the birth story
Alright, everybody strapped in and ready?
For a refresher, you can see how we handled weeks 40 and 41 here.
Here we go:
After failing at moving my induction date forward, we arrived at the hospital on February 1st (my mom's birthday!) very promptly at 7:30 AM. My doctor had told me to eat a light breakfast before we arrived since as soon as I was checked in, I would be under a no-drink-no-food rule until I delivered.
Let's take a minute. You want me to eat a LIGHT breakfast before conceivably not eating for another 24 or 36 hours?! Yeah, right. So, obviously I had a lot of fun planning my "last" breakfast days in advance. We woke up at 6:30 AM and I proceeded to eat everything from my favorite yogurt and granola to scones to big hunks of cheese. By the time we got to Beth Israel, I felt awesome.
While we'd been told we might have to wait an hour or two before getting checked into our room, we arrived at an off time, apparently, and were the ONLY couple on the labor and delivery floor. So, registering only took about 30 seconds. I had been mentally prepared to hang out in the lobby for a bit, so actually being escorted to our room threw me into a bit of a panic. When they first took my blood pressure, it was very high, which is super unusual for me. I could feel my heart pounding behind my eyeballs.
I was a very healthy and cautious (nerd alert) child, so other than being born myself, this was my first trip to a hospital as a patient. I won't lie: putting on that gown and settling into my room made me incredibly nervous. Not that I ever wanted to deliver at home, but I can definitely see the advantages of being in a comfortable, familiar space as opposed to a regular hospital room. But luckily, Mike could sense my unease from the beginning and made every attempt to calm me whenever he saw me starting to get a little freaked out.
The resident on call came in probably after an hour and said they wanted to start with a Foley balloon, Cytotec and Pitocin. I had done enough research on Cytotec to know that I absolutely did not want to use it in my own labor and, thanks to my doula, felt empowered enough to say no (it was also written on our birth plan). While I could tell the resident was a little hesitant, she did, in fact, go talk to the OB on call, who said that since I was dilated 2 centimeters, she was fine just starting with the Foley and the Pit.
If you're not familiar with either of these induction methods, a quick primer: the Foley balloon is not actually a balloon, but it does help widen the cervix when placed. Mine was set to widen me to 4 centimeters. Pitocin is probably the induction tool that people are most familiar with: it stimulates your uterus to start contracting. The major difference between Pit contractions and natural contractions is the former's strength. While your body's own contractions will start off gradually, the Pit type often become close to unbearable within just a few hours. From what I read, the majority of women who are given Pitocin almost always choose to have an epidural since the pain gets severe so quickly.
While I originally had planned to TRY and labor without drugs, once I knew I was getting induced, I knew that I'd probably choose to have an epidural and was totally at peace with that decision. The insertion of the Foley balloon and the first dose of Pit were surprisingly not painful. My IV hurt more than either did (and I had to have an IV as soon as I got settled since I was GBS positive and needed my first dose of antibiotics). My body responded so well to the Pitocin that we didn't even raise the dosage after the first half hour.
After the first hour on Pit, though, when they raised the dosage, things started to get gnarly. While it wasn't a 10 on the pain scale, it became clear to me immediately that there was no way I was going to be able to labor at that level (and more!) for many hours. So, I called for the anesthesiologist, who was tied up in a C-section and came around 45 minutes later. Those 45 minutes were rough, no doubt, since the contractions were already coming 2 minute apart. But it IS true that when you're not contracting, you feel fine.
By the time the doctor came to administer the epidural, she said all of my muscles in my back were so tight there was barely enough space to put the needle in. This confirmed for me that I was making the right decision: the more tense you are, the harder it is to labor effectively. You need to be relaxed to make that baby move down the birth canal and it was pretty apparent that without an epidural, that was going to be a very slow process for me.
A note on the epidural, since I was terrified of that needle: the pain factor as compared to the sessions of prenatal acupuncture I did was mild. I was all geared up for it to be some of the most intense pain I'd ever experienced (I mean, a needle in your spine?! Come on!), and it really wasn't more than a pinch for a few seconds. It took about 10 minutes for the drugs to kick in, and I could feel each contraction getting less powerful. The relief was absolute and amazing. I literally felt my muscles melt.
Also, in the interest of sharing everything: you have to get a catheter put in when you have an epidural -- no ifs ands or buts. I was also afraid of this being painful and weird, but they wait until you're entirely numb and you don't feel anything, truly. You can, however, feel your legs enough to move them, which I didn't realize. I figured I would be totally numb below the waist. This was helpful in two ways: I was able to move positions during labor (but not walk around) and also feel the pressure in my stomach when it came time to push.
After the epidural, it was a waiting game for many, many hours. My parents and our doula arrived soon after and I felt drowsy enough from the drugs that I snoozed on and off for most of the morning. My body responded well to the Pit, to the point where I actually came off of it after about 2 hours since I started contracting on my own. The Foley balloon also worked rather quickly and soon after they removed it they broke my water, which got me from four centimeters to eight within an hour. We were high fiving a million angels at this point. You only have to get to 10 centimeters to push and I only had two to go, we were going to have a baby in no time!
Famous. Last. Words.
Here, dear readers, I stop and give you some hard-won advice. Don't listen to any time table that anyone gives you when you're in labor. You could be told you're going to not dilate fully for 10 hours and then have a baby within the hour. Or, you could be told you're minutes away from pushing and be stuck at eight centimeters for eight hours.
Unfortunately the latter, more or less, is what happened to me. Every time we tried to move positions, the baby's heart rate would drop, so I ended up lying on my right side for most of the day. This is not exactly conducive to labor speeding along. Getting from eight to 10 centimeters took all afternoon and evening and even when I finally got to 10, we still had to wait until I felt the "urge to push." In order to feel it more fully, we turned down the level of the epidural. This didn't mean I was in a lot of pain, but the amount of pressure you feel when the contractions get strong is absolutely painful.
Which brings me to another point: even with an epidural, labor still hurts. I was under the illusion that when I started to push, I would hardly feel anything because of the drugs. And that, also, by the time I started pushing, it would only be a few minutes before our baby popped out.
What actually happened was me pushing -- hard -- for two and a half hours and it hurt like a motherfucker. Now, would it have hurt more if I didn't have an epidural? Absolutely, so I'm not complaining. But it would have been better to be a little more prepared for the length and pain of the process. Here, I give a huge, huge shout out here to both Kim, our doula, and, of course, Mike. Their commitment to helping me through the process was absolute and I am so, so grateful for their love and support. I have found reserves of love for my husband that I didn't know existed until this experience. Having him tell me that I was doing a awesome job even when I felt like I was hardly making any progress kept me motivated. And it's very possible that this delivery would have taken a different turn if I hadn't felt so protected and been in such a positive atmosphere.
I also found it a little difficult to know exactly WHEN to push. Maybe this was because of the strength of the epidural, maybe this was because I started pushing a little earlier than I should have, but I did feel like some of the time I was kind of guessing as to when I should push. Towards the end it got a little more apparent, but it wasn't as black and white -- pressure and pain wise -- as I was expecting.
I was very fortunate to have a doctor who let me push for that long, even after my water had been broken for many hours. The words C-section were never uttered in front for me and for that I am eternally grateful. One of the labor and delivery nurses came up to visit us the next morning and told me that in any other hospital she had worked in, I would have ended up with a C-section hours before I gave birth naturally at Beth Israel. The only time things got a little dicey was when my doctor told me that baby was getting a bit "angry" at still being in the birth canal and we needed to get her out ... soon. While I didn't quite get her out on the next push, she was born probably within 15 minutes without the need for forceps or the vacuum. My guess is that if that process had gone on much longer, we would have ended up with some sort of intervention to make sure she was born quickly.
But! In the end she came out all on her own. And it is true that once the head is out, it's only one more push to get the whole baby born. Those few seconds were the most exciting of the whole delivery, as you can imagine. As I'm sure you heard or read from other women's birth stories, it is the epitome of an out of body experience to have your baby placed on your chest after delivery. And I'll be honest, the first emotion I felt was kind of a mixture of excitement and fear. Like: what the fuck did we just do?! I had a baby? And it's this baby that's currently lying on my body? And she was inside me this whole time? And she's also related to Mike? Because we made her? I made a human?
It turned out the culprit behind this protracted process was a very short umbilical cord. It was most likely the reason a) I was two weeks overdue b) why labor progressed so slowly from eight centimeters and c) why I ended up pushing for so long. But luckily, even with a short cord, she was born pink, healthy and with a strong cry that only lasted for a few seconds.
All in, I labored for 18 hours, and I feel very lucky. Other than a few dips in her heart rate, which happens with many labors, it was a pretty straightforward process. I thank the whole team at Beth Israel for keeping me and Avvie safe.
Now, three weeks later, it's still incredibly surreal to me that I have a daughter. That I'm someone's mom. That makes me feel weird. But every day, as she becomes more alert and I start to see myself and Mike in more of her features and I get to spend hours just smelling her head and squeezing her little body, it's becoming a little less weird and a lot more cool. And, if I remember correctly, that's pretty much how I felt about the first few weeks of pregnancy too. Full circle guys, it all comes full circle.
More on how we've survived post-delivery coming in the next few weeks...