Starting about a week before he was born, I experienced several nights in a row where I began having contractions as I relaxed at bedtime – around 11pm or midnight. I would have a few contractions an hour, sometimes uncomfortable or painful contractions. I had prepared for a natural childbirth by taking Bradley classes and doing Hypnobabies self-hypnosis, and both methods encourage you to rest and try to sleep in early labor to conserve energy for later. I would sleep off and on, between contractions, listening to hypnosis tracks, and being sure to drink plenty of water. Sometimes I would also get up and have a snack in the middle of the night in case it was the last meal I would get. The last two nights this happened, I finally got up around 4am and took our dog Trooper for a walk (about a mile) to see if this would hasten “real” labor. Each time, the contractions stopped by 5am.
My due date was on Wednesday, and that morning I broke down and had a good cry. I was so ready for the baby to come, and these false starts were really affecting my sleep. I was exhausted and at my limit – it seemed like there was so much pressure to go into labor: I was uncomfortable, Ben was waiting for me to give birth before he would go out of town on a job interview, my parents were staying with us waiting for me to give birth, friends would check in every day…
Thursday morning I had a regular appointment with my midwife, Lucie. I told her about the stopping and starting labor every evening. She said that it was possible that the baby was not in a good position to be born, and that my body was ready in general but when it sensed that his head wasn’t engaging properly labor would stop. She gave me some exercises to do that day – leaning forward while sitting, lunges, etc., to help get baby in a better position. I did them regularly all day.
After dinner that night, around 8pm, my back started to hurt. My mother had experienced back labor, so I knew it was a possibility. I went upstairs to rest and between 8 and 10pm the back pain grew steadily worse. It was a strong, dull pain in my lower back that stayed pretty constant regardless of what position I was in. I was starting to get my hopes up that this was, in fact, labor, and I did some online research about back labor – only to learn that it was associated with babies in the posterior position. It all clicked for me – how the previous several weeks I had always been able to feel baby’s tush in front, but that for the last few days there had been two lumps instead of one – they must be knees! And the little flutters up high in front were feet! Uh-oh – this was going to be difficult…
The pain continued to get more intense in my back, and I started to recognize contractions in front too. Unfortunately, the back pain was so strong it was hard to time the contractions, but they seemed to be 7-8 minutes apart. Astonishingly, they lasted for 1 ½ -2 minutes each. I was using an online website to time them, and the website told me contractions that long were impossible (but that is how long they stayed for most of the rest of labor, so much for the contraction timer!). I tried to relax and listen to my self-hypnosis tracks, but the back pain made it almost impossible to relax. I needed to be constantly moving, changing position, usually on my hands and knees, and the hypnosis required you to be sitting or lying in a fully supported position. I finally yanked my iPod out of my ears and flung it across the room!
At 12:30 I called my midwife’s office, and the midwife on call suggested we labor at home for a few more hours, especially since Ben and I were still having trouble timing the contractions. I took a shower, and then drew a bath, and spent most of the next couple of hours in the tub. It helped for a while, but as the pain got stronger I started to feel desperate. The contractions became time able as they strengthened, and were still 1-2 minutes long about 4-5 minutes apart. We called the midwife again at 3:30, and begged to be allowed to go in to the hospital! I didn’t want it to get any more intense and then have to get in the car.
Ben gathered the last minute things for the bag, I dressed, and we woke up my parents to let them know we were leaving. I knelt in the backseat for the drive. When we arrived at the hospital, they whisked me into triage and hooked me up to monitors, etc., to get me back to the labor room as soon as possible. During the monitoring, I had a contraction so strong I threw up.
It turns out I was 4-5 cm dilated, and luckily the natural birthing room was available (it has a regular queen bed, a private Jacuzzi tub, and more homey atmosphere). We settled in and I got in the tub. The next few hours are a blur of more or less constant back pain and increasingly powerful contractions. I labored in the tub on my hands and knees for most of it. It seemed necessary to me to keep myself propped up by my arms at all times. At 7pm my midwife left, and a new midwife arrived. While she was a stranger (a rare time when all 5 of the midwives in my regular group were not on-call), I think I lucked out as she was very experienced and gave me great confidence. I continued to throw up and was unable to keep any liquids down – so pretty soon they gave me both an anti-nausea tab and IV fluids. The IV went in near my wrist, making it very difficult to labor on my hands and knees as I had been – that IV needle was the bane of my existence for the next few hours!
We knew we had to get the baby to turn from posterior to anterior in order to come out easily, and so the midwife and nurse kept suggesting new positions to labor in – on my side, on the toilet, walking, etc. I tried them all – and was able to stay in some of them for a few contractions. Others were just too painful. I kept going back to my hands and knees.
Around 10am I started to get more emotionally desperate. I wanted my cervix checked more often as proof that this was progressing (about 7-8 cm at this point), I started begging to know how many more contractions there would be, how long this would take, how many hours… I started saying things like “I can’t do this,” and “Please make this stop,” and I felt like I was trying to crawl away from the pain or claw my way out of my own skin. I started asking the midwife and Ben, “is there anything we can do to make this stop?” I think I was daring them to offer me anesthesia, even though it said in the birth plan not to offer me anything. They never offered me drugs, and I never specifically asked them for it – although I remember many times having that question on the tip of my tongue.
Around this time, the midwife did a cervical check and accidently broke the waters. There was some meconium, so we knew we would have to have hospital staff on hand to suction baby’s stomach in case baby didn’t breathe right away. Luckily, they decided not to transfer me to a regular labor room immediately, as the meconium was relatively light. I continued to labor and complain! Everyone was very tolerant and supportive of my whining and self-doubt. I remember thinking that the hardest thing was that I never had any break at all – in between each contraction, the back pain kept me constantly suffering and unable to relax, ever. I thought I would have been able to handle the contractions better if I had only had a chance to catch my breath during the breaks between. I did moan and vocalize throughout the entire labor.
The meconium flow got heavier as time went on. By 12 I was feeling kind of pushy. I started giving little pushes sometimes during contractions. At 12:30 the midwife said it was time to really push and I remember thinking, what have I been doing for the last half hour??? She gave me some pointers, and helped me push on my back with my legs supported in the air. I had figured I would push on my hands and knees, but that just didn’t feel right when it came right down to it. By this time, baby was no longer completely posterior, but had shifted into a transverse position. Unfortunately, the back pain continued.
About an hour after I started pushing, I could tell that the mood in the room became more serious. The baby’s heart rate had been monitored every half hour or so by Doppler, but it had dropped and wasn’t coming back up over 100 in between contractions. They gave me oxygen to breathe and put in another IV line (the first one had closed) for more fluids. This helped somewhat, but the mood stayed serious and I now needed to wear a belly band monitor every so often as well to monitor baby’s heart rate.
At about 2pm the midwife asked if she could use her hand to try to rotate baby’s head and keep the head turning and descending. We did that off and on for the next hour. We tried different pushing positions – squatting, toilet, on a nurse’s lap, hands and knees, side laying.. but mostly legs in air. Slowly we progressed, and the head turned a little bit, but by 2:30pm it seemed like baby was really stuck with the head tilted at an angle behind the pubic bone. The midwife kept assuring me that I was pushing really well and really hard, and that there was plenty of room in my pubic bone for a baby’s head, but that his head was just stuck at the wrong angle.
At 3pm the midwife said that they were worried about the meconium, baby’s heart rate, and my energy level. She suggested that we ask a hospital OB to give the baby a vacuum assist to clear that last bit of pelvis and come out quickly. I was so ready to get the baby out already that I consented immediately. We moved from the natural birth room to a regular labor room (next door). The OB came in and everyone said that in order to do the vacuum assist I needed an epidural. They all started congratulating me on how far I’d come without pain meds, etc, and that I had done so well, etc, - buttering me up for consent, according to my husband. I was pretty ready to agree to anything at this point, including a c-section, but I did have some concerns – mainly that it would take longer to get an anesthesiologist in and get it set up, and that I really doubted I would be able to hold still long enough for them to get it in. I couldn’t hold still AT ALL. The contractions were about 30 seconds apart and I HAD to push during each one. In between, the back pain caused me to tense and writhe. I asked my husband what I should do, and he had the presence of mind to ask if there was any other option. They said the only risk was that the vacuum was very painful and there was a strong likelihood of tearing. The OB said he could just give me a shot of lidocaine in the perineum and we could go for it – and we agreed immediately. He gave me the shot and attached the vacuum very quickly and in three contractions at 3:25 our son was born! The vacuum was as painful as the most painful part of labor in transition, but feeling the head and then especially the body come out brought instant relief. They cut the cord immediately (we had hoped for a delayed clamping, but oh well) and whisked him next door for the meconium to be sucked out. My husband followed him and was there with him. I had only a second-degree tear, and needed some stitches (I don’t know how many – between 5 and 12 I think), but that was over in a few minutes and they brought him back very soon with a clean bill of health and rested him on my chest. My husband and I wanted to give him time and space to find the breast on his own, and he did make some crawling and groping motions, but I think he and I were both in shock from the violence of the last few minutes (I shivered uncontrollably for about an hour). We assisted him to the breast, and he explored it a little. A few hours later we reintroduced them and he fed very well, then and ever since!
Despite the vacuum assist, I do think that I got the natural birth that I wanted, and I’m proud of the work we did! It’s impossible to know if it would have gone differently if I had tried to birth at home, or if the vacuum assist and other hospital procedures were truly necessary. I shudder a bit at the thought of ever giving birth again, but I trust that feeling will fade. I would try for a natural birth again, but I will do everything possible in the weeks before birth to try to keep baby in that anterior position, in hopes of avoiding the terrible, terrible back labor!