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The Story – Part 3: The Real Deal

(This is the last installment of my labor story, which began with Parts 1 and 2. My son is now a month old, and like people said it would, the memory of the pain of his arrival fades as I fall more and more in love with this beautiful boy. I wanted to write about the labor and delivery not to scare anyone with my “horror” story, nor to convince anyone one way or another about natural birth vs. medication, but to document the details for myself in all their gory glory as well as share with others who are as curious about how things can go as I was when I was pregnant. Every labor is different, and this is just one of the possibilities.)

The morphine took effect immediately, like a warm weighty blanket being pulled over my battle-worn body. “I feel heavy,” I murmured to my husband as I surrendered into much-needed slumber. We were in a small triage room at St. Luke’s Hospital. When we stumbled in just after 4 am, the midwife on duty had examined me and found I was dilated 3 cm and was 100 percent effaced. The prodromal labor had prepared my cervix, but was still not progressing into active labor. It was not a busy time at the hospital, so they let me sleep there after administering the morphine, and my husband went home to sleep in our own bed after I passed out. I remember waking a few times feeling the pressure of the contractions and hearing the din of the hospital distantly as if I were at the bottom of a pool. I pressed my hand against the wall to feel something sturdy and real, then slept hard for nearly four hours.

I awoke slowly and groggily, greatly relieved from my rest. A nurse came in to hook me up to a machine that monitors contractions and it began to look like a record of spiky earthquake activity. I called my husband to come back, convinced I was going to have the baby that day on his actual due date. The midwife now on duty, Mary Newberry, came in and checked me out. Of all the midwives I’d met at this practice, she was the most reserved, always keeping a professional distance and an all-business approach. She seemed very capable, but not particularly comforting, like a couple of the others who were like cheery camp counselors. At 10 am, I was still only between 3 and 4 cm and the contractions were about 5 minutes apart, lasting less than a minute. She was not convinced this baby was coming any time soon. “First babies usually take awhile. Why don’t you go home and come back when the contractions are closer?”  Returning home to labor endlessly was not an option for me. At this point, all my lofty goals of natural childbirth had dissolved, and I didn’t care if they induced or cut me open, I was done hanging out in this miserable limbo.  “No”, I said, surprising myself with my assertiveness, “I don’t want to go home. I’m having this baby today.”

She decided to humor me and said, “We can’t officially admit you until you’re in active labor. I’ll give you one hour to prove to me that you’re making progress. Walk around, try some different positions, do what you need to do, and we’ll meet back here at 11 to see if you can stay.” Determined to get this baby going, I hauled myself out of bed and hobbled around a couple floors of the hospital in my gown, looking like sweaty, bloated death on two feet. As a modest person, one of my big fears before this experience was how I would handle going through this very private process in such a public place. Let me tell you, by the time this was over, I could care less who saw or heard what. Your body is no longer your own and you don’t even care when lactation consultants are grabbing your boob and jamming it down your baby’s throat. But I get ahead of myself. At this point, I already didn’t care who saw me drop to a squat in the hallway holding onto my husband for dear life and moaning my way through a contraction.

We headed to the postpartum floor to check out the nursery and ran into another couple from our childbirth class. They had been there for nearly a week, they said, and were finally going home today after recovering from a c-section after complications. “Don’t worry,” they said, ” We’ve taken one for the team. Yours will go smoothly.” They showed us their beautiful daughter and it felt like the motivation I needed. When this was finally over, we’d have one of those in our arms. With my eyes on the prize, everything sped up. I had contractions every couple of minutes on the way back to the triage room, and even had to stop in a bathroom to yak up my breakfast they were so intense. I don’t remember being warned about the barf, but man, I did a lot of it over the next few hours.

Midwife Mary met us back in the room and after seeing the monitor’s record of how close and strong the contractions were coming now, she officially admitted me. I could stay! I was in active labor! She said it would probably still take awhile, so I wouldn’t be transferred to an official delivery room until it was closer. “Take a shower, continue to walk around, do whatever you need to do to be comfortable, and I’ll check in on you in a couple hours.” At this point, my husband went back to our house to get our suitcase and walk our dog, since we live only a few minutes away. I took a shower, crumpling to the ground and gasping for air every couple of minutes. I waddled back to my room, and leaned over the bed. I couldn’t walk around any more. The world was suddenly blurry as all I could focus on was the acute agony of each contraction. Nurses came and went and I couldn’t track what they were saying or even look in their eyes. Finally Mary came back and saw the shape I was in, and talked me through a contraction. Suddenly she was not the clipboard professional, she was my savior. She laid her hands on by back and in a calm, soothing voice told me to stop fighting the pain. “Breathe in energy and courage. Relax your shoulders. Stay with the breath. Breathe out your tension. There, you got through it.” She walked through several more with me, saying just the right thing each time to give me a focus other than panic. And suddenly, I felt it.

“Water. Breaking.” I muttered as hot liquid gushed down my legs. She said, “Look. A piece of the amniotic sac!” but I couldn’t look. “Going to throw up…” I stammered as I dropped to all fours on the floor. She put a bin down in front of me just in time to catch another couple rounds of vomit. “So dignified, huh?” I managed a strained smile with puke on my lips and in my wet stringy hair. “Don’t worry,” she said, “I’ve seen it all.”  “So, how about that epidural?” I asked. She said she’d have to examine me again to see how far along I was, so with her help I got back onto the bed. “This is really unusual,” she said sounding shocked. In just two hours, I had gone from around 4 cm to almost 10 cm. “No time for an epidural,” she said, “This baby is coming. And by the way, where is your husband?”

He came in just as we were dialing his number. He’d taken his sweet time thinking we had lots of it, but he got there just in time to help me into the delivery room. And this is where it all gets fuzzy. I continued to retreat further and further into my interior world to be able to muster the strength needed to get through each powerful contraction only to collapse again between them. I couldn’t tell you what color the walls were, or how many nurses came in and out, or even if I was wearing clothes anymore at that point. I could hear Mary’s calm voice and I could feel my husband dabbing an ice cold washcloth on my face and neck, his lips near my ear whispering encouragement, but above all else was the pressure, and this fear that I couldn’t do anything to relieve it.

At first I was on a birthing stool, and Mary was telling me it was time to push, and I strained with all my might, but I didn’t have much of it left. Soon I couldn’t even hold myself up so we moved to the bed. I lay on my side and with each contraction my husband would lift my upper leg and Mary would insert her fingers into the birth canal and say, “Push into this. Right here,” and I could focus on that spot and push two or three times until that contraction passed, everyone telling me I was so strong and me feeling like I should have been in training for a marathon the last few months because I didn’t have any more endurance and I didn’t think I could do this and then all of a sudden, out loud, I said “Oh God, I’m going to poop!” That was my other big fear about delivery. The thought of pooping in front of people was just too much, a sign of total loss of control, which I am not good at. I don’t even like being drunk because of what I might do with my guard down, much less having a bowel movement in public when I’m stone cold sober. Even though in this case the “public” was a midwife and nurse who’d seen it all, and my own husband, this was a huge mental roadblock for me. I know some couples who can brush their teeth right next to their spouse doing their business on the john, but that is the one place we draw the line. We do our thing behind closed doors.

“That’s the feeling you want,” said Mary. “You’re almost there. You’re not going to poop. And even if you do, it doesn’t matter. Push into that feeling.” I remembered my sister-in-law saying that giving birth felt like shitting out your spine. I thought at the time she just seemed crass, but now I can say that’s exactly what it feels like. Just let go, I thought, just push it out. And I pushed with everything I had. I feel bad for any poor woman who was just being admitted out in the hallway. I was screaming and grunting and making noises like a wounded wildebeest.  I was fully out of control. And it was working.

“I can see his head!” Mary said. “Keep going just like that.” I always thought that once you see their head, it’s gravy from then on. A couple pushes and they slide right out, right? Oh no. For me, it seemed like his head was in the birth canal for an eternity. A push sent him two steps forward, and the pause before the next push sucked him one step back, creating excruciating pressure in my pelvis as he hung out in there. Finally I rolled on my back, my husband took one leg, a nurse took the other, and they pulled them up to my shoulders during each contraction. He made faster progress that way, which led to my next big fear. “I’m going to tear!” I screamed as he crowned and I felt like my body was going to rip apart.  “No, you’re not. He’s almost there and you’re stretching just fine.” Mary said as she rubbed some kind of oil on my perineum. “We call this phase the Ring of Fire. Push past it and you’ll be done.”

The Ring of Fire. No shit. I hadn’t cursed at all until this point, but choosing to push into the most exquisite piercing pain you’ve ever felt in your life and just knowing you’re going to die there on the table and leave your husband with a motherless child has to be accompanied by an F-bomb or two. Mary had me reach down and touch his head for more motivation. What a surreal moment that was, feeling a soft squishy surface that wasn’t mine down there. It reminded me what this was all for, and that he was so very close to being out and so what if I tore, and with another tremendous push and the help of Mary’s fingers reaching into “the Ring”, I let out a sound that must have echoed through the hospital like Westley’s scream from the Pit of Despair when a year of his life was sucked away, and my baby’s head passed through the Fire. Then, another heave ho and his body followed, along with immediate relief.

And then there he was. On my chest. A whole little body with big open eyes, deep and alert, staring at me as I welcomed him to the world. Commotion continued around us – there was the passing of the placenta, the cutting of the cord, a stitch in the one tiny tear I had – but none of it even registered on my radar. My baby was born. I had survived. I hadn’t pooped, though it wouldn’t have mattered if I did. I made it through days of prodromal labor, an intense active labor semi-intentionally without any pain medication and two hours of pushing, and here he was already smacking his lips and looking for my breast, ready to move on and embark on this new phase of life. I had done it, with indispensable help from my husband and my amazing midwife, and I’ve never felt prouder of myself, more in awe of life and how our bodies work, or more in love with any living creature. This is when my instincts finally kicked in. As he latched on and my body miraculously continued to provide for his every need, I knew what it was to be a mother. People say your life will never be the same, but now I knew what that meant. The extent to which I will live and die caring for my baby has no bounds, regardless of past and inevitable future pain. I am his mama, and there’s nothing else I’d rather be.

baby-footprints

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The Story – Part 2: It’s Called Labor for a Reason

(Things have gotten tough around here as Little Man thinks nighttime is party time with an all-you-can-eat buffet. So it’s taking me awhile to write this in short spurts, on little sleep and with one hand, so please pardon typos or nonsensical rambling. The rest of the story will include some nitty-gritty details that may be tough for those with weak stomachs or no up close and personal experience with childbirth. It’s a messy, bizarre process. Be forewarned.)

Prodromal labor is the pits. Having never heard of it before, I was overjoyed when I started feeling regular cramping sensations in my lower abdomen the Sunday before my son’s Tuesday due date. They actually started Saturday night, after a spicy Indian dinner at Vik’s Chaat in Berkeley (maybe it’s worth giving a try all you ladies ready to induce), but were so mild and a couple hours apart, I didn’t think much of them, even though they woke me up throughout the night. I carried on as usual that Sunday, and even tried out a new church, St. Gregory of Nyssa Episcopal Church. I mention this only because I wonder if the highly unusual experience also contributed to the process.  There was incense and singing and dancing in circles around the beautiful sanctuary painted with a mural of saint icons that included the likes of John Coltrane and Sojourner Truth right alongside Mother Teresa and Frances of Assisi. During the dancing, the cramping became more intense, but I was so distracted by my husband holding hands with other parishioners and concentrating hard on his grapevine step, that I was busy just trying not to laugh.

Mutually deciding that was not the church for us, we went home to walk the dog, and that’s when these sensations that had felt like my usual period cramps started to intensify and come more frequently, about every half hour. My aunt called (sensing something from afar?) and I told her what it felt like and said, “But it can’t be contractions because I can talk through them, right?” I had the movie version of labor in my mind where women are always sweaty and cursing, but she assured me that “This is how it starts. You’re in labor!” Sure enough, when I got home from our walk and went to the bathroom, there was my mucous plug (I told you this would be nasty), a brownish gelatinous blob in my underwear. With equal parts revulsion and elation, I thought “Here we go!”  I packed up any last items in our hospital-bound suitcase and my husband installed the car seat. I read over my affirmations and relaxation techniques one more time, preparing myself for this beautiful, natural, miraculous process to begin. I texted some friends and family the exciting news.

This turned out to be a bad idea. I was suddenly inundated with texts and calls checking in every few minutes to see how things were progressing. Which would have been great if there was progress to report. But for the next grueling twenty-four hours until Monday afternoon, these “cramps” became full-on contractions around ten minutes apart, but never closer than six minutes. The natural childbirth books suggest changing the language of labor to decrease the fear around it.  Instead of contractions, they call them “surges” or “waves”, and encourage embracing each one as bringing your baby closer to arrival. But “contraction” was definitely more appropriate verbage. For about 30 seconds to a minute my body would tense up with enormous mind-numbing pressure. I tried to breathe into it. I tried getting in various positions – on all fours, draped over a birthing ball, my husband applying pressure into my hips or back, even taking hot showers – but nothing eased the feeling of  a boa constrictor squeezing my mid-section tighter and tighter until the contraction passed and the serpent released me to recover for the next six minutes. My instinct when the constriction began again was not to breathe and relax, it was to tighten up and fight the pain.

Needless to say, I was not sleeping through this. So with the third evening approaching, and the contractions not getting any closer to the magic 5-1-1 we learned was the ticket to hospital admission (contractions 5 minutes apart, each lasting 1 minute, over at least a period of 1 hour), I called the labor and delivery midwife on duty exhausted and desperate for a solution.

“Sounds like prodromal labor,” she said.  “Real labor always progresses. Contractions consistently increase in frequency and length. Yours have bounced back and forth between six and ten minutes. We can’t admit you until it turns into active labor.”

“You mean this is not real labor?” my voice cracked and tears started pouring down my weary face. If this pain wasn’t the real deal, how the hell could I handle active labor when it came? “This is all for nothing?

“Prodromal labor is often called false labor, but it’s not nothing. Your body is preparing for birth. Your uterus, baby and cervix are getting ready, but prodromal labor can last for days, even weeks. Have a glass of wine, relax, and since you live close, don’t come in until your contractions are consistently three minutes apart. The best thing you can do now is get some rest.”

REST?! How can I possibly rest?! I can’t take this anymore. Isn’t there anything you can do?” As another contraction came on, panic set in. This was not at all what I had imagined. Screw natural childbirth, I was ready for them to cut the kid out of me if that’s what it took to stop this pain.

“We can’t admit you, but what we can do is give you a morphine shot to help you sleep, which often is what your body needs to kick it into active labor.”

I hung up completely discouraged. This could last for days?! They had told me before they wouldn’t induce until 41 weeks. I might have to endure another week of this? Still, morphine seemed like a strange option. I immediately hopped online to see if anyone had anything to say about the matter. Turns out prodromal labor is not uncommon and I found several threads about women getting morphine to successfully rest up for active labor. As the hours pressed on and I found myself screaming into pillows in the living room at 4 a.m., I thought there’s no way I can carry on like this. I roused my snoring husband and said, “It’s time,” not in the sweet, exciting way I’d envisioned, but in an urgent, despairing tone. “Take me in, please. I need that morphine.”

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The Story – Part 1: Great Expectations

(It’s been 10 days since the birth of my son and I am finally feeling normal enough to participate in the world again. If I waited for enough time to write out the whole story of his arrival in one sitting it would never happen, so I’ll just do it in installments.)

It’s funny to me now how backward my expectations of labor and delivery and the first days with the baby turned out to be. I didn’t worry much about labor because I thought of it as this very brief window of time where my body would surely kick in and do its thing, while I dreaded the idea of bringing home a newborn who would need constant care around the clock because I didn’t trust my instincts to deal well with sleep deprivation. Turns out I am thoroughly enjoying my Little Man at all hours of the day and night, but there was nothing enjoyable, or even instinctual, about labor.

In preparation for the big day, I read a couple books and took a crash course at the hospital and thought I was good to go. I’d had such an uncomplicated pregnancy, I naively assumed my l & d would go as smoothly and even thought I might try for a drug-free childbirth. Both Ina May and the Mongan method assured me natural childbirth could be pain free and even orgasmic. I don’t know what kind of natural crack they smoke, or if S & M is their thing, but for me birth and pain were inextricably linked. Another friend who attempted to drink their Kool-Aid and failed pointed out later that most of the births described in the books were the women’s second or consequent times, which are usually quicker and easier. If the memory of this birth doesn’t fade like people say it will, there may not be an opportunity for me to test that theory since Little Man will most likely be an only child.

During the last month of pregnancy, I dutifully did my Kegels and practiced my visualizations of a beautiful rainbow-filled relaxed birth. I didn’t go as far as perineal massage, but I repeated affirmations like “I welcome my baby with happiness and joy”, “My body is not a lemon; I trust my body, and I follow its lead”, “I feel a natural tranquility flowing through my body”, and best of all, “My baby’s birth will be easy because I am so relaxed.” According to the gurus, avoiding pain was just a mind game of conquering fear. I wasn’t afraid, so I was ready, right?

Nothing prepared me, however, for prodromal labor.

(Little Man stirs. Hopefully I’ll get further in the next installment. To be continued…)