Our son was born September 13, 2004, following a labor induced with cervidil due to escalating pre-eclampsia. Contractions were one minute apart throughout the 17 hour labor. The last 7 hours I stalled at 8cm. We tried rupturing the membranes, but this did not help with cervical dilation. I agreed to a c-section, feeling that the baby was malpositioned and was not budging from zero station.
For this birth, I changed providers (both midwives and hospitals) at 24 weeks, following the suggestions of the local ican group. I needed a birth team which would be on the same page as us and would help us birth Mary gently, via a VBAC with minimal interventions. I also hired a doula (and had a second doula accept to be at our birth as part of her certification). Other things I did differently: walked or did prenatal yoga almost daily during the third trimester; got regular chiro adjustments to help with any pelvic space/flexibility issues I might have; observed the optimal fetal positioning suggestions very closely; took extra calcium, ate more protein and fewer carbs, took juice plus, practiced relaxation, listened to affirmations/imagery CDs frequently, learned more about labor positions that may help with baby malposition I also joined the ican and Atlanta ican lists and learned a lot from these wonderful ladies.
Mary’s due date was August 15, 2006.
At the 37 and 38 week appointments I declined cervical checks. At 39 weeks I agreed to getting a baseline check but made sure there was not going to be any membrane stripping. I was 1cm, thick and soft.
On Monday August 14th (the day before the due date) at 8pm I had the first painful contractions. I had been having lots of Braxton-Hicks contractions for many weeks, but this time the peak 10-20 seconds were in fact uncomfortable, with the discomfort low and in the front. From the beginning the contractions came about 6 minutes apart (5-10) and lasted 40-45 seconds. I was happy to have avoided pre-eclampsia this time, and gone into labor on my own!
While nursing Roy to bed (from 10-11 pm) the contractions got stronger and more frequent (about 3-4 minutes apart).
I went for my usual fast walk (11:30pm-midnight), then took a shower and had a snack (cereal and frozen yogurt). The contractions got less frequent, about 10-15 minutes apart.
During the night I was able to get a few short stretches of sleep, dreaming about each contraction as it happened. I slept from 2am to 3:30am, and then nursed Roy from 3:30 to 4:30am (again contractions got pretty painful). After nursing I noticed some bloody show!! I slept again from 5:30-7:45am while contractions continued on, every 6-10 minutes.
I nursed Roy in the morning from 8:15 to 9 am, and then got more bloody show with lots of egg-white cervical mucus. Around 9am we called my in-laws, to come over as they have a 7 hour drive and they were to be our 2 year old son Roy’s support people. Contractions were at this point every 5 minutes and pretty intense at peak.
I emailed my doulas (Guina and Tracey) to let them know I am in early labor.
I posted on my ican message lists to let people know I was in labor, and got some good suggestions and some nice supportive replies. I also wrote my sister and some of my friends. I didn’t tell my Mom as she was nervous about VBAC and laboring at home, and I didn’t want to worry her. She would be my first call once Mary was born.
At some point I put together our “birth wishes” document, printed a few copies and also emailed it to my doulas.
My son went to day care, my husband chose to stay home for the day, and I started my “labor project”, baking some brownies.
I rested between 12 and 1:30pm. The contractions were stronger when lying down.
We had lunch then my husband and I went for a walk. I rested again from 4-5pm, then took a shower. I emailed some friends asking for prayers.
My parents-in-law arrived around 6pm and at 7pm while having dinner I began having significantly more painful contractions, which my father in law timed at about 3-5 minutes apart. I feel that this is when the real labor started. I was no longer able to talk through the contractions. I labored for the next 3 hours while playing with our son, nursing him to sleep and chatting. At 11pm I called my midwife Margaret, to touch base before the night started. I had one contraction while on the phone. She suggested I come in an hour. I told her I think we still had time and that I was going to labor at home for a while longer. She then said ok, 2 hours? I told her probably even later. She suggested we come before traffic if I make it until early morning. She said there had been a lot of births in the past day or so, and now it was quieter. She also said “I don’t think you’ll be here too early”. I told her I wasn’t crazy about being on the monitor and she said not to worry, I’ll only be on it for a 20 minute strip (the hospital policy is continuous monitoring for VBACs).
My husband went to sleep (I was hoping he’ll get some rest in preparation for what may be next) and I continued laboring on my own from 12-4:30am. There was no way I could sleep through the contractions, though I tried. I relaxed lying down a couple of times, though this made for the most intense contractions. I also labored in the bath, sitting, upright, etc. I listened to my hypnobirthing CD while lying down to help me cope with the contractions and relax.
Around 4am I began to feel that I would like some help while laboring, and also given the intensity of the contractions, I felt confident I was in active labor.
So I finished packing the labor and post-partum bags and woke my husband up, then got dressed for hospital labor (a tank top and shorts, socks and the crocs shoes). I had been wearing my lucky labor necklace (not proven, but hoped to be lucky, with three silver circles reading “serenity”, “strength” and “faith”). We called Guina to tell her we’re on our way to the hospital, and left before 5am. I had contractions every 4-6 minutes in the car, but with breathing they were manageable.
We got there and carried the labor bag, ball and body pillow in. There were no forms to sign (I had completed a basic pre-registration online) and we got directed to an L&D room. We got settled and shortly after that my doulas arrived as well.
I got on the monitor, we got a CD in. Later I also had the hep-lock for the IV put in place (it was annoying but not too much trouble in labor) and some blood drawn.
A while later, my midwife Margaret came by (she had 9 births in the prior couple of days so was exhausted and was napping between visits). I agreed to a cervix check hoping for 5+ cm. I was 5cm, 90% effaced, with a low but still pretty bouncy baby. The midwife was happy to see a 5, I was pretty neutral as I could pretty much tell from the strength of the contractions that I was about in there. A lower number would have been disappointing, a higher one is always nice…
My husband took a nap on a sleeper armchair, to have some energy for the more exciting hours to follow.
With the help of my doulas and later my husband’s, I continued laboring, changing positions fairly often among standing, sitting backwards on the toilet (a favorite), ball (seemed too easy, so remembering my last stalled labor I somehow avoided it), standing, squatting, some standing side lunges, lying down on my left, some slow dancing… I also drank Gatorade.
At some point the nurse came for another 15 minute monitor strip (to get some variability, as baby’s heartbeat was pretty constant at around 139 between contractions – I never worried about that, her brother’s had been 136 between contractions during labor too), and as she never returned after 25 minutes or so we took it off to change positions to the toilet.
A little while after that, the nurse comes in with a form, telling me that since I was refusing continuous monitoring (? never said I was, did they read my mind?) I was risking the death of myself and my child and can I sign this form to absolve the hospital of responsibility. I said yes, signed, then asked if this was the ob on call speaking. Turns out the current ob’s round was ending (dr L) and he saw me being off the monitor and felt that he had to cover his back as he passed me on to the next ob (dr S). A few minutes later dr L himself comes in to give me a similar speech about how I have to sign that form so that I cannot sue the hospital. Meanwhile I was laboring on the ball. When he finally left I was somewhat annoyed, but glad that with the form signed now we knew there was going to be no continuous monitoring and it was basically up to me to request monitor strips (which we did about hourly or so). I joked that I would like to sign a similar form to perhaps have eggs brought in for breakfast instead on the green jello I had been offered.
For the next 5 hours I kept laboring. The contractions were getting really strong (we laughed at my “square belly” shape during contractions) but were still about 4-5 minutes apart on average. The energy in the room was warm, optimistic and supportive, I was joking a lot, and overall it was pleasant to be laboring this way and feel this warmth.
The midwife came to check me again around 10:30am (4-5 hours after the first check) and the cervix was a 5-6cm. This was disappointing. The midwife suggested rupturing the membranes, which I was uncomfortable doing so early in labor. I was concerned about possibly locking in a malposition, about it being the start of cascading interventions, about handling waterless contractions as early as 5cm with no pain medication. So I declined.
She felt the baby’s position was good (and I felt her being LOA/LOT too), but I was worried about how would she “land” once the water was gone.
I continued laboring, a lot on the toilet facing backwards, where I seemed to get the stronger and more frequent contractions and where I felt it was easier for my body to relax the pelvic floor muscles. The doulas and my husband were taking turns massaging me and refreshing my drink, while I rocked a little and made moaning sounds. We listened to my “Successful childbirth” CD, and some music. More bloody show apppeared throughout labor. My husband fed me some mac and cheese.
I also took a shower at some point and it felt nice. Every time I would pee I would get a contraction.
The frequency remained around 3-5 minutes apart.
At some point I remember lying down with the monitor on and listening to my hypnobirthing CD, and I was so tired that I began drifting away between contractions. I would wake up with each contraction (very painful when lying down) and slow breathe through it, but I still appeared as napping, so the others let me rest for a while.
The midwife checked me once again and I was 6cm. I refused AROM (artificial rupture of membranes) again, to her growing restlessness. I just didn’t feel ready. She went for lunch and then to the ob practice across the street, and only returned a few hours later. I was almost at 7cm. At this point I had been dealing with really painful contractions for quite sometime and the 1cm per 5 hour average rate of dilation was beginning to drain me, so I agreed to the AROM. I felt more comfortable with this decision at 7cm rather than at 5cm.
I had the membranes ruptured. The water was lightly green stained with a bit of meconium (for some reason I always felt that she had passed a bit of meconium in there, not sure why, she was just so active and reactive to my emotions during the pregnancy).
The midwife recommended I labor in the exaggerated Simms position (on my left side with the right leg flexed at the knee) and she also instructed my husband on the kind of back counter pressure to apply. The contractions got more intense. I am not sure of their frequency, probably 3-4 minutes apart. Breathing very deeply and slowly then exhaling through the relaxed mouth (horse lips) was what helped me cope this time. The doulas continued to enourage me and massage me. Tracey kept taking pictures too.
After 20 or so minutes in this position we went to labor on the toilet for a while.
I got checked again a couple of hours later and was a 7-8cm. The baby’s head was nicely onto the cervix with contractions, but would float right back higher up between contractions, thus not applying constant pressure on the cervix.
The pain of the contractions was getting hard to handle. I was using slow breathing, rocking, moaning, the doulas were constantly lightly touching my back, and encouraging me along. Guina suggested some IV fluids which I wasn’t very receptive to, as I didn’t want to get restricted to the bed, plus I didn’t see why Gatorade would not be enough. She felt it would be a boost in my energy and perhaps help me cope with the long labor. My husband also agreed that fluids may be a good idea. I put it off for a while, then I asked that they check for the midwife’s opinion. She thought the fluids may help, so I reluctantly agreed. I wasn’t really opposed, just didn’t see the point.
With the IV in place, I kept laboring sitting on the bed with the feet on the lowered bottom bed segment in an approximate tailor sitting position, while my bottom was on a v-cut in the bed such that my tailbone was not restricted. This was suggested by Tracey, as an alternative to the toilet, and it worked pretty well. As the contractions were even more intense, I cried at some point and was telling the others that all this hard work has to mean something, it has to have a point, I need to see some progress…
After another while (timeline is blurry) I got checked again and was 8cm. The midwife suggested adding a very low dose of Pitocin (2-4 mU/min) to get the contractions to become more effective. I asked if she was not worried about increasing the risk of uterine rupture, she said not at all at such a dose. (I do think there is a very slight documented increase in UR risk, but I was not too worried about it). Since I had no better suggestion, and at this intensity and exhaustion I was concerned about facing many more hours of labor, I agreed (though was not looking forward to even stronger contractions), in hopes to see more clear progress.
The pitocin was started, as was the monitoring, and a blood pressure cuff was put in place which the nurse said will inflate every 15 minutes for the first hour, then more rarely. The “first hour” words kept resounding in my head – how many more hours were we anticipating this to last? It was about 9:30pm, I had been in the hospital for 16 hours during which, with AROM and all, had progressed less than 3cm. I was still hopeful that this would be a vaginal birth, and I kept having “flash-forwards” in which I could see the slippery body of my daughter freshly birthed onto the bottom of the bed.
I then entered “labor land”. Contractions got so strong that opening my eyes and talking were no longer options if I were to remain sane. I became more silent as the pain got stronger. I remained aware of what went on in the room (thankfully not much except some confusion as to why dr S was around and was he going to come in or not – I couldn’t care less). Most touch felt unbearable and I shoved some hands away (nobody held it against me thankfully). I felt hot, then very cold. In my mind, there were two main sets of coping images going on: 1) this is only pain; it is strong but it won’t kill you. Will you let it end your dream? 2) finding the edges of pain/comfort: really staring the pain in the face: this area (my lower front belly and some side/back area too) is in incredible pain; it must suck to be in there; good thing here, in my chest, nothing hurts; this is where I am, away from that pain.
I was still sitting on the “v” in the bed, shaking the squat bar and moaning pretty softly. I would occasionally lose it, especially in the beginning of a contraction, but then I would return to labor land, often prompted by the doulas’ instructions: “stay with us, Oana; find your rhythm; stay in your place”. They also kept telling me how strong I was.
Their support was essential in helping me keep going. They believed in me, laughed at my jokes (earlier in labor), and reminded me of how hard I worked to achieve this birth.
At this point the contractions were much longer (over a minute for sure) and with little space between them (1 minute maybe?). My husband saw the doulas carrying on a conversation and from the gestures he inferred something along the lines of: “we tried this, that and the other. How about we pray?”
After I felt the blood pressure cuff inflate 3-4 times (so after 45 minutes to an hour) I really felt that I was “pained out”. I simply admitted to myself that I have limits, and that I had reached them. I opened my eyes and began to cry. I told the doulas that I can’t do this any longer. That it is becoming all about the pain and little about the birth, and that if I am to wait the pitocin out to do its job I will need pain relief. My husband came over too and I told him I cannot do this anymore. He asked me what did I mean and I said I needed an epidural. (we had a code word for if I really meant that I needed an epidural, it was “flamingo” – I never said it; when I told my husband what the code word was going to be, early in the morning, I also told him I didn’t see the point of such a word, why can’t I simply mean it when I say it – but then I said we’ll have a word anyway, since I heard about this suggestion in many places. Now I knew why a code word could help: it allows you to try that option on, hear yourself say the words, see how it suits you, at least verbally, allows you to imagine it. I was able to discuss it with my husband and doulas as if I really meant it, without a final commitment to it, and that was helpful).
I felt that if I decide on an epidural at this point, it would be to save the chance for a vaginal birth. I felt pretty certain that I would not regret this decision. My husband was the only one understanding my words at this time, through my tears.
I saw my doulas mouthing the word “transition?” to one another, and I felt somewhat annoyed. I too knew I had shown transition signs, the weeping, the “can’t do it”, the mention of pain relief… But I didn’t want to get my hopes up yet again, plus I was telling myself sometimes people really can’t do it anymore, without being in transition. Sometimes they really mean it!
But first, I needed to be checked again. The midwife arrived and saw me crying. She didn’t know I was talking about the epidural, she just knew I wanted to be checked. The contractions were coming fast and furious and I was beginning to lose my focus anticipating some pain relief. She checks me, and guess what: about the same, 8 – 9 cm. My heart sank for a minute, after which I simply accepted that I may take that epidural and wait for the pitocin to hopefully finish its job. With the hand still inside and pushing on my fundus, the midwife was checking to see where the baby would descend to with the stronger contractions (that hurt even more, and I barely stopped from pushing her hand away).
Well, this is when something unexpected happened. It was about 10:30pm, one hour into the pitocin (and over 27 hours of real labor, following 23 hours of early labor). I was at 8-9 cm with a fully effaced and very soft cervix; those last two centimeters would just not flip out of the way. I felt very transitiony. I was at the end of my rope. My doulas were praying. I forgot to even do that. I was simply going with the flow, hoping to somehow remain afloat, trying to remind myself this all was about that little bouncy baby inside of me. Then, Margaret the midwife says, while still checking me: “why don’t you push a couple of times?” Bewildered, I say “push? What do you mean?” She says, “as if you have a bowel movement” (which really was not my question… I merely meant, what do you mean push at 8?). So I push once. She says: “push again”. I push again and I hear her say with a smile: “that just got you to complete”.
Then she repositions herself on the bed more comfortably. I realize she means business. I am semi-sitting at this time, in the last position I imagined I would be pushing. I felt exhilaration (complete??? Pushing?) mixed with panic (now what? What about pain relief?). She says ok, you can push when you’re ready. With the next contraction I felt the urge to push! Wow! It was not an overpowering huge pushy urge, but rather an uncontrollable reflex where my body simply folded over in a spasm like a closing pocket knife and gave a grunty push, which I helped by pushing with all my might. That brought about the most intense pain I ever felt in my life. I no longer could even feel the contractions as painful, they were drowned by the continuous pain of my lower areas feeling as if they were ripped apart. The only way I could tell I was contracting is by the pushy spasms. I felt the urge to bellow. I made the most otherworldly sounds I ever made, not screechy but not low by any means. Like I was pushing with my vocal cords as well. Relaxation, calm and control no longer entered the picture. My mind had to quickly switch from anticipating pain relief, to realizing I was now pushing a baby out and it hurt even more than transition! That took me by surprise, I admit it. Never having gotten this far with my first birth, I thought pushing would be less painful than the worst contractions. Now it didn’t seem that way. What really was scary was knowing that people often push for hours – I knew I could not handle that at this point. So my mind and body were on a mission: get the baby out! My first two pushes got her to crowning! I am pleased to say pushing was largely undirected. Margaret reminded me where to push and when I would ask “what next?” she would tell me to push when I felt like, which I did. I used the “urge” of each contraction for a push, then fit 1-2 more pushes per contraction. There was no counting. Margaret did shout at me to stop a couple of times as I was tearing from the speed with which my tissues were stretched by the descending baby. I actually asked Guina if that was the best position. She said yes. Truthfully, while this allowed best access for Margaret, side lying may have been a better compromise between getting access and minimizing tearing. But all this felt minor to me then. Margaret suggested resting between contractions, but there was no real pain relief, as the head was putting lots of pressure on both my pubic bone and my tail bone (and all the skin and muscle covering them), so I didn’t feel like a break. I kept saying that the baby needs to get out, in between the crazed vocal releases. I took a glimpse of my husband’ s face. He looked pale and sunken inside himself. I realized I was probably scaring him terribly with my vocalizing, but could not help it at that point. Margaret suggested I touch the baby’s crowning head, which I did. I expected it to feel unexpectedly mushy, which it did. Felt like marmalade! After a brief “how cool” thought, my main thought was “that only feels coin-sized, it needs to get head-sized and out, how will all this happen??” Margaret said that she could have cut me and we would have had that baby by now. She knew I didn’t want to be cut though, so she tried to help minimize my tearing instead.
I pushed for maybe 3-4 more contractions while feeling like there surely will be no more private parts remaining of me after all this, but it did not matter any more. Then I felt the head being birthed!! Blessed, immediate relief! I didn’t even think to push again, but Margaret reminded me after a brief break that I still had to push the shoulders out. Which I did, in two more pushes, while Margaret appeared to dislodge her a bit with a slightly worried look. Tracey told me afterwards that she had a hand by a shoulder so that’s why it took a bit of extra work. Then, the rest of the body slipped out and there she was, covered with vernix and a little blood, on the bed, my baby! Just like I had imagined!
17 minutes after being at 8-9cm and considering an epidural, I had pushed Mary out of me! I am still working on wrapping my mind around this. Such a long labor, followed by such a fast and intense pushing stage!
The overwhelming feeling was not triumph. It was relief. A big, whole-body sigh of relief. It’s over. We’re through. She’s here. Her life is beginning. Give me that baby!
Margaret placed her on my chest, where I tried to nurse her but she was not immediately interested. Tracey took pictures of the whole birth, crowning and all – I am very excited to have these to document the most intense time of my life!
After a while my husband cut the cord, and after more snuggling she got wrapped in a blanket and brought back almost immediately for me to nurse. This time she took on!
I gave a minor push and the placenta also came out. Later I asked to see it and the midwife gave us a nice "presentation" of it. The cord insertion point was on the edge of the placenta (marginal or Battledore), which is rare but usually benign, like in our case. Looked great, what an amazing organ!!
Afterwards I got stitches on my 2nd degree tears. This took a while. Tracey fed me some more mac and cheese. I called my Mom while being stitched. She didn’t even know I was in labor (plus I woke her up) so she started crying. We were so very happy. Baby was in my arms this whole time.
Mary Anca was born at 10:47pm on August 16th. A couple of hours after birth she was weighed at 7lbs 8oz (3400g) and 19.5 in (50cm), with a head circumference of almost 14 in (35.5 cm). Her Apgars were 9 and 9.
Her birth was a rollercoaster of emotions, and I would not change a thing. I am so thankful for all my husband, midwife and doulas did to help me achieve a vaginal birth with no pain medication.
Our daughter is a very peaceful, alert child, who rarely cries (just to let us know it’s time to nurse, or that she’s uncomfortable in some way). She immediately calms down as soon as we pick her up or as soon as her need is met. She is really a miracle and we feel so blessed to be the parents of two amazing children!