And So the Story Goes

It's been almost three weeks since I birthed Lucy. I have intended to write the story of Lucy's birth sooner, but for some reason it has felt very difficult to devote time to it. I mean, it's a birth story - it must be a great work of literature that can be read for generations to come. And, there is no concise way to tell a birth story. Only TLC can concisely edit birth stories to tap into the dramatic parts and shave out the rest. My birth story actually involves a lot of sitting and waiting.

In hindsight I can see that my labor with Lucy was very similar to my labor with Grayson, except I spent a majority of my labor with Lucy in the hospital. A quick recap, the labor I experienced with Grayson was very long but also very quick. I was dilated at about 5-6 cm for days. I woke up in the middle of the night to the sensation of my water breaking, and Grayson was born shortly after we arrived at the hospital.  Since everything was such a rapid whirlwind after my water broke, it was assumed that this labor would progress even faster once my water broke.

When I was pregnant with Grayson I wanted to labor at home as long as possible. I got my wish. I practically did all my laboring at home and in my sleep. My first birth experience was great. I cherished every unique minute of it. This time, however, I was not so adamant about laboring at home as long as possible. We live less than a quarter of a mile from the hospital, but the midwives still joked that I could deliver at home, in the car, in the parking lot - basically anywhere but the delivery room. With every joke I would give a small chuckle and mutter something like, "Yeah, my husband is reading Emergency Childbirth to prepare just in case." This would make the midwife laugh. But in my gut I would have a knot. John really did read Emergency Childbirth in preparation of a rapid birth, and I personally know women who delivered in their home, in the car (the gal just threw her legs on the dash board and gave a good push), in the hospital parking lot. As much as the extreme stories make good fodder for conversation, I did not want a birth experience that would require me to think about anything beyond allowing my body to do what it needed to do.

Thankfully - spoiler alert - John and I did not have an emergency childbirth situation in which we had to MacGyver our way through the birth of our child.
The days leading up to my due date I had all the classic signs of impending labor. The tricky thing about labor is that 'impending' is a very relative term. Anyone who has been pregnant knows that the final weeks and days of pregnancy are some of the most confusing days ever. Sometimes I felt like I would have an easier time reading tea leaves than I did interpreting the signs of labor. On Tuesday I had an appointment with the midwife. I told her that I thought Lucy would be out and about soon. I was definitely starting to have many rumbles of labor. For some reason I like to think of my body rumbling before labor, seismic activity. I woke up each night for about a week with contractions in a regular pattern. My rule of thumb was if I could fall asleep during the contractions it was not true labor. My first pregnancy was emotionally exhausting with the start and stop of what would appear to be true labor, but this time I knew better than to throw too many emotions into my contractions.

By the time Friday rolled around I was feeling more aches of labor. I started having consistent contractions in the evening, strong enough to lay me up in bed at 6 pm. After a solid hour of having contractions five minutes apart we decided to call the midwife and head to the hospital. I could still speak through all the contractions, but I figured it was better to risk going to the hospital too early rather than too late. One of the major pearls of wisdom I stress when I teach childbirth classes is to leave all insecurity at the door, to go with what feels right during labor. It felt right to go to the hospital early, but I had such a hard time shaking the insecurity. I don't believe that any woman should know what it feels like to be in labor. Maybe women know after having three or four kids, but I still had so much uncertainty because I know that every labor can feel different. One midwife told me repeatedly when I was pregnant with Grayson, "Labor will find you. When you are going to have the baby you will know." That is so true for when the baby is moments away from coming out, but before that point labor seems like such a great mystery to me. I apologized to John and my mom as I calmly walked into the hospital. I was insecure that our hospital visit would be a false alarm and we would be sent home empty-handed, me with a full belly. Thankfully my mom and John were extremely gracious and were not ruffled by the idea of false alarms.

I heard rumors about a labor and delivery room call the Taj Mahal. The Taj Mahal room was rumored to be a spacious room with a view. When I checked in to the hospital I requested the Taj Mahal. I figured why not pull out a little audacity? After all, I was a woman in labor. I had the right to be audacious. Unfortunately, the woman at registration did not know about the rumored suite and just brushed off my request. When registration was complete, the room we were escorted to was spacious and had floor-to-ceiling windows. The view was of the 24 hour Subway, but it was a view nonetheless. Since we did not do a hospital tour - we were so delinquent with this delivery - there was no way of knowing if we were in fact in the legendary Taj Mahal. If this room was not the Taj Mahal I could not imagine what it would be like. When the nurse came into the room the registration representative laughingly asked if there was a Taj Mahal room. Maybe it was the contractions or the adrenaline from actually being in labor, but the moment when the nurse smiled, waved her hands across the room as is to display it, and said, "You are in it!" felt so dramatic to me. It was perfect.

So there I was in the Taj Mahal having contractions. I had the monitor to prove that I was having significant contractions. That took away some of my insecurity that this hospital visit was not the real deal. Since we checked into the hospital around 9 pm on a Friday night everything was pretty low key. It's always amazing to me how much hospitals dial down on the weekends. I was very grateful for the modest atmosphere. The midwife on call came in and chatted with us for a bit; she brought John some fresh coffee. It was a very relaxed yet festive time. The midwife checked me because I was curious to see how dilated and effaced I was. I was about 3-4 cm dilated and 90% effaced. I was surprised that I was not more dilated, but I forced myself to remember my mantra that "dilation is a just a number that can change within minutes" and I rolled with the festive labor spirit. The way things were looking it seemed like I would deliver by early morning. I had visions of being in transition around 3 am, so I made every effort to sleep. It was harder to fall asleep during the contractions I was having, which to me was a good sign. My mom and John were so accommodating and sat next to my bed, massaging my entire body constantly. At some point I fell asleep. When I woke up the contractions had slowed and the intensity had dropped significantly.

I was surprised when Saturday rolled around and there was no baby to tend to. The midwife on-call Saturday checked me in the morning and I had not progressed much since the night before. If this was my first time laboring I think I would have completely drained emotionally. I was somewhat grateful though. Even though I missed being at home with Grayson, it was a treat to have my parents in town to take care of him while John and I stayed at the hospital. We treated our time in the Taj Mahal as a staycation. We were able to spend uninterrupted time together, lounging around. We don't have cable or basic tv at home, so the ability to flip through dozens of stations was luxurious. We found ourselves watching 16 and Pregnant and Extreme Couponing. Our show selection was somewhat embarrassing - and heartbreaking, given the nature of 16 and Pregnant - but we were on staycation. There is no shame on staycation.

As Saturday progressed my feelings of labor seemed to diminish more and more. I felt better than I did the day before. My parents brought Grayson to visit and walked around the hospital a bit. Unlike a lot of hospitals,  the midwives at the hospital did not have rules against eating during labor. The midwives and nurses tend to give some general advice for what to eat during labor that will not be nauseating when things get very intense, but my status was so far from laboring on Saturday that the midwife said she did not care what I ate. I consumed multiple cookies from Subway (how could I resist when I had been staring at the sign all night?), a brownie with whip cream, and a cookie sandwich - all bad decisions for a laboring woman. Each time I ate something sugary and heavy I made note that I could be paying for it later, but I was so entrenched in my staycation mindset that the idea of being in labor anytime soon seemed so foreign and unlikely.

By Saturday evening I was starting to wonder what the hospital staff would do with me. I had become somewhat of a squatter. The midwife told me that she was fine with me staying at the hospital as long as I needed and she did not advice going home, because she was confident that the baby would come fast once she started to come, but the issue came down to my insurance coverage. If I stayed in the hospital in my inactive state for too long the insurance company would likely start to poke around and there was the possibility of not having my staycation covered. I think at a different point in my life I would have been riled up by the fact of insurance companies dictating labor and delivery timelines, but at this stage I just nodded when the midwife told me that we needed to start thinking about some possible interventions. Part of the reason I did not get riled up by the injustice of our healthcare system was likely because the midwife did not offer any intervention that I was opposed to. When I was pregnant with Grayson I was urged to be induced with Pitocin. When I declined Pitocin it was a very awkward interaction and I think it probably led me to having a bad review in my chart. Pitocin was never mentioned by any of the midwives. This proved to me that it is possible to have a hospital birth without the pressure of medicine.

The midwife's options for induction were nipple stimulation, breaking my water, and sex. I was hesitant to have my water broken because I was sentimental about feeling the unique feeling of having it break on its own. Also, I knew that once my water broke it was going to be a quick transition and I was not exactly ready to give up my staycation. Plus, I had just finished the final cookie of the day and I was not sure I would not throw up everywhere if I was suddenly in active labor. I was on the fence about nipple stimulation because it has been shown to cause strange contraction patterns, and who wants strange contraction patterns? So, naturally, the best option was to have sex. John and I had actually discussed this option earlier in the day but decided it was not a viable option because hospital doors do not lock. John and I discussed this concern with the midwife when she brought up the idea of having sex. She brushed off our concerns and said she would put a sign on the door; she did the same thing for another couple a few nights earlier. It entertains me that it appears that at any given time there are couples having sex on the labor and delivery unit. The entire conversation with the midwife was so bizarre to me. It was so medical. Obviously sex is medical to midwives. It was obviously sex that landed me in the hospital - that was no secret - but it was strange to discuss it as a medical intervention. We agreed that we would try the sex route and if in the morning I had not delivered we would go more extreme and break my water. The midwife ended the discussion very professionally and asked that when we were done having sex if we could call the nurses' station so someone could remove the sign from the door. The midwife assured us that no one would know what was going on in the room, but I could not see how they would not know. What was I supposed to say to the nurses when I called them, "Um, we are done. Thanks!" When the midwife left the room John and I just stared at each other for a minute. Have you ever had sex in a hospital room? It is a very confusing place to wrap my mind around. The night before "code blue on the third floor oncology unit" was repeatedly call over the intercom. It's hard to think about having sex in a place where people are dying. But, hey, this was a medical intervention that needed to be done, so we pressed on. When it was time to call the nurses' station I tried to play it cool by simply asking for some juice. My guess is that the nurses all rolled their eyes at each other and laughed at my modesty. When the sign that was hung on the door was removed I learned that it read, "DO NOT ENTER. PROCEDURE IN PROGRESS." I wish I had taken the sign with me, but that would leave the next couple who was dealing with a stalled labor in the lurch when they needed an intervention.

After the procedure my contractions started to pick up again. The procedure seemed to work! However, by Sunday morning I did not feel any intense contractions. I was hooked up to the monitor and it showed that I was having contractions, but I was not feeling them, so I figured my labor had stopped again. When the midwife checked me and I was about 6 cm dilated. It was time to break my water. The nurse started setting up all the tools for delivery. It was clear to me that everyone else was ready for something to happen. I was somewhat hesitant. I had been living the life of being waited on with meals, cable television, uninterrupted conversations with John. Did I really want to birth this baby and end the staycation? The midwife pulled out the crochet needle and as she broke my water I was able to feel the pressure in my body change. It was not as dramatic of a feeling as having my water break on its own, but feeling my entire body pressure change was remarkable in its own way. Once the midwife broke my water I sat up in the bed, cross-legged, and waited for the inevitable intensity to begin.

The midwife sat with John and I for the first ten minutes after she broke my water. We chatted about maternal health and epidemiological research with the CDC. What possessed me to have such serious conversations when I was approaching the most intense time in labor is beyond me. I guess I wanted some street cred like, "I am so hardcore that I chatted it up about birth outcomes while I was giving birth." The midwife planned to stay with me until I was ready to push but there was a woman down the hall who was ready to push, so the midwife had to go use her baby-catching skills. Right after the midwife left, and my mind my not distracted by public health conversations, I started to register the intensity of the contractions. I got up to change positions and as soon as I got on my knees I knew I was at the point of absolute no return. The shift in my position seemed to give gravity extra force and I felt the baby drop completely. She was coming.

The first time I gave birth I was taken by surprise by transition. I was mainly surprised that I intrinsically knew what was going on with my body and the baby, especially since I had been so confused about labor leading up to that point. During my first labor I felt like I had to convince everyone that Grayson was coming down the canal. This time I was able to calmly say, "Yes, it's time. She's coming." The midwife who broke my water was still in the other room, so a different midwife came on the scene. As luck would have it, the midwife to attended to me was the one midwife I did not want to have during delivery. My sole reason for not wanting this particular midwife had to do with her hands. She has bigger fingers and more aggressive hands than any of the other midwives. Over the months of prenatal care I created a fictional story that this midwife grew up on a farm and learned a lot about labor and delivery from working with farm animals. In my story she was so accustomed to working with farm animals that she did not realize how forceful she was when working with humans. When the midwife checked me to see if I was in fact ready to push I had a vivid image of me being cattle at the vet. Since it is best practice to vocalize using low-pitched moans during labor, I believe I moaned as a cow would when the midwife checked me.

Transition is the most interesting time during labor. It's the most isolated time for the laboring woman, and probably the most awkward time for everyone else in the room. Most women end up completely naked during transition because of the intense hot flashes. Helpful techniques like massage are suddenly not helpful. My mom came into the room right before I was about to push. She started rubbing my back like she had so lovingly done before and I had to break it to her that I was not in the mood to be touched. So the scene during transition typically involves a group of people watching a naked woman moan and rhythmically move through each contraction. At one point most of my sweaty hair was in my face, I was rocking on my hands and knees in the bed, moaning like a farm animal, and for some reason I got the image of Linda Hamilton in Terminator. She was so hardcore in those movies. I felt so hardcore during labor.

When the midwife confirmed that it was safe for me to push I asked her if I could wait a few minutes to get my wits about me. She was agreeable to the idea and she said I could deliver in whatever position I wanted. I did not have any strong preference in birthing position. I was on my hands and knees at the time and I could not think enough to move a muscle. Before I got the chance to take the break I asked the midwife for my body took over and began pushing. So much for taking a breather. As intense as it was to have no control over my pushing, it was nice because it took away the responsibility of thinking about pushing. At one point I rhetorically asked everyone in the room, "Why do I do this?" Within five pushes the intensity was over, though. Lucy came barreling out of me. I was convinced that she fell on the bed, but my mom promised me that the midwife caught her. Birthing in the hands and was a much easier position than the seated position I was required to be in when I birthed Grayson.

The time span from when my water broke to when Lucy was born was about 45 minutes. I am so grateful we stayed at the hospital. Even though we live so close to the hospital it would have been a very chaotic time trying to get settled into a room before Lucy was born if we waited at home until my water broke. Chances are Lucy may not have been caught by someone. The midwife who broke my water came into the room right as I was figuring out how to get my tired leg over the umbilical cord so I could lie down and hold Lucy. I said to the midwife, "So, I had my baby." She said, "Yes! I see that." I really love the conversations that are had immediately after delivery. They are so on point. I think maybe what should be chronicled more is not necessarily the birth story but the conversations during the afterbirth. There is a book idea.

John, admiring his sweet baby girl.