I’m a verbose person in general & labor was over 26 hours, so I don’t think the story could be told briefly, therefore this is LOONG – you have been warned. ;)
At 39W, 2D gestation, I woke up at 3:30 AM – as was typical for quite a few months now. Normally I’d be able to eat, read, and fall back asleep within an hour or so, but this time I was up until 5:00 – when I lost my mucous plug & started to have some very minor contractions. I decided to time them, but wasn’t keeping a very close record. I think they were 53 seconds long and varying between 3 and 5 min apart. But they were so minor – like minor cramps.
DH walked into my room around 6:30 to let the dogs out & I said, “Don’t get too excited, but I’m having ctrx.” I knew they were so light that they could easily peter out & stop, not starting up again for a day or more. So I wasn’t saying, ‘I’m in labor.’ Still, he said, “Yeaa!” Ha. I didn’t want him to go to work & he decided to set up the pool in my bedroom. I stayed in bed – think I tried to sleep some more & I may have also been reading. Didn’t pay much attention to timing ctrx.
Ctrx were so minor, I didn’t even call the MW until 7:00 or 7:30. I told her I know it’s not really time for her to come until ctrx are more serious – like I can’t talk through them, feel the need to vocalize through them. She said yeah, but keep her posted.
She called me back at 9:30 – so 4.5 hours that I’d been having ctrx. I told her they had picked up slightly in intensity, but were still quite minor. She said her apprentice/asst could come down in about an hour to check me. I asked if the apprentice could strip my membranes – since that had started labor the first time, I thought that would help it get into high gear. I mean, I’d been having ctrx for 4.5 hours at this point, and the ENTIRE 1st stage with my DS (my first) was less than 5 hours total from the first minor ctrx to the urge to push! She said Asst had never done it before, but she could examine me.
Don’t Want to Know How far Dilated I am
Asst arrived around 10:30. I told her I didn’t want to know how far dilated I was if I was less than 5 cm. LOL – DH says, “Well if she doesn’t tell you the #, you’ll know you’re less than 5.” OK, yeah, true. I said so don’t tell me at all. She checked me, said she’d “massage” my cervix a bit – which I believe also helps release prostaglandins the way membrane stripping does. I mostly wanted to know baby’s position and she said she felt the sutures & baby was “right on.” She said, “Well you’ve made wonderful progress.” & said she was going to go get herself some lunch & would be back.
I figured that meant I was at least 4, maybe 5. Considering she said, “wonderful progress” and she wasn’t leaving to go home. DH told me many hours later I had been 3 cm!!!!!!!!!!!!!!! REALLY good thing I didn’t know because I would have been a bit discouraged & maybe worried had I known that. With DS, I was at a 3 before I’d ever had ANY ctrx at all! The CNM stripped my membranes & I went to a 4 immediately (ctrx started 2 hours after that). Now I’d been having regular ctrx 4.5 hours & was only 3 cm? Yeah, I’m glad I didn’t know.
Watching TV, Enjoying Ourselves
After noon or so, things picked up a bit more in intensity, but still pretty minor. DH & I just hung out –watched some TV. I soon felt the need to moan just a bit through ctrx, rest my head down & close my eyes, so he’d pause the show while I had a ctrx. We were really enjoying ourselves- almost amused how cool it was to just be watching TV laboring. I was sitting on my stability ball in front of the bed & had propped 3 pillows on top of each other to rest my chest & head on during ctrx. MW arrived around 1:00. She & Asst were checking FHT periodically.
OK, WHY is this taking so long?!
I can’t remember when, but I’m thinking maybe by 8:00 PM, I started getting worried & concerned. Again, 1st stage with DS – my first- was under 5 hours from the first very minor ctrx to the urge to push. The vast majority of the time, 2nd labors are even faster, and now I’d been in labor more than 15 hours - TRIPLE the time I was with DS! Nearly 300% increase in duration! I started wondering if something was wrong.
MW was reassuring and said stuff like ‘I’m not in any hurry. The process has a reason for taking the length it does.’ I forget how she phrased it- but basically ‘trust nature/ trust your body’ it takes as long as it needs to. That made me feel a little better.
Certainly by 8:00 PM things were getting more intense, but I don’t remember feeling they were at all intolerable – as long as I moaned through the ctrx. I had been in & out of the tub several times at that point. MW said not to stay in more than an hour. She said if I got out for 15-20 min, that would be OK, but DH was discouraging me from spending too much time in there since he noticed ctrx would space farther out & seem less intense.
I think maybe 9PM, MW checked me (only 2nd exam I’d had since 10:30 AM) & her exact words were, “You’re not QUITE a 9,” which I took to mean I was an 8. (She neither confirmed nor denied this exact number.) Yeah! Homestretch! She said there was a bulging bag, which made it hard to feel the sutures. Baby’s HR had still been doing very well all this time. She’d also given me some homeopathic stuff to ‘regulate’ labor.
Well, I can’t remember when, but some point – I think AFTER that – we finally started suspecting a posterior baby. I still don’t understand why it wasn’t suspected MUCH sooner, and why they didn’t feel baby’s position from my belly to confirm (Since the last cervical exam, it was hard to feel the sutures because of the bulging bag.) Eventually, I feel like we all started thinking things weren’t quite right. At one point, Asst suggested walking the stairs & lunging with my R foot up on 2 stairs. DH held my hand while I held the banister & we did that several times.
They also suggested we try lying on my back with my hips up on towels to be inverted – to get baby to move UP towards my neck, in hopes she’d settle back down into the pelvis in a better position – in case her head was cocked. This is about when things started getting dark.
“We Need These Contractions to be Stronger”
While on my back with hips up, MW felt my belly during a ctrx, I realized the whole belly wasn’t hard. She asked me where I was feeling them – it was mostly lower belly, lower back, and cervix. She said, “We need these contractions to be stronger.” I couldn’t help but think, “I’m almost 9, how can ctrx that got me to almost 9 be inadequate?!” Not only that, but it was discouraging to think we needed to make labor MORE painful. But I didn’t question her – I don’t know all the timing, but whenever this was, I think I had been “not quite 9” for several hours, so I knew she was right – the last few cm shouldn’t be taking so long.
Making an Effort to INCREASE the Pain
So I spent quite a lot of hours of my labor making an effort to make it MORE painful. I realized later that of course this contributed to a much tougher experience than normal. On these boards, we always seem to talk about how hospitals do things to make it more difficult for the mother to cope with normal labor pains. & here I was having a home birth doing things that were deliberately making it even more painful.
I was in the pool up on one knee instead of kneeling on both leaning forward like I wanted. I was lying on my back with my hips propped up on towels, I was sitting on a birth stool -- which was totally torture & just prior to transfer, I couldn’t make myself sit on it again. As soon as a ctrx started, I just stood up – couldn’t force myself to do it anymore.
We also tried nipple stimulation. I loathe nipple stimulation. It makes my blood run cold. I’ve always disliked it. I know many women find it arousing while making love. Not me – I find the sensation totally unpleasant & always have. So that was really fun to add that to my repertoire of physical discomfort & pain. I considered using my breast pump instead of DH & I each working on one nipple while lying in bed. Not sure why I didn’t. Think I was losing some hope at that point.
AROM as Last Resort
We did AROM at some point in here. I can’t recall where that fell in the order of all these events – I think it was towards the end – maybe near midnight. I know they wanted it as last resort and I agreed it was best as a last resort. MW brought it up first, but I was definitely going to ASK for it, as I know it can help push you over the edge when you’re at 9 or 9.5.
MW actually was able to break the bag just with her hands – didn’t need an amni-hook, just ‘snagged’ it. She said there was light mec staining, but very light, nothing to worry about. Again, baby’s HR continued to be great. They had been checking sometimes like every 15 or even more when we tried pushing.
Pushing at 9.5 cm on a Cervical Lip
I think this was after midnight – so 19 hours of labor – that I was 9.5 – so just a cervical “lip” remaining. MW encouraged me to push while she held back the cervical lip. This is an experience I’ve read about before online & seem to recall that it’s always torture. It was. It was awful. With the lip there, I had no natural urge to push at all. Trying to force myself to do so against the lip, without the urge, and feeling it wasn’t effective at all (didn’t feel baby moving) was awful. I remember MW saying, “You’re drawing back,” and thinking, “Well, sh!t, yeah, I am.” I had trouble forcing myself to bear down & push. I think I got a couple little pushes in over a couple ctrx until we stopped that.
“Need” an Epidural
MW suggested DH & I rest for a while. See if labor naturally on its own might get me all the way to 10 cm. We did that. Hours later, we tried the experience of pushing against the lip again – still stuck at 9.5. This time I tried more pushes without MW holding back the lip but it was really nearly as awful. That’s when I was thinking, “If THIS [pushing against lip] is really what it’s going to take to get this baby out vaginally, then I ‘need’ an epidural.” It was just too much to bear & I wasn’t willing to do it anymore.
This thought first occurred to me around midnight, but I didn’t say anything. I thought I’d give it another hour – I mean, surely I must be close to full dilation & pushing soon?! Finally more than an hour after thinking I wanted an epidural, I mentioned it to DH. He said, “I don’t know… I’d just hate to see you come this far & end up with that outcome.” OK, good point. Very good point, I’d made it like 20 hours, might as well hang in the last few hours. I agreed with him & didn’t think about it more. At some point, I remember being in the birth tub crying – but more from feeling discouraged & worried about why it wasn’t going the way it “should” more so than the pain.
Bragging About my DH
Another point, a few hours later, I mentioned transferring to DH (Hadn’t said it in the presence of MW or Asst yet). He said, “With DS, it was at least this intense for you – maybe more so. Trust me, I remember, it was. Do you trust me?” I trust him with my life, he’s very wise – so when he said that, I believed him & dropped it again. He also cried at that point – only the 2nd time in our 11 years together I’ve seen that (first was our wedding.)
Of course, with DS, the really painful time lasted about 90 min – AND, I never ONCE remember thinking, “I can’t do this – I need the drugs.” Not once. Not at all. And I was ALREADY planning a hospital birth anyway with DS!!! So in that regard, DH was wrong – this labor was already more painful & intense, but I trusted & believed him. I never felt he was discouraging me from transferring – but more he was encouraging me to stay with my goal. He was fantastic. Absolutely wonderful.
Later he said he was also in awe of me that I hung in so long. I felt so wonderfully supported by him the whole time. I told him I felt like DS’ short, relatively easy & joyful birth was a great experience that brought us closer together, AND – this long, awful birth was ALSO an experience that brought us closer together, so there was something positive there.
“Drowning” in the pain – Give me Coping Tools!
At some point, trying to push on the lip, I felt like I was drowning in the pain. I felt desperate to escape it. I felt I just couldn’t cope with it anymore. (Well, I think if I was just laboring, it wasn’t QUITE so bad to deal with the ctrx that were happening naturally) but trying to actively force myself to push against the lip was more than I could bear. I said, “I feel like I need more tools to cope with the pain.”
Obviously, my MW has no pain-relieving drugs! By saying “tools” – I meant mental tricks, breathing, focusing your awareness, etc. the types of “tools” that the book “Birthing from Within” lists. I was looking for MW & Asst to say something like, “Imagine yourself as a birthing warrior linked to all the other women on earth birthing today,” or “Try focusing your mind & eyes on a focal object that’s comforting.”
In truth, I did not think such “tools” would not make a big difference, but I felt I NEEDED SOMETHING. I needed a “handle” mentally – I needed something to wrap my brain around besides pain because I felt I was mentally drowning in the pain & it consumed my existence. I felt if I tried one of these new tools (well, something “new” to me) It would give me something mentally to hold on to instead of feeling so overwhelmed & consumed by pain. Plus, there is that whole placebo effect! If I THOUGHT a new tool could help, it was likely to provide some degree of assistance. (Yes, all these thoughts went through my head as I asked this question.)
& ya know what my MW says in response to this request?
“The only way past the pain is through.”
So I replied, “No, that’s not true, I could transfer for an epidural!”
(This may have been the first time I voiced this thought to her, a thought I’d had for several hours by then.)
I think she said, “Well, I hate to tell you, but I think they’d do the same thing at the hospital – they’d have you push against the lip.” To which I replied, “Maybe… but they could give me an epidural first.”
At one point, during the torturous experience of trying to push against the lip, when I mentioned transferring, the MW says, “You can still have this baby at home.”
I replied, “I don’t know that I WANT to anymore. I wanted a safe & pleasant home birth. I didn’t want a home birth at all costs.”
She said, “I know,” in a very sympathetic tone.
I am Not & was Not Vehemently Anti-Epidural
Maybe I should have had that this discussion with her earlier. Maybe I should have let her know that I wasn’t obsessively focused on an HB & vehemently opposed to an epidural. I THOUGHT my viewpoint on it was very normal & healthy. You’ll note above I said I wanted a “safe and pleasant” HB – obviously I didn’t want a pain-free birth. I’m not stupid – I know such a thing is rare. I was perfectly prepared to deal with pain.
However, with my son, I was a bit adamant that, “I am NOT having an epidural!” It wasn’t an option in my mind. It was “off the table.” Luckily, the birth was TOTALLY manageable on the pain scale & less than 5 hours for first stage. I never even had ANY desire for one. No desire at all – no doubts that I could do it – even when the pain was intense.
But in the nearly 3 years since then, I’ve read lots of birth stories, & have read a few where women – even in the best of circumstances (HB, well-supported) - still experienced a pain level where they said they had post-traumatic stress disorder, felt they were going to die, and didn’t want to have more kids because it was so awful & I remember thinking, “THAT is a situation where an epidural would have been a good thing.”
I’m not anti-epidural by any means. I remember reading how Henci Goer wrote about the difference between pain & suffering – they don’t always go hand in hand. I agree, but sometimes they do. So when the pain reaches a level where it IS suffering and that drags on & if I were in horrible pain, the concept of an epidural was NOT “off the table” for me. I think this was a wise & healthy view. But I’m not sure I ever told my MW that this was my view.
The Decision to Transfer
We stopped the pushing again, MW suggested birth stool again – that’s when I stood right back up again, couldn’t force myself to stay on it. She did another check & said the cervix was starting to swell & I think I actually said, “That’s it, let’s go.” That was 6:00 am – 25 hours total labor, probably 8 hours or more of which I’d been 8 cm or more.
So we got in the car & I called the hospital. Figures, the MW on call is one I haven’t met & I haven’t even heard anything about. I hadn’t had full on “shadow-care” but I’d had enough apts with the CNMs so that I wasn’t “on the radar” – so that I could plausibly claim hospital birth was my plan all along & thus hopefully avoid any hostility. So I decided not to tell her the truth.
Lying about Attempting HB
Lying was kinda stupid in hindsight – I came in, met her, she checked me, said AGAIN I was 9.5 with just a lip. We started having the epidural discussion & I realized I needed to be honest with her. It wasn’t more than a few minutes before I fessed up, but she was annoyed that I wasn’t honest up front. Thankfully, she was very nice to me – but she was “snippy” with DH as they walked to the LDRPP room (I was being wheeled on the stretcher & didn’t hear this convo.)
On the on the one hand, I can’t totally blame her – a health care provider needs all the data to care for a patient. But on the other hand I’d been up 26 hours, was delirious with pain, AND anyone who knows anything about birth should realize I feared hostility in the hospital for having attempted an HB, so I should hope she also saw OUR point of view- and I DID fess up in a matter of minutes.
Getting the Epidural??
Anyway, the reason it became so critical to fess up in minutes was because I kept asking for the epidural & she said, “But I think you’re going to push your baby out soon.” She said, “We can keep you pregnant if you really want us too, but I think you can have this baby very soon. It’s going to require 20 min for your bolus IV, then they have to wash your back, get the epidural catheter in place.”
I know you need a bolus IV infusion prior to epidural, I hadn’t realized that alone required 20 min.
But the crucial piece of data here is that – I HAD A BULGING BAG! It had been many hours since MW broke the forewaters, but somehow, the rest of the waters had shifted around – I guess during the car ride, and a bag was now bulging again. She said she thought if she popped that bag, I’d be able to push.
<sigh> OK, I remember thinking, “Well, the presence of a new bulging bag changes things. So IF she pops it, AND the lip gives way, AND I FEEL THE URGE TO PUSH, then I’m willing to give it a go. However, I am NOT, willing to push ON the lip anymore without an epidural.”
So they wheel me down the hall & even though I’m not pushing on the lip, I still feel like I’m “drowning” in the pain. I suppose at this point the pain felt intolerable because I’d made the choice that I wanted an epidural so I wasn’t willing to cope with it anymore – which made it harder.
HB MW Coming Along?
MW & Asst followed us to the hospital, but they didn’t come back with us (100% my choice). I guess I thought at first that I might be caught in the lie if she came back – even if we claimed she was the doula. I guess I also felt it I had left homebirth behind, so it just made sense to place myself in the hands of the CNM and not look to the HB MW anymore. She did come into the room later after everyone had left, hung out for a while & got us some breakfast.
We get to the room, she pops the bag & says there’s meconium. Awesome. I told her that the MW popped the forewaters hours before & there was “light” mec staining. She says, “This is not light staining.” She tells me there are going to be more people in the room to “greet” my baby because of the mec.
Next ctrx, I start to push & I FEEL IT WORKING! I feel her moving down – so the lip must have given way just as the CNM said. Thank goodness! Of course, I still felt all my ability to cope with any pain had drained away completely & I was just screaming – not moaning - screaming. I was lying on my left side – I had no strength to try hands & knees so I just wasn’t capable of being in any other position.
CNM says, “You’re wasting energy up top. Use that energy down below. Curl your chin to your chest, bring this top leg back a bit to give you something to push against & bear down.” Not sure if she suggested holding my breath as well, but I know it can make your pushes more effective & I was so DESPERATE FOR THIS TO BE OVER WITH that I decided to do that too. Plus the screaming wasn’t helping anymore anyway, so I figured I might as well hold my breath.
I felt the pushes working, so I pushed with insane intensity. I even pushed a bit between ctrx. I held my breath, took a quick gasp of air & kept pushing. CNM said baby’s HR went down into the 50s (WHOA! I know 80s is a matter of concern) so they gave me some oxygen & encouraged me to breathe it & breathe more. LOL, I remember thinking, “Ooh yeah, right, I can’t hold my breath THAT much because baby needs oxygen.” But the nurse, CNM, and DH (who was holding my right leg for me) were encouraging me to push push push – and I was glad for that – glad for the positive feedback that obviously THIS WAS WORKING – and that means IT’S NEARLY OVER!
The whole pushing stage lasted only 12 min. She was crowning and CNM says, “I’m going to assist the delivery.” I said, “WHAT?!” and said bolt upright as if I’d been shocked- thinking she might have meant episiotomy. But DH had strict instructions to stop that & I knew I could count on him – she just meant she was going to apply some counter pressure & guide the head out. Whew! She also encouraged me to not push hard, just little pushes as her head emerged, which I was glad for. After I felt the intense relief of her head being out, her body SHOT out! LOL- DH said she just shot out onto the bed & no one caught her. Not sure why the CNM didn’t grab her, but kinda funny how he says she just shot out onto the bed. I saw a little hand sticking up & it looked yellow-ish, but I guess that was the presence of the mec.
I tore on the same spot as with DS – 1st degree, just needed 2 stitches, same as with DS. They clamped the cord immediately & I started to protest, but CNM said, we have to make sure she doesn’t breathe in the mec. I asked to have her quickly & I think maybe 5 min went by before I got her naked on my chest – not bad & I was glad to see her.
She looks SO MUCH like her big brother looked when he was born, but she’s only 6# 4 oz! He was 7# 4 oz. Good thing she was so small since it’s hard enough getting a sunny-side-up baby out vaginally! (Yes, she was born face-up.) I enjoyed listening to her little sounds & watching her. She was born at 7:25 AM – 26.5 hours since ctrx started.
Trauma vs. Misery?
5 days after baby was born, I was chatting with a good friend who’s a psychologist. I told her I had read on MDC about some trauma therapy that’s supposed to be helpful dealing with short-term isolated traumas, but I couldn’t remember what it was called. She also forgot the acronym, but said it’s something with eye movement & it IS proven effective. But she said I didn’t sound like I was traumatized. She said I wasn’t using any of the specific terms she hears from traumatized people. I didn’t feel out of control, just that it was misery.
I agreed with her that I definitely didn’t feel I had been victimized. On the contrary, I feel grateful that the hospital CNM talked me out of the epidural- encouraged me to try pushing, and “talked me off a ledge” – as I felt – when I was screaming my head off during the first push. As I kept saying, I felt I was “drowning” in the pain & couldn’t cope anymore. She was authoritative without being authoritarian & gave me the GUIDANCE I needed to just get the job done – and she was right, it worked! I felt I had options, I felt supported.
So I was glad when my friend said, “You don’t seem traumatized” (as far as the clinical definition goes.) Not that she was discouraging me from talking to a counselor, just giving me that opinion. I agreed with her & was glad she shared that clinical opinion with me.
Edited by MegBoz - 3/23/11 at 8:33am