First let me start by saying that my husband, Mike, and I prepared for Téa's birth by taking Bradley Method® classes starting in about my fourth month of pregnancy. We also read tons of books, one of my favorites being The Birth Book by Dr. and Martha Sears. We knew just how we wanted this birth to go and had the birth plan to prove it! We got almost exactly the birth we wanted…
October 12th, a Friday, was my due date according to the doctors' and midwives' reckoning. It came and went without much ado. (Since I knew exactly when I ovulated, I figured my due date to be October 15th.)On the next day, Saturday, Mike and I decided to try a certain "natural induction technique" (intercourse!). I went to sleep that night with mild contractions, but they stopped after an hour or so. I woke up the middle of that night to use the bathroom (big surprise - nine-month-pregnant lady getting up to go potty!) and when I wiped there was a pink-streaked mucousy blob on the toilet paper. "Hooray," I thought, "It's my mucous plug!!!" I would have performed a jig in the bathroom had my considerable girth not prevented me. The next evening, I apparently was nesting, since I felt the need to bake an apple pie from scratch. I again went to bed with some mild contractions, but nothing I couldn't sleep through. "More Braxton-Hicks," I thought. This was about 11 p.m. I awoke at about 1 a.m. with contractions I could no longer sleep through. I wondered if this might be it! I was feeling very smug that I seemed to be going into labor on what I knew to be my TRUE due date! I awoke Mike and told him about the contractions and that I was going to go watch TV since I couldn't sleep anymore. Let me tell you, there's not much on TV at one o'clock in the morning! We had the Disney Channel at the time and I ended up watching Davy Crockett - wow is that ever un-p.c.!
Mike got up too, and made me some oatmeal to eat. Meanwhile, I discovered that even as early in labor as I was, sitting on the birth ball was a Very Good Thing. At this point, my contractions were five minutes apart, but I knew it was still quite early in labor because I could still talk through the contractions, although it was more pleasant not to.
At about 3 a.m., the contractions were continuing on as they had been, so I decided to call my doula, Brigitte (who was also my Bradley instructor), since she wanted to know as early as possible when labor started. I dialed the wrong number the first time and woke some poor guy up! When I got a hold of Brigitte, she suggested trying to get some more sleep, even if it was just between contractions. So Mike covered the rocking chair with plastic bags and towels in case my water broke (new rocking chair with nice padding - didn't want it ruined!) and I slept there while he camped out on the floor near me. I woke up with every contraction (they were still about five minutes apart), but at least I got a little more rest. I slept a couple of hours, if I remember this part correctly.
When it was light out, Mike and I decided to do some walking, as my contractions were now starting to space apart more. We just walked up and down our large backyard several times. This didn't seem to bring the contractions closer together.
By noon, the contractions had become very irregular (12 min, 5 min, 7 min, etc.) but were lasting about two minutes each. We decided to let our midwife, Roberta, know what was going on and see if Brigitte wanted to come over now. She did come, and made us sleep some more! Again, I woke up with every contraction, but at least they were a little farther apart now. She also fixed me some eggs to eat.
During all of this time, if I wasn't trying to sleep or taking a walk, I was sitting on the birth ball during contractions. Mike, and later Brigitte and my sister-in-law Shannon, would apply pressure to my lower back. They also used heating pads and rice socks. This felt great. I was also using the Bradley relaxation techniques to completely relax my whole body and tune into what my body was trying to do with each contraction. I would try to picture my cervix opening up to make way for my baby to be born.
Some time in the early afternoon, we called Shannon and she came over to help out. We had also earlier let my Mom know that labor seemed to be beginning and that we would keep her posted. My contractions were still kind of all over the place as far as how they were spaced out, so we weren't really sure what was going on. They were getting harder, though, so we were pretty sure this was the real thing. Brigitte tried massaging my feet, focusing on pressure points which are known to trigger labor to help move things along and get the contractions more regular. This felt great, but it didn't seem to help much. I was actually eagerly anticipating each contraction. I didn't want this to peter out and not be "real" labor. I was truly glad when I would feel another contraction coming on and it got strong.
I'm sure if I had been at the hospital at this point, my labor would have been considered to have "stalled", and I would have been pressured to accept an intervention like pitocin or a prostaglandin gel. I am really glad I had stayed home to labor and also that Mike and I had gone through Bradley classes, because later I realized that I was on what the Bradley Method calls a "natural alignment plateau". I wasn't dilating as quickly as a "textbook" laborer, but things were happening in my body and mind that needed to take place in order for me to be ready to give birth.
Brigitte convinced me to try taking a shower and see if that helped things along. I was initially not going to do this or use the labor tub, because due to my dry skin and eczema, and also a rash called Pruritic Papules and Plaques of Pregnancy(say that five times fast), I often found my skin unbearably itchy after a bath or shower. She convinced me to try it, though, and boy was I glad she did. It felt so good to stand with my back in the stream between contractions and to turn and put my belly under the stream of water during them. Mike stood right outside the shower with me and talked me through things. I should mention that aside from when Brigitte was rubbing my feet (during this time Mike ate lunch), Mike was at my side through my entire labor. He covered our windows with cardboard to darken the rooms and put in relaxation CDs so that I could labor in a dark, peaceful environment. (Shannon took over the CD rotation when she got to my house.) He talked me through every contraction, helping me to relax every muscle in my body to get out of the way and let my uterus do its work with the contractions. He massaged my back, applied counter pressure during contractions, rubbed my shoulders, brought me water and made sure I drank a few sips with every contraction, etc. He was a truly wonderful coach.
By the time I was done with the shower, we were well into the evening. I was so unsure about whether to go to the hospital or not. It seemed like I had been laboring so long, but I didn't seem to be deep into the active phase yet. Brigitte asked me how far along I thought I was. I guessed five centimeters, six at the max, and Brigitte agreed with my estimation. I was hard to read because I was having long, intense contractions, but they were at irregular intervals, and emotionally, I didn't seem like someone who was deep into labor. Between contractions I was still chatting happily and trying to make sure that the pie I had baked the night before got eaten. I ate a piece myself probably at about 8 p.m.
Brigitte presented to me her idea for a strategy. We could call my Mom and tell her it was (finally) time for her to come over, and have her stop and buy an enema on her way here. I would administer the enema to myself and then (after its obvious effect had taken place) we would go to the hospital. I agreed to try it. The reason for the enema is that often they speed labor along (or can even induce it sometimes). This is because the cramping they cause is not limited to the intestines but affects other organs of the abdomen too, including the uterus. So Mom came over and brought two enemas (she wasn't sure what kind we wanted) but forgot to get herself a disposable camera. So she left to get one while I did the enema thing. Although Mike had been by my side constantly, I preferred to be in the bathroom alone for this!! I commented to Brigitte that this was the most un-dignified thing I had ever done! She laughed and told me to just wait and see how un-dignified things could get!
After the enema, it took us a while to figure out what cars to take and pack the cars, etc., so we didn't actually get out the door until about 9:30. At this point the contractions had really picked up due to the effect of the enema. I had to stop and sit on the birth ball a few times on the way to the cars! Brigitte pointed out afterward that there was probably a psychosomatic component to the contractions coming on faster as well, since we were on our way to the hospital and likely I subconsciously felt safer and that I could go ahead and have this baby. Mike and I rode with Brigitte in her van and during the 45 minute drive to the hospital, the contractions got stronger and more frequent. I was still chatting it up between them though.
When we arrived at the hospital, Brigitte offered to drop Mike and I off at the front door and go park the van. (The midwifery practice does not tell patients to go to the emergency department, nor do they require them to go to the ob triage. Midwifery patients can go straight to their room!) I declined the front door/wheelchair option and said that I wanted to walk in myself and could walk from the parking garage, since I knew that walking can help keep the contractions coming, and I didn't want them to slow down now that I was in a good pattern. This proved to be the wrong decision, since just about the moment we parked, the mother of all contractions hit. At least that's what I called it in my head. Out loud, all I did was moan so loudly you wouldn't believe it. I had been using "sounding", better known as moaning, for quite some time and found it an effective way to deal with the contractions, but this time Brigitte and Mike could both tell right away that this contraction was different from my volume and intensity! Brigitte told me to get on my hands and knees, so I did, on the back seat of her minivan. It helped with the intensity of the contraction. So began transition. Shannon later told me that I shouted, "I am NOT doing transition in the parking lot!!"
I was still determined to walk to my room myself. So I did walk a few feet, but that's it! My contractions were "camelbacking", coming one on top of another and/or double-peaking, while I walked, and each time one hit, I had to sit on the birth ball and hold perfectly still. It would have taken us at least an hour to get up to the birthing unit at that rate! Thankfully, someone had irresponsibly left a wheelchair in the parking garage, so we used that. Unfortunately, it was a "double wide", made for a person much larger than I am, and Brigitte found it difficult to maneuver! So into the hospital we went, me moaning very loudly, Brigitte trying to push this unwieldy wheel chair, and Mike, Mom, and Shannon following up carrying all sorts of bags, pillows, and of course, my beloved birth ball.
On the way in, hospital employees and visitors alike were giving me concerned and alarmed looks. One woman, who looked like a nurse, asked, "Do you need any help?" I turned to her and said very seriously and impatiently, "I'M HAVING A BABY", a fact that was rather obvious.
Brigitte sent Mom up ahead to alert the nurses on the labor floor that I was coming and to start filling the tub for me. We followed a couple of minutes behind. Even people who worked in the "family maternity center" were looking at me funny. I remember thinking to myself, "What, haven't you ever seen a woman in labor?" (Actually, since most people do not choose to labor at home like we did, and since well over 90% of this hospital's - and all of the other area hospitals' - patients receive epidurals in labor, they probably rarely see a woman unmedicated and in transition, and just arriving at the hospital at this late stage!)
Mom had been delayed by the labor nurse, who was insisting that I be put on the fetal monitor for a 20 minute strip, so the tub had not been filled. Mom was politely trying to explain to the nurse that we did not want to use the fetal monitor. This was part of our birth plan and had been approved by all of the six midwives in our practice. Brigitte ran up ahead to see what the holdup was and explained once again to the nurse our wishes. She came back and said, "She wants you to do a one-minute strip." I yelled down the hall, "NO WAY! NO MONITOR!!! THE MIDWIVES SAID I DIDN'T NEED IT!" Brigitte just said to the nurse, "Well, you heard her!" So did the rest of the unit, I think!
We came into the room, and I needed to use the toilet. We rushed right past the dismayed nurse (who's shift thankfully ended ten minutes later) and into the bathroom. While I used the toilet, Brigitte was trying to fill the tub, but couldn't figure out how to do it. Thankfully, at this time, Roberta arrived and showed Brigitte how the controls for the tub worked, and then I got in. At first I didn't like it, because the Jacuzzi jets were on high. Someone turned them down for me and then I decided that the tub was a wonderful, wonderful thing. Mike stayed by my head, stroking my face, back, and arms, and Brigitte used a bed pan to pour water over my belly during contractions. (I was on my side, but the tub just wasn't deep enough to get my whole belly in.) Mom and Shannon were taking pictures. I really wanted pictures of my labor! While I was in the tub, Roberta was checking the baby's heartbeat with the doptone, a small ultrasound device.
Somewhere during this time, the contractions changed again. My "sounding" changed, too. For that contraction, I started out at the tone I had been using right along, but then my voice deepened and I almost sounded like I was grunting. Roberta asked if this was the first time I did that, and Brigitte and Mike looked at her knowingly and said that it was. They all knew that I had started pushing, but I didn't realize it yet.
I pushed in the tub for quite a while, and then my water broke. What a strange feeling! And even though it took place under water, everyone in the room could hear the pop! Unfortunately, the amniotic fluid was heavily stained with meconium. After a few more pushes, Roberta wanted me to get out of the tub. With Mike's help, I did. Then she wanted to check my cervix to make sure it was fully dilated. I refused at first! I was so afraid it would hurt. (I know, I know, I was already in terrific pain, what would a vaginal exam hurt? But I didn't want any more pain!) Mike and Brigitte convinced me that the exam wasn't such a bad idea, so I consented. At this point, I was sitting on the toilet again (which felt great - next best thing to the tub) so Roberta checked me right there. She wasn't able to check my cervix, however, because there was a HEAD in the way! "Yippee!" I thought, "This is moving right along!" Next came the trip to the bed. Mike helped me all the way there, and during a contraction, I put my arms around his neck and went limp, hanging all of my weight from him. Poor guy! But he was so great. Once there, I declined the squat bar that I had planned to use, assumed a side-lying position, grasping the rails on the bed for dear life, and pushed with all of my might with every contraction. Roberta set the monitor on my belly but did not put the band around me, so I could still move around. This was ok with us because the meconium had introduced a risk factor - it can sometimes be indicative of fetal distress. We had planned ahead of time to use self-directed pushing(rather than the "hold-your-breath-and-count-to-ten" method), since this is better for mother and baby and generally more effective. In what seemed like no time, my baby was crowning! I was so happy, because everything I had heard and read said that when the baby crowned, there was one more (excruciating) pain and then it was all over. My little baby, however, continued to crown for another half an hour! Someone told me to open my eyes and focus on Mike, which helped me push more effectively. He kept encouraging me! During this time, I got a painful muscle spasm in my hip! I was writhing in pain, and no one knew what to do for me. No one, that is, except Mom, who kept saying, "Get her on her back!" Roberta and Brigitte didn't think this would work, but they did it anyway, and the spasm went away. Phew! Now I continued pushing in the "classic c" position. Brigitte provided perineal support while I pushed to help avoid tearing. Shannon kept her supplied with warm wet washcloths.
Finally Roberta said, "She's almost out," and I responded, "You told me that an hour ago!" (It was really only half an hour, but I didn't have a very accurate concept of time right then.) She said that this time it was true! She told me to push gently and lo and behold, a few seconds later, there was my baby lying on the bed in front of me! It was 1:31 a.m. It turns out that the reason she took so long to crown was that her hand was in a little fist pushed up against her face. I'm glad for that though, because the cord was also wrapped around her neck, but since her hand was by her face, her arm was up and between the cord and her neck, which kept it from tightening around her neck. To get her to come out, Roberta had reached in and flattened her hand, but her elbow still was sticking out and resulted in a large tear.
A little aside about Téa's birth… My dad was waiting outside the room while all of this was going on, as were a couple members of the pediatric staff since there was meconium in the water, and he of course heard me grunting and pushing. He said that at the end, you could hear me yelling at the top of my lungs while she came out, then dead silence, and then me saying, "OH MY GOODNESS! OH MY GOODNESS!!" Everyone in the hallway cracked up!
Unfortunately, Téa was taken over to the pediatricians for a few minutes while they suctioned her lungs to get the meconium out. Next time, I will include in my birth plan that any suctioning should take place while I hold my baby. Since they had her over there anyway, they weighed and measured her. She weighted 8lbs, 0.4oz., and was 20 ½ inches long. We had included in the birth plan that they should wait until after bonding to do this, so we were very disappointed that this request wasn't followed. But anyway, a few minutes later, Téa Shannon was handed to me and she nursed a little bit. She was so beautiful I could hardly believe it! I was so exhausted but so happy. It's hard to describe.
At this point there were some complications. I delivered the placenta (without artificial help like pitocin), but even though I was nursing the baby and Brigitte was stimulating pressure points for contractions, my uterus wouldn't contract, and I was hemorrhaging. This was possibly due to the fibroid that I had had throughout my pregnancy and which was behind the site where the placenta had been attached. It became necessary for me to receive a dose of pitocin. (I was happy, though, that if I was going to receive medication, it wasn't until after my baby was born.) Unfortunately, my uterus still wasn't contracting, and I received a dose of Methergine. Still no results. During this time, Roberta was vigorously massaging my abdomen to encourage the uterus to contract and shrink up, two surgical residents were working on stitching up my third degree tear, and nurses (unsuccessfully) and later an anesthesiologist (successfully) were trying to get an IV into my arm so I could receive IV fluids and more pitocin. This seemed to me to go on for quite a long time. Mike was meanwhile holding Téa, and I could see her gazing up at him with her calm, alert, blue eyes, seemingly fascinated with the face that went with the voice she had been hearing for so long. I said to my mom, "She really is beautiful, isn't she?" I thought she was the prettiest newborn I had ever seen.
Finally the bleeding slowed to a normal rate and they were done stitching me up, and I got to hold Téa again. This time she nursed even better than before, and I was able to focus on her more. It was amazing to be so in love with someone I had just seen for the first time.
It took me some time to recover from the hemorrhage, but I was able to go home two days later. Now Téa is 5 ½ months old and I can't believe how time has flown. She is such a wonderful blessing and the light of our lives!