** This one is a long one, ladies! I want to record it for posterity so that I will forever remember one of the most beautiful moments in my life and I want to give an honest account for anyone hoping for a natural birth. No holding back! **
Last Wednesday was a crisp, cool day here in the Northwest. Autumn had definitely arrived. Our lawn was already covered in fallen leaves and the skies were gray. And it was still dark outside when my husband called the hospital at 6:30 a.m. to see if and when we would be reporting for our induction. I expected them to tell us to call back at noon, or 4 p.m. or 6 p.m., or midnight. I did not expect them to say they were ready for us and we should report at 8 a.m., but that is exactly what they told us.
We scrambled around that morning, finishing the packing of our hospital bags and getting dressed and ready to go and preparing my daughter for her overnight stay at my friend Lillian‘s house. It was a frantic, hectic, chaotic start to the day — and to our newest adventure.
After dropping Cupcake off, we (Honey, my mom, and I) arrived at the hospital fifteen minutes late. We were out of breath, anxious, nervous, and excited. We had been waiting for this day to come for a very long time. And still, we waited some more. In fact, we spent the next eight hours waiting. Waiting to be checked in and taken to our room. Waiting to complete all the admission questions. Waiting through an hour of fetal monitoring. Waiting for my blood work to come back and my urine to be tested. Waiting for the doctor (not my OB, but one of his partners) to do an ultrasound. (Skittle was still head-down, thankfully.) Waiting for my first dose of Cytotec* (which I did not even get until 11a.m.). Waiting through more fetal monitoring. Waiting for contractions to start. Waiting for them to get stronger and closer together. The waiting was endless.
Around 4 p.m., the few contractions I was having pretty much petered out. They were at least ten minutes apart and I couldn’t feel them at all. It was decided then that I’d be given a second dose, this time twice as much, of Cytotec. This meant at least another two hours of fetal monitoring. It felt like I would be tied to my hospital bed forever. I ached to get on my feet, to stretch my legs and back, but instead I had to be happy with switching from sitting to side-lying on one side or the other. The whole process seemed endless and I was beginning to worry if an induction would even be successful this time.
And then everything started to change.
Within an hour of my double dose of Cytotec, I went from having essentially no contractions to having them every 90 seconds. They weren’t yet strong enough to cause me the sort of pain that I would experience in the hours ahead, but they certainly were enough to make me stop and catch my breath. And they gave me hope that this thing might happen after all. That my body could and would respond to another induction and bring forth the baby I felt kicking away in my womb.
But then there was a sharp, scary turn of events.
Skittle’s heart rate dropped. During one of many contractions, her heart rate dropped from the 130s to 80 or so. My nurse had me quickly recline and turn onto my side and Skittle’s heart rate returned to normal, but I could tell the nurse was shaken by it and so was I. We waited and watch in the minutes that followed and while her heart rate did not decelerate again, it also didn’t show the variability (the up and down of a heart rate that often occurs with contractions or movement) that is considered a reassuring sign. The charge nurse came in to watch the fetal monitor alongside my personal nurse, but nothing changed. I became worried. They kept assuring me that my baby was okay and probably just sleeping, and I could hear her heartbeat and knew she was alive, but I suddenly felt very vulnerable. We were in a hospital and well on our way to welcoming Skittle into this world, but she still wasn’t safe. She wouldn’t be until she was in my arms. It was a horribly frightening realization and I couldn’t hold the tears back as I lay there, waiting and hoping for some sign that my baby was going to be fine. That she could, and would, recover from this. That she could, and would, endure these too-close-for-comfort contractions.
What was supposed to be two hours of fetal monitoring became two-and-a-half. Three. Three-and-a-half. I was so sick of lying in bed, but they wouldn’t allow me to get out until they saw a change in the baby’s heart rate. It was decided that I would be given terbutaline, a drug sometimes given to stop premature labor, but for me it would be used to slow down my contractions, hopefully giving Skittle the time to catch her “breath” and bounce back after contractions coming too close together for too long.
Around this time, I also decided I was ready to text my friend Leigh to ask her to come to the hospital. Leigh is one of the few people who has walked alongside me through this entire journey. And while she has never known the pain of infertility or miscarriage, she has somehow always shown such sensitivity and gentleness in regards to my experience, and she has always said the right things. She birthed her second child naturally and hopes to one day study to be a doula, so a couple months ago I asked her to attend my birth (her first ever!) and help me have the natural labor and delivery that I so desired. With the contractions becoming painful, my body shaking uncontrollably, and my heart so full of fear for Skittle, I knew then that I needed her, not only to help me through the contractions, but to give me the extra emotional support and comfort.
Leigh arrived 45 minutes later just as my contractions were finally slowing down to a more manageable spacing of 2-3 minutes apart. The doctor arrived shortly thereafter to check my dilation (3cm, I think?) and try to tickle the baby’s head to see if her heart rate would respond to touch. I was also encouraged to go to the bathroom and, just as I climbed back into bed for more monitoring, our precious Skittle finally woke up and began kicking and wiggling away, which led to the heart rate accelerations we had all been waiting for. The relief in the room was palpable. I felt such a sense of calm flow through me and my shaking stopped almost instantly. So the terbutaline had done its job and Skittle was rebounding nicely, but there was a new problem: my pulse was abnormally high. It was most likely a side effect of the terbutaline, but it was a cause for concern nevertheless and once again kept me from being free from all the wires. So I was monitored some more. Le sigh.
Finally, though, after hours stuck in bed and some begging for freedom from both me and Leigh, the doctor and nurses agreed to let me walk the floor. I would still have to be monitored the entire time and kept hydrated with my IV fluids, but I could use the portable fetal monitor instead. So I walked about as the contractions grew in their intensity and my mom, Leigh, and Honey took turns pushing my IV pole and holding my gigantic jug of apple juice. (Did I mention I was only allowed clear fluids since my arrival at the hospital? No food. Yeah…that was fun, too.)
After an hour of walking the halls of the birth center, I was ready for a change of pace. My contractions were back to being about 90 seconds apart and they were becoming more difficult to talk and walk through. We decided to try the bathtub instead, since the portable fetal monitor was also waterproof. That hot (so hot we had to add ice cubes to it!) water was such a relief. The first couple contractions I spent there I didn’t even feel and the ones that came after were much reduced in intensity. I felt like I could have spent the rest of my life, or at least my labor, sitting there immersed in that warmth.
But. (Isn’t there always a but?)
But the water made it difficult to monitor Skittle. They kept losing her heart rate and eventually the doctor ordered me out of the bath and back to my bed.
And so to the bed we went.
As the contractions continued to come very close together and seemed to become more painful with each one, we tried everything we could to manage them:
- A variety of positions: all fours, side-lying, sitting on the edge of the bed while leaning over a table, sitting on a birthing ball while leaning over the bed (my favorite), reclined in the bed
- Massage from a rolling pin on my back
- Counterpressure from a rolling pin on my back
- Hip squeezing
- A hot water bottle against my lower back (I loved this.)
- Alternating hot and cold rags on my back
- Cold rags on my neck and face
- A small roll of tape rolled on my lower back (because I forgot the tennis balls)
- Low back massage
- Shoulder massage
- Listening to my labor CD
- Low moans and deep abdominal breathing (This really helped me keep my focus.)
We had quite the “toolkit” of pain relief methods and yet nothing felt like it was enough. The back labor had me crippled with each contraction and, with the contractions so constant, there were no breaks. No recovery time. I felt like I was treading water. And sinking.
When my water broke shortly after midnight in a gush that soaked me and the bed, I got scared. Throughout my labor, I had been telling Leigh, “I’m scared. I’m scared.” And I was. It was my constant mantra, this admission of fear. Fear of the pain. Fear for my baby’s well-being. Fear for my ability to endure. Fear of the unknown. But this time, I really meant it. I was afraid. So afraid. Afraid because I knew the contractions would get harder without the cushion of amniotic fluid. And they did. Oh, God, did they! Ten minutes ago, it had been hard to imagine any more pain than what I was experiencing in that moment. But now I knew…it could get worse. It would get worse. I still had a long way to go.
I will say this: I was really at my most vulnerable, my most primal, during my labor. The low, deep moans. The wailing and whimpering I couldn’t control. The wild hair that has me cringing when I look at photos, but that I didn’t even ponder when I was in the middle of it all. The cries for help. The farting. The peeing. The vomiting. I didn’t poop during delivery, but I did just about everything else. It was not my finest hour.
And yet, I had never felt more present in my life. I had my eyes closed throughout much of it, but my senses of touch and hearing were incredible. I could tell who was touching me just by the weight of their hand. I heard every conversation even as I turned inwards to get through the worst of the contractions. I was able to respond to questions, able to hear my baby’s beating heart, able to laugh when Honey told a joke. I felt more empowered than perhaps I ever had. I was doing what female mammals had been doing for thousands of years. I was experiencing, fully, truly experiencing the glory and grief of womanhood at an acute intensity. It was amazing.
It’s a funny thing to feel so strong and weak at once. Strong because I felt completely and totally alive. But weak because I really was beginning to feel like I couldn’t go on. I was tired. And I was in excruciating, unbearable pain. I won’t lie…more than once, I wished that Skittle had been breech after all and I’d been forced to have a c-section. And with those thoughts, the “e”-word also rose to the surface. Epidural. Epidural, epidural, epidural. The four syllables thudded through my head over and over and over. I wanted to give in and give up. I wanted someone to give me the permission to do so.
I started to feel some painful rectal pressure and I said so. It was about 2 a.m. The nurse checked me. I wanted her to say I was 7, 8, 9, 10 centimeters dilated. I needed to know the end was near. And I told myself if it wasn’t, I would consider accepting pain meds. I would admit my weaknesses and cry uncle.
I was then told I was 4-5cm along.
“Oh, god. I can’t do this. I can’t do this anymore!” I felt like crying. I was only halfway there? Really?! This was all starting to feel like a cruel joke.
The charge nurse, Debbie, knelt before me. She told me to open my eyes and look at her. She told me I had a decision to make. “You need to decide what you want to do,” she said. “Not during a contraction. Not immediately after. But in between. Talk to your husband. Decide what you can live with. And we will support you in whatever you choose.” Essentially, she was giving me the permission to give up that I so desired.
After another contraction, Leigh gently asked me if I wanted to talk to Honey. “No, I want to talk to you,” I said. “I don’t want to let you and Lillian down. You were both so strong and I know this isn’t the kind of birth you wanted to attend.” Leigh laughed. She said not to worry about her, that this had nothing to do with her. That each woman’s labor is unique and I had already been so strong, so amazing.
Another contraction gripped me and then I asked my husband if he would be disappointed in me if I asked for an epidural. Though I yearned for the permission to give up, a part of me was hoping he would say yes. That someone would require me to stick with it. Instead, Honey whispered loudly, “Honestly, I can’t even remember why we want a natural birth.” The nurses laughed. Mom and Leigh laughed. So did I. “Why do we want to do this again?” he asked.
“Because it’s what’s best for the baby,” I said. I believed it was best for Skittle and I believed it was best for me, but with another contraction coming on strong, it was hard to feel much conviction. And so as soon as I caught my breath, I relented. I asked for an epidural. I was disappointed in myself, but relieved too. And desperate for the anesthesiologist to come as quickly as he could. Fast would not be fast enough.
I kept asking for the epidural. Or rather, screaming for it. Begging for it. “Where is he? Where is he?” I asked over and over. “I need heeeeelllllp!” I could feel myself losing control, spiraling. I was a mess. A number of times, it occurred to me that if there was another pregnant woman walking the halls in early labor and if she happened to pass my room, I would probably scare that baby right out of her. My pain terrified me; surely it would terrify someone else too. But even while I knew that I had lost all grip on my pain management, and even though Leigh worked very hard to guide me in getting it back under control, I couldn’t. I wouldn’t listen. I wanted no part in working with the contractions anymore. I just wanted pain relief. And I just wanted that baby out of me.
And then suddenly, I felt the most incredible, undeniable pressure. It felt like I was being turned inside out. Like I was being ripped apart. “I feel like I have to poop!” I screamed. But even as I said it, I knew I didn’t. I knew I just needed to push. I knew Skittle was ready.
And when the nurse checked me, just fifteen minutes or so after my last check when I was only 4-5cm dilated, sure enough…it was confirmed that I was fully effaced, fully dilated, and ready to push.
The problem? The on-call doctor was at home a half-hour away. And the other doctor on the floor was no where to be found.
“I have to push! I have to push!” I screamed.
“No! No, don’t push!” Everyone screamed back. My nurse ran to gather a team of nurses to help in the delivery while Debbie (the charge nurse) tried to convince me that I had to wait until the doctor arrived. And I did try, but only half-heartedly. I already knew that I couldn’t hold back much longer.
“I can feel her coming! I feel her head. I need her out! I need her out!” Phrases like that streamed out of me, over and over, while everyone kept telling me not to push. To wait. To hold on.
But there came a point of no return. Skittle was coming, ready or not, and so I let go. I screamed and I pushed. One, two, three. Three pushes, one vivid ring of fire, and less than five minutes later, and then there she was, in the hands of Debbie, whimpering. Not crying, It was 2:23 a.m.
“Is she okay?” I asked, straining to see her, already on my way to forgetting the intensity of the pain that I had just endured.
“She’s fine,” they told me and she was placed on my chest, warm and gooey and beautiful, and then she did cry a loud, perfect wail and the greatest weight was lifted from my shoulders. Skittle was here, safe at last, and nothing mattered more than that. This was the moment I had been fighting for, crying for, praying for, waiting for, hoping for, yearning for, preparing for, for months and months and months. Perhaps my whole life.
I will never forget what it was like to hold her, to see her, to touch her. To realize she was no longer inside of me, but outside of me. Tears are falling down my cheeks as I type this. It is still surreal. Unreal. I have spent so many days trying to get here. Perhaps it will stop feeling like I dream once I have spent just as many days with her in my arms.
Those first moments after her birth are vivid and perfect to me. I opened my eyes to see Skittle and to see a room filled with nurses I had never met. My husband cut the cord and took pictures of the placenta. A doctor I didn’t know came to sew up my second-degree tear. I snuggled Skittle and then handed her over to be weighed, measured, and swaddled. The anesthesiologist showed up about fifteen minutes later and the on-call doctor a few minutes after that. Honey became weepy and hugged my mom and Leigh and wouldn’t let go. And then he hugged me and cried into my shoulder, telling me how proud of me he was, how wonderful I did. He had never cried like that at Cupcake’s birth and seeing him become so emotional at Skittle’s made me love him even more. He held Skittle and I heard him tell her “I love you,” and my heart melted. He didn’t say those words to his first daughter until she was two, or three or four, months old. To hear him say it now was shocking and wonderful. Perhaps I wasn’t the only one who had been transformed by this experience.
I still have some mixed feelings about my natural birth. Quite honestly, I cannot believe I did it. I think I was doubting myself more than I cared to admit. I am proud of my accomplishment, and having done it with an induction no less. I feel like I am part of an exclusive club. Like I overcame the unimaginable. And truly, it feels like the first step in a long process of healing after the darkest days in my life. I love my body for what it did and I love myself for somehow surviving it.
But. (There’s that but again!)
But I also feel a bit like a fraud. I did ask for an epidural, after all. Can I really claim to have had the strength and willpower for a natural birth if I was begging for mercy? If I would have had an epidural had my labor not accelerated at the rate that it did? I do know that I would not have been able to do it without my doula-friend, Leigh, there at my side. I have talked extensively with her about my birth experience and she constantly assures me that I am strong, brave, and capable. She calls me “amazing” over and over. Surely, I did not accomplish a natural birth with as much grace as she did, but I’m glad to hear that she seems to have no doubt that I deserve to feel proud and empowered. She says few women are able to do a natural birth with an induction because the intensity of contractions are so great. She says few women would have lasted as long as I did with contractions coming so strong and close together. My dear friend Lillian, for example, had contractions four minutes apart throughout all of her labor. Mine came every minute or two. And Leigh says I only screamed for an epidural because I was in transition. Many a laboring woman has declared that she’s ready to quit as she makes the final dash to the finish line. And to go from 5cm to 10cm in fifteen minutes is one hard, fast, breathless, crazy dash.
So I am trying to see myself the way that Leigh does. The way Lillian and my mom and Honey do. They brag about my natural delivery. They sing my praises. They assure me that what I did was an incredible feat. I want to feel incredible. I want to believe I’m incredible. I have a long way to go, but here is what I know: I am glad everything happened just as it did. I am unbelievably thankful I never had a cesarean and enormously happy my epidural never arrived. I believe a natural birth was the right choice for me and Skittle. She was more alert than Cupcake ever was in her first day of life and has been a champion nurser since her first hour after birth. And my recovery has been ten thousand times easier and faster than when I had an epidural in my first delivery. An epidural was a necessary and precisely right choice for me then, but laboring without one was the best thing for me in this moment in this place in my life.
If you had asked me an hour or so after Skittle’s birth if I would ever do it naturally again, I would have hesitated. I wouldn’t have known what to say. The pain was still too sharp and fresh. But now? I’d say yes. Absolutely. Of course. No regrets. And if I could, I would do it over and over and over again.
In the end, though, it matters very little how Skittle came into this world. That Clomid, lots of time, and a thousand prayers were required. That I cried many tears waiting for her. It doesn’t matter that I had to be induced, almost needed a c-section, had high blood pressure and plenty of small scares along the way. Or that I asked for an epidural, but never had the time to get one.
All that matters is that she is here, she is safe, and she is mine.
I feel so lucky. I can’t stop holding her, touching her, kissing her, telling her how much she is loved. I snuggle with her for long hours, her body pressed against my chest, just feeling the weight of her. I stare at her face. I run my fingers through her fine, silky, dark hair. I have already taken hundreds of photos. I know from experience that these moments will be gone too soon. That Skittle will grow too quickly. So I will cherish this, the good days and the hard ones alike. I will not waste a second. I will treasure my child and I will hold her close for as long as she lets me.
She is my rainbow and, after a dark and stormy season, I finally get to lift my face to the sunshine. Alas.
* For those of you who don’t know, Cytotec is a vaginal pill given to ripen the cervix. It is usually administered prior to Pitocin for pregnant mamas who have not made much cervical progress prior to their induction in order to soften and efface the cervix and make the Pitocin more effective. Often, it will start contractions on its own and Pit will not even be needed. It can hyperstimulate the uterus and cause too many contractions, however, and that is why fetal monitoring is required for an hour or two after administration.