On the afternoon before I was officially in my 42nd week of pregnancy we had an appointment with the midwife for a final non-stress test, and a conversation about how to proceed with delivery since I had not gone in to labor on my own. The midwife I had been seeing for all of my appointments over the past two weeks, Elizabeth, was on call at the hospital and had several patients in active labor. Because she was delivering babies we ended up meeting with one of the obstetricians in the practice whom we had not met, Dr. Barrett. Dr. Barrett reviewed the non-stress test and felt my belly to assess the level of amniotic fluid. He said both were still looking really good which meant Max was doing well. When he checked my cervix, however, we got some bad news. On the scale they use to determine the body's readiness for labor, a Bishop's Score, they are looking for a ten which means the body is ready to go. Unfortunately I was closer to a one or a two at best. He summed it up by saying I have a "great pelvis for giving birth, but a terrible cervix." We already knew that there was a strong chance we would have to be induced, but Dr. Barrett shared that induction usually works best when the mother's Bishop Score is already closer to a five or a six. He said we could start with Cervidil and Pitocin to see if anything would happen, but reading between the lines we knew he thought a cesarean section was in our future. Dr. Barrett sent us home to eat dinner and pack up and told us to check-in at the hospital at 7:00pm to begin the induction.
After nine months of planning and practicing for a natural labor and delivery we were absolutely devastated to hear this news. I was extremely upset and Ben did his best to stay strong and positive to help me grieve a potentially lost dream and re-group with a new mindset. He encouraged me to remember that we still got a baby at the end, and that our overall goal and mantra has always been "healthy baby, healthy mom". Deep down I knew he was right and that this was in Max's best interest, but I was still heartbroken. After calling our parents and emailing a few of my girlfriends to let them know what was probably going to happen, we got cleaned up, packed the car, ate dinner, and took one last picture as a family of two in the driveway. Tears continued to flow on and off both from the heartache of knowing I may never experience natural childbirth, and from the excitement of knowing that when we returned we would be a family of three.
The car ride to the hospital and walk from the car to the admission desk was emotional. Our plan had been to labor at home for as long as possible, and get to the hospital as close to being ready for delivery as we could. Instead, we were riding quietly and calmly without pain or a need to rush. As we checked in at the admission desk another couple came in. The mother wasn't acting like she was in labor, but they were clearly there on their own timing and after checking in the mother was whisked off to the back in a wheelchair. We ended up sitting and waiting to find out what room we were in and just walked back with the admission person. It was more like checking in to a hotel than checking in to deliver a baby.
Once in the labor and delivery room, I got to work with a few to-do's from the nurse and changed in to a hospital gown. Ben took some photos and a short video of the room so we would have it to remember as we would be transferred to another room after Max was born.
After a little while our nurse, Kimmy, came in to complete a very large stack of paperwork and consent forms, and discuss the plan for the night. (As an aside, I could not imagine having to comprehend, complete, and sign this amount of paperwork if I were in significant labor pain.) Kimmy said the plan was to insert the Cervidil around 8:30pm and that I would have to stay in bed until 10:30pm. Between 10:30pm and 12:00am I could get up and walk around, use the bathroom, and have something to eat as I would not be allowed to eat after midnight. They would take the Cervidil out at 6:00am, give me an hour long break, and then start the Pitocin at 7:00am. She offered me a sleep aid, too, as she said it would be important for me to be rested when they started the Pitocin in the morning. I hate feeling overly groggy, so I declined the sleep aid. Ben asked Kimmy if there was any chance the Cervidil would be enough to start labor, and she said that it would not as it merely prepared the cervix and did not encourage dilation.
Elizabeth, our midwife who was still on call, stopped in to say hello and see how we were doing. She knew this was not how we imagined labor proceeding and recapped for us how the induction drugs would work. Elizabeth also shared that Susan, another midwife, was next on call and she would oversee the Pitocin administration and next steps. We had only met Susan two or three times during the pregnancy, so I was a bit disappointed that Elizabeth or Breia (the other midwife I saw the most times) would not be the midwife delivering our baby.
After taking some blood samples, hooking me up to some monitors and IV fluids, and checking my cervix again the nurse did a quick ultrasound to make sure the baby was still facing head down (he was). She inserted the Cervidil which was a bit painful for a few moments, and then she left us to rest. Ben and I chatted for a little while and tried to keep each other's spirits up. We decided we should start getting some rest as we knew we had a long day ahead of us, so Ben changed in to sweatpants and set-up his bed along the window wall.
A little while later I started to feel some mild cramping low in my belly which was to be expected. It wasn't painful, just uncomfortable. Around 10:30pm Kimmy came in to check on us and asked if I wanted anything to eat. I mentioned we had some granola bars, but Kimmy reminded me I wouldn't be able to eat after midnight and offered to get me a sandwich. I decided that would be a good idea as I wanted to have as much energy as possible just in case the Pitocin worked the next day and I was able to labor. Because I was emotional and nervous I wasn't terribly hungry, but ate half a turkey sandwich (it was big), a few potato chips, and some strawberry yogurt and shared the rest with Ben.
As we were wrapping up our little meal a new nurse, Destiny, came in to introduce herself. She said Kimmy had been an on-call nurse and had been sent home for the night. Destiny said she'd be with us through the night and into the morning. She made sure we were all set, adjusted the monitors on my belly, and encouraged us to get some rest. I was allowed to get up and move around for short periods of time at this point, but had to keep the monitors on my belly on the whole time since the Cervidil was being administered. Destiny showed Ben and I how to disconnect and reconnect the monitors so I could get up to go to the bathroom if needed. After Destiny left I used the bathroom, brushed my teeth, and Ben and I kissed goodnight.
My mind was racing, but I did my best to calm down and try to lull myself to sleep. Sometime shortly after midnight the cramping began to become more uncomfortable and occur more frequently. I started to get nervous about how the Pictocin would feel the next day if I was already feeling very uncomfortable cramping just from the preparatory drug. I called out to Ben who came over to sit by my bedside to offer comfort and encouragement.
My sweet husband had planned to surprise me with comfort items throughout the labor process. Since we knew we were headed down an alternate path, he handed me the bag and had me open everything all at once. He selected a large gel pack that could be frozen or warmed in the microwave, cooling aromatherapy massage lotion, and a massage ball. All of these items were incredibly thoughtful and would have been perfect for the home laboring we had anticipated. I felt so lucky to have such a thoughtful and invested birth partner, and also a little sad that the gift giving and usage hadn't played out as he hoped. I couldn't really use any of the items, so Ben repacked them in our hospital bag.
The intensity and frequency of the cramping low in my belly began to increase and I suddenly felt really nauseous. Ben grabbed a "barf bag" that the nurse had left out for us (I had a nervous tummy earlier and Ben asked what to grab if I did decide I needed to throw up and couldn't make it to the bathroom). After the next crampy spell subsided I vomited, but it didn't really do anything to make me feel better aside from making the nausea go away. By this point I was constantly laying on my right side hanging on to the bed rail, and Ben sat in a chair by the side of my bed and continued to be supportive. Destiny came in and out to check on us throughout the night and adjust the monitors on my belly as they slipped around a bit due to baby kicks and my movement.
As the time passed I kept needing to get up to pee and also had a mild case of diarrhea. The cramps were getting worse and I started having to breathe through them. I confessed to Ben my fear of not being able to labor without an epidural in the event the Pitocin worked the next day. I could not imagine the pain of actual labor if this was just what it felt like to have my cervix get in to a better state. When Destiny came in again, Ben shared that I had vomited and was having a little diarrhea. She commented that those were good signs and asked if I wanted her to check my cervix, but I declined because I was afraid I would get discouraged if she said I was only thinned out or maybe dilated a few centimeters.
The cramping was becoming very intense and was some of the worst pain I had ever felt. I clung white knuckled to the side of the bed and would pull hard on the bed rail through each cramp, while moaning, talking, and taking quick breaths. Ben tried to rub my back and stroke my hair, but for some reason I could not stand being touched. He provided me with sips of water as my mouth became dry, and stayed right by my side. During one big cramp I opened my eyes and saw he was leaning back in his chair. I asked (or probably demanded, looking back!) that he lean forward. Somehow having him leaned in but not touching me made me feel better. I also kept asking what time it was because I wanted 6:00am to come quickly so they would take out the Cervidil and give me a break from the pain.
Ben got my iPhone and started to time the cramps using the contraction timer app, and commented that he thought I was in active labor. I dismissed the idea as the nurse had clearly said Cervidil would not induce labor on its own, and Dr. Barrett had essentially said my body would not go in to labor. I kept getting up to go to the bathroom, and would have to work through a few big cramps on my own in the bathroom before I could make the walk back to the bed. During one trip to the bathroom I stood up and noticed blood in the toilet. I called out to Ben to tell him and then felt like I needed to stay in the bathroom a bit longer to get through another big cramp or two.
Ben went out to the nurse's station to find Destiny and tell her I was having some bloody show, and that he thought I might be in active labor based on what he was seeing on the contraction timer. Destiny said she was noticing a pattern of the baby's heart rate decelerating during each contraction which was a positive indicator as well. She told Ben that she felt strongly about checking my cervix as they both suspected labor was well underway.
When I opened the bathroom door Ben was there (I didn't know he had left the room) and he helped me back to the bed and get my monitors plugged back in. He explained that he and Destiny both felt like I was in labor and that it was important for me to let her check my cervix. After working through another big cramp (I refused to say or think they were contractions), I rolled to my back and Destiny checked my cervix. I was in complete shock when she shared that I was dilated seven centimeters! I opened my eyes and Ben and I shared a moment of quiet excitement with big smiles and teary eyes. My body was working and I had made it through all of active labor on my own. I knew I was about to enter the transition stage of labor (dilation from seven to ten centimeters) which was going to be the most intense stage.
Destiny paged the nurses station and told them to get Elizabeth (who was still on call), and some other people came in the room as well. By this point I was primal and literally could not control myself as I clung to the side of the bed. It was like I was turning into the Incredible Hulk and I felt as though I might tear the rail right off the side of the bed. Destiny could tell I was getting close to feeling like I needed to push and told me I was going to have to resist the urge until Elizabeth arrived. For some reason I thought Elizabeth was coming from home and that I would have to resist the urge for more than 30 minutes. She wasn't coming from home, though, and was still at the hospital and I heard her voice a few minutes later (my eyes were shut almost the entire labor).
Side note-- In my head I was completely calm and rational through most of the labor and delivery. I was unable to communicate anything, however, and only my primal instincts to deal with the pain came out. Another random thing is that my ponytail had come loose due to me writhing around on the bed and it was driving me nuts. During the breaks between contractions my body just wanted to relax and I couldn't make myself fix it or ask someone to fix it for me.
I was oblivious to everything around me and just tried to work through every contraction and relax as much as I could during the breaks. During one contraction my water broke in a big, warm gush. I didn't know what it was and just screamed that something was coming out of me. Destiny cheerfully shared that my water broke, and during the next contraction I had another big gush. They noted that there was meconium in the amniotic fluid which is not uncommon with post term babies (this means he had his first stool in the womb). Elizabeth told us that she was going to have to make sure the baby did not take a breath right away, because it could be dangerous if he breathed in the meconium. The respiratory specialist was called in so he could be ready to suction the baby and address any respiratory issues immediately after birth.
The nurses started to break down my bed and Elizabeth donned her gear to deliver the baby. She asked if I felt like pushing and I said yes. She had me roll to my back and bear down during the next contraction. I heard her say she just realized that she was having me push in the exact position I didn't want to push (laying on your back works against gravity), and asked if I wanted to roll back to my side. I was so relived that she asked and went back to my right side and clung to the bed rail that had become my anchor. I pushed through a few contractions on my side, and Elizabeth said she wanted me to try pushing in a squatting position. The nurses attached a bar to the bed for me to lean on, and Ben and Destiny helped me to a squatting position. This felt so good and I really liked being upright. During the pushes I tended to alternate pulling down on the bar really hard and pushing up really hard. Again, I felt like I was going to be able to rip it right off the bed.
After a few more contractions, labor started to slow down a bit and I was having long breaks between contractions. I felt very peaceful and at one point almost felt like I could sleep between pushing sessions. Because my fast labor was slowing Elizabeth and some of the other medical people left the room, and Ben and Destiny stayed by my side to help me through each contraction and push. I felt Destiny check to see how far down the birth canal the baby had descended, and it was sufficient enough for Elizabeth and the others to come back in the room.
The pushing became more intense, but it was somehow not painful. It felt like something really big and hard was stuck in my bottom which I shared with everyone in the room more than once (clearly I had no self control at this point!). During some of the pushes I would be at the end of my ability to keep going before taking another breath, and suddenly I would feel my body push hard a little more all on its own. Everyone was encouraging me and telling me I was making progress and doing a great job. I kept telling myself in my head that I couldn't believe I was actually giving birth to my son just the way I wanted to give birth. I silently willed Max to work with me on each push and imagined him inching his way down.
Elizabeth told me she could see lots of hair and asked if I wanted to touch his head. I was afraid I would lose focus so I declined touching him, but in hindsight I wish I had been in a mindset to ask for a mirror so I could see him. The baby was getting closer and closer and Elizabeth even played with the baby's hair for a little while! She also worked to stretch me with her fingers to prevent tissue from tearing since there was a possibility he could be a large baby (the ultrasound the Thursday prior estimated he could be over eight pounds and those estimates are often off by as much as 20%). I kept pushing and Elizabeth said she wanted to give me a small incision because I was starting to tear internally and she was concerned I would tear badly if he was a big baby.
The pushing continued and I started to feel the "ring of fire" as the baby began to crown. This was the most painful part of the pushing stage, but the pain gave me energy to push even harder as I knew the pain would go away once he came out. I was completely inside my head and everything around me was fuzzy. I could hear everyone, particularly Ben and Destiny, cheering me on and telling me I was almost there. Suddenly I felt something that was warm, hard, and soft slide out of me and I opened my eyes to see Elizabeth holding our slimy baby. Because of the meconium in the amniotic fluid she had to cut the umbilical cord quickly and they rushed Max to the other side of the room so the respiratory specialist could get to work. I relaxed back on the bed and finally opened my eyes to look at Ben. We both had tears in our eyes and my heart overflowed as he smiled and said, "You did it!" A few minutes later we heard Max cry and I could see his little arms and legs waving around in the baby warmer across the room. I didn't have any big rush of emotion, but it was like my primal side suddenly clicked off and I was myself again.
Elizabeth began stitching me up and I asked her if the placenta had already come out. She said it had not and that she liked to repair the mother and then work on delivering the placenta as it sometimes takes a little while before the body begins to expel the placenta. When it was time to deliver the placenta I had to push while a nurse rubbed by abdomen and Elizabeth guided it out. Surprisingly this almost hurt more than pushing out the baby, and I also welcomed holding Ben's hands for the first time the whole labor and delivery. Once it was out and the nurses and Elizabeth were continuing to get me fixed up, I encouraged Ben to go see Max who was getting fixed up in the baby warmer. The umbilical cord had already been cut since they had to get Max to the respiratory specialist quickly, but it was still long enough that Ben got to do a "ceremonial" cutting of the cord to trim it down.
Ben came back to my bedside with a huge smile on his face to tell me about Max, and a few moments later one of the nurses brought Max to meet me. I couldn't believe this little baby had come out of me and that I was officially a mother and Ben a father. Ben and I kept staring at him and each other in awe of our little miracle.
We knew skin to skin contact was important right after birth to help with bonding, so the nurses helped get Max unwrapped and they snuggled him down on my chest. It was crazy to look down and see a deflated belly beyond his little body and know that he was once curled up inside me. He seemed so big laying on my chest and it was hard to believe he actually fit inside me just a few minutes before.
The nurses were great in not only the medical side of things, but also in helping us capture this special moment. They offered to take a few photos for us which we really appreciated.
All three of us were given matching ID bracelets, and they brought in a breakfast try for me. After all that hard work food tasted so, so good. While I ate my breakfast Ben packed up our bags and took them upstairs to our recovery room. Once I was done eating one of the nurses helped me out of bed and had me take care of a few things (I'll spare you the details on this one as post-partum is more gory than labor and delivery in some ways!). As part of it, I had to walk across the room to the bathroom so Ben put Max down in the bassinet and worked with the nurse to support me on the walk. The room was big and at that point the bathroom seemed really far away. When I got up again I got really woozy and nearly fainted, likely due to all the blood loss. The nurse put my arms around Ben's neck and told me to lean on him while she got a wheel chair and helped me sit down. Once I was back to normal we wrapped up in the labor and delivery room and began our transfer to the recovery room. The nurse pushed me in the wheelchair and Ben came along behind us pushing Max in his bassinet.
I had a huge smile on my face and tears in my eyes as we went down the hall. We passed a few doctors and nurses on our way to the recovery room, and when they offered smiles and congratulations I had to choke back tears. I still couldn't believe I had labored and naturally delivered a baby with only mild induction medication and no pain medication.
Once we got to our room the nurse and Ben helped me transfer in to the bed, and we got a few initial instructions regarding baby logistics (bassinet had to stay between our beds, the baby must stay in bassinet if he's outside the room, etc.), and then we were finally alone as a family of three.
We stayed in the hospital a few more days and had a really fantastic experience with all the nurses that helped care for me and Max. We also enjoyed visits from family and friends, and cherished the quiet moments when it was just the three of us getting to know each other.
When Thursday rolled around we were discharged from the hospital and were excited to begin life together at home.
And we all lived happily ever after. :-)
