my birth story, finally! (long)
All through my pregnancy, I had had a ton of Braxton Hicks contractions. Way past the "call if you're having this many in an hour" number (usually 4-5), but towars the end of my pregnancy, they lessened. I had them infrequently and they were uncomfortable, but not painful. I was sure I was going to go way overdue.
I was due Wednesday, November 25th. On Tuesday the 17th I had an appointment with my midwife. I brought up my concerns that Eva was posterior, so she felt around but seemed to think her position was okay. Looking back, I think it was hard for her to tell just as it was for me due to my anterior placenta. I also brought up my concerns that she was very high up but my midwife assured me some babies don't drop until labor. Wednesday the 18th I lost part of my mucus plug. It wasn't bloody, though, so while I was glad that maybe my body was doing something, I wasn't hoping for more than going into labor prior to 42 weeks. I went to work in the evening as usual. Driving back, I felt my first contraction, and I remember thinking, "Oh, so THAT is what a contraction feels like." No big deal, they didn't start coming frequently or anything. I had a few that evening.
Thursday the 19th I woke up in the early morning with diarrhea and what I suspected was my bloody show, or at least the start of it. I wasn't sure, though, because it was brown blood, not red or pink. I had painful contractions on and off all day, and though I had to stop to deal with them, they weren't frequent. That evening, I lost more of my plug and it was tinged red. The contractions started coming more frequently and I started timing them around 7 PM. They were coming every 10-15 mintues and lasting about a minute. I figured I'd be able to go to sleep and that would be that, but I wasn't. By the time my husband got off work around midnight, I was in too much pain to pick him up (I had the car), so I made him take a taxi home. Again, I figured I'd be able to get some sleep since the contractions weren't that frequently, but I was actually up the entire night. The contractions started coming every 5-7 minutes and kept me awake the whole night. My midwives advised to call if contractions keep you up for more than an hour at night, but I was convinced I wasn't in labor so I didn't call. I kept expecting them to stop. Additionally, they were all in my back so I convinced myself I was constipated, and that it hurt so bad because Braxton Hicks must be painful when constipated. (Logically I realized this didn't make a lot of sense since I had had diarrhea that morning, but the contractions weren't picking up in intensity though the frequency had picked up.)
Friday morning the contractions slowed down to about every 7-10 minutes, but they were still very painful and I hadn't slept at all. I decided to call the midwives to see if it sounded like early labor or if they could advise me of something to do to sleep - I had tried the bath, eating, changing position, etc. and none of it was working. Marsha, the midwife on call, asked me to come into the birthing center around 11:30 to be checked and see if things were progressing (I had last been checked at 36 weeks when they did the strep B test, at which point I was high and closed but starting to thin and soften), and if they weren't she could give me a sleeping pill so I could maybe get some sleep. I got to the birthing center but Marsha was running late. Regina was there, though, and she offered to see me, which was convenient because she was the only one of the 5 midwives I hadn't met, and she was also the first on-call midwife for the evening. She checked me and I was 80% effaced and 1.5 cm dilated. Of course, I ended up not contracting the entire time I was in the exam room so she couldn't feel for that. She said, like Marsha had on the phone, that it sounded like early labor, but it could be several more days. I wasn't convinced and thought about how I always heard of people being at 1.5 for weeks, and figured I'd have weeks to go. I was mentally panicking at the thought of contracting every 5-7 minutes for three more weeks, but Regina assured me that was unlikely. She prescribed me Ambien and told me I could take it for day or evening sleep (though the idea she and Marsha had was during the day). She prescribed me half a dose and if it didn't work, take another one after an hour. (Due to the fact that I'm very small, she didn't think I'd need a full dose.) She told me if it wasn't labor I'd be able to get some sleep and my contractions would probably slow, and if I was really in labor I probably wouldn't be able to fall asleep but it might relax me so labor could progress.
I went home but I didn't fill the script then because I was in too much pain to stop at the pharmacy and wait. My husband was supposed to work until midnight but he got his evening shift covered and came home at 4. He cooked dinner which I felt too nauseated to eat (all I had eaten that day was a pancake), and we went to the supermarket to get my script filled. I also bought Colace, still convinced I was constipated. We came home and I took the Colace and drank some orange juice, hoping to get things moving there, and then I took the Ambien. One made me groggy, but no dice - I was still contracting at 5 minutes apart. Each time I was almost asleep, I'd have a contraction. I kept running to the bathroom with each one to labor on the toilet, convinced I needed to have a bowel movement. After an hour I took a second Ambien which made me groggier and really confused, but still no sleep. I was up every 5-7 minutes until about 2 am on Saturday. Around 2 am I was in the bathroom, squatting through a contraction, when a gush of water came out. It landed on my sweatpants, which were pink, so I couldn't really tell what it looked like but when I wiped it was straw-colored and it smelled sweetish. I woke Carlos up and told him I thought my water had broken and that I was calling the midwife. He seemed skeptical (I don't blame him, after two days I was too). He ended up mostly speaking to her because I was contracting. Regina thought the best course of action was to come to the birthing center so she could see what was going on. With the risk of my water being broken I agreed, since I was worried about cord prolapse with the baby being so high up, though she was moving fine.
We met Regina at the birthing center around 3:15 and got settled in. Carlos called Katie, my sister. Regina told me she had already called Lori, my birthing assitant, and she got there not long after along with a student she was training. Regina gave me a long q-tip swab thing and said it would turn blue if what I was leaking was (most likely) amniotic fluid, and it turned blue right away. It was set - we were staying. I labored on the bed over the birthing ball and against the bed railing for a couple of hours. I alternated with sitting in the rocking chair with my back against a heating pad, since I was still having back labor. My sister arrived around 4:30 or so, and my mother came around 7:00. My contractions started slowing down around 6:30 or so while sitting in the rocker, which I really think was at least partially because I was starting to get scared, I was exhausted, and I had already been laboring for days and felt like nothing was ever going to happen. Regina came to talk to me about trying different things to get them going again, like nipple stim and walking. We went outside at 7:40 to walk around. The birthing center is in the historic center of town, so it was really pretty to walk around (even if I did scare a little kid)! I threw up once outside, and I just remember my husband having to direct me NOT to vomit in someone's yard. We came back inside around 8 and then walked around the birthing center starting around 8:20. Around 9:20 Regina suggested maybe it would be better if we tried the nipple stim since she thought the socializing might be overwhelming, so my sister and mother decided to go to the movies and Carlos and I decided to try nipple stimulation. We did the nipple stim for about 30 minutes and I threw up again around 9:40, but my contractions didn't pick up again.
I hadn't eaten almost anything in days, so arond 11:15 I tried eating. We had eggs and a muffin but I could only manage a few bites. At 12:15 we went and walked around the birthing center again, but contractions still didn't pick up. We had avoided vaginal exams up until that point due to my water having broken, but we decided to do one then to see if the contractions had made any progress and decide where to go from there. I also consented to a stretch and sweep in hopes of getting things moved along. The policy with the birth center was that I had to be pretty close to delivery within 24 hours of my water breaking, and at this point I had been painfully contracting for days. I was 100% effaced and 3.5 cm dilated, which she was able to stretch to a 4. Baby was still at a -2 station, and Regina said my water was just leaking, not fully broken as she could still feel the sac over the baby's head. At that point Regina talked to me about options to get labor going again since by then my contractions were coming 15 minutes apart and I was falling asleep between them. I didn't feel comfortable going home with my water broken since baby was not engaged. We decided on castor oil to see if that got things moving, and that way we still had the option of Cervadil later if needed. I took the castor oil with ginger ale and orange juice around 1:30. It didn't taste that bad going down but I was nauseous so it was hard not to throw it back up in the next several hours.
For awhile, nothing happened. Finally around 3:00 I started feeling stomach cramps and I had diarrhea at 3:45. This was somewhat of a relief since I still felt somewhat constipated, and the contractions were also making it difficult to urinate. Of course, after the first time I went, there was no more relief, and then it was just painful to contract, have diarrhea, and feel like I needed to vomit. Contractions picked up again around 4:00. Around 5:30 my bowels were empty and I went to lay down on the bed and then labored on the ball for a bit. These were anamolies, throughout almost my entire labor I had my hands on the bed frame, rocking back and forth and vocalizing, sometimes squatting - it was the most comfortable position for all the back pain. I pulled the frame so hard that Lori, Carlos, and Regina had to pull it the other way to keep it from cracking or moving.
We did another cervical check at 6:15 since contractions had picked back up and I was 100% effaced, 8 cm dilated, and baby was still at a -2 station. Around 6:45 I stopped feeling so much back pain and started feeling them more in my pelvis, though the back pain came back some later. Around 7 my contractions were really intense - one on top of another, and still very long (they had been 90 seconds - 2 minutes throughout active labor, partially because I was frequently having 2 contractons back to back) and Regina told me I might find myself spontaneously bearing down soon. I didn't believe her, but sure enough, a couple of contractions later I was sitting on the birthing ball and that's exactly what happened. It wasn't exactly an urge to push, just a need to bear down to get through the contraction. I started pushing officially at 7:05 PM. At 7:15 Regina suggested I try to urinate since it would only get more difficult but I found I couldn't at all anymore.
I labored and pushed in a variety of positions - squatting, on the toilet, on the bed, etc. Regina was really good about suggesting different positions peridocially to help things along. Some of them I knew were beneficial - ie squatting - but were so painful I found I couldn't. I found myself increasingly frustrated, especially when another woman who had come in much later than me (around 4 or so) gave birth about 4 hours after being there, barely having to push at all (of course, she was on her 5th child, but I could hear her from the next room and hear her baby and I just felt like I was NEVER going to have my baby). Thankfully, after the first 15 minutes when I felt I had been pushing forever only to be told it was only 15 minutes, I lost track of time so though I knew it had been awhile, I didn't really know how long. (Luckily for me the EVERYTHING is documented with the birth center, so I can look at my labor and birth flow sheet to see when things happened!) At 8:20 Regina did one more vaginal exam to make sure I was fully dilated, so that I wasn't wasting energy pushing if I wasn't and so that if I wasn't she could suggest better positions to help move the rest of the cervix out of the way. There was just a lip of cervix left - she said she'd call me 9 3/4 cm - but it moved out of the way easily when I pushed so she said I could continue pushing.
At 9:30 she tried to place a rubber catheter just to drain my bladder quickly, hoping that would help me to push more effectively, but baby's head was in the way so it failed. She also noted that at that point, the baby was right occipital posterior. I swore I wouldn't labor laying down but found myself doing that a lot towards the end due to sheer exhaustion. Fortunately Regina and Lori were there to remind me to switch it up and helped me rotate sides and positions to get her rotated and past my pelvic bone. 9:30 was also when they could first just barely see the head. At 10:35 we started doing the tug-of-war pull, where I laid down and Lori held the end of this jet ski-like rope and I pulled the other end with each push while Carlos and the other birth assistant (I think, I can't even remember anymore) helped pull my legs back. At 11:00 I labored on the toilet again. I just remember the pain being so excrutiating, and thinking she was never going to come out. I kept suggesting to everyone that maybe she was stuck, maybe her head was too big, etc. and they kept reminding me about transition and how feeling like I wanted to quit was normal and that babies heads were rarely too large, OBs were just c-section happy. I also remember freaking out and thinking she wasn't coming down at all because I could still feel her up under my ribs but Regina assured me that babies stretch out when they're coming down and that she was coming down, and reminded me that she had felt her head lower, etc. I felt somewhat better once they could see her head, though Carlos told me later it was just barely when I pushed and that he too had started to doubt if she was ever coming out.
Towards the end, I found myself alternating between sleeping between contractions on the bed and later crying between them, thinking I just couldn't do it any longer. At 11:15 I laid on my side on the bed to push and we also did the tug-of-war pull some more. Like I said, I was so sure I wouldn't birth reclined because I knew it was counterproductive but it ended up working. Finally, I started feeling her head coming out but it was SO SLOW and kept going back in. I would push as hard as I could and think there was no way I could push anymore, only to have her slip back in. Sometimes I would have contractions that would start up and then fade away before I could really get any good pushes in. I could barely see because the blood vessels were popping in my eyes from pushing so hard and my face was completely swollen. I ended up laying down with an ice pack over my eyes. At some point the birth assistant went to get my mother and sister, which made me feel better because we had agreed they'd get them just for the birth so I knew it must be soon. Regina helped me a couple of times to feel her head during a contraction but I didn't really know what I was feeling for. When she finally started to come out, Regina asked me if I wanted to look and though I did I remember yelling, "No!" because the effort to move into a position to see during a contraction, not to mention open my eyes, was just too much. I knew we were getting close when Regina started explaining to me how she was going to put pressure on my perineum with olive oil and that it was important to let the head come out slowly, so even though it was hard I needed to breathe through a couple of contractions when she told me to allow the head to come out without tearing. She also told my husband to watch where he was standing because there would be a big splash.
I ended up not needing to breathe through a couple of contractions - once her head finally got past a certain point it just came out, and then she told me to push again and her shoulder would be out and then the rest of her would slip out, which I didn't believe at ALL but it was true. Her head came out and they checked for the cord, which was loosely around her body but not around her neck and not posing any risk (I kept asking in panic!), and then I pushed again and out came her shoulder and then the rest of her, and then next thing I knew they were telling me she was here and I could reach down and grab her. I expected to cry but I was so overwhelmed and exhausted all I could do was look at her.
She was born at midnight exactly on Sunday, November 22nd. Her head was significantly molded because she came out anterior, which I'm told is also why labor and pushing took so long - she was posterior, and turned in the birth canal. She was tiny but healthy - 5 lbs 6 oz and 19.5 inches. The umbilical cord stopped pulsing after a bit and Carlos cut it. At 12:15 Regina suggested I give a practice push while she held the umbilical cord to see if the placenta would just come out, and much to my surprise, it just slipped out. She said it was slightly smaller than normal but that wasn't cause for concern since Eva was also small. Her Apgars were 8 and 9 and my blood loss was low, less than they usually see, she said. I expected to be all ripped up from so much pushing and pain and pressure, but all I had was one first-degree tear, a periurethral laceration (though unpleasant to heal since it kept reopening).
I finally ate something, relaxed, was able to use the bathroom, took a quick shower, they examined both of us, and we left and went home around 3 AM.
In the end, it was a LONG labor but I am SO glad we went with midwives and the birthing center - chances are at a hospital I would not have been allowed to labor that long, they would have augmented with pitocin, not castor oil, with the severe pain I was in I probably would have caved and asked for an epidural (believe me, I thought about it but the idea of going anywhere to get something was worse than anything else), and I doubt I would have been allowed to push for 5 hours with her not engaged in my pelvis. (Fortunately, Eva was a real tropper, and her heartrate never fluctuated out of normal range throughout my entire labor.)
An hour or so after birth ... you can see how molded her head is!
A couple days old. Don't be fooled, she is not a fan of this bouncer!