Natural Child Birth, Baby #1

A Natural Childbirth in a Hospital Setting

Getting Ready

I was due on Monday, July 10, with my first baby. I didn’t know if I was having a boy or a girl, and I was very anxious for labor to begin. I had been told, over and over, how most babies are NOT born on their due dates, and that it’s very common for first born babies to be late.

So I was kind of impatient, but kept telling myself just to relax and wait, and to trust that my body would know when the time was right. Thursday before my due date, I was having strong Braxton Hicks contractions, and I left work a couple hours early. I went to my scheduled prenatal appointment and Dr. J. told me, “Any day now!” but she said there was no reason to check my cervix yet.

Friday I went to work (it was my last day before starting maternity leave) and I did not have a single contraction all day! I was disappointed…

Then Saturday I started having a few contractions here and there. They felt like menstrual cramps. On Sunday, I began to lose my mucous plug, and I was getting very excited. By Monday morning, I began to believe my baby might indeed be the rare one who shows up right on time!

Early Labor

Monday morning the contractions were irregular but strong enough to pass the rest of the mucous plug. By noon, they were happening regularly enough that I called my doula, Karen, and told her that I thought I was in early labor. She advised me to keep hydrated, eat lightly, but often, and to get rest. My husband, D., who works from home, kept coming over to the bedroom to check on me. He was finishing up one last project before the baby was to arrive.

During the day Monday I was way too excited to just sleep. With each contraction, I just kept on wondering how much progress I was making, if any. I also did a little nesting here and there. Vacuumed the nursery and ran a load of wash and did the dishes. Nothing major. The contractions were getting closer and closer together as evening arrived.

By about 6 PM I was feeling distracted and irritable. I talked to my mom on the phone and when I told her that I thought I was in labor, but wasn’t really sure, she asked me if the contractions were like anything I’d ever felt before. I admitted that they were not quite like anything I’d ever felt, and she thought I should get over to the hospital ASAP. At that point, the contractions were still 10 to 15 minutes apart, and were about 20 to 30 seconds long each.

I called Karen again, and she advised me to cool my heels at home. She said that since I still could talk through the contractions, I was probably still in early labor and would be more comfortable at home.

I began to have some diarrhea- another sign that labor was indeed in progress. I was hungry and my in-laws came over with dinner for me and D. But I was in a distracted and irritable mood and I didn’t let them come upstairs to the bedroom where I was hiding out. I’m sure they understood.

The pains were getting more intense and closer together, but I was still feeling like I could bear the discomfort without any special treatment. By 9 PM or so, I called Karen once again and asked her what she thought. I was still able to talk through the contractions, and she said I sounded chipper enough that going to the hospital would be premature. Instead, she suggested that I get a hot shower and then try to sleep.

Meanwhile, D. went to bed on Karen’s advice as well. I told him I was doing okay on my own, and that I would wake him if I needed him. I reasoned that he would need some rest if we were going to have a baby in the middle of the night, so I let him sleep until the contractions seemed really close together and I wanted him to time them and to give me emotional support.

Before I woke him up, I got into the shower, and put a little footstool in the shower to sit on. I stayed under the hot water for about an hour! It really felt great on the contractions. I keep thinking, my god, I don’t want to get out of the shower it feels too good! But I was also kind of scared because it seemed like labor was progressing a lot at that point, and I didn’t want to deliver this baby there and then by myself in the shower!

So finally I got out of the shower, and woke D. up. We timed contractions for a while. By now, it was after midnight so we knew that our baby would not be born on her due date. However, we had to give her credit for starting labor so promptly!

Time to Go to the Hospital

After about an hour, I went over to the bathroom and there was a lot of bloody show when I wiped. Bright red blood! It alarmed me. I was not aware that it was normal to have blood come out after the mucous plug had passed,  in the early part of labor.

So we called the doctor, who agreed we should come to the hospital and have my progress monitored and make sure that there were no complications. We called Karen and told her that we were getting ready to go to the hospital, but told her to wait to come because we thought that the doctor would likely check my progress and send me back home. But, if I was to stay in the hospital, we’d call her and ask her to come.

We calmly gathered up our stuff. There was a lot of it– 6 pillows, a birth ball, D’s clothes for the hospital stay, my clothes, the baby’s clothes and diaper bag! We called our parents and told them that the time had come, we were Going To The Hospital. It was exciting for us, and I felt really pumped up that something was really happening. At the same time, I felt a little scared of going to the hospital. I’d wanted to labor at home for as long as possible, but I wasn’t sure where I was in labor yet. I had no idea what was to come.

D. drove nice and slowly to the hospital for me. When the contractions came, I breathed slowly in through my nose, and slowly out through my mouth. This seemed to make them tolerable, and I felt like I was in control.

Getting Admitted to the Hospital

At the emergency room, they admitted me to the hospital in what seemly like a leisurely manner, especially when they heard that it was my first baby. Apparently most first time moms get sent back home– especially in the middle of the night when the attending physicians are not around.

I was wheel chaired up to my room where they introduced me to the resident doctor, Dr. W. I didn’t especially like her, but was anxious for my cervix to be examined so I could find out if I was to go home or to stay. She decided it was appropriate to check my placenta to make sure it was not blocking the cervix (remember the bloody show was why I’d decided to visit the hospital). A quick ultrasound confirmed that the placenta was high up and not at all a problem.

Active Labor

Then she did the internal exam and declared me to be in active labor, as I had dilated to 5 centimeters. I was not going to be sent home– I was staying in the hospital. I was quite excited about this, and we called Karen and told her to come right away. She said she was on her way, and asked if there was anything we needed her to bring, besides her usual labor equipment. I asked her to bring a hoagie, because I was getting really hungry! But of course, the hospital’s policy is “no food.”

Dr. W then came in and asked me if I wanted to get an epidural. No thank you, I said, I think I’m doing fine without one. She seemed sort of surprised, and left the room. Then it was just me and D. for a little while, trying to pass the time. I felt a little silly being in the hospital, but I was glad to know that my baby was fine and that I was progressing.

A nurse came in and said she had to start an IV. I didn’t like that at all, because I wanted to walk around to pass the time and help labor along. I was starting to have some significant back labor, and D. was helping me by pressing on some acupressure points that we’d practiced at home. These points really did provide relief from the pain. We finally agreed to the IV though, because I have tough veins to stick and we didn’t want to be bothered with getting the IV under an emergency circumstance.

By now, I was starving. I really wished I had stayed home longer and eaten more of that chicken salad that my inlaws had brought over! By the time Karen arrived, I was grateful for the assistance. I was having some really strong back labor pains. Because of this, we figured out that the baby was in a posterior position, with the back of her head against my spine.

All about Back Labor

I’m convinced that my baby was posterior for most of my labor. The back pain was awful. I labored a lot on my hands and knees, squatting on a birth ball in a hot shower, and also walking around helped. Also, squatting with one foot on a bench, and the other on the floor, seemed to ease the pain. I followed the pain and did what I could to ease it by changing position. Finally, after one very strange feeling contraction, I felt the baby turn inside of me. After that, the back labor was over, and I began to progress in dilation more.

This was probably why labor turned out to take so long for me. I was at 6 centimeters when Dr. W checked me at 6:30 AM. I don’t remember all of the details of that part of labor clearly. I do remember cracking a lot of jokes and laughing hysterically. I also remember Karen and D. applying a lot of counterpressure to my back. I spent a long time on my hands and knees, and also on the birth ball, squatting. We walked some up and down the halls and I convinced Dr. W. to let me take a shower. She didn’t want to let me take a long shower, because she was afraid I would go through transition! Well, duh, that’s what I was hoping for!

Dr. W. only wanted me in the shower for 5 minutes. What the heck was that? I didn’t need to wash my hair in there, I needed it for pain relief and relaxation. I ended up spending about 15 minutes in there, and then it was back to bed and onto the monitors again. As the morning wore on, I was working pretty hard. I felt like I was progressing. I was checked some time later that morning and had dilated another centimeter. I remember thinking before that, that I was about to go into transition. The nurses said I wasn’t, and Karen and D. just listened to me and asked why I thought that’s where I was? I said, “sudden emotional change!!!” And starting bawling, I mean really sobbing. I did not feel sad. I just felt weird and shaky and like I needed to cry a whole lot. Then I started laughing hysterically. It was a very emotional part of labor for me! I had no particular thoughts going through my mind at that point, just suddenly urges for these expressions of emotion. I can’t recall what was funny– I just felt like laughing, hard. Karen and D. stuck by me. They looked on with what seemed like amazement. Here I was, after many hours of labor, sitting on my birth ball, alternately bawling and cracking up. But, alas, the emotional interlude was not transition.

Transition: Getting from 8 to 10 cm dilated
(The part that hurt)

Transition began around 4:30 PM. I remember this because although I had not been aware of the time for a long while, I was looking at the clock, wondering how much longer I would have to endure the pain. Transition was the cruel part of labor. It was long, intense contractions, one on top of another, that made me howl and bite D. whereever his flesh was exposed to my mouth. I sobbed during this part of labor, I yelled, I moaned and D.  swears I also screamed. This would make sense because it was really quite painful. But I found that screaming did not help with the pain. I was still using the same breathing pattern– as much as I could. When I was breathing out, though, it felt more like I was just forcing air out of me into some kind of arena where air was not welcome. I remember making blowing sounds with each breath, and I remember the way it felt to be trying so hard just to breathe slowly and relax.

Relaxing when you are in such pain is not easy. It seems impossible, in fact. Instead, I would just describe what I was doing as enduring and trying to cope. There were times during transition that I was sobbing, and D. was too. I don’t know what he was feeling at that time. I was not really aware that he was crying until afterwards, and he told me that he cried too. I remember being grateful for his arms holding me, for the smell of his hair close up. I had my arms draped around his shoulders, I think, and I was just hanging on, clinging to him, in hope that it would help me through it. I don’t know if Karen was rubbing my feet or my back, but I remember loving the hot rice sock for quite a long time. (A doula trick: Get a clean, thick, cotton tube sock, and fill it with plain uncooked rice, and tie off one end… microwave it for 2 minutes, and it makes a great hot compress).

I had to get a catheter inserted so I could empty my bladder; it hurt like heck but the fact was, my full bladder was getting in the way of the baby, and vice versa. Because her head was pressing down so hard, it was not physically possible for me to empty my bladder on my own.  Getting that done was one of the more painful moments; it stung a lot.

But having a hot compress felt really good! I remember saying, “PRESS!” When I wanted more pressure and “LOW!” when it needed to be lower, and “HIGH!” when it needed to be higher. ONE syllable was all I’d manage to get out, but in my mind, there were still plenty of words. In between some of the contractions, I still felt HUNGRY! I didn’t get to a point where I felt nauseous like some people describe. I kept thinking of Dr. H. and how she had admonished me that I wouldn’t be thinking of food during labor. Boy, was she wrong! Food was practically all I thought about for most of labor.

However, during transition, I did not feel as hungry. In between contractions, at some point, I did remark “The pain wouldn’t be so bad if I wasn’t so F*CKIN’ HUNGRY!” but that was not during transition. That was earlier.

Anyway, once the evil contractions subsided, I felt ok. I felt like I had weathered a tremendous ordeal, and needed to catch my breath. I also felt a little like pushing, or so I thought. By this time, Dr. J. was on call. She was called away from her sandwich and came and checked my progress. Way to go! I was 10 cms and completely effaced!

Stage Two Labor– Pushing– or “Show Time!”

Well, with that pronouncement, it was show time. Everyone got quite serious. A bassinet was wheeled into the room. I was excited to think I’d soon be supplying that bassinet with a baby! Dr. J. got all dressed up in her scrubs, and a little table of doctor equipment was wheeled to her side. Some of the stuff on her tray scared me. I still did not want an episiotomy, I told the doctor that I’d rather tear a bit, if needed. She agreed to help as much as she could.

Unfortunately, I was expected to push this baby out in the traditional “lithotomy” position, meaning on my back, with my feet in stirrups or else holding up my own legs with my arms. I had been laboring, at that point, for more than 24 hours, if you include the early labor when I was having contractions 10 minutes apart. I’d been on my hands and knees for much of that time. Not to mention the fact that even at my best strength, my legs are darn heavy and my arms not that strong. So that position was uncomfortable to me. I tried, but made no progress like that.

Actually, one really neat thing that I did during that time, was to push hard enough to finally break my bag of waters. When that happened, it was comical. It was a POP and splush! GUSH of water came running out of me. It seemed like everyone cheered, although I got the floor all wet and several nurses were soaked as well. But other than the water breaking, they felt I was taking too long. And I didn’t want to stay in lithotomy; it was too tiring.

So they put together the bed with a squat bar. This also did not really seem to help much. I never thought that so much upper body strength would be needed to have a baby! My arms felt weak, and I felt ineffective. My spirits started to sag. I wanted to be on my hands and knees again, where it felt the most effective to push. So, naturally, the whole team was convinced that I would push like that, at least for a while. That was how I got C. down from 0 station to travel down the birth canal some.

At some point, however, Dr. J. simply said that she did not know how to deliver a baby in that position. I’d made a lot of progress, but still had several more pushes before the baby would be out. It seemed non-negotiable. They turned me back over again.

There was a nurse named Judy who was doing something to me that felt like she was jabbing my vagina with long fingernails. It was irritating but somehow it also helped me to focus on where to push.

After pushing about 15 more times, each one more grueling than the next, her head was showing once again. I reached down, at someone’s urging, and felt the hard top of my baby’s head, just an inch or two inside of me. It was amazing. I can’t remember how it felt, exactly, to have a baby so close to being born, inside of me. It felt strange, uncomfortable, I suppose quite painful. I was very ready for her to come out, then. I just had to find the strength inside of me to push her out at last.

I finally stop talking

At this point, I could not speak at all. I was incapable of articulating anything. I would motion to D., with my hand pointing to my mouth, to give me some ice. One of the nurses had put a little apple juice in my ice so I could enjoy that flavor instead of icky hospital water. I also had a lollipop, though I was forbidden to keep that in my mouth while pushing. I guess it was a choking hazard.

So I was struggling with my energy levels, searching for some hidden source of strength from within. I remember calling out to my ancestors, to dead relatives in the beyond, asking to lend me some of their other-worldly strength. Of course, this was all in my mind, since I truly could not speak a word during the intensity of second stage labor. I really needed help. I was being required to deliver in the lithotomy position, but I could not hold my legs up on my own, and the stirrups of the birthing bed that I was in, were broken. So D. and Karen each took charge of a leg! I pushed with all my strength, into their supporting arms.

To help inspire me to push, the nurses set up a mirror opposite me. I could see myself widening to allow the baby passage. I knew she was going to be born soon, but I was awfully tired. The nurse, I think it was Judy, kept poking at me, trying to get me to focus on pushing out the baby. When a contraction would come, the whole birth ‘team’ would begin to coach me- deep breath, hold it, push! 1-2-3-4-5-6-7-8-9-10! Another breath! Again! Hold it! Push!

And with this ‘purple faced pushing’ I delivered my daughter. I watched as first her head emerged. I saw in the mirror, her tiny head come out and Dr. J. gently cleaned out her nose and mouth. Throughout my pregnancy, I had been convinced somehow that I was carrying a little boy. So, not knowing I had a girl, when I saw her little head, I exclaimed, “There he is!” Then, another little, easy push and out came the rest of her beautiful, bright red little body. She made two tiny little cries, Wah, Wah, and she was plopped down on my (very mushy) stomach, where nurses wiped her down and swaddled her in a baby blanket. She was handed over to me, to nurse. I stared into her alert, wide open blue eyes, marveled at her blond hair, and cried out in wonder: “It’s Mini-me!” laughing in joy and wonder.

She’s here!

I took this tiny, blood covered, meconium stained baby in my arms and tried to apply my limited knowledge of breastfeeding to the hands-on course. At first, I couldn’t get her latched on. I called over to Karen, please help! And she did, she adjusted the angle of the baby’s head, and soon C. was nursing and I was ecstatic. I had my little angel in my arms at last.

D. was soon on the phone, calling our parents to tell them of the birth of their new granddaughter.

The incredible joy of having accomplished the natural childbirth that I wished for, along with the sheer wonder of this new little person in my arms was ample distraction for me as Dr. J. carefully stitched up my small tear. A very funny moment happened when I stopped Dr. J. before she could start working on my tear and I said, sincerely, that although I had wanted a natural childbirth, that I would definitely like some local anesthetic before she stitched me up. She smiled, OF COURSE!!! Did you think I would be so cruel as to sew you up with no anesthetic??? Although I had been completely brave during the long labor and delivery, I was terrified of getting the stitches. I said, wait, how do I know I am numb? Dr. J. said, Can you feel this? Yes, I said, in a terrified and shaky voice. What do you feel, she said. Just pressure, I said. She smiled, and said, well that’s going to be the worse of it- What you are feeling is the needle. Can you handle that? Sure… go ahead, sew me up!

After a while, the nurses wanted to weigh C. and measure her, and do whatever routine things they do to new babies, including assessing her with an Apgar score (9- very good). I felt so alone all of sudden. D. and Karen had gone with the baby to the nursery, and I suddenly realized that I was naked, and even a little chilly. “Someone get me something to cover me with! I am naked!” I had been unaware of being naked during the labor and delivery, but now that it was all over, I was all too self-conscious.

But soon after that, the nurses brought the baby back to me, Karen said goodbye and wished us well, and D. accompanied me to our recovery room. My mother and father in law were waiting to see us. They were thrilled that we had a girl. I was too. When Dr. J. proclaimed, It’s a Girl!, I could not believe it. D. had a double-take too, because he didn’t hear right at that moment, and had to ask for a second answer, do we have a boy or a girl? I remember thinking, oh this is good, we don’t have to concern ourselves with circumcision.

Epilogue

Today as I finish writing down this tale, C. is 4 months old. She is a wonderful baby, and I believe we are truly blessed. The story of her birth will be one that stays with me always.

Second Editing Epilogue

C. is now almost 7 years old.  I nursed her for a total of two and a half years, at which time I weaned her because I was 4 months pregnant with her sister and breastfeeding was no longer working out for me.   I hope to post another page about the birth of C.’s sister, A. at some point in the future. A’s birth was a very easy once compared to C’s birth, and was significantly different as an experience in that it was brief and in a lovely birthing center.

Glossary

0 station:The “station” of the baby refers to where in the birth canal the baby’s head is. It goes from -3 (floating, in the amniotic sac) to 0 to +3, (I think). At +3 station, you could see the top of the baby’s head sticking out of the mom. I am not sure about this exactly- it might actually go to +4. (Whatever. “0 station” means she was smack dab in the middle- her head was some where in the middle of my pelvic bone, and not going anywhere for a while. Yikes!)

acupressure: By applying pressure to specific areas of the body, pain can be relieved.

bag of waters: Also known as the Amniotic sac, which is filled with Amniotic fluid. The fetus lives in this fluid.

birth ball: Also called an exercise ball. This ball is a large rubber ball, inflated enough to be able to support a person sitting on it, or leaning on it. It is a soft place where someone can lean for support.

Braxton Hicks: These are so-called ‘false’ contractions, sort of “practice” for the uterus to contract.

cervix: The cervix is the opening to the uterus. It is like a neck, and has to both thin and open (dilate) to approximately 10 centimeters diameter to allow the fetus’s head to pass through.

dilation: The term is used to describe the opening of the cervix.

doula: A doula is woman trained to support a woman and her partner in labor. She will provide support, massage, encouragement, and information to the couple to help them achieve the birth in the manner that the couple wishes. effaced This term refers to how thin the cervix is.

epidural: The epidural (sometimes called a spinal) is a popular method of anesthesia in which the laboring woman is blocked from feeling anything from the waist down. This means that she will not feel the contractions as pain, but more like pressure. While many women sing the praises of the epidural, it can have dangerous side effects for the fetus and is a risk factor for a C-section. Drugs administered by epidural have also been linked to ’sleepy’ babies who cannot latch onto the breast well in the first days of life.

episiotomy: A controversial procedure which involves the doctor cutting the mother’s perineum in order to allow the baby’s head to pass more quickly through the vagina.

mucous plug: The cervix has a plug which deteriorates and falls away during early labor.

natural childbirth: By natural childbirth, I mean that no drug or surgery was used to give birth to the child.

posterior: The orientation of a fetus in utero can be in several different ways. A posterior baby would have her head facing down, but be rotated so that her back of her head is against the mother’s spine, causing the mother back pain.

transition: Transition is the part of labor in which the cervix dilates from 8 to 10 centimeters.