Here it is, the first story in our Local Birth Stories series: Jennifer’s story of the birth of her son Ian! Her story includes thoughtful reflection on many birth-related issues; the day-of birth story details are at the end, under “The Birth Story.” Thank you, Jennifer, for sharing your beautiful story so eloquently with us!
THE BIRTH OF IAN
“Giving birth was the most empowering moment of my life… People told me it would hurt, people told me that it would be hard, but no one told me that I would leave feeling like a superhero. That part was a surprise.”
–Michaela Knox in “Birth Matters: a Midwife’s Manifesta” by Ina May Gaskin.
The Before and After: My background and the things I learned from my experience
I had a wonderful, empowering, fulfilling, joyous birth at a hospital-based birthing center. I began my first pregnancy planning to deliver at a hospital in Williamsburg, but after a huge mental journey, ended up transferring to a birthing center in Norfolk halfway through my first pregnancy.
The whole thing–not just labor itself, but forming a more accurate picture of the current “normal” in hospital births along with my associated realistic options–was a huge learning experience for me, and even though I expected birth to be a positive experience, it ended up being even better than what I had hoped for or imagined.
I originally wrote what follows just for myself, a kind of diary so that I would remember what it was like. I’ll apologize in advance that it is extremely long–I guess childbirth is a topic about which I’ve become very passionate, due largely to the huge discrepancy between my initial and present understanding of what a woman can expect if she just goes with the flow in America today. Even if I never intended to share it, it was therapeutic for me just to type it. Feel free to skip right to the birth story if you grow weary of my philosophizing!
I wrestled for awhile about whether I should share my experience with friends of mine when they were expecting. I didn’t want to be pushy about my opinion and the way I saw things, to make it seem like I’d done it “right” or that my good experience cast any kind of criticism on those who’ve had bad experiences. But I’ve also realized how few of my peers had really TALKED to me about their experiences, how it was really only my mom who’d ever given me details and talked about birth in a positive light. No one had ever told me how GOOD birth could be, that it could be an experience that I’d look back on frequently with joy and satisfaction. “Spiritual Midwifery” (loaned to me by a friend) was really about my only other source of first-hand, good birth stories.
My mom had two unmedicated births, in 1978 and 1980, and although she didn’t have near the midwife-quality level of care that I was so fortunate to have, they were both positive experiences overall. I was born two weeks before the newly-constructed birth center opened at her hospital, and so she labored in one room, was moved mid-pushing-contraction to a gurney, wheeled to the delivery room, moved back onto a bed, delivered, and was moved to a shared recovery room afterward. My brother was born in the more home-like environment of the new birthing center two years later.
Initially, I’d been going to an OB in Williamsburg, whom I liked very much, but as my pregnancy progressed and I started to really understand what the current “normal” is in regards to birth experiences at my hospital, it just felt more and more wrong for me somehow. Hearing Mom’s stories, I naively assumed that things had continued moving that direction, away from the horrors of chloroform births in the early 1900′s, the exclusion of fathers through the 1960′s, and the doctor/hospital-driven practices of the 1970′s, to a more natural and mother/baby-centered experience.
I had it in my head that birth was normal and natural and that women had, you know, done it at least a few times in the past. Instead, the nurses I talked to seemed intent on helping me to understand just how dangerous (their word) birth was, that my growing instincts (which were ever more loudly telling me to trust my body and follow its lead in labor) could get me into trouble and I really needed to put more trust in their established policies and procedures. As an example, I’d asked if it would be okay to opt out of having an IV port put in my hand “just in case,” which was their default protocol, instead wanting them to give me an IV only when and if it became necessary. My OB was supportive; the hospital staff were irritated by the request. I was a little concerned by their policy forbidding eating or drinking while in labor, other than popcicles or ice chips [Note from Williamsburg Mothering: in the time since Jennifer's experience, the hospital has changed their policy on eating and drinking during labor, and now allows it.] Having never been in labor before, I had no idea if I’d be hungry or thirsty, or if I’d abhor the sight of food. But the “no food or drink; we’ll give you an IV with fluids and nutrients if needed” policy seemed, I don’t know, too high-tech and complicated. That kind of thing.
The more questions I asked, the more rules I encountered, and I started to feel trapped by the rigidity and narrowness of their accepted bounds of what constituted acceptable and “normal” courses of labor. And they seemed to have plenty of protocols to keep your labor in the middle of their comfort zone if it threatened to veer away from the center of the bell curve.
It took a lot to overcome the mental block I had against driving to Norfolk from Williamsburg (being in labor + bridge tunnel + rush hour = yikes!). But one day I realized with a start that I was planning to leave for the hospital later and later and later in my loosely-formed mental idea of labor, so much so that I almost saw myself arriving just barely in time to hop up onto a bed and push the baby out. Why? I had subconsciously moved to a defensive mental posture as I increasing felt the need to put safeguards in place to prevent things being done to me against my will, to preserve some small bit of freedom and autonomy to follow my body’s lead in labor. In doing so, I’d become one of “those” patients–a thorn in the nursing staff’s side. It didn’t feel healthy, this mutual lack of trust and growing tension. In a very unexpected twist, I realized that I didn’t feel…safe…at my hospital. I ended up transferring to the birthing center about halfway through my pregnancy and I’m so very glad I did.
They require you to do a lot of self-education and preparation, which I found to be enormously helpful. There are all kinds of tiny details–well, that seem tiny but psychologically are surprisingly huge–like the fact that the midwives have you weigh yourself on a scale at each appointment and have you do your own pee-in-a-cup test (they teach you what you’re looking for). It creates this subtle shift of power, of who’s in charge. I mean, I never thought about it at the doctor, but of COURSE I know how to work a bathroom scale. It builds a sense of trust between you and them, instead of the usual surrender-yourself-to-the-expertise-of-the-doctor mindset. And, “Don’t expect us to rescue you; this is YOUR deal. YOU have to birth this baby–we’re just here to guide and help you.”
In the end, I found the experience empowering, thrilling, challenging, transformative, and even healing. I didn’t even realize that I had some deep-seated issues with my own femininity. I’ve often felt ostracized from the “woman” club because I’m not into Cosmo or People magazine, I hate shoe shopping, am indifferent to diamonds, had trouble gaining adequate weight in high school when my friends were going on diets, and find it easier to form friendships with guys than with girls. I like airplanes and hiking and football and sailing and science. I change my own oil. I was a late bloomer whose period has never been regular, to this day. All this had bred a subconscious sense of self-doubt, a sense of wondering if I were broken somehow, if I were somehow not fully woman. The amazing thing about pregnancy and childbirth for me was that it was fully FEMALE, something independent of any cultural definition. And I came away feeling so…solid. Heroic. Whole. I AM a woman (hear me roar!). I am not somehow less of a woman because I don’t fit the Sex-and-the-City archetypes. Society and its definitions are what’s warped–not me or you or who WE are. Those are what’s real.
By way of summary, there are a few analogies that have stuck with me about the whole labor experience. It was a TON of work, physically, like a workout at the gym where you really push your limits. I was sore all over afterward–my calves, my biceps–didn’t expect that! And the pain came in bursts, in groups, the way it does when you’re doing sprint on an interval or something, or reps with free weights. It wasn’t the kind of pain where you don’t know when it’s going to end–contractions are fairly predictable. You can look a the clock and know it will be over in a few seconds, unlike having intestinal cramps with the flu or something (similar in feeling, but finite in duration).
But I was also never SUFFERING, and I learned that to me, pain and suffering are separate concepts, often linked, but not in this case; I was mentally UP the whole time–bring it on, baby! We can do this! When I was a swimmer, there were certainly workouts where there was PAIN involved (and in running, same thing). But somehow, knowing that I was pushing myself with the goal of getting better and faster, I kept going. Not really suffering. Suffering, to me, involves a mental mindset, an emotional state of pain. After the death of a close friend, or even (I’m a wuss) after having a cold for a few days, I’d say I was suffering (cue small violins). Labor was intense and focused, with a huge goal in front of me.
My final two analogies were running a marathon and climbing Mt. Everest. Until I went to cheer my best friend on when she ran a marathon, I’d never understood why anyone in their right mind would put themselves through that kind of pain. Then I saw the energy, the satisfaction, the sense of accomplishment–that I-ran-a-marathon-so-I-can-do-this-other-hard-thing mentality that she came away with, a slight shift in how she saw herself. And in the Everest analogy, same thing. In both cases, they’re solo endeavors…often with a great support staff. In the words of a cousin of mine, we do these kinds of things because “It’s an expansion of previously-believed internal boundaries.” That is to say, there is tremendous value in the process, in the journey–not just in the end goal itself. Taking a helicopter to the top of Everest or getting a ride to the finish line of the marathon wouldn’t be quite the same. And the midwives have a saying: a birth is not just the bringing forth of a baby into the world; it’s also the making of a mother.
Before I went through labor the first time, I didn’t fully understand what midwives did or how their roll differed from that of a doctor or nurse. In the Everest analogy, midwives are Sherpas; people who’ve been up and down the trail a bunch, who know where the tricky parts are, who can give you salient and credible advice–and who know when the unexpected storm moving in means it’s time to call off the summit attempt and get off the mountain. OB\GYNs become the search-and-rescue teams in this analogy.
It’s hard sometimes, to be openly proud of what I accomplished—and there is SUCH a feeling of pride and accomplishment in having done something so physically and mentally hard and brave and valiant and strong–in a way that is clear that it’s not a criticism of anyone else who chooses (or is forced onto) a different path. But, shoot, I can celebrate the achievements of my ironman or marathon-running friends with absolutely no sense of it reflecting poorly on me that I’d be winded after half a mile (no joke). And I feel NO guilt that there’s no summit attempt on Everest in my future. In that spirit, here is my story. Take the parts that seem helpful or insightful to you, and leave the rest.
It’s divided into 3 major parts: my struggles with getting pregnant, the agony of waiting for an “overdue” baby, and finally labor and delivery.
Doubts, Fears…and Hope:
I’ve been surprised how much…work?…these first two months have been. And I’ve had it super-easy compared to some women, even if I do feel pretty queasy most of the time. Haven’t puked yet. So, where to start?
How about with The Day when everything changed? My alarm goes off and I hit the snooze, like usual. After a few minutes, I drag myself out of bed, and wonder. I feel my breasts—yep, still sore. As I stand up, I note that for one more day, my period still hasn’t started. Day 20, I note, silently congratulating myself on holding out the extra 5 days from when I could have tested. On the counter is waiting a clear glass cup that I brought upstairs before bed last night, hoping. I take my temperature, as I’ve been doing for, oh, a year and a half. It’s been a half a degree higher for two weeks, and now—these last 5 days—it’s been another half a degree higher. 98.3.Well, that’s a start. I get the test, still in its little foil pouch, unfold the instructions and skim them one more time, though I know what they say.
Did I take a deep breath? I had so determined that this test—this one here that I was holding in my hand—would not be negative. I’d carted it with us on vacation, all the way to New Zealand, expecting either my period or…a chance to take the test. My period didn’t come the earliest I thought it might—on Thursday morning—and I decided I’d take the test on Saturday if it still hadn’t come. Then, just before bed on Thursday, I think I feel it start, head to the bathroom, and sure enough, I’m bleeding. I didn’t cry, but I remember the feeling of disappointment. Sitting back, on the toilet at a friend’s house, and closing my eyes, trying not to think about the 4 months of waiting we now had in front of us. Taking small consolation from the fact that I hadn’t used the test in vain. I mean, I’d bought a two-pack of the cheapest test that Rite-Aid sells. I figured, these tests are much more likely to give false negatives than false positives. Why spend two or three times as much just to be able to test a few days earlier? Here, I was determined that patience would save me the difference. With the first two tests—the negative ones—I was still learning my patterns, learning what objective signs and symptoms I could trust, which subjective feelings had to be deliberately ignored. But now, I had a strong sense of the odds. And they were looking better than they ever had.
My husband and I had gotten into a frustrated discussion on Wednesday night. I’d told him that I was 3 days later than I expected. That I’d only ever been 1 day late (in the 3 cases for which I had a recorded, reliable record). That my temperature was still elevated, and had in fact increased again on the day I expected my period to start. And the breast tenderness had not diminished, and in fact had increased in the last three days—I couldn’t face the shower directly—ouch. I now felt that the odds had surpassed the 50% mark. I felt that there was an increasingly strong case that the evidence was more probably explained by pregnancy than by any other explanation. But I didn’t want to be hasty—I really wanted the one test I still had to be the one that was positive. So I was going to wait until Friday before I took it. He was decidedly unimpressed with my case; my periods were so highly irregular, so all those things don’t really mean anything. Yes, I countered, I am irregular (often going 3-6 months between periods), but the time from when I ovulate—from when I believe that I ovulate based upon a rise in body temperature and a coincident sudden nipple tenderness—had been 14 or 15 days, every time. If I knew when the temperature rise happened, I knew when to expect my period to start. I’d read that that’s a common occurrence in women who are irregular—an abnormal follicular phase but a normal luteal phase.
He blew me off. Couldn’t understand the point of a home pregnancy test in the first place—I mean, you’ll know eventually, right? [Fair warning: extreme nerdiness ahead in the next few paragraphs. I'm a physicist and must occasionally be granted such indulgences—what can I say!] Speculation was meaningless until the wave function was collapsed. I agreed that it was very analogous to an uncollapsed wave function. That’s where my unsettledness came from. I was existing in a linear combination of:
The weighting constants in front of these two orthogonal states had, I felt, finally passed the 1/sqrt(2) point. As a function of time, the constant in front of the latter was increasing hyperbolically, with it approaching its asymptotic value of 1 by, oh, the weekend, whereas the constant in front of the other was decreasing accordingly (with the sum of the squares of the two, of course, adding to 1).
That is, at that point on Wednesday night, I felt that it was much more of a stretch to come up with reasons why I might not be pregnant than to begin to consider the more likely possibility that I was, in fact, pregnant.
I, obviously, did an inadequate job of clearly laying out my case, explaining why it was not based around emotion but was founded in objective observations, why the conclusion that I was proposing was, in fact, based on new information—on an increasingly large amount of information. Every tenth of a degree change in my temperature, every incremental increase in breast tenderness, every hour that ticked by without that subtle, silent, sudden, sliding, wet oh-I’d-better-run-to-the-bathroom-and-check-and-see-if- that’s-my-period-starting feeling was another straw on the pregnancy side of the possibility scales.
Now, this very real possibility that I wanted to discuss and marvel at might have been backed up and motivated by a very rational process, but I was extremely emotional—in that my emotions were strong, mixed, and heightened, not in that I was upset—precisely because I had finally allowed myself to crack the door open just a tiny bit to hope.
And in the tiny space of that crack in the door, hope had come rushing in, all the pent up, unspoken, resisted fears and doubts had built up more pressure than I’d realized, and I felt a bit like I was in danger of drowning. Because coupled with hope comes fear. If I hadn’t begun to hope, then the disappointment of a negative test would be bearable, as it had been before, and met with reaffirmations of my faith in God’s goodness and wisdom and kindness and timing. But now, here I’d allowed myself to really start to hope, to engage in wondering if maybe it were really possible.
And so, I wanted to wait just a little longer, let the odds stack up even more strongly on the one side, because I was a little afraid of the fall if I turned out to be mistaken. Suddenly, it seemed like a long way down. Further than before, perhaps, because this time I’d decided I’d at least go to the doctor’s and have them test my hormone levels to see if there were any obvious anomalies. And somehow even doing that would feel like a tiny concession of—well, if not defeat, then perhaps of—doubt. And it looked like a long and slippery slope down. How far down that hill were we supposed to go? One step at a time. We could decide about each bridge as we came to it, and it was okay not to know right now. Right now, there was a little foil pouch waiting for me upstairs, waiting for Friday morning.
But my husband didn’t see the cliff I was talking about, didn’t understand the two diametrically opposed worlds, in each of which I had one foot at the moment. He was still happily back in the comfort of the woods, far away from the clearing I’d come to and the diverging fork in the road I thought we were facing. To him, nothing had changed, everything was as it had been for the last year and a half. So my overly-charged emotions—the excitement, anticipation, wonder and hope on the one hand, the whisper of disappointment, discouragement, and uncertainty on the other—really seemed uncalled for and out of proportion to him, I think.
It’s rare for us to have such a hard time understanding each other. He apologized for not being able to empathize, and I broke down and cried until it didn’t hurt so much. Then I went and found solace in the scriptures that I’d been praying through for the last week and a half.
[A note from WilliamsburgMothering.com: Williamsburg Mothering is a secular blog, not affiliated with any system of religious belief or non-belief. For many women, faith is an important part of their lives and of their journey to birth. For many others, it is not. No matter our spiritual beliefs, however, we can all appreciate, learn from, and find inspiration in each others’ stories! Birth is universal.]
[A note from Jennifer -- Fair warning: a few paragraphs of churchiness ahead] The Sunday just over a week ago, God had really spoken to me through several scriptures that were read. Psalm 105:1-5:
Praise the LORD, O my soul; all my inmost being, praise his holy name. Praise the LORD, O my soul, and forget not all his benefits-who forgives all your sins and heals all your diseases, who redeems your life from the pit and crowns you with love and compassion, who satisfies your desires with good things so that your youth is renewed like the eagle’s.
It really touched some deep things in me, things I hadn’t taken out and looked at in awhile. There are those thorns that the enemy sows amongst the wheat, the lies that our past sins aren’t completely forgiven, that the failure/suffering/sickness that we’re currently enduring are our just punishment for past sins, that we’ve forfeited the best things and will have to settle for the curses we’ve invited into our own lives. If you read the whole Psalm, it’s just a beautiful picture of God’s nature, being full of love and compassion and forgiveness, of his desire to bless and redeem and heal and renew.
Thus says the Lord GOD, the Holy One of Israel:
“ In returning and rest you shall be saved;
In quietness and confidence shall be your strength.”
This helped adjust the attitude of my heart—rest, quiet, confidence. The antidote to useless anxiety.
If that is the case, our God whom we serve is able to deliver us from the burning fiery furnace, and He will deliver us from your hand, O king. But if not, let it be known to you, O king, that we do not serve your gods, nor will we worship the gold image which you have set up.
In this passage, I feel the power of the three words, “But if not.” It’s a wonderful addition to so many prayers in which we ask God for something. God, this is what I’m asking you for, and I know that you’re able to do it, but even if you don’t—for whatever reasons I cannot know or comprehend—I will not turn my back on you or cease to love you. God, you are able to give us a child, but even if you don’t….
Then He said to His disciples, “Therefore I say to you, do not worry about your life, what you will eat; nor about the body, what you will put on. Life is more than food, and the body is more than clothing. Consider the ravens, for they neither sow nor reap, which have neither storehouse nor barn; and God feeds them. Of how much more value are you than the birds? And which of you by worrying can add one cubit to his stature? If you then are not able to do the least, why are you anxious for the rest? Consider the lilies, how they grow: they neither toil nor spin; and yet I say to you, even Solomon in all his glory was not arrayed like one of these. If then God so clothes the grass, which today is in the field and tomorrow is thrown into the oven, how much more will He clothe you, O you of little faith? Do not fear, little flock, for it is your Father’s good pleasure to give you the kingdom. And do not seek what you should eat or what you should drink, nor have an anxious mind. For all these things the nations of the world seek after, and your Father knows that you need these things. But seek the kingdom of God, and all these things shall be added to you.”
Again with the not worrying, the reassurance of God’s pleasure in giving us the kingdom.
And finally, Psalm 127:1-5:
Unless the LORD builds the house, its builders labor in vain. Unless the LORD watches over the city, the watchmen stand guard in vain. In vain you rise early and stay up late, toiling for food to eat—for he grants sleep to those he loves. Sons are a heritage from the LORD, children a reward from him. Like arrows in the hands of a warrior are sons born in one’s youth. Blessed is the man whose quiver is full of them. They will not be put to shame when they contend with their enemies in the gate.
Wow, if that’s not appropriate! You know, I’d always seen it as being two separate parts—the first talking about the futility of endeavors apart from God, the second talking about kids. This was the first time I saw it as one coherent Psalm. And it occurred to me that now was a good time to begin practicing turning over my cares about being a parent to God, knowing somehow that doing so will be a lifelong process. Now I have the chance to put it squarely in His hands, starting with getting pregnant. Who knows all of the worries I’ll be tempted with as our children grow? Birth defects, childhood illnesses, problems in school, with friends, with college, in their marriage, whatever. An endless well of things to worry about, but an unmoving God on whom to stand, in whom to rest and find shelter from such things. God, I’ll let you do the building, let you be the sentry. Thank you for the second verse, too—that you grant sleep to those you love! Hey, do you not love me or what?!? How about some more sleep???
Taking the test:
I don’t really remember Thursday, or what I did to get through it. I do remember this ridiculous acronym that I’d seen in online discussion boards running through my head—TDTWW, the dreaded two-week wait. Well, I’d made it almost three weeks. Hrumph. Why couldn’t my husband understand just how commendable that was, what strength of patience and will-power I’d exercised? Ah well. I’d just have to pat myself on the back. And hopefully it would spare me from looking down at a negative test again.
So, Friday morning. Standing at the counter in the bathroom in the muted light of the rising sun, filtered through the trees and then through the wavy block glass of the bathroom window. Did I do the math and count to when our next chance to try would likely be? Probably just before Christmas, at the earliest, or maybe as late as the end of March, if it went like this last time. Or would the doctor recommend Clomid and advise us to try again in a few weeks? If these kinds of thoughts clamored again for my attention, I pushed them away and wordlessly mumbled something to God, probably along the lines of, “well, here we go, eh?” (He puts up with me mumbling a lot to him in the morning, usually along the half-awake lines of things like, “g’morning, God. Thank you for today. You’re good…I love you…Why is this so hard?…ugh.”)
So I unwrapped the foil wrapper, took my glass cup and peed in it. Then I took off the purple cap and held the tip of the test in the cup while I counted to twenty. Then I replaced the cap and laid the test down flat on the counter, kneeling on the rug with both my elbows up on the counter and my lips pressed against my intertwined fingers. I didn’t have to wait long. You could see the liquid moving up the internal strip of the test, just like dipping a piece of litmus paper into some chemical in chemistry class.
It was a big, blue +.
No question there. I didn’t feel any rush of emotion—just kind of numbness, but I glanced up into the mirror and was surprised to see a huge, huge grin spread across my face.
Thank you—oh thank you! I turned and bowed down, with my hands and head on the floor, and started singing quietly. And then I was giddy; I wasn’t crazy! I really was pregnant! Rather than wake my husband up, I left him a note on the bathroom door that asked what his plans were for the end of April, said that I might have an early birthday present for him. And then I left the test, along with the instructions on how to read it, on the bathroom counter. Tee-hee!
Tom Petty was Right (The Waiting is the Hardest Part)
The long last month:
That last month was a battle with impatience. At my 36 week (by their count; 34 by mine [sorry--this is a pet peeve of mine, counting from two weeks before the day you get pregnant, instead of from the day you get pregnant. So unnecessarily complicated! It means that all women, even virgins, are walking around 1-2 weeks “pregnant” all the time, and that the day you get pregnant, you’re suddenly 2 weeks pregnant. What?!? Sorry. It shouldn’t irk me so much. An online due date calculator that 1) allows you to use your conception date instead of your LMP (last menstrual period) date and 2) actually uses the average human gestational period instead of the obstetric 40 weeks! http://www.diaperpin.com/calculator/DueDateCalculator.asp]) appointment, I found out that I was already 1 cm dilated. We scheduled my next several weekly midwife appointments and the midwives felt like it was unlikely that we needed to schedule the last appointment, thinking that I’d probably go early.
So, my expectations were changed and I started thinking—almost every day—“Maybe today’s the day.” Even though I’d done my research and knew that my obstetric “due date” was just some arbitrary day, I still found myself looking at that date on the calendar and thinking he’d be here by then. It didn’t help that my neighbor and I had the same due date, and that her OB obviously took that date as gospel. In fact, they scheduled her for an induction at 1 week past this due date. Surprise, surprise—they scheduled the induction for 5:30am on a Monday morning—very convenient for their schedules, terribly inconvenient for her. Wouldn’t you think you’d want the mom to get a good, full night’s rest and maybe even have a decent breakfast before she started labor, if you had the choice? Anyway, that’s another issue.
I knew that my own due date 8 days later was a much more reasonable date to plan around, but, hey, I was already at 3 cm—this kid was coming early, right? My obstetric due date came and went and I found myself frustrated with the medical profession’s propensity for embracing standard practices that aren’t tied to anything evidence-based. Everyone tells you, “Firstborns tend to be late.” Well, it’s out there in the collective folk wisdom, and it’s out there in the peer-reviewed medical literature, so no, firstborns are NOT late—due dates for firstborns are determined by a flawed algorithm. [If you want to read the journal article for yourself, Google “The Length of Uncomplicated Human Gestation” by Mittendorf, Williams, Berkey, and Cotter, in Obstetrics and Gynecology, June 1990, Vol 75 No. 6 p. 929-932.]
I kept telling myself that it really was not until my extended due date that even 50% of women would have gone into labor spontaneously, and silently cursing the medical establishment for their nice, round 40-week rule of thumb that they use so predominantly. I realized that it gives one false hope. And I think that the name–”due date”– is part of the problem. Anything else in life with a “due” date must be completed no later than that date. Like taxes, or homework. But this due date—in addition to being shy of the median—is more like a “don’t expect the baby any earlier than this” date, or a “the baby can come anytime after this date and not be considered high risk for preterm complications” date. Admittedly, those names are more of a mouthful. People always talk about childhood development in percentiles—maybe the “50th percentile date” would work. I like that. Accurate, and, hey, who doesn’t like being in, say, the 90th percentile on something? It’s like getting an A! Or how ’bout “target date,” as in, “aim to keep that baby inside you until at least this date so that they’re fully developed and at lower risk for problems after delivery”?
I like “target date.” So, instead of saying someone is “past due,” you could say that they have successfully met their target date, plus a few days. See? That makes them look like an overachiever instead of making them feel like a failure or slacker.
At what turned out to be my last midwife appointment, since I was 5 days past my obstetric “target date” (but still 3 days shy of my 50th percentile target date), the midwife did a non-stress test, which is to say she listened to the baby’s heart rate for half an hour. They just want to see that he’s moving around, and that when he moves, his heart rate goes up by about 15 beats a minute, and then goes back down again (or that during a contraction, his heart rate increases. If it decreases during a contraction, this could indicate that the umbilical cord is being compressed somehow and that the baby is at risk of oxygen deprivation). This test went fine.
What was not fine at this appointment was my blood pressure. The systolic pressure was 146—yikes! Before pregnancy, normal for me was around 110. During pregnancy, it had consistently been in the 120’s. What was going on? I’d gotten caught up at work and then faced a tunnel backup, so I was about 15 minutes late to my appointment. It was no big deal, as the midwife ended up being busy with her previous patient until then anyway, but I do hate being late. I also was well aware that it was important to pass this test–giving rise to a bit of white-coat syndrome–as I have a friend who was unsuccessfully induced due to concerns about preeclampsia that were based solely on a high blood pressure reading late in pregnancy. But I didn’t have protein in my urine and really felt like stress could account for the high reading. The midwife re-took my blood pressure after I’d laid down for 15 minutes (for the non-stress test), and it was down to 134. Still high for me, but below their threshold of 140. But preeclampsia is no joke and so now there was reason to be somewhat concerned. Great. She checked in with the OB who was on call, and he was fine with “letting me go” (as opposed to inducing me right then).
We scheduled an appointment with an obstetrician for the following Tuesday (it was Friday). The midwife cautioned me that, while the OB who was on call right then had been around a long time and was fairly laid back, the OB who would be on call on Tuesday was newer and would try to talk me into an induction.
Turns out that there’s a score that’s used to estimate the likelihood of labor beginning spontaneously, and it also serves as a predictor of the likelihood of an induction being successful (meaning that it does not end up in a caesarean, I guess). It’s called the Bishop Score and you get points for dilation, effacement, fetal station, cervical position (anterior vs. posterior), and cervical ripeness (degree of softness). As an aside, I’m not so sure I liked having my cervix described as “ripe.” Too much like evaluating a piece of fruit at the grocery store. Yick.
Anyway, I had such a high Bishop Score and was such a good candidate for induction that the midwife said that this OB would think that inducing me was a no-brainer and wonder why anyone would want to just wait it out at this point.
So I ended up spending bits of my weekend trying to determine what my posture would be on Tuesday. I decided that I’d make sure to get to the appointment early and have a chance to sit for at least 15 minutes before they took my blood pressure. I’d avoid any caffeine or sugar for breakfast (confession time: I’d had 3 donuts before my last midwife appointment. Totally not normal for me. Our housemates had brought a box of Krispy Kremes home the night before, so I had one of those for breakfast, and then one of my coworkers brought our secretary Krispy Kremes for Administrative Professionals Day, which our secretary begged us to help her finish. Hey, I was just helping out! Made me wonder, though, if a huge blood sugar spike like that can temporarily raise one’s blood pressure).
Before I left the appointment, the midwife elected (with my concurrence) of doing what they call sweeping the membranes. Basically, during a vaginal exam, she ran her finger around the inside of my cervix (since I was 3 cm dilated, this was apparently pretty easy) and gently separated the amniotic sac from the edge of the cervix. It feels a lot like an annual female exam—kind of crampy. The idea is that this irritation makes your cervix release prostaglandins, which can help jump start the labor hormonal cycle. Afterward, I felt some minor cramps now and then, and had some pinkish mucus, but the cramps never developed into anything like a regular pattern. Hey, it was worth a shot.
Saturday passed with no changes. Lots of people were calling, texting, and emailing my husband to “check in” and ask “if anything was happening.” I learned that battling impatience is not made any easier when the people around you are even more impatient than you are!
Saturday night, my husband and I got home around 9pm and ran into our neighbor. He had a DVD in his hand and was headed home to watch it with his wife, the one with whom I shared a due date. He sounded a little discouraged, but resigned to the impending induction on Monday. They were going to enjoy a movie together, just the two of them. Sunday morning, I was awake early (that’s 8am for me). I decided to go for a walk and texted my neighbor; we’d become walking buddies, especially now that we were “past due.” But she didn’t text back, and when I went outside, one of their cars was gone. Probably out for breakfast, but I prayed that it was something else—maybe they were at the hospital!
We headed to church–where I spent the service walking up and down the hallway since it was so uncomfortable to sit–and a girl said she wanted to read from Habakkuk (who reads Habakkuk? Who even knows how to pronounce it? HAAA-buh-kuk or huh-BACK-uck?). Now, she was talking about God slowly working in her life, but needless to say, the verse struck me a different way:
But these things I plan won’t happen right away. Slowly, steadily, surely, the time approaches when the vision will be fulfilled. If it seems slow, do not despair, for these things will surely come to pass. Just be patient! They will not be overdue a single day!
Very funny, God. Very funny.
We got home and our neighbor’s car was still missing; my hopes rose for them. Sure enough, that afternoon we got a text message saying their daughter had been born. Yay! Happy day! The induction had been scheduled, mind you, because of concerns that the baby would get to be too big. All this based on a due date determined from an ultrasound when the mom was about 3 months along (she hadn’t realized she was pregnant). At best, dating ultrasounds have error bars of +/- 5 days, and that’s when they’re done at the optimal time. Hers was done much later and therefore had a greater uncertainty. Nevertheless, her OB treated the due date that resulted from that ultrasound as extremely definitive, so much so that he was willing—no, intent on—inducing labor once it had passed.
Her baby was 6 lbs 1oz and 18 inches long. A post-term baby? Really? On Monday, we went to visit them in the hospital. They’d had a good experience overall and were very relieved that the induction hadn’t been necessary. In their own words, “There’s no way this was a post term baby.” Interestingly, my labor ended up very much following hers—starting about the same time of night, lasting about the same amount of time. She told us that once they arrived at the hospital, she’d asked for something for the pain. It took them awhile to administer it, but they ended up giving her a narcotic. In her words, “That totally messed me up.” She’d wanted a drug that would just dial down the pain a little; instead, the narcotic she took not only made her feel nauseous, fatigued, and, well, drugged, but also slowed her progress in labor and added, in her estimation, about 2 hours to the pushing process. She said if she could do it again, she would not have taken the narcotic.
So the rest of Monday went by. It was April 27th, the due date that I had determined marked the median of likely delivery dates. I kept telling myself that only half of women would have gone into labor by now—I really wasn’t as late as everyone was making me feel. Everything was still just fine. But the next day’s appointment loomed large in my consciousness.
What if my blood pressure were still high? I didn’t want to put myself or my baby at risk, but everything I’d read made me seriously doubt that I actually had preeclampsia. What if the OB really wanted to induce me? Would I consent to having them break the bag of waters? It was so hard, because I so very much wanted him to be here already, so wanted labor to go ahead and start.
But there was still this nagging part of me that felt like I should have enough humility to accept that maybe there was a reason labor hadn’t started yet. Everything had gone so perfectly with this pregnancy; my body had been so wise at every step of the way. Couldn’t I trust it one more time? It just seemed arrogant to presume that somehow I knew better than my body now, at this stage of the game.
And the old insecurity about whether I was broken, whether my female parts worked properly, reared its ugly head [I didn’t get my period until I was almost 15, and afterwards have always been extremely irregular. This made me wonder whether I’d ever be able to get pregnant at all, especially since we tried for about 2 years before I did get pregnant]. It took me a few days to realize why—as much as I was tempted to do whatever I could to make labor start, from walking to eating spicy foods to having sex—why I really, really didn’t want to have them induce me, even by breaking my water: I’d feel like I’d failed, like my body was not quite good enough to see this thing through to the end. It would somehow feel like I was conceding a large part of the ground I’d won in reconciling with my body through this whole pregnancy.
The pregnancy had made me marvel at how amazing my body was; everything just worked. It blew me away, watching my body change, feeling my baby grow—all without me doing anything to make it happen. My first trimester, the smell of citrus fruit would help fight back the nausea. And then I find out later that citrus fruit is really high in folic acid. Stuff like that. My body just knew. Once I realized that that was my issue—and could tell myself to be rational, that being induced wouldn’t negate all the amazing things I’d watched my body do, wouldn’t mean that I was still somehow broken or inadequate, wouldn’t really mean that my body had failed me once again—I was able to come to a little more peace with the idea. A little more. Seeking solace, I reread part of the transcript of something a stranger had said to us at church three months earlier:
“I wanna prophecy over you, dear sister, that I’m just going to give you a grace in the bringing forth of your children, that the days will come that—and, and I know that everybody goes through the fear of it all and I know that there’s the agony and all that, but God wants to give you a peace and a joy. And like little Isaac who came into this world, she said, ‘Now, people will laugh with me!’ And she laughed over the fact and enjoyed the fact that God gave her this beautiful child and named him Laughter. He changed the world. And God wants you to have joy and excitement in what’s about to take place. And I’m gonna add children to your life. You’re gonna have a happy home. You’re gonna be known as good parents and a good couple. Your success is already set. Did you hear that? Already set.”
God, give me grace. Thank you for your peace and joy and excitement.
The Birth Story
We headed to bed Monday night, and my husband prayed for us, prayed that we would have wisdom at the next day’s appointment [where we were anticipating facing pressure to induce labor by breaking my water]. We said our goodnights…and then—hmm, was that gas? I didn’t think so. It felt an awful lot like a menstrual cramp. I looked at the time: 12:41 am. I told my husband that I might have just had a contraction. After the second one, I went to the bathroom and there was a little bit of blood. These seemed to be real! I told my husband to try to sleep and I’d wake him up later. By the third one, I realized I wasn’t going to be able to sleep through these. My husband told me that they were 8 minutes apart. Huh, that was closer than I would have guessed.
We debated for awhile about what to do. It seemed too early to head to the hospital—we both were expecting this to go on for a long time. But we agreed that it would be prudent to get through the bridge tunnel before morning rush hour. And once it became clear that we weren’t going to be getting any sleep anyway, and since we were still awake (if somewhat tired), we decided to go ahead and get the other side of the tunnel. Once we got to the hospital, we could re-evaluate and decide if we wanted to go knock on our friends’ door (friends who lived relatively near to the hospital) at 3 in the morning or go for a walk or what.
My mom had been planning to get on a flight in Colorado in the morning anyway (she’d taken the week off work and I told her to go ahead and come on out; we could visit even if the baby hadn’t come yet). We called my parents and told my dad to get on the flight with Mom in the morning. My husband showered and I packed some food and tried to rearrange the car in a way that would be comfortable, including putting my exercise ball in the back seat. By the time he was out of the shower, I told him we really needed to get going; if these got any harder or closer together, they were going to be very hard to do in the car. My husband packed the last minute things and I took a quick shower.
In retrospect, I realize that we never really had a period where I felt excitement about finally being in labor—maybe just for a moment after I saw blood on the toilet paper. It felt fairly serious from the beginning. I thought the seriousness was just due to the frustration of not getting any sleep—having labor start just as we were going to sleep—and the fear of rush hour traffic and the bridge tunnel that made us feel pressure to start driving to the hospital when we otherwise would have chosen to stay at home and labor awhile longer. But perhaps I should have recognized the seriousness as an emotional signpost saying that this process was going to go faster than we expected.
I was finding that when a contraction would start and as it intensified, there was a real tendency to want to tense up. For the first hour or so—maybe the first 7 or 8 contractions—deep breathing seemed to help. But after that, it was hard to relax. I’d put my forearms up against a wall and lean my head against my arms and breathe. It seemed a little early to start trying low guttural vocalizations, but what the heck, right? So, on one contraction I tried breathing in slowly and deeply and then kind of moaning, “Come, baby,” really drawing out the mmmmmm in “come.” It helped! I could feel myself relax and the pain was gentler.
By the time we left home (about 2:40 am), I was surprised to have learned just how much of a participant I could be in this process. It really seemed like I had a lot of control over whether I relaxed and invited the contractions to come or whether I resisted them. And somehow, they felt that much more productive when I welcomed them. With a few of them, I had waves of nausea. Near the very beginning, I even got really shaky all over. I never did throw up, but asked my husband to grab a bucket to have in the car just in case. Right before we left, I had a good, er, cleansing trip to the bathroom that emptied me out. Good. More room for the baby to make it out.
The car ride was not easy. After all my arranging, I ended up just sitting in the front seat anyway. I asked my husband to put on “Under a Blood Red Sky,” a U2 album that I’d been listening to that week. I knew that I-64 had a lot of potholes on the east side of the bridge tunnel, but I’d never noticed just how bumpy it was on this side too! Not cool, VDOT! But at least there was zero traffic at 3 in the morning.
By the time we got through the tunnel, I’d been in labor about 3 hours (sure didn’t feel like it had been that long), and the contractions had been a pretty consistent 7 or 8 minutes apart. I will tell you, though, that while we were at home, there were a few times that I’d start to think one was coming after only 3 minutes or so, but those never really intensified to the same level as the 8-minute apart ones. Also, I noted by watching the clock that although the intense part of the contraction lasted right at about a minute, it would take a full 3 minutes from the time one started before I really felt like it let go of me. And I was a little surprised at the variability in the intensity of the contractions. There were definitely easier ones and harder, bigger ones.
After making it through the bridge tunnel, I’d start to feel a contraction begin and when I looked at the clock, I thought, “No, it’s too soon for another one yet.” Well, they quickly became 3-5 minutes apart. After two of those, I decided to go ahead and call the midwife answering service. But as I listened to the phone menu, a contraction started and I handed the phone to my husband. Now, I’d called the number a few days before to make sure that I knew which number on the menu to push. (None of the options say anything that sounds relevant like, “If you’re in labor, press 7.”) I really thought you were supposed to push 4 to talk to a triage nurse. Apparently not. My husband got a voicemail box instead of a live person and so he left a message. Not that it really mattered, as we were less than 10 minutes from the hospital—actually, we were getting off on the Granby exit when I handed him the phone, because I remember gesturing to the left, concerned that he appeared to be headed to the naval base on the right instead of getting onto Granby by bearing left (poor guy—I’d kind of thrust the phone in his hand as the triage nurse’s voicemail message started playing and said something incoherent about telling them that we were on our way and the contractions were 5 minutes apart, and this right as we’re exiting the interstate).
As we came off the exit, we passed a cop, went under the bridge…and then the lights on the railroad crossing gates lit up and started flashing! Ahhh! My husband quickly sped up and ducked under the gates that had just started to come down. I was extremely grateful; he’d normally never do something like that, but all I could think was how I’d sat at that same railroad crossing for 15 minutes with my engine off on the way home from my last midwife appointment while a very slow coal train went by. It would have been ironic to have made it through the bridge tunnel with no traffic only to be stopped by a train!
We pulled into the hospital parking lot about 3:30am. “X” had beaten us there and came out to meet us. [X is a close friend of ours. I’d asked her to attend the birth. Because my husband’s work schedule as a pilot could have meant that he was in Cleveland when I went into labor, I wanted to make sure that I had someone who could take me to the hospital and who would be with me during labor. X brings the zen into my life and seemed like an obvious choice; on our wedding day, I'd asked X if she would come and just play her guitar while my bridesmaids and I got ready. She did, and it was wonderfully soothing and joyful. Looking back, an added bonus of having her at the birth was that she kept my husband company too.]
I was wearing my husband’s bathrobe and flip flops and remember leaning up against the car during two contractions while X and my husband got stuff out of the car. Boy was I happy to be standing up instead of sitting down! We went in through the emergency room entrance, and I started to walk up to the midwifery center and said so to the receptionist as I passed her. She gave me the “Oh, no you don’t” treatment and told me to wait while she called someone to come push me in a wheelchair. She then asked me for my name, birthday, and social security number. It occurred to me to ask for a piece of paper to write them down rather than say them out loud in front of a room full of strangers, but I was having a contraction and just gave her the information verbally. I was silently counting on it being unlikely that anyone in the emergency room had a piece of paper on which they were taking notes! And I steeled my will to ignore the strangers in the waiting room and just do what I needed to do to cope with the intense contractions I was having. I just leaned right up against the emergency room wall in my bathrobe and flip flops and did my loud “Commmmmmme baby” moaning to get through them. They could think what they wanted. I could not allow myself the emotional energy to care.
Then the receptionist took me into another room and asked me a series of questions, all of which I thought we’d taken care of during the pre-admission process months before, but whatever. Finally, someone arrived to push me in my wheelchair (I had tried to point out that my husband or X were both perfectly capable of pushing a wheelchair, and that actually, I was perfectly capable of walking, but to no avail). I told the lady that I’d really prefer to walk, having just endured sitting through a 50 minute car ride down I-64. Nope, against policy. I’m thinking how much I wished it were normal business hours, how I’d just walk myself up to the birth center, how it was totally arbitrary to make me run this gauntlet just because it was 3 am instead of 3 pm. But I was so big and waddled so much that I didn’t think I had a chance of outrunning them. Fine. I’d sit, but I asked her to be prepared to stop whenever I asked her to.
As the next contraction started, I said something like, “Stop, stop; pull over!,” which she did. I stood up and leaned against the wall and did my “Commmmmmmmmmmme, baby” moaning thing. “What’s wrong?!?” she asked me worriedly. “I’m having…a…contraction…But it’s okay…it’s good…. This is what…makes…the baby come,” I told her between breaths. We were surprised to find out that she had two kids of her own. Hadn’t she done this herself before? She just seemed awfully worried or freaked out by my behavior. Oh well. I was going to listen to my body and do what it lead me to do.
We got to the first elevator, and after she’d pushed the button repeatedly with no response, she muttered under her breath that she hoped this elevator would work okay, since it had been getting stuck lately. “Why don’t we go use another elevator?” one of us suggested. She finally decided that was probably a good idea. I had one contraction as we got into the elevator and another as we got out.
As we rounded the corner to the midwifery center, my midwife came walking toward us. She said hello and then asked, “Why didn’t you call me?!?” That’s when we found out that 4 is evidently NOT the correct number to push when calling the answering service. My midwife said she lives half an hour away and wasn’t actually supposed to be there right then but happened to have been sleeping in her office. We apologized and told her that even if we’d pushed the right number, we’d have only given her about 10 minutes warning anyway.
She ushered us into a room and a nurse hooked me up to the fetal heart monitor so that they could get a base line on the baby’s heart rate. Oh, man, did I NOT want to have those things around my belly. It did not feel good to have anything touching my belly at that point. I remember yanking the tie open on my robe during the next contraction as I leaned on the bedside table. I wanted to rip the elastic belts off too, but restrained myself.
My husband was kind of caressing my back during contractions, and that felt really good. I do remember the contractions intensifying to a point where I wanted him to keep his hands up high, across my shoulders, and not to touch my lower back at all. For some reason, that made me feel nauseous.
When the nurse came back, she realized she’d forgotten to turn on the paper recording part of the monitor. You mean I’ve put up with having these f***ing things on my belly for no reason?!? (By now, I couldn’t really talk at all, so these were internal thoughts–but seriously, I do NOT understand now how most women go through labor with those things touching them. I wanted to fling them across the room—and I only wore them for a few minutes total.) I told her I’d really like to pee, so she unplugged the wires from the monitor, draped them around my neck, and let me go to the bathroom. I had a contraction leaning against the sink, and then my midwife came back and suggested that we find out how far along I was and took the monitors off. I think we were both pleasantly shocked to find out that I was 8 cm!
And then she said, “Hang on; this is a very misleading exam. Are you having a contraction?” I told her one was starting. She said, “You’re a rim!” In my mental state at that point, I had a brief moment where I thought she meant that I had come un-dilated, like that I was less than 1cm. I said, “Oh, okay,” feeling a little disappointed and confused. But when she clarified and said that I was almost there—maybe 9 and ¾ —I couldn’t believe it. I mean, the contractions were coming about every two minutes, and I wasn’t really getting a break between them, but could I really be almost through the dreaded transition?
I don’t remember how or when, but I know I ended up on the bed with an exercise ball over which my midwife kindly draped a sheet (I was naked by this point. That’s another thing I no longer understand–how women labor with one of those hospital gowns on. I did NOT want anything touching me). I was kind of on all fours, but with my torso draped over the ball, hugging the ball, laying my head on it like a pillow, resting, between contractions.
After what seemed like just a few contractions, my midwife suggested that I try bearing down on the next one. “Like I’m trying to poop?” I asked. Now, for the last trimester I’d noticed that when I went to the bathroom, if I leaned backward, it really felt like I had to poop. If I leaned forward, the sensation would go away. I never got used to it, but figured that it was the weight of the baby pressing up against my descending colon that created the sensation. So now, in labor, it seemed natural to kind of squat when I tried to push. I’d rock back on my haunches, which would create a feeling of needing to push, and try pushing.
The first time or two that I tried, nothing really happened. But then, then next time—oh man. I started in, trying to push, and suddenly my body joined me and amplified the effort. Kind of like when you feel like you have to throw up, if you gag yourself with your finger, suddenly your body takes over and heaves for you. Not a perfect analogy, but it’s the closest thing to which I can think to compare it. And wow was it a lot of work. Labor is a perfect word for this part of the process (which, oddly, is the part they call “delivery,” not “labor.” I’d call the first part “big cramps” and the second part “labor/pushing”). I’d done some studying of the beginning of Genesis, of the oft-thought of verses (3:16-17) where God tells Eve that she’ll have pain in childbirth, Adam that he’ll bring forth fruit from the ground through toil, by the sweat of his brow. Turns out, in Hebrew; God uses the same word—transliterated itstsabown–for both of them. For Eve, people tend to translate it “sorrow” or “pain,” but for Adam, they translate it, “toil.” But I think the “pain” thing is cultural. By great “toil” will you bring forth your children. By the sweat of your brow. With great deliberation and effort, to the limits of your ability to work hard; as man must work to bring forth crops from the ground, so you must work to bring forth the “fruit” of your womb. Labor, indeed.
And then begins the long period in which I have almost no sense of the passage of time. (You could have told me afterward that I’d pushed for half an hour or for three hours and I would have believed you. We went and got a copy of my labor record—which I love having! It’s so concrete and detailed and factual, recording almost every contraction, the time, my vitals and the baby’s heart rate—and it says that I pushed for a little over 2 hours. My midwife said that’s textbook for a first labor.) The contractions got further apart—somewhere between 5 and 8 minutes, according to my husband and X. I was tired by this point and pretty much kept my eyes closed for the duration, resting between each push. I remember feeling really hot and flushed and my husband bringing cold towels to put on my back, which felt wonderful. For awhile, they weren’t cold enough, and his hands felt too hot. Then he must have started using ice water, and I remember my midwife and X in unison telling him to “wring it out first!” before putting it on my back. But the colder the better it felt to me, and he started putting it soaking wet with ice water straight onto my back. And I remember getting shaky and feeling nauseous and asking for something to puke in, which I never actually did.
I also remember that my internal monologue was much more upbeat and lively than how I must have looked. I wanted to let my husband and X and my midwife know that I was doing well and was in good spirits, but I found that I was conserving just about every bit of energy and could barely speak. I might have managed a “I’m okay; I’m doing good” at one point, but that was about it. For awhile, my midwife sat at the foot of the bed, knitting. I noticed and tried to tell her that X knits, too. I had a brief thought of trying to make a witty Madame Defarge reference, but couldn’t find the strength to do it.
Once when I asked for something to puke in, my husband was holding this little bag for me and holding my ponytail off my neck, and he made some comment to my midwife about how he hadn’t done this since college. Inside, I laughed, but I’m not sure if my smile even made it to the surface where they could see it. There really is something to that 3 foot circle of solitude that we talked about in childbirth class.
At one point, my husband’s mom and sister showed up. They came in and I could hear that they were excited. I had my eyes closed, so I never saw them, and if they’d wanted to stand silently in the back of the room, I wouldn’t have minded. There was no sense of shame or modesty. But the emotion–the excitement–was all wrong at that point. My husband’s mom kissed me and I remember thinking, “I love you too, but I can’t respond.” I felt like I’d lose my place, like trying to hold on to a dream when you’re starting to wake up; trying to stay in that dream world and find out how the dream ends. It was big and serious and important not to let it slip away.
I had a pushing contraction while one of them was there, and I could tell that the growling and grunting sounds that I made as I pushed were probably upsetting to them to some degree. I was fine, but knew that it must have sounded and looked like I wasn’t. But I didn’t have the resources to explain all that. X or my husband kind of ushered them out and stood in the doorway whispering, giving them an update on how things were going, I guess. Maybe because she’s done this just a few times before, but somehow my midwife picked up on how incredibly distracting it was for me right then, like having someone tapping on your shoulder when you’re trying to make out. Like having someone want to start a conversation and shake your hand when you’re in the middle of bench pressing the largest weight you’ve ever attempted. She asked them to take it outside and I was relieved.
One of the main things that I remember from this stage, believe it or not, is all the paperwork. I could have sworn that I’d taken care of most of the forms during previous visits to the midwives. But it seemed like between every contraction, the nurse was asking me to sign something. It would be funny to see those signatures now; I bet they’re completely illegible. I sooo didn’t care, and doubted any of the forms would even hold up in a court of law since I was being asked to sign them between pushes. She even got my thumb prints on what was, I realized the next day, the for-the-baby-book birth certificate. Seriously, we could have taken care of that at the same time that they got the baby’s footprints much later that day.
I was also mildly annoyed when she’d listen to the baby’s heart beat after each push. It just felt bad to have anything touching my abdomen. I understood that she was just doing her job and that they wanted to make sure that the baby’s heart rate continued to be okay. But there came a point near the very end, when I knew it was getting pretty close, that I thought to myself that even if they got a worrisome indication, there would have been no time to prep me for a c-section, where it would have taken more time than it was going to take to push him out the rest of the way. After this point of no return, it seemed pointless to continue monitoring, since there was only one way he was coming out at that point. I tried to say something to that effect, but I don’t think it came out very coherently.
I got tired enough that I did the nod-off-in-chemistry-class thing twice while on the exercise ball and almost rolled right off of it. my midwife suggested that I might want to try laying on my back. Not how I’d imagined pushing, but somehow that didn’t occur to me at the time. I was just really tired, and it felt great to rest so completely between pushes. I know I fell completely asleep at least a few times. I remember having a dream involving my car at one point and being amused when I woke up that I really had fallen asleep. My mom had told me how she’d fallen asleep between pushes and I’d always had a hard time understanding how that was possible. Now it makes perfect sense.
On my back, I’d reach down and grab my knees or thighs and pull them up toward me when I was preparing to push. My calves eventually started cramping and so I’d stretch my legs out onto my midwife’s knees and the bed between contractions. Then, once the baby had passed a certain point, I felt like I really didn’t want to put my legs down too far between pushes, like he’d slip back up if I did. But my arms eventually got worn out and started shaking, so I asked for help holding my feet. X held the one foot, and I put the other foot on the nurse. But as soon as I’d try to relax that leg, she’d back up and my leg would slip down (I think she was busy writing things down and looking at a machine or something—probably the fetal heart monitor). This was frustrating, and I think my midwife saw my frustration and eventually said something, told her to pay attention.
It took me a few days of processing afterward to understand my feelings about having the nurse there—not her personally, you understand. Just the general presence of an RN during labor. I guess I’d known that there’d be nurses in and out, but hadn’t expected the continuous presence of one. In no way am I upset with her or do I think she shouldn’t have been there. I just finally realized that the other three people who were there—my husband and X and my midwife—were all there for me. They were all huge supports, physically and emotionally. They poured into me and I was able to really draw strength from them. I’m still not sure that they really realize just how much their support and encouragement helped me, how it spurred me on and gave me that extra little bit to really give it all I had. I remember a particular swim meet—the first time I’d ever swum backstroke in competition—and how I felt this extra surge from seeing my teammates and coaches cheering me on, walking along the side of the pool, waving their arms wildly and yelling for me to kick, kick, kick! Go, go, go! The verbal applause and encouragement that my three supporters showered on me really gave me that extra surge, helped me feel that I was making progress and was doing a good job. It made me feel stronger and happier and at peace.
The RN was just doing her job. It wasn’t terribly detrimental to me—annoying at times, like a fly that you keep trying to swat away. But mostly, it was just neutral. It didn’t feel like she was there for me (which, I know, she was). She was there for me as part of her job, maybe, but not for me personally. We didn’t know each other, and I didn’t feel her pouring anything into me the way I did with the other three people in the room. Even in their silence, and especially from my midwife, there was a continuous flow of this sense of trust and strength. It felt like they were really in it with me. But it felt like the nurse was somehow oblivious to the fact that I was in labor, as strange as that is to say. The paperwork and everything just seemed so out of place—like a landscaping crew trying to mow the grass in the middle of an outdoor wedding ceremony.
I remember my midwife busting out the castor oil and doing some perennial massage. And then came the point where my midwife came up close to my face (I had my eyes closed for almost all of labor, and as a result, I think, I sometimes have this strange sensation of having missed the whole thing) and told me that we were getting close, that it was going to be like getting to the top of a steep hill—it’d be really hard work getting to the top but would then be downhill fast on the other side.
Well, there was another push or two, and I realized later that I guess I expected a verbal instruction from my midwife to back off on the pushing, because I never backed off. I didn’t realize that he was crowning as soon as he was, one—because I couldn’t see what was going on, and two—because there was no sensation of stretching before he really, really crowned. It burned just a little, and then as his head and shoulders and body and hips and legs came out, I remember being surprised that it still felt like my body had to push each one of those parts of him out, and surprised at how bumpy it all felt; in the videos, it looks so smooth and slippery! And suddenly, there he was on my chest, all goopy and red and wonderful. He felt so heavy, so warm, so strong!
There had been a small bit of meconium staining when my water broke (during one of the early pushes), so my midwife had prepared us that there would be a pediatric nurse there right when he came out and that they’d cut the cord immediately so that they could suction him out and try to prevent him aspirating any meconium. But as he lay on my chest, he squawked his first squawk before the nurse got the nasal aspirator to his mouth. I heard one of the nurses say, “Oh, he’s fine” as they scooped him up and made sure that he was alright.
Then I remember my midwife holding up his umbilical cord, which was still attached on the inside to the placenta, and saying, “Look at this nice long cord.” I reached down and said, “Wait, wait; I want to feel it. Oh, that’s very interesting,” which made my husband and X and my midwife laugh in a “That’s Jen” kind of way. I pushed the placenta out on the next contraction—too easy, drill sergeant. And then my midwife started cleaning me up. She said I had torn, which surprised me since it hadn’t hurt at all, and proceeded to start stitching me up.
Then, on the next contraction, a big gush of blood and fluid came out. “Jennifer’s hemorrhaging,” my midwife said in a “Dang it” kind of way, putting down her stitching, and directed the pediatric nurse to get the baby to my breast and the nurse to go get a particular drug. They gave my baby back to me to stimulate contractions when he nursed, and I was amazed at how immediately he commando-ed his way up, found my nipple and started sucking. Who taught him to do that?!? I remember thinking that I couldn’t quite see his whole baby face, just with the way I was lying down and the way he was lying on my chest. And my midwife told me she was going to administer Cytotec via a suppository to help the contractions continue to stop the bleeding.
They got the bleeding stopped and she resumed her stitching. Somehow it seemed to flow, the transition from her knitting to her stitching. Reassuring that she knew how to sew or something. And when she was done, she remarked that she usually gets some level of complaint from the moms in the cleaning up process. I mean, it didn’t feel good when she checked to make sure all of the placenta got out (I don’t remember when it happened, but I do remember wanting to see the placenta in the tub and recognizing the maternal and fetal sides of it), but shoot, I’d just pushed out a baby and all the other stuff seemed pretty minor at that point.
My overall feeling one was one of great, pure effort. Like an athletic event. I’m sure if you asked someone when they were running a marathon, “Does it hurt?,” they’d think about it for a second and concede that, well sure–their feet were aching and their knees were begging them to stop. But the question would seem a little…off. Not the right question, because they’d be focusing on finishing, on the finish line, on pushing through and giving it all they had. That was what labor was like for me.
It took everything I had physically, and some serious mental discipline. But I can understand how people talk about pain-free childbirth. Probably misleading to many, but then again, there’s a big difference between pain and suffering. Break your leg–that’s suffering. Have the flu for a week–suffering. Giving birth–incredibly challenging, an amazing amount of work, but for me, there was never a moment when I even came close to suffering.
The whole thing was…good. As in good, not bad. Suffering is bad. This was hard, but holy. Worthwhile and filled with purpose. Full of light. Oh, how I wish we would talk more and share more, as women, to remove all the fears and worries surrounding this sacred rite of passage–to share in the wonderment and joy, the bizarre and awesome beauty of this transformative miracle that is pregnancy and childbirth…
“I have heard that a wave of amnesia falls over new mothers to make us forget the trial of childbirth, so that we will continue to procreate. I don’t believe it. I think we remember every moment of the vomiting, the back pain, and the contractions that make our whole body scream. Remembering it all, we look into our babies’ eyes and like heroes we move toward pregnancy once again, because we know that the light at the end of the tunnel is indescribable bliss.”
–Michaela Knox in “Birth Matters: a Midwife’s Manifesta” by Ina May Gaskin.
Hospital-based birth center: Midwifery Center for Birth at the Bon Secours DePaul Medical Center, Norfolk, VA
OB/Gyn for prenatal care (up to 22 gestational/24 obstetric weeks): Susan Lontkowski, MD, formerly of Womancare of Willamsburg, now relocated to Riverside Gynecology and Obstetrics of Gloucester, on the campus of Riverside Walter Reed Hospital.
Midwife for delivery: Blair Conger, CNM