed out. Doula J didn’t know anything about us or our birth wishes, but because I was in so much pain, she just jumped right into helping me through. It took a leap of faith to throw myself emotionally and physically into the arms of an unknown person, but utilizing a doula had been the hallmark of me agreeing to a hospital birth, so I just abandoned my hesitations and went with it. We soon discovered a bit of kindred spiritedness.

Because I was no longer comfortable in the bath, I felt robbed of my most effective pain-management strategy, which was another emotional blow.  Around 1:30 AM Doula J suggested that we put the exercise ball in the shower and she and Dave took turns aiming the spray at the small of my back. This gave me the benefit of the water, but without breaking the rules. It was a brilliant suggestion, and we spent most of the night like this. I would have to get out for monitoring, but then would go right back in to the shower. The shower was a lifesaver. The one big drawback was being cold. I was warm where the water hit, but not elsewhere.  Dave and Doula J tried to keep me warm with towels in the shower, but it was never quite enough, and I don’t think I could even recognize that in the moment. I chose to be in the shower because it was the best pain-management choice, but it meant being cold. The in-and-out for monitoring also played into being cold and expending energy. Tradeoffs that seemed small in the moment added up.

A strong and unpleasant sensory memory I have of the labor is of being cold. I associate that with desperation and my increasing loss of control. The previous night in the hospital, I would get cold when I had to get out of the bath for monitoring and then either stay in my wet swimsuit top or put it back on while it was clammy.  At home in the bath, the water just couldn’t get deep enough to cover me and it didn’t stay warm, so we draped towels on me to keep warm—but eventually they too would get wet and cold. These may seem like minor details, but I would relive being helplessly cold in my panic attacks. It took me months of processing later to understand where that was coming from, so it is a valuable detail to me.

We kept the lights off in the bathroom, which ended up having the added blessing that the staff backed off on pushing monitoring. I took it as respect for my wishes and niceness, but at one point they genuinely thought we had left the room for a long time.

I don’t remember a whole lot from these hours besides unrelenting pain, exhaustion, and the water on my back. I think a part of my brain shut off in order to keep functioning. The next few paragraphs are pieced together from my medical records, Dave, and flashes of memories that would come to me later.

During the monitoring a little after 3 AM, baby showed some “non-reassuring” heart decelerations on the monitor. Dr. Vu encouraged me to have two bags of IV hydration and extended monitoring.  I also agreed to an internal. This showed dilation of 7-8 cm, baby at 0 station and bulging bag of waters.  Dr. Vu expressed concern about the strain of a long labor on my body. I don’t remember any of what he said, perhaps because of my nature to trust my body to do this (and my fear of the intervention domino effect). It was obvious that my body was doing its job—ever so slowly—and my contractions were continuing every 3-4 minutes. I think I thought that delivery was nearing, and that perhaps baby would even be born in his sack.

A little before 5:30, I got out of the shower for monitoring, but brought the ball with me and sat on that during the read. While there my water broke and spread down the towel-covered ball and all over the floor. 

Dr. V stopped in after my water broke and shared with us the idea that baby might be occiput posterior (OP). He wanted to do an internal exam to feel and tell me but I refused to avoid the chance of infection now that my water had broken and because I felt like I was now on a delivery clock. I suggested they do an ultrasound rather than an internal, since he didn’t seem to know how to feel a baby’s position by touching my belly. I got a bizarre line about how ultrasound wouldn’t show us, but a bit after 7:30 AM, Dr. V returned with a portable machine that showed baby was head-down and very likely OP.

During that night and early morning, I was much less chatty than the first days. I remember being mostly silent. Or maybe I wasn’t and I just felt silent. I felt silent and alone while in the shower for all of those hours. Not abandoned, but definitely like this was my road alone to conquer.  I know that I dozed-off some on the ball. I know that scripture ran through my head a ton, as did worship songs. “I can do all things through Christ who strengthens me,” was a mantra. Verses I didn’t even know that I knew came to my mind and sustained me.

But, eventually, I know that I was miserable and begging and crying for help. I don’t know that I wanted medicine, but I wanted hope and answers. The pain was relentless and unbearable. I felt like I had been tortured for days by a body that was supposed to innately know how to do this. I was tried and sick of people getting me out of my relaxation zone for monitoring I didn’t want in the first place.

But, then something in me changed. I went from desperate to deciding that no one was going to make me do anything I didn’t want to. No more compromises. When I was told it was time for monitoring again, I talked myself into it. I no longer felt the need to rush to do it on their timeline. This was my birth and I did have choices, even beyond the details we’d put in our birth preferences. This is what I had diligently prepared for, for months, for years.

I started using lots of “I” statements out-loud to motivate myself. “I am choosing to get out of the shower.” “I am choosing to get monitored”. I got very articulate. I decided that though I couldn’t take my relaxation with me out of the shower, I could still take my intense focus. I think that it was a gift from God to prepare me for the next step in my labor: meeting Dr. M.

Dr. M started off very unlike the previous doctors. From our first encounter, on the morning of January 4, it was clear that she had her own way of doing things. She yelled into the bathroom where I was laboring in the shower and refused to come in when invited (inviting people into the bathroom rather than me coming out was part of my new assertion strategy). She insisted that she could only meet me if I was in bed and agreed to an internal exam. She didn’t care about my place in labor; she wanted me for monitoring even if I was in a middle of the contraction. She actually asked me what my problem was when I had a hard time moving because of the frequent contractions. When I motivated myself to come out, she told me that she’d talked to our reproductive endocrinologist about me and that this was a special day. I found her reference to our infertility without me first bringing it up very over-personal.

She was high-pressure about doing an internal, but I had decided that I was ready to know where I was at. I don’t remember where I was at, nor did she enter it into my medical records. She asked me my shoe size and then told me that there was no way I could deliver my baby vaginally. (It seems that my small shoe size confirmed to her that I had a small pelvis.) She also said that my pelvis was not shaped the right way, so baby couldn’t come out. This was shocking because Dr. S had told me twice in my pregnancy that my pelvis showed no contradictions for vaginal delivery, even with the pelvic separation that had developed. She told me that with her twenty years of experience with natural birth, I just wouldn’t be able to do it vaginally.  Even though she was definite in her negativity, and in her position that we were moving toward a c-section, somehow we did get her to suggest that if the baby turned out of the OP position, there was a chance he could be born vaginally. I was upset by her comments, but I don’t remember believing a word of her talk about my pelvis and inability.

I was, however, motivated to get baby to move. Dr. M suggested adding fluid through my cervix and manually moving baby with her hand.  She also suggested laying on my side and stomach (similar to the Bradley relaxation position). I asked for some time to think about it, as I knew to do with all interventions. I didn’t like the idea of introducing anything into my uterus and I was concerned about the relaxation pose. My pelvic separation made laying on my side unbearably painful, and with all of the pain I had already been through, I just didn’t think I could do it. 

In retrospect, I find it interesting that I knew to trust the pain of labor and birth and let it guide me, but the pelvic pain was something that truly struck fear into my heart. When I lay on my side, I felt like half of my pelvis was suspended, unsupported in space and that I might actually do serious damage that way. It intrigues me to think that I felt empowered to deal with the pain of labor without meds, but not with the unnatural pelvic pain.

Doula J helped us walk through the low tech ways to move baby: namely a slow dancing move and leaning over the ball. We tried both. The extent of my physical exhaustion became apparent. Any of it was just too much for me to sustain. While I was on the ball, Doula K rejoined our group. I thought that Doula J would leave, and was bummed out by that idea since we had bonded. But, when Doula K and Doula J talked about Dr. M’s approach to me, they decided that both would stay. They both had previous experience with Dr. M that was not supportive of a natural birth or a relaxed environment.
With Dave and the doulas, we talked through the pros and cons of the various options. I couldn’t bear the thought of laying on my side without some relief, let alone the doctor trying to manually turn the baby. I was so, so sad to be considering an epidural, but with my renewed mental clarity and resolve and ownership of my experience I could see that it seemed like the path most likely to avoid a c-section given my physical exhaustion and the new, hostile environment. After a decade of envisioning an unmedicated birth, meds seemed to be the sanest path to a vaginal birth. Dr. M never mentioned an epidural—the one thing I respected about her care—but I didn’t think I could get through her proposed steps without it. Even with the burst of clarity-of-mind I was having, my strength and sanity were giving out from the work of the previous days. Doula J and Doula K walked Dave and I through our options and questions, but did not offer their opinion. I later learned that they both though this was wise move and knowing Dr. M’s style feel certain she would’ve moved me to a c-section quickly had I not gone this route. (Far out from the birth, I also believe this.)

We decided that I would ask for one more internal to see if maybe I was more ready than I thought, if maybe my desperate emotions had actually been a signpost of  transition followed by the resolve of getting ready to push. But if not, I would get the epidural to facilitate the interventions: side-laying first and the fluid if that didn’t work. When Dr. M came in, I forgot to ask for the internal and just said that I was ready to move forward and that I wanted an epidural to facilitate things. I beat myself up emotionally over forgetting that in the months after the birth. It’s not that an epidural is bad, it’s just that since age 16 I had felt strongly about natural birth. I felt like a sell-out, despite also recognizing the wisdom of the compromise in a hostile setting. Despite that regret, I do think that decision was wise. I’ll skip ahead and share that the epidural helped me relax enough for baby to descend and I was able to get in some rest before the most challenging part of the birth. But, we’ll get there soon enough…


Concludes in Part 4: Delivery.

V's Birth Story Part 2 -- The Hard Work of Progress

Continued from Part 1.

For Baby E's half-birthday birthday, I shared the story of his amazing, empowering birth (plus gorgeous pictures). Writing big brother V's story has been harder.  At first, I was afraid to face my own story, but I moved beyond that and wrote and wrote. Then, I moved into being afraid of others hearing my story, that they would judge it: that was your traumatic birth? That was nothing or If you would've just gone along with X like everyone else does, you wouldn't have been so upset. Ultimately, I decided that others judging it is ok. I'd rather share it and let a few people glean something helpful than not share it out of fear.

So, what's the deal with birth trauma anyway? Some people say ‘healthy baby, healthy mama’ is enough when it comes to a birth. For me—logical to you or not— it is not. Yes, the “destination” is imperative, but the journey matters, too. It is possible to both celebrate an amazing new life and mourn the journey it took to get there at the same time.

For example, if you completed a marathon, but got injured on the way, no one would say, “All that matters is that you crossed the finish line”. No, people would care about your twisted ankle, they’d want to hear your story, maybe they’d even commend your endurance. They would know that the medal is great, but the journey also matters.

With V’s birth, I walked away as a healthy mama with a healthy baby with a complication-free birth, but for all of those wonderful things to celebrate, the rest of the journey still mattered. So, what is it about V’s birth that was so traumatic that I had panic attacks for months after? That I would wake in the night with thoughts racing? That I learned that there is a thing called Post-Partum Traumatic Stress Disorder (PPTSD) that fit me to a T? Was the length of labor? Was it going into birth having already been in chronic pain for four months because of extreme pubis symphysis diastasis (essentially, a dislocation of the front part of my pelvis)? Was it that I chose natural birth in a medical environment that is so disconnected from what normal labor looks like that they couldn’t believe in me?  I think it is all of it together, and more. As much as my trauma was about the birth, it was also about what happened in the years before and year after. Infertility and loss make the start of the journey long, hard, and sad. The physical healing my pelvis and back required after pregnancy makes the story go on for another nine months (and then years to a lesser degree). But, getting into all of that would make it a life story rather than a birth story, and frankly this birth story is long enough already, so here we go…

Disclaimer: You've probably already noticed, but just to be clear: this is a birth story. It involves bodily functions. I have not shared anything here that I am not comfortable saying aloud to you face-to-face. But, if you aren’t interested in such details, stop reading now.

38 Weeks: 2 weeks before V's arrival

On December 31, 2010, I noticed that I was having some contractions, but nothing with continuing frequency. The next evening, Saturday, January 1 (officially at the 40 week mark per IUI dating, which never synced with ultrasound dating) we had dinner with Dave’s parents, and I noticed the contractions were back, but I didn’t say anything. Before bed, I inserted some Evening Primrose Oil for the first time. Once I was in bed, I noticed the contractions were getting stronger and more consistent.  By 1:30 AM when I finally fell asleep, they were 7 minutes apart. At 3:30 contractions woke me up. I let a few pass, and I sensed they were consistent. At 3:45 I woke up Dave to time them. They were at 5 minutes apart and surprisingly painful from the start. I was expecting intense pressure in my belly and pelvis, but I was experiencing this was pain through my back.

For the next 5 hours we did shower time, I relaxed/breathed through the contractions in bed, I listened to relaxation scripts and music, and Dave got the last of the things together when I needed alone time. I had anticipated wanting him right there with me for it all as the trusty Bradley coach. But, I discovered that I relaxed best alone.  I was finding him distracting, so it was good for him to stay busy. I practiced lots of relaxation and listened to the relaxation script and music that I had downloaded from Kaiser. I was surprised to realize that vocalizing really helped me through the pain of the contractions.

The contractions kept going steadily and progressively, and after five-ish hours they were three minutes apart, lasting a good while, and I couldn’t talk through them. Around 8:30 AM, we called Doula K, and we called the nurse’s line at Kaiser and everyone agreed that it was time to start working our way in. The drive to the hospital was tough with the frequent painful contractions. Going over bumps was the worst. We got to the hospital at about 10:30 AM. I was determined to walk up to Labor and Delivery rather than go in a wheelchair, even though it was tough. I was admitted into an awesome room with a laboring tub (the hospital only has 2 such rooms), my own doctor, Dr. S, was on call (a rare occurrence--they cycle through 8 docs), and a nurse we'd met during our external cephalic version (to move baby from transverse to head-down) who we knew was med-free supportive. It seemed like that day, Sunday, January 2, was going to be the day for our baby boy to be born!

I had not been doing internal progress exams during the pregnancy, but decided to do one when we arrived at the hospital. I was at 75% effaced, 1 centimeter dilated, and baby’s head was at -2 station.  This minimal-progress news was surprising given the frequency and pain of the contractions. Nonetheless, Dr. S was encouraging and we prepared for labor to keep on trucking along, though the contractions had slowed from where we’d been at home.

At that point, I got a heplock put in, which I knew from previous visits to L&D was something if refused would start things off on the wrong foot with the nurses. I figured it was a small, reasonable compromise that would set a peaceful tone.

All settled in around 11:30 AM, I decided to take advantage of the labor tub because of the terrible back labor. Doula K was there by that point and devised a way to keep the heplock dry with a medical glove and medical tape. The tub felt great, but I was never able to 100% relax because I had to focus on not getting that hand too wet. Nonetheless, I was on the path to relaxation. Doula K put electric candles in the bathroom and she and Dave took turns talking with me and helping me relax. For twenty minutes of every hour, I was supposed to get out of the water and be monitored in the bed. I didn’t fully comprehend it at the time, but that was jarring to my relaxation and the move from the water to the bed expended emotional and physical energy. I felt very supported by Dave and Doula K and we passed the time with walking, relaxation, abdominal breathing, time on the ball, etc. After a few more hours things slowed more and more.

Monitoring session on the ball

Five hours later, around 4:30pm I asked for another internal.  I was 100% effaced but only 2 cm dilated. Dr. S was still encouraging about being slow and steady. I tried to get down some food and drink. (I had no intention of following the hospital’s orders to starve myself during the marathon of labor.)

I realized that the bath was really the most comfortable place to be, so I spent much of the next few hours in the water (but getting out for monitoring, though sometimes the staff would extend my time off the monitor).

At some point in there, I realized that I needed to use bathroom. I spent a long time laboring on the toilet trying to work through the back pain as well as relieve myself. The nurses kept warning me to not push on the toilet as though the baby was going to come even though I had made no progress. My feet couldn’t touch the floor which meant my lower back was unsupported through the pain. I tried to prop my feet up on anything I could find, but nothing was quite right. It was a feeling of helplessness. By the time I was done, a baby had—of course— not come out. I did, however, lose my mucous plug. I was happy to see it, as it was a cue that my body did indeed know what it was doing and I could trust my intuition, despite the nurses who did not.

Around 7 PM, friend Jill came to visit to bring much appreciated apple cider and conversation. After she left, I wanted to walk the halls. I walked super-slowly, stopping for each painful back contraction. As I walked, I noticed that the contractions were slowing. Around 10:30, I asked for another internal. This exam found no change.

Because I had made no progress for so long, we were offered the chance to go home, but decided to sleep through the night at the hospital in hopes that being settled would gear me up again. I was nervous about losing the room with the tub after the water had been so soothing to me and I did not want to make another painful trip in the car. Plus, we’d done everything “right” in terms of when to come in the first place with contractions consistent and hard enough I couldn’t talk through them. Dave and I decided that everyone should get some rest and we sent Doula K home while we slept at the hospital.

I woke up at 1:30 am (Monday, January 3) with regular, intense contractions. Dave and I worked through them in the tub and shower but then they stared to decline and so we got some more sleep in. By the time morning rolled around, I was having no contractions and had only made 1/2 cm progress. Since I didn't want to be induced (we were told this was the normal protocol at this point), Dr. S suggested that we go home and wait it out, and we agreed.


Continues in Part 3: Labor Intensifies.

V's Birth Story Part 1 -- Birth Story for My Son

After a challenging first birth, I joined a birth trauma support group called Mothers Healing Together to help me move to a place of greater peace. Our final exercise was to write a birth story for our child at his current age. V was one at the time. As he turns a big three today, this version is still how I tell it to him.

40 weeks pregnant

1 week post-partum

Birth Story for V

Mama and Daddy had so much love for each other that we wanted our family to get bigger so we could share even more love. We tried for a very long time to get pregnant with you and were very lucky to finally find a doctor that helped us.

You grew big in mama’s belly and we waited patiently for you to be ready to born. Finally, one night we thought it was time and we were so excited! Mama and you worked very hard for you to come out, and daddy took good care of us both, but you just wouldn’t come. But, that was ok. We’d waited two years to meet you, so another couple or hours or days was nothing. So, we waited longer and worked even more. It was hard work, but you were worth it.

Finally, it was time for you to be born. After we’d worked hard for so long, the doctor helping us didn’t believe that it was finally going to happen. But, you and mama surprised her and out you came! Daddy was right there with us making sure that we both felt lots of love.

When you came out, you were very quiet. My first words to you were, “My baby! My baby!” The doctor rested you on my belly and I got to see you and your umbilical cord for just a moment before the doctor took you and Daddy over to a special table where some helpers made sure you were all right. I waited eagerly to hear that you were ok. With Daddy right next to you, you started crying for the first time. We were so happy to hear your voice! Your cry had a little squeak at the end, which was really cute.

After a couple of minutes, Daddy brought you over to me and we got to cuddle close.  Even though you were brand new, you wiggled your way up my body so that we could look at each other even better and so you could try to nurse. You were very alert, and looking into your eyes was so amazing. It was hard to tell their color at first, but later we would see that they were blue. You had a little bit of duck fluff hair. It was too short to tell the color, but we guessed it was dark blonde. Once it grew in more as you got older, we could see that it was blonde with some red in it.

Mama and Daddy loved looking at every bit of you. One of your ears was folded down because when you came out of mama, you were holding it with your hand. As you got older you would continue to love touching your ear when tired. Your fingernails were long and scraggly and your feet were dried and wrinkled and looked like an old man’s feet.  You barely had any vernix on you, a neat substance that helps babies’ skin stay healthy inside their mamas’ bellies as they float in water. These were signs that you had grown big and strong in mama’s body and had really been ready to come out.

Mama and Daddy had to have so much patience to wait to meet you, but all of that waiting was worth it! God blessed our family by putting you in it, and—as is always true, even when it is hard to see—His timing was perfect.

The End (and just the beginning)



I'll share the full birth story in subsequent posts, but I wanted this version to lead the way. I share it because when we strip things down to a childlike, innocent level—leaving just love—the tears, fears, anger, etc. just fade away. The things that were hard are still hard, but the love becomes so much bigger than the struggles.  -Pamm

Read Part 2: The Hard Work of Progress, the beginning of the detailed birth story.

Birth Story: Baby E

Our dear E is six months old today!

Here is the story of his birth:

Wednesday and Thursday, August 1-2, 2012
39 weeks pregnant

On Wednesday, I took V out for some fun at Fairfax Corner and he played in the spray area, then we got caught in a big, neat thunderstorm. That evening, I started having contractions. Many were about 10 min apart, but others were longer or shorter. It was over 5 hours of that. I sat at my desk at home and furiously tried to knock everything off my “do before maternity leave” list for work. I would pause to relax and breathe through the contractions, but apparently that wasn’t relaxation enough because the next day, I just couldn’t bounce back. So, I took off from work, sent V to be with my dad and stepmom, and spent the day in bed (save for an encouraging lunch visit from Jill and kids).

Friday and Saturday, August 3-4

On Friday, we went to a mid-day appointment with the midwives. It was time to broach the question of if I should keep working. Obviously walking, working, etc. was exhausting me into contractions, but yet I didn’t want to be sitting around waiting for two weeks for labor to start if I went to 42 weeks. One of the staff, Marina, a mama of ten kids, reminded me that it wouldn’t serve me well to use my energy on working all weekend only to go into labor exhausted. Midwife Mayanne agreed. She also confirmed that baby was still occiput posterior (OP) (face up) despite all of my swimming and chiropractic adjustment. I realized at some point that I was going to be plagued with back labor once again and that’s all there was to it. A few weeks earlier, I had been in tears about the prospect of another OP labor, but now I was armed with a “can do” attitude towards a very long, hard labor.

As someone who prided myself in my “work until the end” mentality, I knew stopping work was the right thing to do, but I ended up deciding to go in for one hour on Saturday to run a rehearsal. When I went in for that hour, any hesitation I had about stopping work went away. As soon as I stepped in the church, contractions started again. That building, for as much as I love it, is just physically hard on my body with the unyielding concrete floor. I pushed through that final hour and then went home committed to truly relaxing through the contractions and saving my mental and physical strength.

Sunday, August 5

On Sunday, contractions woke me up at about 5am and continued all day. I heeded the wisdom learned from Wednesday and stayed in bed. I relaxed through them and napped, I wrote a couple of babywearing blog posts, and I did stuff on the computer from bed. I used lavender essential oil to encourage a calm environment. I napped. The contractions were persistent, but not consistent in terms of time, and by 3pm I was feeling irritated and bored, despite knowing that all of this had value. Dave’s parents joked about how their food put me in labor with V, and we accepted their invitation to dinner. The contractions continued through the meal, now at a pace of every ten minutes. I continued to relax and breathe through them.

On the drive home, the contractions began to feel more intense and more consistent. I used the lavender essential oil and got in bed. While Dave put V down to sleep (and fell asleep with him), I laid in the Bradley relaxation pose. (And I marveled at how easy and helpful this side-laying pose was in this pregnancy compared to the excruciating pain it caused in my pelvis last time.) I think that I dozed for a few hours. Around midnight I started to think this might be it, but wasn’t sure enough to wake Dave, despite reaching the point where I had to start working to relax. The relaxation pose no longer felt good, but leaning back against the headboard concentrated the contractions in my back. I just couldn’t get comfortable in bed. So, I sat on the exercise ball and watched Netflix. I discovered an adorable show called Jane By Design and watched several episodes. Leaning forward over the bed, while sitting on the ball, was helpful for a long time, as was the occasional hip swirl. After a while, I really wanted to be in the water, so I drew a bath and got in. As in the bed, reclining in the tub caused my back contractions to feel much worse, so I made a towel pillow for my forehead and leaned forward. I didn’t have any sense of the timing of my contractions through any of this. I wasn’t totally convinced that this was really it, so I didn’t bother with timing the contractions. After all, my first birth taught me that the clock really means nothing with an OP baby. It also taught me that even super-intense, consistent contractions don’t guarantee anything.

Monday, August 6

Around 2am, I was losing the ability to relax myself through contractions, so I woke up Dave and then got back in the bathtub. We decided to call Peggy just to let her know that we seemed to be on the path to active labor, though we weren’t ready to call it that yet.

Eventually, the bath stopped feeling good. Since I had already ruled out the bed as being comfortable, I decided to lay on the couch on my side. The sagginess between the cushions seemed to help. Dave slept on floor beside me. When he was awake for a contraction, he did counter-pressure on my back with hands or peanut massager, which made a huge difference. Contractions were certainly intense, but I was able to stay in relaxation enough to doze off in between the contractions.

Around 4:30am, V (19 months) woke up. Dave brought his twin-size mattress into the living room and tried to get him back down to sleep. My vocalizations didn’t help. V was concerned and curious and kept asking about mama, mama, sometimes saying mama…mmmmmm (imitating moan). When Dave would press into my back my back, V wanted to help. Dave had V put his little hands on top of his own. At one point, Dave was in the other room for a contraction, so V came up and started pushing on my back. What a dear little boy. We had decided previously that we wanted V at the birth, but only if it was the best thing for him and my relaxation. We quickly realized that things were getting intense enough that we couldn’t give V the focus he needed, as I needed all of Dave’s attention on me, coaching me through the contractions. So, we called my parents around 5am to come and get him, with the idea that we might have him come to be with us again whenever it seemed right.

Dave needed to get V packed up to go, and I felt I couldn’t make it through the contractions on my own on the couch, so I got in the tub again. It was helpful to switch things up again, but relaxation was getting tougher and tougher to maintain. My vocalizing through contractions was getting stronger and I was starting to have intense downward pressure. My dad and stepmom showed up about 5:30 and got V and then Dave and I talked about our next steps. Dave called Peggy with an update, but I didn’t think I was ready to go to the birth center. I was terrified of getting there and being sent home, having to make the drive there twice, getting there and being days away from having a baby. Even with six months of work done in the Mothers Healing Together birth trauma support group and careful selection of providers who focus on mother-empowered care and the emotional side of birth, certain aspects of my first birth were coming back to haunt the corners of my mind. 

Peggy asked to speak with me, and while we were talking, I started crying. I still wasn’t even sure that this was the real thing. After all, I’d lost no blood, no mucus plug, and no water. I told her that I couldn’t bear to take a car ride there with the current intensity of the contractions, yet the thought of them being even stronger and making the drive was even worse.

With that burst of fear and emotion, I think Peggy recognized what I could not/would not see—not only was the real deal, but pretty far into the real deal. Peggy reminded us that she needed one hour’s lead time to get a midwife to the center, and we all agree that Mayanne and I would meet there in an hour. A few moments later she called back and said someone would be there in five minutes. I text Heidi (photographer) to let her know, and she decided to come right away (versus waiting until we had a progress check, if elected) to avoid the traffic that would soon build as rush hour heated up.

Dave and I prepared for the drive. Before we left, I went to the bathroom and had the tiniest swipe of bloody show on the toilet paper. I cried a tear of joy, hoping that maybe there was some validity to this labor journey after all.

The car ride started tough, especially two speed bumps in our neighborhood, but once we were on 29, I felt trancelike. I hung onto the handhold above the car door and breathed and relaxed through the contractions, almost swinging. I could do this! Nothing was going to stop me this time. That early in the morning, there was little traffic, and the ride went quickly. I almost floated there.

When we arrived at the birth center, I was thrilled to see that Kim was the midwife there. Everything felt even more right and the fears that had been starting to build in me relaxed out. She was the midwife I connected the most with emotionally through the pregnancy. I might have teared-up because I was so happy. Kim came outside to greet us and she helped me inside. As I started walking, I felt a gush of fluid. I thought it was my water, but the volume wasn’t enough to actually leak, so it might have just been more bloody show. When we got into the Lotus Room, where I had done most of my prenatal appointments, I felt at home. 

Leaving me in good hands, Dave went to the car to bring in our stuff. Previously, I thought that I would decline all internal exams, but I needed proof that this was real labor so I agreed to one. Kim checked me and said that I was at 7 centimeters/a stretchy 8 and baby was still OP. I was shocked at my progress, and happy, yet still emotionally holding back that this was going to happen. The OP baby was no surprise, as the back labor was a tell-tale sign. Kim told me that the water in the tub was warm and ready, and I was eager to get in. I put on the clothes I had chosen for the birth (a modest top—what I felt comfortable in for pictures), and by the time Dave got back from the car, I was checked, changed, and getting in the tub. He came over and got right to coaching, bring chocolate coconut water with him. Someone posted my visualization posters on the wall by the tub and we put on the Reefscapes DVD I had liked from prenatal visits.

Relaxation Visuals

At the tub, Dave told me that our photographer, Heidi Daniels, also had arrived. She was so quiet, and I was so in my zone, that I didn’t even notice her at first. I caught him up on the past few minutes. Dave was surprised that I had done the internal check, but he was supportive. I told him how many centimeters I was, and asked him to ask Kim if I would have the baby today. I couldn’t ask her myself because I knew it was a ridiculous question, yet I was so afraid that maybe the end wouldn’t be in sight and, like with my first birth, the pain would be relentless for days. Kim assured us that baby would likely be coming very soon.

Photo by Heidi Daniels

Sure enough, things started picking up intensely. Almost as soon as I got in the water, I lost my mucus plug. The contractions were getting very intense and I tried to stay in relaxation, though it was getting very difficult. I pictured the things from my visualization posters, breathed, and relaxed so much that I was floating in the water, as I didn’t want to use my muscles to push myself down. Kim and Jo helped me remember to keep my vocalizations in a low tone. I focused on two ideas to get me through the waves of pressure: strength and relaxation. To relax, I imagined myself in the Bade Pool at Spa World under the mushroom-style fountain--totally relaxed, surrounded by others, yet alone and distant--inward, focused. I also focused on being strong and enduring like the Caryatids of the Athenian Acropolis.

Things got more and more intense and I started to mentally lose it. I wanted to be out of my body. I wanted to be done. I was ashamed of these feelings, yet I knew that hiding them would take energy, so I just said what I thought. “I can’t. I want to go away. I’m too tired.” I never wanted to leave my baby, but I desperately wanted to pause life, leave the moment, rest, and then come back and do this. Ah, the mental struggle of transition.

With Kim, Jo, Dave, and Heidi crouched around the side of the tub, I had a community of supporters helping me stay in the present and get through it. This image of being encircled by love and support at my eye-level around the round tub is a quintessential memory/symbol of this birth: being part of a circle of women empowering each other and trusting that our bodies are strong and wise, brilliantly designed by a loving creator. It is everything about life, community, and God that I want to stick with me.

Photo by Heidi Daniels

In this circle of strength, my team gently cheered me on as I felt my strength and sanity waning. Perhaps Kim sensed my exhaustion and frustration, and she suggested that having Dave lift my belly during contractions would help baby’s head put pressure on my cervix to encourage dilation. Dave took her suggestion, and I hated it. It made me angry, and I said so (in a polite, blunt way). I remembered the strategy of getting angry at the pain, so I utilized it. But really, it made me mad and I wanted to stop. Yet, I/we kept going with it. I knew that Kim wouldn’t have suggested it if it wasn’t worthwhile. Sure enough, it worked. I felt an incredible, painful burst of pressure shoot out of me. In my mind, it made a sound like gunshot. I don’t know if it really did. I looked down and honestly expected to see that baby had been birthed in that furor of pressure. Alas, no. That was my water breaking. It was meconium stained.

Very quickly after that, the urge to push started. It was intense and unlike anything I’d felt before, so I recognized it by that new feeling. I had been nervous about knowing what to do during pushing, but I just went with it and Kim was supportive of letting me heed my body, which was great since I wanted to avoid coached pushing. But, when Jo used the Doppler to take a heart reading, Kim began to coach my pushing. It was one of those things that could’ve made me so mad, save that this time I had a provider who I could fully trust. If Kim told me I needed to do it, I needed to do it. I didn’t get an explanation right away, but I could see from the way that Kim and Jo were looking at each other that something was up. Kim became more urgent, telling me that my baby needed me and I had to put all of my effort into pushing. I tried, but I could tell that it wasn’t strong enough. It wasn’t baby’s time yet, so my body could only go so far. Kim told me I had to get out of the water NOW or she would have to “make the call” [to 911 for ambulance]. I didn’t hear it as a threat, like what I heard in the hospital with my first birth; it was simply reality from someone who cared deeply for me and my baby. We were all calm, there was no hysteria or panic, it was just a simple next step to help my baby.

While I trusted Kim, the idea of getting out of this deep tub with high sides while pushing out my baby felt simply ridiculous. The fullness I felt made me think baby’s head was already partially out. I told her that I couldn’t do it, and she told me that I had to—my baby was not happy in the water with a heart rate staying at 70. She said that they could all lift me out if needed. Somehow, got my focus together and got myself out of the tub. In that moment, I felt very light and in my mind, I semi-floated out. I made it mostly on to the bed when the next contraction hit and it was time to push again. Baby’s heart rate bounced right up to 140 and everyone was relieved.

The hard work of pushing continued and as I felt burning, I realized that baby’s head actually had not been partially out, like I had felt. Now, baby was really coming. This was hard, tiring work. I reached down and touched baby’s head, but couldn’t make sense of it. It was like touching my own skin when it’s numb—I could feel it with my fingers, but not from the other surface. I found it distracting and uncomfortable to reach. I needed to keep my focus. Dave, trying to motivate me, asked if I would like to know what color hair the baby had. I was so perplexed by this statement. Baby had visible hair? Huh? (Big brother V was born with only light duck fluff.) The thought distracted me, and I needed to keep my focus. As I pushed baby out, Kim told me to reach down and catch my baby. With her hands doing the guiding, I was able to touch, catch, and bring baby up to my abdomen. I could see that baby had lots of dark hair, which was a shock. (Now Dave’s comment made sense to me.) Baby was quiet at first, but then quickly gave a brief cry. After a few moments of marveling, I remembered that we needed to see if baby was a boy or girl. I thought it must be a girl, because Jo had said something about “catch her” a few minutes earlier, but really no one probably had a chance to see the genitalia in that quick swoop out and up. I moved baby up to look and couldn’t tell what I was looking at from that angle—I thought I was looking at a freakishly swollen vulva before Dave said it was a boy and realized that was testicles and then put baby in a more front-facing angle to really see. At some point, I announced, “He has a name. This is [E.J.]”

He was born at 8:07 am, just a mere hour after arriving at the birth center, and after just 30 minutes of pushing.

Photo by Heidi Daniels

I kept E on me and snuggled him. I marveled at his beautiful umbilical cord that was draped down my belly. After a few minutes, it was time to push out the placenta. This was not pleasant. I wanted it to feel natural and come out of its own accord, and I was getting lots of coaching on pushing it out. It seemed to take forever. Once the placenta was out, it was time to cut E’s cord. We gave Dave one final offer of doing it and then I did it. This was a true highlight for me—it represented everything that a non-medicalized birth is: I am the one who brought my baby out of me and I am the one who separated him from his life-giving placenta.

We spent time cuddling, trying to nurse (not too successfully, E like to sucked in his lower lip, which was great for giving him comfort but would break the latch), I got to see the placenta and how the amniotic sac had covered him. As the hours went by, I got to rest, drink, eat (laborade cubes and my stepmom’s white chicken chili). Mayanne came in and congratulated us. Birth Assistants Kaycee (who arrived at some point right before delivery) and Jo took my vitals sporadically. It was amazing to have this community of women around me, genuinely celebrating with me. I was on an incredible high. Birth, in all of its rich-yet-simple beauty was triumphant!



Photo by Heidi Daniels

My dad, stepmom, and 12-year-old niece who was visiting from Texas (and flying home just hours later), brought V. Heidi took pictures. When V came in, he said “baby” and was interested and was happy to be in the bed with us and touch his brother’s head. When E cried, V started crying as well. 

Photo by Heidi Daniels

Over the hours of resting, we recounted the birth. As we talked, Kim shared that baby had actually come out face down (i.e., occiput anterior, OA) , not OP as he’d been when we’d arrived, and he was born with a nuchal hand (a hand by his face). We rested and waited for Peggy to do the newborn exam and my sutures. When we got around to the newborn exam, E weighed in at 7lbs 2oz and 20.75 inches long. Peggy guessed that E was flipping from OP to OA when his heart rate had dropped. It made perfect sense. My body and my baby were doing just what they should. Technology gave us a window into that moment, but it was a window of frosted glass, unclear.

Photo by Heidi Daniels

Photo by Heidi Daniels

After the action slowed down, Dave, E, and I stayed in bed and rested (and watched the Reefscapes DVD over and over again). Dave fell asleep. I was tired but wired. E was shaky and his blood sugar was low, so I focused hard on trying to get some colostrum in him and get him past sucking in that lower lip and unlatching. After about 8 hours, we were ready to go home, so I took a shower and Dave packed us up. We were home at about 5 PM. I wrapped E, nursed him in the wrap, and finally snoozed.

Here is the birth day story, told in pictures:

{birth} E.J. from Heidi Daniels on Vimeo.