"Every good and perfect gift is from above." – James 1:17
On July 8, 2010, at 10:23 p.m., I experienced the greatest moment of my life thus far: the birth of my son, Michael Louis. Given that I had a LONG labor, I start his birth story here because the HAPPY ENDING is the best part! I assure you it took a lot of work to get to this miraculous moment. So, let’s rewind a couple days.
IT BEGINS
In the mid-afternoon of July 6, I began to feel strong pressure in my rear, the type of feeling you get when you need to have a bowel movement. However, when I would try to use the restroom, nothing would happen. This was odd to me because I had not experienced constipation problems during the course of my pregnancy. However, I was hopeful that this pressure could be related to cervical change. This was very exciting because, as of June 30, my cervix was still closed.
The pressure on my rear became more painful throughout the day, and I also began to experience increased painful pressure on my pubic bone. By 9:00 p.m., I was fairly certain that my labor had begun. Even though I was now 41 weeks pregnant, I didn’t want to get too excited since there were several times over the previous two weeks in which I felt, “I think it’s starting.” Then, I was disappointed when the contractions did not progress. Further, I had Braxton Hicks contractions throughout most of my pregnancy, which had increased in both quantity and intensity in the last few weeks. Thus, I didn’t want to tell anyone what was happening until I was sure it wasn’t false labor.
At 9:45 p.m., I passed my mucus plug (a/k/a “bloody show”), and knew we were on our way! I became full of energy, but felt it would be best to settle down and try to get some rest because I had no idea just how long I might be in labor. I began to put into practice what I had read regarding The First Stage of Birth and relaxation techniques in “Natural Childbirth the Bradley Way” by Susan McCutcheon. Additionally, I reviewed some notes from our sessions with Gaylea McDougal (our amazing doula), which said to try to sleep as much as possible because the contractions will only get stronger. Sleeping was very difficult because I had so many emotions running through me (as well as pain from the contractions), but I did my best to rest between contractions as much as possible. I also spent a lot of time in prayer, thanking God for the gift of my son and asking Him to please protect my child and be with us throughout my labor.
At midnight, I called my obstetrician to let her know that my labor had begun. Since we had planned for an unmedicated birth, I was thrilled that we would not have to go through with the induction scheduled for July 13. At this point, our goal was to labor at home as long as possible. The plan was to try to stay home until 6 to 8 cm dilation and arrive at the hospital when we were close to The Second Stage of Birth and ready to push. I felt this would be the best way to avoid any unnecessary interventions, and I would be far enough along that the change in environment (from home to hospital) would not slow down my labor.
I labored throughout the night, and called Gaylea at 6:30 a.m. on July 7 to let her know that my contractions were 5 to 7 minutes apart. My wonderful husband, Damon, was a great coach, and we worked together through each contraction that day. We walked, used the birth ball, and did a lot of dancing. (Labor dancing involves the mother putting her arms around the coach's shoulders and neck, resting her head on the coach's chest or shoulder. The coach's arms go around the mother's abdomen, clasping hands at her back. Once in position, the mother and coach sway together as if they are slow dancing.)
A few weeks earlier, Damon put all the songs from our wedding and reception on the iPod, which we listened to while we worked together. I have never felt closer to my husband. We used dim light, candles, music, and touch to create a beautiful laboring environment. At 3:40 p.m., I called Gaylea again because the intensity of my contractions had increased. She suggested a warm bath, which was very helpful.
Using the Birth Ball
REINFORCEMENTS
By 7:30 p.m., Damon had helped me by himself for nearly 24 hours, and it was time to bring in reinforcements. Therefore, we called Gaylea and asked her to join us. She arrived at 8:15 p.m. I was in bed, utilizing the Bradley side position for labor. My contractions were still 5 to 7 minutes apart. Gaylea provided me with some massage and used the TENS unit on my lower back. By this point, the pain in my lower back, buttocks, and legs was intense. I was able to relax my head and upper body through the contractions, but I was not able to relax my lower body at all. I had read about back labor and was prepared for that pain, but I was not prepared for the pain that rushed through my legs with each contraction. This pain went all the way down to my feet, and was agonizing. While Damon applied counter-pressure to my lower back, Gaylea massaged my legs. This helped, but every contraction seemed to hurt more than the last. We tried to move into different positions, and the only position that felt good was sitting on the toilet.
At 11:00 p.m., I took another bath. After that, we tried to walk and dance some more, but the pain in my legs made it difficult to stand. I could no longer find any comfortable position. I didn’t want to lie down, sit, or stand. Every inch of my body hurt, and the various labor positions didn’t seem to give me any relief. Around midnight, Gaylea suggested we head to the hospital because she feared I would not make it in the car if we waited much longer.
HOSPITAL
We arrived at the hospital on July 8, at 12:30 a.m. I was praying that we were at least 5 cm. and was devastated when the triage nurse said, “3 to 4 cm”. How could this be? We had worked so hard for 27 hours! I was scared this was going to negatively impact our birth plan for two reasons:
1. Our laboring environment had been changed way too early, and
2. This meant a longer hospital stay and increased chance for interventions.
I was admitted, and there was no turning back. The doctor approved intermittent external fetal monitoring (15 minutes of monitoring each hour instead of the standard continuous monitoring) and a heplock (a small tube connected to a catheter in a vein in the arm for easy access, which is an alternative to using an IV). Thus, I was able to move freely throughout the room for 45 minutes of every hour, and My Team (Damon and Gaylea) helped me through each contraction. Because my legs were hurting so much, I utilized the birth ball quite a bit and also found it helpful to get on my knees and lean over the bed to take some pressure off my back. (This made my knees very sore, and the knee pain continued for a week after birth.) I felt like my only respite was sitting on the toilet. I wasn’t having bowel movements, but it felt like my baby was trying to come out the wrong exit. This was extremely painful and worrisome because we feared the baby may be OP (occipito-posterior, face up with the baby’s spine against mine). An OP baby and mother have to work harder in labor to have a vaginal birth, and labor is often longer and more painful while the baby tries to rotate to the anterior position (face down). A common side-effect of OP labors is excruciating back pain, caused by the hard surface of the baby's skull pressing on the mother's lower back.
I tried to be as encouraging and motivational to My Team as possible. I told them they were doing a “good job” often and continually thanked them for all their help. This helped me as much or more than it helped them. It had been a long haul, and I needed everyone to stay energized so we could work this baby out. In moments of fear or worry, I asked My Team to “focus” and pray to God for help opening my cervix so the baby can come out. I continually visualized my cervix coming up and over my baby’s head. I would close my eyes and see him coming down and out. I would repeat, “Down and Out, Down and Out, Down and Out.” I was determined to get my cervix open so I could hold my sweet baby!
Labor Dancing
Damon and I listened to the iPod music, danced, and even laughed. I got a kick out of it when Gaylea said, “I never knew you were this funny.” We made it a positive labor experience, even though we weren’t at home.
The following is a chart of my labor progress after admission to the hospital:
Time 1 am 5 am 6 am 9 am Noon 2:30 pm 3:30 pm
Dilation 3 cm 4 cm 5 cm 6 cm 7-8 cm 8 cm 8 cm
Effacement 90% 100% 100% 100% 100% 100% 100%
Station -1 0 0 -1 -1 0 0
Time 4:45 pm 7 pm 8 pm 9 pm
Dilation 8 cm 8 cm 9 cm 10 cm
Effacement 100% 100% 100% 100%
Station 0 0 +1 +1
As evidenced in the chart, I had great difficulty progressing after 8 cm dilation. Because I did not seem to be progressing, my doctor suggested rupturing my membranes (breaking the bag of waters) at 3:45 p.m. We had hoped this would help move things along, but it didn’t. When the doctor broke my water, she discovered light meconium (infant's first stool). This made me nervous and anxious for the baby to be born because of the risk of Meconium Aspiration Syndrome, which occurs when a baby inhales meconium contaminated fluid. Additionally, the doctor became concerned of some irregularities on the fetal monitor, so they began continuous external fetal monitoring. I could no longer move about the room, and this decreased my ability to get into different laboring positions. Thus, the mood began to change. Even though our space to move was limited, I still managed to rock on the birth ball. I leaned on Damon, and Gaylea applied counter pressure to my lower back. I asked My Team to “focus” and pray to God for help to open my cervix. I continued to use visualization and repeat, “Down and Out.”
INTERVENTIONS
At 5:30 p.m., my doctor said it was time to get things moving. She said, “One way or another, this baby has to come out.” This really scared me because the last thing I wanted to was have a C-section. The doctor believed it was now necessary to start pitocin. She thought the baby was OP and was not pushing on my cervix. Getting the pitocin was the next step if we wanted to try to avoid a C-section. I was really scared because I knew that pitocin contractions would be different from natural contractions, and they would possibly be even more painful since my water was broken. I talked with My Team and I asked the doctor if I could have a few minutes to walk around the room to see if that would get things going, but the doctor would not approve this. She said it had been long enough, and it was now in the baby’s best interest to intervene.
So, we started the pitocin, and it was horrible! The pain was about 50 times worse than a natural contraction. I could not relax at all. I tried to “ride the wave”, but I couldn’t get on top of it. The contractions came one after another with no breaks at all. I could still feel the last contraction when another one was starting. It was the worse pain I’ve ever felt in my entire life. I became very frightened. Because they have to give you a lot of IV fluids once pitocin starts, I was confined to the bed. I could not get into any of the labor positions I had practiced over the last several months. There was nothing I could do but lie there in agony. While Damon held my hand, Gaylea would apply counter pressure to my lower back. Because the pain in my hips was so bad, I would have to switch sides after each contraction. (I had hip pain throughout my pregnancy, which only worsened as the contractions became stronger.) Due to the pain from the never ending contractions, My Team had to move me from one side to the other. My body was no longer my own. I could think and feel, but I had no control. The contractions completely overtook me. All the while, I prayed to God for help and guidance. I asked God to protect my baby and to ease my pain. I asked God, “Is this what is best for my child? Is this part of y our plan for us? Are we making the right decisions?”
It got the point where I could see in my husband’s face that something wasn’t right. I was crying for someone to, “Please, help me!” Damon and Gaylea were really concerned now. At 7 p.m., Damon called in the nurse. I had been in labor for nearly 46 hours, and my strength was gone. The pain in my legs and lower back was unbearable, and there was no way I could continue like this. I asked the nurse to please turn off the pitocin so we could discuss the next step. She didn’t want to turn it off at first, fearing it would slow down the contractions. I told her, “I need to be able to make the best decision for the health of my child. I cannot think clearly in this much pain. Please turn it off so we can discuss what to do next.” She turned off the pitocin, and My Team had a great discussion with the nurse.
I had already been doing the “pretzel” position for an hour and half to try and get the baby turned around. Although we didn’t know yet if he was in the right position, the nurse said that there was still hope that the baby could be born vaginally. She suggested an epidural might help to ease my pain enough to get the last two centimeters I needed. She reminded me that I would have to get an epidural if they did the C-section, and I was running out of options. It didn’t take long for Our Team to decide that it was in the best interest of my baby to get the epidural now in an effort to avoid a C-section and lessen the risk of Meconium Aspiration Syndrome.
I prayed about it, and I knew that getting the epidural was now the best choice for our child. By 9:00 p.m., I was fully dilated. Having the epidural gave me enough time to rest and re-fuel for pushing. I asked the nurse to turn off the epidural so that I could help push. I wanted to be able to use my legs and what I had practiced to help get my baby out. We did some practice pushes, and I was a quick learner because it only took a few contractions before the nurse called the doctor. Once the doctor arrived, I pushed through three contractions, and there was my baby!!!!!
ARRIVAL
The pretzel positioning and relaxation from the epidural helped move Michael into the anterior position. The umbilical cord was wrapped around his neck twice, but the doctor easily removed it. As soon as the umbilical cord was pulled from his neck, Michael screamed. My husband cut the umbilical cord, and we began to cry tears of joy. This moment was what we had been working so hard for. It took just shy of 49 hours of labor for Michael to arrive, and every second was well worth it! The nurse rushed Michael off so the NICU Team could suction the meconium. Damon went with Michael to make sure everything was okay. Our baby was just perfect, and even scored a 9 of 10 on the APGAR!
As soon as he was done with the NICU Team, they brought Michael to me. He breastfed right away, and I was thrilled to finally be holding this angel I had been praying for. He weighed 7 pounds, 2.5 ounces and was 20.5 inches long. His head was round, his skin so very soft. He was the most beautiful baby I’ve ever seen! A calmness filled the room, and I thanked God for the gift of my son, Michael Louis.
