As told by Kaylah:
Sunday afternoon, with labor nowhere in sight, I felt that awful performance anxiety return and called Zaina to talk about my options. We discussed sweeping my membranes and the introduction of blue and black cohosh. Since I had the herbs on hand, I began alternating doses of each every 30 minutes. After 12 hours of puny contractions but no labor, I took a break from the herbs. Monday evening while I was taking the dog out to pee, I felt a trickle of fluid down my thigh and wondered it I was peeing myself. I took a few steps back towards the house and the trickle turned into a warm gush. I practically shouted as I came back inside – “My water broke!” – as if that was evidence of anything at all. It was 9:30pm. I was hopeful that labor would be close behind. Mostly I felt relief. Things are actually going to happen now, I thought. I had begun to believe the rumblings made by the midwives at MCA and spoken by my own mother about my 35 year old uterus on it’s fifth pregnancy being unable to rise to the occasion to get this presumably big baby out. They talked about it in terms of quantifiable risk, but I heard it as a judgement of my body, and by extension, judgment of me. I returned to my affirmations about trusting birth, trusting my body and trusting my baby to be born on her own terms. There is a kind of surrender that is necessary when you really lean into trust, and that surrender is kind of terrifying. But a huge part of me was just done and ready to let go. Okay, baby: your move.
I called Zaina with the update and said, “Okay, this is it. No turning back now.”
She packed up and made the drive to our house. As we waited for the arrival of the midwife and my labor, we watched a particularly gruesome episode of Game of Thrones. I sat on the birth ball that was draped with a towel and continued to leak fluid, circling my hips and rocking back and forth. Because time was now a factor and my contractions were nil, we brought the blue and black cohosh back into rotation. They helped to facilitate some good contractions, but they were irregular and not quite strong enough to kick off real action. Again, I was advised to rest, but my brain totally rejected that suggestion. I remember thinking that this was my last chance, and that maybe the reason why my labor had stopped twice before was because I had fallen asleep on the job. I didn’t recall labor being at all like this from my past experiences . . . something that would start and stop and fool you by disappearing like a slippery fish. Doubt crept back in at the edges of my mind, along with the specific fear that labor was hard work that you have to DO, and obviously I wasn’t doing it right. Practically all night I walked and rocked and moaned and groaned. The next day on precious little sleep I squatted and lunged and walked some more. We practiced every Spinning Babies position and adjustment in the book. We went to lunch at the Orchard to take my mind off of things, during which my contractions completely vanished. As evening drew closer, Zaina came into my bedroom to talk to me about the reality of our window. The 24-hour mark since my water had broken was only a few hours away. If labor didn’t start in earnest by 9:30pm, we needed to discuss the possibility of going to the hospital. My mom’s anxiety at this point was palpable. She kept mentioning the risk of infection and worried about all the things we couldn’t know for sure were okay since we didn’t have a way to constantly monitor the baby at home. Nathan and I confronted this potential outcome of a hospital birth head on. Details like: packing a hospital bag, who would come, who would stay behind. Nathan admitted he had already packed a bag earlier in the day, sensing this inevitability. The admission depressed me.
He joked to lighten the mood, “Well we’ve eaten all of our birth snacks so obviously we need to go buy more. Plus, I have prescriptions waiting at the Target pharmacy that I forgot to pick up…so we should run a quick errand to knock those things out.”
I looked at him and sighed. “Fuck it. I’m not in labor. Let’s go.”
On the drive to Target I had one tepid contraction. In the store I wandered aisles aimlessly in a fog of resignation. I felt like it was as good a place as any to hide from the ticking clock. As I met up with Nathan near the office supplies, I was suddenly slammed with an intense contraction that almost brought me to my knees. I cried out in surprise and grabbed the nearest shelf to lean on as I rode it out. While we were in the check-out line I had another big one. Fellow customers were either steering clear of me or stepping up to offer assistance. All of the sudden it felt like a terrible place to hang out. We paid and made it to the car before the next one hit. After that, I was back in a pattern of contractions – every 2-3 minutes – kind of kicking my ass in the passenger seat. Nathan tried to drive through Chik-fil-a for a milkshake and I moaned low and loud as he ordered. I wanted to go home but instead Nathan suggested we drive to Starbucks. He claimed he needed caffeine to fortify for the night of labor ahead of us, but what he was doing was stalling for time. He had made the connection between my labor picking up steam away from home and totally stalling out whenever we returned. His private plan was to keep me away from the house until the baby was practically crowning. I stayed in the parked car while he ran in for coffee. What I didn’t know then was that he was also calling Zaina and instructing our team to, once again, fill the birth pool. It was 8pm. I begged him to take me home. I was beginning to suspect back labor from the intensity of pain in my sacrum and I needed to change positions immediately. We pulled up to the house and didn’t even make it from car to front door before I had another violent contraction. After it subsided I went inside and up to my bedroom and tried to avoid making eye contact with anyone who looked at me. I rocked around on hands and knees, slung over the birth ball.Ten whole minutes went by without a contraction. I felt myself sinking inside. Zaina listened to the baby, who was still doing great, and I meekly asked if I could get in the pool. At that point I was exisiting in a world suspended between prayer and wishful thinking. If only I can get into that birth pool, I’ll be able to give birth, I thought. I don’t remember whose idea it was to check me. It may have been mine. 3-4 cm. No change from the last time I was checked a week earlier. Tears slid quietly down my face and my chest heaved with emotion. Zaina came to sit close to my head where I lay. She lovingly told me that it was her honest opinion that my labor needed a bit of help, that she had consulted with another midwife and felt that she had exhausted her ability to help me progress beyond the point we were standing in. I nodded, fully understanding the truth of her statement and simultaneously not wanting it to be true. I took a moment for myself and then got up to pack the rest of my hospital bag. As I made my way to the bottom of the staircase, my mom turned her phone screen towards me so I could read a text sent from one of her best friends, a woman who is like another mama to me. It read:
“May the Lord hold you in the palm of His hand.”
I felt broken open by the words and wept in my mother’s arms, grieving the home birth, the end of the pregnancy and the illusion of control that is such a tricky master. I was wrung out, utterly exhausted and deeply disappointed as we pulled out of the driveway for the short drive to the hospital. I cried hot tears in the parking lot, but by the time I walked through the Emergency Room doors I had internally shifted from sadness to acceptance. I felt determined to greet my baby with grace and full presence. She was making her terms known and we were in it together. And I still had work to do.
We settled into a labor and delivery room and the nurses tethered me to a bunch of machines for a period of initial monitoring. I made my mom promise to stick to the story that my water had broken earlier that day, not the night before, so I’d at least have a shot at a vaginal delivery. The midwife on call that night was Karen. I liked her no-nonsense manner that was knowledgable and steady. She embodied a kind of tenderness that night that I had not previously encountered in prenatal appointments. The monitoring showed contractions that were irregular and not nearly strong enough to be doing much of anything (obviously). When she checked me she thought I was sitting between 2-3 cm and my baby was posterior. We talked labor augmentation. To her professional credit, she had read my birth plan that requested no unnecessary interventions, and offered first and foremost to bring in a double breast pump for 30 minute intervals of nipple stimulation. The alternative was a dose of cytotec to stimulate contractions, in the hopes that it would be enough to jump start labor. The cytotec would take a few hours to kick in. As I considered my options I felt the exhaustion from the last 36 hours weighing heavily. The idea of taking a nap while waiting for meds to work was far more appealing in that moment than hours of breast pumping to reach the same end. We talked risks, benefits and considered doing nothing, but I wanted more than anything to avoid the use of pitocin if at all possible. I understood that when the overseeing OB returned in the morning, if I wasn’t in labor, pitocin would be the next course of action. I chose the cytotec and promptly passed out. Two hours later I awoke to back labor. Excruciating back labor. It was enough at the start of the contractions for Nathan to provide counter pressure on my sacrum while I was laying down, but it wasn’t long before I couldn’t stand to be in the bed. We walked the halls and continued our dance of swaying, kissing, moaning, and counter pressure. Back in the room I sat on the ball and draped my body over the ball and lunged and leaned on the bed and sat on the toilet. No position brought relief. My body tensed tightly against the pain and barely unraveled at all in the breaks. Karen tended to me while I was in the bathroom. I was trying to pee between contractions with very little success. This went on for hours. After an especially long and brutal back contraction, I asked if it was too early or too late to discuss pain management. Karen said we could discuss it at any time and offered to check me to assess how far things had progressed since our arrival. I reluctantly agreed, thinking I just might be able to hang on if I was close to transition. Nothing had changed at all. It was looking increasingly likely that pitocin would be needed to avoid a c-section. I weighed the risks and benefits of an epidural. Since pitocin was likely to intensify things considerably and I was already in a place of coping poorly and utterly exhausted, it seemed like the benefit of the break it would provide was worth the associated risks. I made the decision with a clear head and felt supported by all involved. The anesthesiologist worked fast, his manner just the right amount of witty, humorous and compassionate. The relief flooded my low back first and I felt my whole body relax. I curled into myself to rest just as the sun was rising.
The next few hours, devoid of sensation but punctuated by moments of excitement, blur together in my memory. When the OB arrived pitocin was administered to help my contractions. Nathan and I dozed on and off and my mom texted updates to concerned friends and family. In a moment of relative quiet in the room, a subtle change in the background beeping of the machines caused my mom to leap off the couch in alarm. She firmly commanded me to get on hands and knees immediately – the urgency in her voice made me move quickly! Almost before I was on all fours she had rounded the bed, grabbed the oxygen mask and was moving it towards my face. Just then a team of nurses rushed in and again the beeping in the background returned. My baby’s heart rate had taken a major nose dive but bounced back up after I changed position. This happened several more times and the constant changing of position was causing me to become tangled in the monitor straps. Karen was present during once such dramatic deceleration that forced a very quick chain of reactions that I had no time or desire to object to – my bag of waters was re-broken and an electrode attached to my baby’s scalp to more accurately monitor her heart rate. An oxygen mask was put to my face to help my baby rebound. At that time Karen said I had dilated to 8 cm – 8!!
I looked at Nathan with wide eyes and said from behind the mask, “Call Lindsey!”
Karen was concerned about the heart rate decels and she knew that the overseeing OB was going to push for a c-section. My mom (who was really trying very hard to resist wearing the L&D nurse hat, but with 20 years experience, couldn’t help but see the situation through those eyes) noticed and repeated out loud that even though the heart rate drops were problematic, the way that it jumped right back up to normal after a position change was a sign that my baby was tolerating them well and that she had plenty of steam left. When I got to 9cm, Karen asked me to push a bit while she helped to move that last little lip of cervix out of the way with her fingers. My baby was still posterior and, Karen suspected, asynclitic – sunny side up and cockeyed. I gave three mighty pushes and it was announced that I was 10 cm. The activity in the dim room instantly quadrupled. A spot light beamed down from on high, the bed transformed for delivery, nurses were moving in and out of the room in my peripheral vision. A new nurse, a young blonde woman who I hadn’t really registered before, was at my side helping to hold up one of my thighs and guiding me towards the moment to push. The epidural had been turned down but I still wasn’t feeling an urge to push so she would tell me when. The oxygen was turned up full blast and created a kind of white noise near my ears that muffled all other sound in the room. It momentarily disoriented me and my pushes were weak and uncoordinated because of it. Karen was speaking to me and I couldn’t hear her so I ripped the mask off of my face and asked her to repeat herself.
She said in a very measured manner, “I think you are a good candidate for a vacuum assisted delivery. Your uterus is tired and your pushes aren’t strong enough to bring your baby down.”
I sat up and replied, “I’d like to try other positions first. I’d like to squat. I’ve only pushed six times on my back and that feels totally unproductive to me.”
Before Karen could argue or even answer, that young blonde nurse had fetched the squat bar and was fitting it to the bed. She was my champion. I was starting to feel more of the sensations in my body and as the next contraction mounted, I hopped up on my feet with help and dropped into a deep squat.
I was happy to see Lindsey enter the room out of the corner of my eye, but she practically became part of the wallpaper pattern, so unobtrusive was her presence. Three strong pushes in the squatting position made me feel capable and determined again. I took sips of oxygen, but didn’t want the distraction of it on my face constantly. Baby’s heart rate took another dive and Karen left the room. The nurse and my mom helped me back onto my side and I felt the urge to push take over. With the next pushing contraction they had me on my back, and the next one on my other side. I immersed myself in the sensation and mission of bringing baby down and out. She wasn’t rotating the way babies usually do, so I did the rotating to help free up space in my pelvis for her to move. A push on my left side, a push on my back, a push on my right side. Nathan’s voice next to me raised to an emotional pitch and he joyfully assured me she was coming. Just then Karen walked in with the overseeing OB who was there to inform me my time was up. I didn’t know it at the time, but they had already prepped the OR for me. The mere sight of them filled me with a mama bear-like surge of adrenaline that helped me to sit up and push my baby to crowning. I was surrounded on all sides by love and encouragement. My mom, the beautiful nurse, my husband, my best friend and in the background capturing every dramatic, primal moment – was Lindsey. The next push brought my fierce, stubborn baby girl – blinking and spitting blood at the sky – into the world. She practically surfed out of my body on a wave of blood and fluid. With help I ripped off my gown and as she was lifted to my hands I brought her right onto my bare chest for the briefest of minutes. She sputtered and squirmed, wearing an expression of shock and disapproval. I couldn’t believe how big her presence was right out of the gate. It felt like I had just given birth to a toddler. After that minute, Victoria was given scissors to cut the cord and our baby was taken to a nearby table to be checked and assessed. Nathan followed her and wept.
I heard his voice yell out to me, “Kaylah, she’s perfect!” And through tears, “Her feet are fine! She is absolutely perfect.”
Her squawk was angry. She didn’t sound meek or mewing the way most newborns sound to me. She sounded strong and loud and pissed off! I looked over at her, feeling proud and relieved. My placenta came quickly. The volume of blood during delivery pointed to the likelihood that it had already begun to detach. Karen was amazed to find I hadn’t torn at all. After the assessment, our sweet girl was wrapped into a blanket burrito, topped with the tiniest of hats and returned to me. I had my gown down around my deflated belly and as I took her into my arms she rolled right into me with her mouth wide open. She latched instantly on my breast as though it was exactly what she was expecting would happen next. I laughed out loud in disbelief, amazement and delight. I marveled that this little baby had so thoroughly dismantled my birth plan – line by line – like she was proving the point that birth isn’t something you can plan or control, even with the best of intentions and efforts. I had wanted to avoid the hospital and that scheduled induction at 42 weeks at all costs – in fact I’d done everything in my power to prevent that outcome. Yet in the end my baby was born right at 42 weeks, ironically on the date of my scheduled induction, in the hospital with the help of pitocin and epidural. It’s funny how the universe sometimes dishes up exactly the thing you are avoiding so as to offer yet another opportunity for growth and healing. The experience of bringing her into the world has humbled me beyond measure and taught me more about myself than the last 10 years of therapy combined. I am grateful for the healing of old wounds made possible by being treated with dignity and respect during my labor and supported in my efforts at making informed choices and giving informed consent. She is the last baby that I will birth with my body.
Cora Maeve McCourtney
Labor began 5/24/14
Born into this world 6/4/14, 2:21pm
9 lbs 1 oz – 21 inches
You are the pink glue that will forever bond our blended family of six. As the seventh member, you belongs to all of us.
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