Leodin’s Birth on New Years’ Day

As told by Julia:

I lived in a rural location with no homebirth midwives and no birth center. I hired the closest doula and she lived two hours away. I was not pleased with the OB practice, and one of the rotating doctors told me that my natural birth plan was not going to happen. I was ecstatic when, at 39 weeks and 6 days pregnant, the only certified nurse midwife in the area got hospital privileges and joined my birth team. With a doula and CNM, I was sure I could get the natural hospital birth I wanted for my baby.

The same day I found out that I would have a midwife, I woke up to bloody show. When I had a check up, I requested a membrane sweep. I regret asking for it and had no reason not to just be patient for labor to pick up on its own. Contractions started about an hour later. I ignored them and was able to sleep through them until about 4:00 a.m. when they really required my attention and I was too excited. For most of the day, contractions were 3-5 minutes apart lasting 1.5- 2 minutes.

Over the phone, my doula suggested I take a shower which felt good and contractions sped to 1-2 minutes apart. However, they slowed back down after the shower. My doula decided to come down and arrived at 7:00 pm. She suggested some positions since I was having a little back pain and I did lots of hip circles and pelvic tilts. As it got later, my doula gave me some homeopathic tinctures. We went on walks. I was in a lot of pain and making noise, not wanting to talk between contractions, but I could walk through contractions. I think this alerted the doula that I was still in early, decidedly prodromal, labor. She decided it would be best for her to go home and sleep and us to do the same. I was devastated because it was the end of the second day of labor and I felt I was in serious painful contractions. I cried but accepted it and went to sleep right away. We slept or at least were in bed for 12 hours. I had contractions in my sleep and they were strong when I got up to pee but my body did some rest.

The next morning, I got a lot of physical contact from my husband and repeated the word “open.” I visualized flowers opening with my husband’s guidance. I tried to hold off for a while in calling my doula to avoid another false alarm but she called and decided to come back. We continued doing lots of walks around the apartment complex. I did need to stop for every contraction now. My favorite during those times was to put my arms around hubby’s shoulders and lean down a little, putting weight on him and swaying. When he or someone else was not in reach at the time, I would put my arms up on the wall, head down, and lean. The worst was when I had a contraction while peeing or just after peeing and had to run to a wall or person. I spent a ton of time sitting on the birth ball or floor. Some hip squeezes which felt good and counterpressure on my sacrum for slight back pain. My doula had me use cleansing deep breath at the end of contractions. We all wanted to speed up labor since water kept slowing it so I pumped with a hand pump sitting on my birth ball by my bed. It made contractions much more painful so I stopped after a few minutes.

She said that my contractions were definitely longer than the norm, staying around 1.5- 2 minutes in duration. I was starting to be in a lot of pain, moaning and crying at the peak of contractions. She said it sounded like time to head to the hospital and that sounded good to me. Contractions in the car sucked because I could not move.

It was 10:30 or 11:00 pm so we had to go through the emergency room, which was empty. They were going to send for a wheelchair but I asked them not to. A nurse walked us up to labor and delivery. The lights were dim. I put on a hospital gown. did some contractions on a birth ball. My midwife arrived as well as an L&D nurse for 20 min electronic fetal monitoring which we had discussed at an appointment and I was fine with. I asked if I needed to lie on the bed and she said no, I could be in any position so they set blankets on the floor and I got on my knees leaning on the birth ball. It was officially midnight, New Years’ Day 2012, but I had no sense of time at all, a very inward focus and oblivious to all around me. We used intermittent monitoring; baby heart tones checked with doppler every 1/2 hour and my blood pressure checked every hour. I declined routine IV.

I had not had a cervical check but I had some typical signs of transition. I was burping a lot and then threw up a few times. Lots of crying. The nurses brought in the delivery cart because everyone thought I might be ready to pop! After sometime, that proved not to be the case yet. My doula suggested we try to whirlpool which was next door. It felt wonderful but contractions slowed down and I spent the next few hours getting them back to where they had been before the tub. My doula reminded me to take it one contraction at a time, but I kept thinking ahead to how much longer and worse they would get and feeling that I did not have recovery time in between. I went back to my room and did a squat to try to move baby down. When I sat up I felt very wet and told my midwife. She did a pH test that showed my water had broken.

I was feeling desperate and needed encouragement. I knew that a cervical check would be risky as I could have a low measurement, but I requested one. I asked that if I am in transition, to tell me the number, and if I am not, to just say ” not in transition.” I heard “not in transition.” I was disappointed but just kept doing what I was doing. I did not attempt any visualization or other coping techniques because I was just too exhausted and could not think beyond the pain. I cried through every contraction and was saying “I can’t do this” “I need this to stop.” I got in the shower and sat on the bench and cried. There was no room for my husband so he sat outside the shower curtain which made me sad. My doula gave me an herbal drink approved by my midwife which had cohosh. I walked through the hallways with my parents and my birth team started taking turns sleeping. I was encouraged to eat and drink but I was not interested. I was likely dehydrated, hadn’t eaten in a long time.

After hours more of labor, I made a plan which I didn’t share with anyone. I would get another cervical check and if I was not in transition, I would ask about drugs. What I really wanted was a break from labor so I could sleep, fearing that my exhaustion would necessitate a c-section. I could deal with the pain but I was just so indescribably tired. I asked the midwife to tell me everything this time. She said that at the last check, I was 4 cm and 100% effaced which was a staggering announcement. That means it had taken me over three days of labor to get from 1 cm to 4 cm. At this check, I was 5-6 cm. With that news, I immediately asked about my pain relief options. My options besides water were an opiate called staydol or an epidural. She went over the details of each as well as the risks. My doula reminded me that epidural could slow labor and might not relieve me very well or in the right places. I decided to get each, though I had planned for no pain medication.

I was absolutely exhausted after days of contractions and little sleep and my body was involuntarily collapsing between contractions. I thought that the drugs would allow me to sleep while my body worked so I could wake up with the energy to push. I chose to get the staydol to take the edge off during the two hours before I could get an epidural. The midwife said that I would need to get electronic fetal monitoring but I was fine with that because all I wanted at that point was to be in the bed.

I got in the bed and was fitted with contraction strap, baby heartrate strap, blood pressure cuff, IV in my wrist with a saline/electrolyte solution and later the staydol. The drugs started setting in and allowed me to sleep between contractions. The contractions were slightly numbed and I made hmmming sounds through them which helped. My husband was very sad during this time as he felt he had failed as my birth partner (he told me this later when I pressed him, at the time I was high on staydol and not much aware of how he was doing.) The anesthesiologist came in and everyone had to leave but my husband. I was terrified to move for fear of paralysis or spinal fluid leak, which was so hard during contractions. Then, I went to sleep immediately. The room was dark and my whole birth team slept which was much needed.

We slept for about 4 hours and when I woke up, my midwife was there. I was 10 cm dilated! I opted for an in-and-out catheter. She had me labor down for an hour which just meant letting my body bear down and move the baby without pushing. I got another vaginal exam and the baby was at +2 station. Time to push! There was a discussion between my midwife, doula, and myself about whether to leave the epidural as is or turn it down for pushing. The anesthesiologist agreed to let it be turned down half way and I was glad to get some sensation back to work with. I was still tired but had some energy from sleeping. At first, I could not feel the contractions so I had to be told when they were going on but I could push at my own pace and will. I started on my left side with legs bent and apart. Birth team helped to hold my legs. My first two pushes were ineffective. I tried exhaling while bearing down. I ended up peeing with both first pushes!. Finally, I got a real push and knew what they were supposed to feel like. The epidural was wearing off.

On the first push, everyone saw baby’s head with hair! I was asked if I wanted a mirror and I said I didn’t want to see myself tear and everyone said I should have it. I was expecting something small but it was a full length mirror. It did help to see which pushes were bringing the baby forward. After a while, I flipped and pushed on my right side. It was taking a long time to get baby’s head to clear my pubic bone because my pelvic floor muscles were too strong. My doula and midwife agreed it would work better on my back semi/reclined position. My knees were up and I would grab my legs and lift my chin to my chest. I still slept between contractions which I was feeling somewhat now. The OB who had to oversee my midwife since she was new was called in because they thought I would be delivering in any second. Delivery took longer than expected and the midwife actually apologized to the OB who left for a time. That was discouraging. Four pushes per contraction that were each eight seconds long seemed to be best. The most effective part was at the end of each contraction so they kept trying to make me sustain it.

The room was all natural light and Eva Cassidy music. I puked on a nurse. Finally, baby cleared the pubic bone and did not pull back into the vagina each time. It took many more pushes for him to crown. The contractions got closer together and stronger. I pooped a little bit. Finally, I felt a ring of fire which was the best motivation to keep pushing. The worse pain was in the upper part of the vulva around the clitoris. They said the cord was around baby’s neck so I stopped pushing and panted though I felt my body continuing to bear down a bit. He was out with two hours pushing total. I reached down and helped move him to my belly in the position advocated by Birth Without Violence with belly down and knees bent. It had only felt like seconds when my husband cut the cord, but my midwife said that it stopped pulsating after only two minutes at which time she clamped it.

Baby was grunting and nurses tried to stimulate and suction him while he was on my chest. Lots of mucous was in his lungs. I agreed for him to be brought to the warmer for suction and oxygen. At first, I declined pitocin for the placenta so the nurses got to worse massaging my uterus. I had excessive hemorrhaging so they needed to give me pitocin to control the bleeding. My midwife said that I had “countless” first degree tearing everywhere, including one in the labia which needed suturing because it exposed a blood vessel, and a second degree perenial tear. Because of the extent of the tears, the OB stitched me up. It hurt like hell and she did not give me a local analgesic. When I asked her about it, she said that I shouldn’t be able to feel it and the only thing she could do was turn my epidural up. Nope.

After about 15 minutes, baby Leo was back on my chest and we attempted breastfeeding. Ian had his hand on Leo’s back ala Birth Without Violence. I learned that I had elevated blood pressure for the last few hours of delivery and postpartum so I needed to be on the watch for preeclampsia but I did not get it. From my first contractions, labor was four days long and my doula counts it as 25 hours active labor.

I am conflicted about my choice to get an epidural. I was exhausted and it allowed me to sleep and possibly gave me the energy I needed to push. I am grateful for a vaginal birth with no augmentation or assistance. Recovery was horrible. Tearing hurt. My back hurt where the epidural was inserted. My arms and torso were in extreme pain from the effort of pushing. My face was swollen from pushing. Leodin had feeding issues which I think were at least partly caused by the epidural. He was so sleepy, he would not eat anything from any source. He went 18 hours without peeing and longer without eating. I pumped endlessly and had to force feed Leo, tracking every cc he was able to keep down. All of these issues were temporary and we did come out of it healthy!

Find the birth story of Leo’s little sister Ary here.

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