This story was supposed to start with how I started labour, how I knew it was time to call Sid and Arjuna, King and Queen of the birth team, and my friend Keely and Marianne, my doula. We were supposed to labour at my house for a while. The plan included taking Monty over to Sid and Arjuna’s, walking around outside with the dogs, checking in with the midwives, and showing up at the hospital’s birth center very soon before the birth, which would happen in the birthing tub at the birth center.
On Friday, October 1, 2010, I went in to the midwives’ office for a non-stress test. Ember was doing fine, her heartbeat was good, she was moving around, I wasn’t having any contractions, everything looked like I would stay pregnant for another nine or so days and then she would be born according to plan. That afternoon, I was out walking Mo Mo in the rain when I decided to check my voicemail. One of the midwives, Annie had called. She is normally a very calm person, she speaks. in. pauses. Very deliberate breaks in her sentences are little places of calm.
There were no pauses, just one long sentence: “Andy it’s Annie you need to call me the labs weren’t very good call me now.”
So I called, fearing what she had to say about my 24 hour urine collection. I was being watched carefully for pre-eclampsia.
She wanted me to come to the hospital, she said “You’re having a baby tonight!”
Arjuna gathered me and the dogs up from our walk, we collected Sid and arranged for Keely and Marianne to meet us at the hospital. I called my mom, to assure her that everything was fine with the non-stress test and that nothing exciting was going on. Then I called my donor, Uncle Shawn, to tell him what was going on and to assure him that it was absolutely fine for him to go away for the weekend and I would see him on Sunday and introduce him to his niece then.
We arrived at the hospital, and started moving in around 5:00 PM.
This part was stressful. I didn’t know what was happening, really. I had discussed the possibility of induction with my birth team and our BirthWorks facilitator, Jodie. On some level, I didn’t really believe inductions worked, I had numerous friends who had been through failed inductions and had Caesarian births, and then difficult recoveries, in part because it’s major surgery and in part because they were so exhausted from hours and days of induced labour. In my mind, it made sense to try the induction but to be prepared to call it off before the point of exhaustion. I also had an intuitive sense that Ember wasn’t ready to come out the first time the possibility of induction was raised. By this point in my pregnancy, I sensed that she was ready. The Saturday previous, Ember had dropped once, and again a bit further on Sunday. Her head had been engaged in my pelvis all week. Earlier that day, I had even wished that she would be born that weekend.
The nurses had lots of questions for me and had to get baseline vital signs. The first hour was somewhat frantic. Annie came in and talked to me about how this would work.
The plan was to do a dose of Cervidil overnight and see what had happened by the morning. I asked if it was possible if my labour would start with just the Cervidil, since I knew that sometimes happened and I wanted to avoid Pitocin, since I didn’t know anyone who had ever had a Pitocin induction with no epidural. An epidural was the number one thing I wanted to avoid, since I feared being unable to move or feel what was going on in my body. After she inserted the Cervidil, Annie said it was unlikely, since I wasn’t at all dilated, but that anything could happen and we should keep an open mind.
Sid stayed with me at the hospital, and we sent the rest of the birth team out to gather supplies. Keely and Marianne foraged at the Coop and brought back enough food to feed our army. Arjuna went home with a lengthy list of things to fetch from both of our apartments, including my favourite pillows and my gigantic birth ball, since I had decided that the ones the hospital provides were simply too small.
After everyone had reconvened, things were calmer in our hospital room. Sid stayed, but everyone else went home and the nurse brought me an Ambian, so I could enjoy my last full night of sleep for a while. By this point, I had adjusted to the new plan.
Annie came in at 6:00 AM on Saturday to check my dilation. Nothing. I was discouraged, it seemed like the Cervidil hadn’t done anything. She started me on my first dose of Misoprostol, or Cytotec. She warned me that the medication could take three doses to work, and I would get another dose every four hours. Annie was a voice of calm and reason in the face of my disbelief and lack of faith in the induction process. She was the one who cautioned me that inductions require patience to be successful, and that it would be a long, slow process, but it would work. Then she bid me farewell – Judie was the midwife on call all weekend. I knew that one way or another, it would be Judie who caught my baby.
I like Judie a lot, and it was very calming to me to know that Judie would be there, in part because we click really well, but also it was just nice to know who would be there, so I could visualize how my birth would go. This was the one major sacrifice I had made when deciding against a home birth – from the beginning, I had trouble envisioning my birth because I didn’t know who would attend my labour. Had I chosen a homebirth, I would know who my midwife would be.
When Judie inserted the second dose of Misoprostol, she did a stretch and sweep of my membranes, hoping to move things along.
The day continued to progress slowly. I was impatient, in spite of Annie’s cautions. Sid and I stayed in the room. Keely and Marianne came by to check in, with Kale, my lucky baby. Kale was born at home the day that I did my egg retrieval for my IVF cycle, so it was nice to have her check in with me as I was starting to come to the end of my pregnancy. They headed off for a day trip to New Hampshire, and Sid, Arjuna, and I continued to hang around the hospital, not doing much of anything. I was having some contractions, but they were not the period-like cramps I had been told to expect. I thought they were more practice contractions, the kind I’d been having intermittently for the past week, especially when out walking. They weren’t painful at all.
Around 12:30 PM, just as we were having lunch, I felt a little trickle of wetness, then another. And another. We paged the nurse and she came in to verify that the fluid was amniotic fluid. It was, and within minutes, my contractions became more intense, though still not painful.
This meant that I needed to get an IV of antibiotics, since I had tested positive for Group B Strep. The IV was started, and now I was on the clock. If Ember wasn’t born within 18 hours, by 6:00 AM on Sunday, she would need to have blood work and other tests to make sure she wasn’t infected. This was my first timeline.
We did the first dose of Clindamyacin by IV, and as soon as it was in, I insisted the IV be removed. I found the IV very disruptive to my focus, even just having the Heplock taped down on my hand was difficult. I feared that it might pull out, or that I might injure myself, I just plain old did not want it.
So they took it out.
I continued to labour for a while, and got permission to labour in the bath tub in my labour room. Because I had pre-eclampsia, I had risked out of the birth tub. Intermittently, I would have to go on the fetal monitor for a few minutes, and get blood pressure readings, just in case, but otherwise, I was pretty much free to do what I wanted to do. After seeing how cramped I was in the little tiny bath tub, Judie let me labour in the birth tub, but she said I still couldn’t birth in the tub. This was great news to me, because all I wanted to do was move around.
However, before I could labour in the tub, she needed to check my dilation again. The concern with the tub is that getting in too early can slow a labour, and this was the last thing I needed, because of the GBS and the induction process.
This check was very, very physically painful for me, because of the contractions and the position of the baby. I was dilated about three centimeters, but not really effaced. Effacement is the process through which the cervix thins out; both dilation and effacement are important for birth.
Once I got in the tub, my pain went away. I was able to float in the water, weightless. I moved through contractions. Keely and Marianne arrived back at the hospital. While listening to K.D. Lang’s version of Neil Young’s “Helpless” I began to cry. I had a huge emotional breakdown in the birthing tub. I had always shared this song with one of the children I used to nanny for. I would rock him and tap his back to this song while he fell asleep for his afternoon nap, just about every day when he was an infant and toddler. Since then, I have rocked a few other kids to sleep to this song. As I listened to the familiar beat, I knew that within hours I would be holding and rocking my own baby to this same song. I realized that this was my baby, she was going to be born and I was going to be able to keep her. For me, it was a hugely emotional to look back and see how many obstacles I had overcome in conceiving this child, in being pregnant, and now, in bringing her into the world. Within the next day, my six year journey to parenthood was going to come to an end, and nobody was going to interfere with that. I kept repeating that nobody could take her away from me. My tears were tears of joy for this great event in my life, but also tears of sorrow for all the pain caused by infertility, discrimination, and lack of support from family and friends that I had faced in getting to this point.
After some time in the tub, our dinners arrived. By this point, I was occupying two labour rooms. I was the only person in labour at the hospital. In fact, it was very slow my entire stay, which was lovely. It was like the childbirth center was our own private home away from home. In many ways, it was not unlike staying at a hotel. I didn’t want dinner, one of very few times in my life when I have felt repulsed by food. The birth team ate and I tried a few bites of pudding. Finally, I left the room and ordered them to eat, and then get rid of the plates and any evidence of food. I couldn’t even stand the smell of food, not even on their breath. This was something no one had told me about – in labour, my sense of smell and taste were heightened beyond anything I’ve ever experienced before. It was not a pleasant thing.
Around 7:00 PM, Ian, one of the pediatricians stopped by to introduce himself. He explained that he was going home for the night, but that he would be there on Sunday when my baby was born. I nodded, and had another contraction while leaning against the counter in my room, with Arjuna squeezing my hips and applying pressure to my back. Then I asked what time he was coming back on shift – 7:00 AM. “Oh, I’m having this baby before that!” I said, definitively. There was no room for negotiation in my mind, this baby was going to be born before 7:00 AM. My second timeline. I’m not sure Ian believed me, but he left.
The next phase of labour we described as the gay dance party labour. I could not stay still, I walked around the halls, pausing with each contraction to have the birth team squeeze my hips while I leaned up against a wall, a counter, or whatever was handy. Sid proved to be the most talented hip squeezer ever. My favourite position was leaning against the birth ball which was placed on the bed. We danced around for hours. The nurse who was attending my labour at this point seemed to quite enjoy us.
At some point during the gay dance party, I became quite confused about my timeline for the GBS. The nurse had tried to explain that the baby needed to be born within 18 hours of noon on Saturday, when my water broke. If she wasn’t born by 6:00 AM Sunday, she would need extra tests. The information confused me and I didn’t understand how they would do the tests at 6:00 AM if she wasn’t born yet. I reminded myself that she would be born by 6:00 AM, and I solidified that timeline in my head. Meanwhile, Keely and Marianne went to clarify the information. Keely attempted to re-explain it to me, but it still made no sense to me, so I just reaffirmed to myself that it was irrelevant, since she would be born in time.
Finally, around midnight, I wanted to go back in the tub as the pain from the contractions was ramping up. The contractions were much more intense, lasting about a minute, about three minutes apart. Judie said she’d have to check me again before I could go in the tub. I was very reluctant to be checked, since the last exam was so incredibly painful, and I felt had possibly had triggered part of my emotional breakdown in the tub. Though I was scared, I knew she had to know how dilated I was before I could get back in the tub, and all I wanted was to be back in the water. I agreed to let her check me after the next contraction.
She checked me and I was thrilled to discover that this check wasn’t at all painful. My euphoria was short lived, however. My dilation had not progressed at all in several hours. Judie couldn’t let me back in the tub, instead, she said we needed to do my next IV of antibiotics and that we needed to start Pitocin to augment my labour, and bring the contractions on stronger so that I would dilate. I was, however, completely effaced. The gay dance party had brought Ember even lower into my pelvis, and had thinned my cervix completely, even if it hadn’t brought her into the world.
Before the Pitocin took effect, Judie had me sit with the news and get another 20 minute strip on the fetal monitor. In that time, I calmed down, stayed in bed on my side to ensure that the fetal monitors could pick up the baby’s movement. My contractions nearly stopped – they were spaced further apart and the intensity had diminished considerably. I feared that my labour would stop. I wanted to call it right then and there, and just have the c-section that I felt was imminent.
We had a new nurse – Sue, who knew Sid from working at the infirmary at his college. They had known each other for years. I was comforted by this and knew they would work well together. Sue started the Pitocin and the antibiotics. It took several tries to get the IV in, and I ended up with the IV back in my left hand, at last. By this point, I was tired. Not exhausted, but tired enough to sleep for two or three minutes at a time between contractions. Keely and Marianne slept in the room, and Arjuna went to rest in the Solarium. Sid stayed awake, and I was awake during contractions for a bit. The most comfortable position for me was to stay on my knees, draped over the raised head of the bed. Sid would apply pressure to my back and hips while Sue would hunt for Ember’s heart beat with the fetal monitor. She worked hard to keep the heartbeat on the monitor, but it was a losing battle since I kept changing position so often.
Throughout this time, I felt parched. I asked if I had a bag of saline, since I was on the IV for the Pitocin anyway. I also had waves of subtle nausea, but never enough to actually vomit, though Sid tried offering me a little plastic barf bag, the bag freaked me out and I made him take it away. Something about having the plastic bag so near my face induced a panicky fear of suffocating. Finally, I had a massive dry heave, without actually vomiting, and the nausea disappeared. In retrospect, I think this was the moment something changed, though I was not aware of it at the time.
Communicating was very difficult during this phase – Sid would squeeze my hips during contractions and I would say “No! Too much!” which sometimes meant he was squeezing too hard, but sometimes it meant the contractions were too hard, which I solidly blamed on there being too much Pitocin. It was all very confusing for everyone.
After a while, I asked Sid to wake Marianne, Keely, and Arjuna. I was frustrated. I was trying to labour effectively, but I felt like my body was pushing against my will. In my body, I felt like I needed to push, but in my head, I knew it was too soon. I knew I wasn’t ready, that the Pitocin hadn’t had long enough to work. A few times, it felt like I was pushing against my will, like there was something inside me that was shoving the baby up against my closed cervix. It felt like running headlong into a barn wall. Sue was also frustrated. It had been almost an hour and she hadn’t been able to locate Ember’s heart beat. I knew that she was fine, it was just that I was moving too much to keep the monitor on the right place.
I wanted to move around more, but the IV and the fetal monitor made it difficult to get out of bed or move, and I was too tired. Sid began rousing the team, but I saw how tired Marianne and Keely were, I asked Sid to leave Arjuna alone, since I figured it would be several more hours and that I would need her support later. Sue took Sid aside and said she was going to page Judie and that it might be time for the birth team to talk to me about an epidural, since I was having so much trouble staying still, and was clearly having a hard time. I am glad that I was not privy to that conversation, since I would have been very discouraged by it.
Around 3:30 AM, Judie arrived back in my room. Judie doesn’t really announce her presence when she appears, she just kind of floats in around the periphery of the room and assesses what is happening. Each time she came back, I was never aware of her arrival, I would gradually become aware that she had been there for a bit, and then she would come over to me and often lay her hands or her arms on me in support before saying anything. Throughout my labour, I found her presence very comforting and her way of fading in gradually is the opposite of the often jarring appearance of someone new in the room.
I became aware of Judie watching me, and I could sense Sue’s rising frustration level with the fetal monitor. Judie told me she needed to get a sense of where the baby was at and how she was doing, but though I could hear the stress in her voice, her concerns didn’t alarm me. I knew that Ember was absolutely fine. I could feel her moving, and descending ever so gradually between each contraction. I could feel her kicking. Finally Judie impressed upon me the importance of getting a fetal monitor on her, and if I couldn’t lay still, we would have to place an internal monitor. I absolutely did not want the internal monitor, but knew it was necessary.
Judie talked with me for a while, assuring me that most people thought it felt good to push. That I would be able to push my baby out. She assured me to follow my instincts and follow what my body wanted me to do, even as I kept protesting that it was too early, that I wasn’t ready. Meanwhile, unbeknownst to me, Marianne was mostly convinced that I was in transition and would be ready to push soon.
Around then, another huge push came from within me, outside of my control. I pooed on the chux pad on the bed. Judie was trying to whisk the poo away without me being aware of it, but my heightened sense of smell made that impossible. Besides, I was delighted to be pooing. I had been hoping to poo for hours, I had so much pressure in my ass since we had started the Pitocin. I remember asking “Am I pooing?” and someone saying to not worry about it, and me saying “No, I want to be pooing!” I was very excited about it.
Judie asked the nurse to change the bed, and we swapped out my postpartum hospital bed for a regular birthing hospital bed. Once I returned to the bed so that Judie could place the internal monitor, I attempted to get on my back or my side, or something. Judie was saying side, I was saying back, Marianne was suggesting something, but I was consumed by a contraction. I also really didn’t want to be on my back.
When I finally got into position, Judie attempted to place the internal monitor. I was dreading what she would find as far as dilation went. In my head, I promised myself that everything would be Ok if I was at least six centimeters, but I really wanted to be at a stretchy eight. I resolved that I would beg them for a c-section or an epidural or something if I was still at three centimeters. She went to place the monitor, but instead announced that the baby was right there and that I could push. This was the best moment of my entire labour. I was so excited to start pushing, I had been resisting pushing for at least twenty minutes because I thought it was too soon and I wasn’t ready yet.
It was almost like Judie’s announcement gave me permission to ramp up the intensity. The contractions became much more intense, almost instantly. Around this time, I realized Arjuna had returned of her own accord, and I was so glad because I knew the birth was imminent, and I didn’t have the presence of mind to send someone to get her.
Meanwhile, the scene in the room was somewhat chaotic. Judie had one glove on, Sue was on the intercom calling to get more people in the room for the birth. Judie was asking for a pair of gloves, now, and meanwhile, blood was arching up and down the wall, from the IV on my hand which seemed to have flown out of its own accord. At one point, Sue was trying to get people in the room, get Judie a pair of gloves, and hold something on my hand to staunch the bleeding. I knew then that I had yet another timeline – it was nearly 4:00 AM and I was due for a third dose of Clindimyacin at 5:00 AM. Now that the IV was out, there was no way I was going to be able to get a third IV, not while in active labour. The first IV had taken two attempts, the second had taken three or more, and I am a hard stick at the best of times. I knew that my baby would have be born by 5:00 AM or I was going to have to get another IV, and that seemed impossible.
I asked Judie repeatedly if she was sure I was ready push – I couldn’t believe it was time for my baby to be born. When she said my baby was ready to come out, I only had one word “How?” Marianne and Judie coached me on how to push my baby out, but I was a very lazy and slow pusher. I am sure had I been much less patient, I could have pushed her out in a few minutes, but I waited.
I tried to savor these last moments with my baby inside me. And I pushed her out slowly, one contraction at a time. As her head emerged and I reached down to feel it, I was surprised at how squishy, nearly gelatinous, the presenting part of her head, her crown, was. I expected the head to feel hard, not like a slightly firm water balloon. The intensity of her crowning surprised me. I had expected the often talked about “ring of fire” sensation, but it felt more like I was tearing. I don’t remember feeling anything burning. I kept saying I didn’t want to tear, and Judie said “I’m doing my best to make sure that doesn’t happen.” She tried every trick in the book – using warm lubricant to stretch out my perineum, and applying a hot compress. I felt quite patient in these last moments before her birth. Marianne assured me that I would meet my baby any minute. I was talking to the baby saying “You need to come out now.” Judie was talking to her: “Ember, we want to see you!” and everyone was commenting on her thick head of hair. Someone asked about heartburn during my pregnancy, and I looked up and said “No chit-chat!” I was finding their chatter very distracting. Finally, she emerged, her entire head was out, Judie was suctioning her mouth and nose, and then her shoulders and the rest of her body tumbled out with the next contraction and Judie caught her and guided her into my hands.
Vienna Teng’s “Lullaby for a stormy night” was playing on my iPod. It was 4:09 AM, and I had met all of my timelines – I beat the next dose of Clindamyacin, my baby wouldn’t need extra tests, and Ian wasn’t back on shift yet.
I attempted to pull her up onto my chest, but her cord was so short that I couldn’t really get her up. Right away, all the pain I had felt at all disappeared, just as Marianne promised me it would. I hadn’t torn at all, thanks to Judie’s efforts. Somewhat apologetically, Judie said she had to cut the baby’s cord right away, because it was so short. Her heart tones were good, but she wasn’t crying, she was full of fluids, and floppy. She reminded me of a baby seal, and was deliciously soft and squishy and slippery warm. Before the cord was even cut, she was trying to suck her thumb. Judie cut the cord and the nurses whisked her over to the warming table to be examined by the pediatrician.
Before long, her indignant cries filled the room. She squawked her disapproval at being born into the air for many long minutes. At last, the nurses returned her to me, with a final delay to weigh her. She weighed in at 6 lbs, 8.3 oz. Vienna Teng was back on the iPod when she came back into my arms – we had been through our entire (albeit limited) playlist. For hours, we had been listening to the same four songs on repeat. KD Lang’s “Helpless”, Bette Midler’s “Lullaby in blue”, Vienna Teng’s “Lullaby for a stormy night”, and James Taylor’s “Sweet Baby James” much to Sue’s consternation. I work best with repetition, and I think it’s a testament to how much I love those songs, I listen to them all daily.
As I held her and talked to her about her name, I decided she would be called Elise, though I didn’t name her officially until later on that day. I had some trouble delivering the placenta, on some level I wondered if it was because I was separated from the baby for so long, though it probably had more to do with the premature removal of my IV and thus cutting off the Pitocin. Judie encouraged me to try to get the baby to latch, and she did, briefly. She also encouraged me to visualize the placenta separating from my uterus. I was afraid, though my fears were unwarranted, that Judie was going to pull on the cord to remove the placenta and that this would be painful. She felt around and decided that it was sitting right inside my cervix. In the intervening time, I had felt a couple of giant gushes of blood. I felt like it was possible that I could hemorrhage and some of my risk factors that might put me at increased risk of post partum hemorrhage flashed though my mind. Fearing that I might feel faint or pass out, I handed the baby off to Keely and Marianne so that I could focus on delivering the placenta.
Judie told me she wanted to administer some medication, and then in a somewhat ominous tone added “Rectally.” Anything was better than another IV so she inserted five tablets of Misoprostol into my ass. Once I had delivered the placenta, Judie examined it and declared the cord insertion “very marginal” and “tenuous.” From where I was, it seemed as if the cord was hanging on by a mere thread. The image of Ember that I had been carrying around in my head for weeks was of a little Jules Verne inspired deep-sea diver with a tiny cable connecting her to the surface. At last, I no longer had to worry about that cord or my little diver. She was out and I was ready to feed her and nourish her.
The possibility of hemorrhage was still on my mind, so I asked Judie if I could have a piece of my placenta. She cut me off two little piece, and I ate a small bite right there on the delivery bed. I was ravenous. I hadn’t eaten in hours. Even under these conditions, raw placenta is not the most delicious thing in the world. I joked that I needed a wedge of lime and some salt with it. It was like eating raw hanger steak. I handed the second piece back to her, and the rest of the placenta got bagged up for Marianne to take home to steam, dehydrate, and encapsulate for me. Sending the placenta home is very routine at this hospital, but in 34 years of being a practicing midwife, I was Judie’s first guy to have a baby, and also the first to eat part of the placenta raw. Once the threat of hemorrhage had passed, I said “See, the placenta worked!” but Judie countered that perhaps the five tablets she had pushed up my butt had something to do with it. Either way, I didn’t experience much postpartum bleeding.
After the team had mostly cleared out of the delivery room, we prepared ourselves to move down the hall to the postpartum room we had picked out earlier. Arjuna held Elise and sang to her while I showered with Sid’s
assistance. We moved down the hall, and Marianne and Keely and Arjuna took their leave once I had settled in.
Though I kept saying we were going to leave any minute, Sid stayed with me and Elise in the hospital for the next two days. Judie had signed provisional discharge papers so that I could leave as soon as I wanted. Elise didn’t need any additional observation, but Sid convinced me to stay Sunday night. Once Monday arrived, I had decided it would be great to stay through lunch on Tuesday. By then, I was familiar with the routine of the hospital and how the staff worked. We liked every single nurse who took care of us. Nobody tried to interfere with anything we wanted to do, and nobody pressured me to be separated from my baby. I went with her for her hearing test in the nursery, and her PKU test was done in our room the day we were discharged. The nurses were very helpful, offering suggestions but never forcing advice on us. We also met with the pediatricians on shift and with the lactation consultant, who offered great advice and support as we attempted to get Elise to latch and started her on colostrum through a finger-feeder.
On Monday, Laura, the birth registrar, came to us with some exciting news. The Commonwealth of Massachusetts had decided that Elise could be the first baby to have “Parent” listed on her birth certificate rather than either “Mother” or “Father.” Massachusetts already allowed people to be listed as “Co-Parent” but never before had a baby been listed as having a parent. I gladly signed the forms and was promised I could pick up her birth certificate from the town clerk’s office in about a week.
When Judie came back on shift on Tuesday morning, she was surprised we were still there, and she stopped by our room to visit with us. When it was time to go home, we packed up and Marianne met us at the hospital to help us with the great convoy home. Walking through the lobby and out the main entrance of the hospital with my baby in her car seat for her first ride, it seemed as though this very familiar place, where I had been dozens of times before, was completely different.
I couldn't help but laugh at your description of the placenta "steak" taste. (P.S. Placenta encapsulation is awesome. DH called them my "happy pills".)
Loving wife and mama to my sweet little son (Fall 2008) and a beautiful baby girl (Fall 2010)
When a stupid man is doing something he is ashamed of, he always declares that it is his duty. --George Bernard Shaw
daughter #2 10/08/10
Me: 27, DW: 31, Mamas to G: 5-17-10
My sweet surro-babe was born on 6-27-12