February 10th came and went. This in and of itself was startling to both of us. I realized that I had been thinking of this baby as a soufflé that would be ready on Monday, all we had to do was not open the oven door until then.
And then it was Tuesday.
When Friday rolled around my parents had been in town for one full week. They were antsy, talking to my stomach promising its contents trips to Disneyworld and junk food, and asking me each day where the baby was. I felt awful for them because it was becoming increasingly possible that they would miss this little one’s birth altogether. (That alone kept me from arguing the semantics of their where is the baby inquiry.) They had flown out to San Francisco from Philly so they could be among the first to welcome their new grand baby to the world, but their return flight was set for Wednesday the 19th, and paying a change fee and extending their lodging was not an option. It had to be now. No pressure.
They heard that pineapples help induce labor. Pineapple made its way into our lunch the next day. My mom swears ice cream was what started her labor with me. They brought us ice cream. This pattern continued.
On Sunday I commenced Operation Walk That Baby Out. Jim, my folks and I set out on a walk through Golden Gate Park, with the goal being to reach the ocean, nightfall, or total exhaustion, and kick off the baby ‘s exit. As we walked — slowly because at 9+ months pregnant that was the best I could do — I joked that I was conducting a tour of the park’s restroom facilities, stopping in and testing each one. (The baby was crushing my bladder at this point.)
At my last checkup with my midwife, three days after the baby’s due date, I learned that I was 1 centimeter dilated. “Game on,” I thought. Once I had that piece of information, the stabbing feeling I’d been having made sense. That’s how I was able to recognize what was happening as we walked through Golden Gate Park. We stopped at the Science Center restrooms. The Stow Lake restrooms. The restrooms just past the lake where the old Asian men pilot remote controlled boats. “This one even has soap!” I’d proclaim exiting the facilities and giving it a rating as my parents and Jim waited patiently to resume our jaunt. I pulled Jim aside. “There’s stuff going on down there,” I believe was the eloquent way I phrased it, “There’s blood.”
This hypothesis stayed just between us, but I suggested to my folks that we catch a bus back home since the sun would be setting soon. Jim, sticking to our original plan, asked my folks if they’d like to join us at our place for dinner at 7:30. I quickly interjected and said we should play that by ear and see how I feel. We’d call them. I knew there was no way in hell I was making it to dinner.
We got home just in time. I had started leaking amniotic fluid. Back and forth to the bathroom I scurried, horribly embarrassed and wondering if I might just be peeing. I vetoed Jim’s elaborate dinner menu in favor of something simpler. Pretty much just as the butter hit the pan for our grilled cheeses my water hit the floor. “There’s no way that’s pee, baby,” Jim assured me and ran to get towels. I ran back to the bathroom.
Oh my God, this is it.
Jim called the hospital and texted our doula. Minutes later we were in the car en route to UCSF. Bags. Birth ball. Pillows. Cord blood donation kit. We pulled up out front and slid the “Woman in Labor” sign onto the dash. I can’t remember what the hold up was, but I remember having contractions leaning up against the car, leaking more amniotic fluid through my tights.
They were admitting us. Normally the hospital just does a check to make sure the baby is alright and then sends you home at this stage, but for us the baby wasn’t for certain alright. Every few contractions the baby’s heart rate went down a bit, so they wanted to keep us around to monitor him/her. I remember looking down at the mat the nurse had slipped beneath my feet and seeing the blood and amniotic fluid trickling out. Jim brought me a juice. It was horribly sweet and we made fun of its unnatural color, unaware that I’d drink gallons of that stuff before we’d leave the hospital. It was 7:30.
Things picked up from there. They moved us to another room just down the hall. Contractions started intensifying and coming more closely together. Alli, our doula arrived. The last thing I had eaten was an apple with peanut butter half a day ago. I tried to eat some Goldfish crackers just to have something in my stomach but because the contractions had gotten stronger nothing would stay down. Like checking on a loved one, I repeatedly asked to make sure the vomit bag was within reach. Somewhere along the way someone had slipped a hospital gown over my clothes. Jim stayed by my side reminding me how much he loves me.
My field of vision narrowed and came in tight as my body and mind began to focus on the barest essentials of the gargantuan task at hand. Breathe. Conserve. Summon what you need from within and don’t be thrown by what’s going on around you. Breathe. Block out distractors. So far, so good — we were on track with our birth plan of bringing our little one into the world with as little medical intervention as possible. I drew from the prenatal yoga classes I had taken. Breathe.
Monday, 3am. They wheeled me down the hall into the birthing room. Contractions had stepped up even more. I was so very hungry. I continued to block out unnecessary things around me, and the hospital staff seemed to understand if I didn’t greet them or verbally respond when I was in the middle of a contraction. That was what Jim and Alli were for. They protected me as I slipped into a different mental space, responded to nurses and doctors, help me stick to the plan we had laid out for the birth and reevaluate if and when it became necessary.
The nurses wanted to insert an IV port. I can’t remember how long I fought them on this, nor when I finally allowed them to do it, but this insertion and subsequent IV feeding were the first deviation from our plan. I hadn’t eaten in a day. Even I could admit that I needed a source of nourishment. So they hooked me up. I had been resistant because I wanted to keep my mobility, and because, to be perfectly frank, although I can donate blood like a champ I can’t look at the damn needle while it’s in me. I just can’t. I didn’t want to risk seeing my hand and then passing out, waking up to find they had done who knows what to get me stabilized. But I hadn’t eaten. And since I couldn’t keep food down this was the only way I’d be able to keep up my energy. So they inserted the port and connected me to the IV, and promised that I could still move around the room. They would work with me.
In the next birthing room a woman was screaming bloody murder to give her drugs and, “get it out get it out, I can’t do this, get it out!” I seriously had never heard anyone yell like that before. The contrast between what was going on in there and what was going on in our room was dramatic, but from the handful of times when my breathing started to get ahead of me I could easily understand how things could get to that point. In those instances however, I was fortunate enough to have a husband assuredly holding my shoulder and a doula modeling the slower paced breathing I needed to get back to. Slow. Deliberate. Long. A good team was essential to maintaining this calm, positive atmosphere. They helped me rein it in and stay in charge. Hearing the woman next door continue to scream was uncomfortable, to be sure, but it was also a reminder of how important it was to stay focused and in control. I was not going to be that woman.
We had a constant flow of people coming in and out of our room, as staff shifts kept ending and beginning…and there I was, still in labor. We met excellent nurses and doctors, but as it turned out, the midwife who was on call that night (it had been our plan to work with a midwife) was the only one all along I really had hoped we didn’t get. Her personality was incompatible with the peaceful atmosphere I wanted to create for our child’s arrival. I whispered to Jim, “I like the doctor better,” and Jim and Alli saw to it that that midwife did not set foot back in our room for the duration.
I had quickly dilated from 1 to 6 centimeters, but then after several more hours of contractions we were still at the same place — numerically speaking, at least. The medical staff was alarmed. Jim, Alli, and I managed to hold them off as long as possible, but eventually they recommended starting me on Pitocin, the drug I had specifically requested not to have. My hackles raised. No.
Pitocin is medicine’s synthetic version of the body’s natural Oxytocin, a chemical in the brain that, among other things, promotes bonding and facilitates birth. In short, Pitocin speeds things along. The trouble with this drug, however, is that it often does so at a pace and intensity that are too much for the mother-to-be and it does not allow natural endorphin levels to increase. Contractions come harder, faster, and much closer together than they would have naturally, which means that the pain it produces is often unbearable, causing the laboring woman to need something else to bring the pain back under control. That next step is usually an epidural.
An epidural was a big “no” for me. This commonly issued injection in a patient’s back is an anesthesia that blocks her nerves’ transmission of sensations. In birth, it dulls the feeling of the contractions, but does so at the price of mobility. Once you’ve received this injection you will labor prone in bed, which, despite TV shows’ depictions, is neither the most effective nor the most comfortable way to go. Jim and I had practiced so many great birthing positions, some of which required me to be standing, kneeling, or lunging, and confining me to bed with no feeling in my legs was not an option. Plus, there’s often a greater risk of tearing since you can’t feel your own pushing and limitations. That was also a “no.” To make matters worse, the epidural oftentimes slows things back down to the point that either more Pitocin is administered or the birth is labelled a “Failure to progress.” The next step, of course, is a Caesarean section. That was my biggest “no” of all.
In a vaginal birth, as the baby passes through the birth canal, natural Oxytocin is released both helping mother and child bond and stimulating successful breast feeding, and what is even more miraculous is that the baby receives the mother’s antibodies. (The human body is ridiculously amazing.) A C-section does not offer these benefits.
We were vehemently opposed to our child’s birth becoming a spiral of medical intervention. The medical team argued that we had to get that momentum back so as not to wear me out or to put too much stress on the baby. Hours upon hours of contractions is tough on both participants, especially if the cervix is not opening more as a result of all of that toil. We bargained for another hour, but at the end of that hour there I was still at 6 centimeters. Damn.
I stared that decision hard in the face and determined that there was still a way to move things along and ease the stress on the baby without relinquishing my control and spiraling toward a C-section: I could get the Pitocin and then be the bulwark. I had a choice, I just had to be strong. I’d stop there. I’d simply ride the waves it brings but *not* get the pain medication. I could do this.
My God, did the contractions ever get stronger. And longer. And frequently one wave ran into the next and I’d have no reprieve at all in between to catch my breath. We certainly had established that the Pitocin worked, now I just needed to hold on and focus. I gave in to the waves. I was talking less and less, conserving energy, and was just doing what I needed to do to get through each one, however long it was. I had reached the point at which I definitely could not be touched during a contraction. It pained me that Jim couldn’t hold my hand, he so desperately wanted to, but I just couldn’t when that pain swept over me. I could tolerate a pressure leaning up against me, and I could be comforted by his voice, but I needed my hands free and I needed to be able to move around quickly and unencumbered if the contraction called for it. After several hours of this wave riding, we had reached our goal of regaining that momentum: I had dilated a few more centimeters.
I could tell the next stage of labor, transition, had begun when my body temperature started radically shifting from on fire to freezing. Nausea. Shaking. This was the most intense stage, but typically the shortest. I began a cycle of needing a cold washcloth for my neck and then immediately after needing to be buried in blankets, then right back to the washcloth. Jim spoke to me, reassuring me that he loved me and was so proud of me.
For the most part all I could do was nod responses during this stage. Making eye contact would mean pulling me out of this special zone I had created, so I didn’t. I nodded. I occasionally whispered. Jim just kept telling me how great I was doing, how amazing I am, and how proud of me he was. At one point along the way, probably during active labor, I had a contraction-free moment and used it to remind Jim that I love him so very much and loved hearing his words but that I couldn’t respond while riding a wave. He already knew that. He understood. “You are so amazing,” he responded as I got swept away by another fierce contraction.
We were 30 hours in at this point and it was Go! time. I had labored on my side, on my back, standing, squatting, leaning on Jim, sitting…you name it. You can cover a lot of positions in 30 hours. I had been receiving my nourishment via IV on and off all this time, and had been sure to stay hydrated as best I could. A kink in this process was that I couldn’t pee. I hadn’t been able to go since Sunday night. The hunch was that the baby was on top of (or was using) my ureter (as a squeaky toy). That meant all that liquid was building up in there and taking up space the baby could be using to journey down and out. So all day, every three hours they had had to insert a catheter to drain my bladder. Dear God. But at this stage of the game basically the entire Labor and Delivery staff had seen my lady parts as doctors and nurses performed checks on my dilation progress, so why not? And, damn it, peeing through a tube felt fantastic as opposed to the stuffed-up alternative, so sure. I wowed everyone with about a liter each time.
I was fully dilated. 10 centimeters. They kept asking me if I felt pressure down there and an urge to push. Yes, I felt pressure, but do I feel the urge to push? I don’t know. How on earth can you gauge another person’s pain or interpretation of how something feels? I knew I didn’t want to start pushing too early, because that causes tearing and exhaustion. I wanted to wait until this baby was really ready to go. But we were all just hanging out at that point waiting for my urge to push to kick in, while I did indeed feel something…but enough to want to push? Maybe? It dawned on me that, oh my God, this was it for real now. After all this laboring, we had hit the pushing part, and that meant our child could be making his/her way to the outside world right now. Okay, let’s give this a shot.
It’s funny because technically pushing is something so natural, and yet it certainly does not come naturally. Or at least to me it didn’t. So that first hour was kind of hilarious. I had no idea what to do, so the nurses and doctors all took a stab at explaining. Like laboring, there are any number of positions you can try (provided you’re mobile and haven’t had an epidural), everyone had a suggestion, and I was game for all of them. Hospital beds can do astounding things, bars pop up, side rails disappear, backs raise, bottoms drop out, etc. We took advantage of all of this, but my favorite turned out to be the birth bar. With the same eye-on-the-prize mentality and controlled breathing, I pushed. Team Birth Bar, as I called them, was boisterous and supportive, literally cheering for me at each one.
Our baby was right there, Jim got to see his/her little head, but just wasn’t coming. That’s when the doctor did a position check and determined that our baby had his/her head turned to the side. They tried to reposition the little one and then have me quickly push in the hopes he/she would stay that way as I advanced him/her further along the birth canal in the new position. No such luck. It’s shocking that our child would be stubborn, I know. After 4 hours most women have either exhausted themselves or popped out a baby. Ours was still in there. I was still going strong. I had been pushing for 6. This was not normal.
“We need to do a C-section.”
That statement just hung there in the air.
After a labor this long and this awesome, that was the last thing you would expect to hear. I had gone through 30 hours of labor and 6 hours of pushing and had not had a single pain med. I was mobile. I still had tons of energy. I had a staggeringly supportive team. The most loving man in the world was by my side. I was still so determined. We were so close.
I stopped pushing. I let the contractions wash over me but I did not push. “Conserve,” I thought. We asked questions. The doctors took time to respond to each and every one. The baby’s head was “coning” too much. Plus, it was turned to the side. They had genuine doubts that the baby could fit through my pelvis.
Jim and I took some time to discuss just the two of us, and everyone else stepped out. I felt so deflated. I could see it in his face that this hit Jim really hard, too. Why go through all this only to have a C-section in the end? That just seemed wrong. But, our priority was safely delivering a healthy baby. If this is what our little one needed, then this is what we had to do. And I could honestly say that I did all that I could to bring this little one into the outside world in a natural, calm, and non-medicated way. I rocked that part. I could be proud of the fact that I was strong and steady for our child. But now, also for our child, we had to change course. I remember the medical staff coming back into the room and my first statement was that someone needed to get me off that damn Pitocin immediately if I was going to have a C-section. And yes, we’ll do it.
We were on the list. They wouldn’t be able to get me into the O.R. for another hour or two, and in the meantime I’d just have to ride these waves. That’s when I had them wheel in the nitrous oxide, because hell. Jim went out to the waiting room to tell my folks. They had been sitting out there for hours. We thanked our doula and sent her home. It was around 4a.m. on Tuesday.
(When I consider Theo’s birth story, of course the arrival of our son is the best part, followed by how Jim and I made tough decisions as a true team and how he stood so strong and lovingly by me the entire time. He is an amazing man and the most wonderful partner I could ever dream of. Our son is beautiful, healthy, and strong. These blessings make my head spin. I am so very lucky. But if I were to name the part of the story that makes me laugh and acknowledge that, holy crap, I was a bad-ass during this thing, it’s this next part.)
It was time. They asked me if I wanted a wheelchair. “No, thank you.”
And that’s when — after a day and a half of IV-nourished labor, no food since Sunday afternoon, no meds, no sleep since Sunday morning, and hours of pushing — I got up and walked down the hall into my own C-section.
They prepped me for surgery. I sat on the edge of the operating table, holding onto one of the marvelous nurses who had been with us for hours, as the anesthesiologist injected me with a spinal block. As they laid me back and strapped me in, I asked how our baby was doing. They said our little one was doing great. I rested my head back.
I felt the whole table tilt to the side. Then back the other way. “No, no, turn it back, turn it back!” Something was wrong. Since the anesthesia injection our baby’s heart rate had plummeted. It had been down for 6 minutes now. They were trying to move me around to get the baby stimulated so the heart rate would go back up, but to no avail. The operating room atmosphere completely changed from casual to crisis, and this standard C-section had suddenly become a “crash” C-section, meaning one of us wasn’t making it.
People began running in and out, calling for backup, paging doctors, and the room was filling fast. In the middle of all this someone said the baby’s father was outside dressed and ready to come in, but a stern voice barked back that no!, he couldn’t come in here. I imagined Jim outside in the hallway all scrubbed up and eager to meet our child only to be denied entrance and then seeing all the doctors and nurses in crisis mode run in and out of the room he knew we were in. His heart must be in his stomach. This devastated me.
Just as this flurry began, they set up the curtain that blocks my view of the surgical area, so all I had to go on were sounds. Pressure was all I could feel. One nurse stood by my head keeping an eye on me and continually telling me I was about to feel more pressure. It was always true. I remembered that during the pregnancy the baby had always responded to my heart rate and breathing, so I flipped back into my birthing mode. Slow, steady, determined, and calm. Strapped to the table with several doctors in my gut, this focus was all I could do for our little one now. I waited, but my mind raced. Had we made the right decision? What does a heart rate that low for that long mean? Could our little one have brain damage? And, my God, what if our child doesn’t make it?
A small eternity passed before I heard the cry. It was part human, part tiger cub in distress. “Is the baby okay?” I begged. “It certainly sounds that way. Listen to those lungs!” was the first response. They were doing more checks. When they told me our child seemed great so far, that’s when all that strength and focus yielded to let the tears pour down my face.
That was the sound of our baby.
It was then that they finally let Jim come in. I read that as a good sign. I still couldn’t see anything beyond my surgical curtain, but they escorted him right over to our little one, who apparently was still quite blue in parts, and let him check the baby’s genitalia and make our announcement. Jim appeared on my side of the curtain, his face streaked wet and quivering. “It’s a boy,” he managed, before more tears followed. I couldn’t move, so he came close and laid his face against mine. Past him I could see a little figure with rosy color coming back into his extremities. “You can bring him over now,” they told Jim, and he carried our son over to touch the 3 inches of me that wasn’t covered in tubes. Not quite the tummy time and crawl for the breast that we had hoped, but he was here and he was healthy and beautiful and oh so very strong.
And we finally found out why all that pushing hadn’t brought him further along. It turned out that not only did he have his head turned funny, but he also had his little arm up alongside his face, preventing a normal exit. Also, dear God, he weighed just over 9lbs. But as luck would have it, although our son had not made it far out enough that they could have vacuumed him out, he had indeed made it far enough into the birth canal to have reaped some of the natural labor benefits - like getting all those good antibodies. That was great to hear. In fact, they actually had to ease him back in (no, seriously) before they could take him out the C-section route. (We joke that I basically birthed this kid twice.)
In the process of getting that little one out I lost a good deal of blood, and in the days that followed my doctors would argue for a transfusion. I’m told my scar will be bigger than most because since they had to get in there so fast they just cut. I have a lot of healing to do, and these next few weeks will be rough. But we did it.
At 6:39a.m. on February 18th, 2014, after a long eventful journey, Theodore Quincy Ray entered the outside world.
Jim and I have a son. <3