Munchkin’s Birth Story, Part 2: Labor

Dear Munchkin,

I have to start this part of the story with the caveat that much of it is blurry for me. I am relying on Daddy’s Twitter feed and our doula’s records for any sense of timing.

Our doula, Michelle, was already in the hospital when we called her from Dr. M’s office that morning. In a twist of fate, another of her clients was already laboring there. Michelle thought her other client would most likely deliver her baby before we really needed her help, but it also meant Michelle would be “on duty” for 2-3 days straight. We are exceedingly grateful for Michelle’s sacrifice and support; she was really a trooper.

Michelle came to check on us earlier in the day, before anything was really happening with me. She was back in our room — to stay — by 5:30 p.m. Her observation was that by then, the contractions had grown stronger and more intense. They were coming almost on top of each other, lasting 1.5-2 minutes with only a minute of rest in between. We were all concerned about whether I would have the strength to withstand such intense labor for very long.

I asked for relaxing classical music early on, and Daddy set it up for me. I had been planning to use lots of position changes, movement, and possibly a shower or bath to help me through the contractions, but because Dr. M ordered continuous electronic fetal monitoring, my movement was pretty restricted by the wires connecting me to the machine by the bed. We even had to call a nurse to disconnect for a bit if I needed to use the bathroom.

Rotating my hips for pain relief, almost as if I was playing with a hula hoop, came naturally. Fortunately, that kind of movement also helps work a baby into the correct position. To make the best use of gravity, I mostly stood or leaned against the bed. As I tired, I tried sitting on the hospital’s birth ball, but it was too small for me to get comfortable. Daddy called Lola to bring my own exercise ball from our house, as well as a heating pad, which Michelle had suggested we try. Once she arrived, Lola stayed to offer help, too.

Daddy was very supportive, gently encouraging me and doing whatever he could to help me through contractions, whether it was holding me and swaying together, rubbing my lower back, applying heat and pressure, etc. Michelle periodically relieved him as he got tired, too, so he could rest and “get back in there.” I tried to rest as much as possible in between contractions, but it was very difficult because they were coming so close together, and sometimes would come two or three fully on top of each other, with no time in between.

I got to a point where I was dreading contractions, looking at the monitor as I felt one begin and watching as the intensity line crept higher and higher. Daddy and Michelle coached me not to look at the monitor, since it just made me tense up, and helped me work to change my focus in order to get through them.

At some point there was a shift change for the nurses; our new nurse, Rachel, came in to introduce herself and see how things were going. Almost before she could speak, I doubled over with a contraction on my way to the bathroom; Rachel caught me and swayed with me as I worked through it. We all decided she was the Best. Nurse. Ever. She approached us as a member of the team, looking for the niche she could fill, rather than as the one in charge. We were very blessed to have her with us.

By 8:30 p.m., I was dilated 1 cm, 80% effaced, and you were at 0 station. This was definitely progress. But the contractions had been coming so quickly and fiercely that Daddy and Michelle were very concerned about me. They knew I really wanted to avoid any pain medication, but there are physical limits for what a body can endure.

They asked Rachel about the possibility of removing the Cervidil, thinking it might be causing the extreme nature of the contractions. Rachel was diplomatic, but wanted to make sure I made a fully informed decision. There was no way to know what would happen if the Cervidil was removed: labor might continue on its own, or it might slow significantly or even stop, making Pitocin necessary to get it going again. I was determined to avoid Pitocin, and insisted I could keep going for a while longer. I decided to leave the Cervidil where it was.

A few minutes later, I needed to use the bathroom again, and the Cervidil just fell out! Rachel mused, “Well, God made that decision.”

There really wasn’t a noticeable change in my labor afterward. Contractions continued to come fast and hard, and still frequently two or three at a time with no rest in between. Michelle observed contractions on top of each other like that often indicate the baby is not in the correct position. The “back labor” I’d been feeling suggested the same thing.

Michelle offered some positions I could try to help you turn: doing cat/camels (arching my back in and out) while I leaned against the bed or on all fours, and sitting backwards on the toilet seat while rocking and rolling my hips. The cat/camels were particularly excruciating in both positions, but sitting on the toilet seat was somewhat more comfortable.

During every contraction, Daddy and Michelle took turns rubbing my lower back extremely hard. It was exhausting for them, and Michelle worried I might have a bruise the next day. I didn’t care, though, repeatedly asking them to rub harder – HARDER! They massaged me in between contractions, too, helping me relax and rest for whatever short respite I was granted. This routine made it possible for me to get through it for quite a while. The contractions were coming so fast and strong that Michelle said I did twice the work in half the time.

Around 10 p.m., I started dropping into a squat and swaying side to side during contractions, holding on to the bed railing for support. Michelle and Rachel got very excited, saying that kind of behavior might indicate it was time to push. Surprised and relieved we were there already, I asked Lola to go to the waiting room, but she decided to wait for the Big Announcement at home. Then an exam revealed my body wasn’t actually ready yet, and we went back to the laboring routine.

By 10:30 p.m. I was dilated 5 cm and 100% effaced. My water broke around the same time. At 11 p.m., I was at 7 cm. At 11:15 p.m., it was 8 cm. I was quite drained by this point and really wanted it to be over. Rachel volunteered a position that almost always worked, adding “but you’ll hate it.” I was willing to try anything, so the team helped me get into the “runner’s stance”: laying on one side on the bed, with my top knee pulled up to my chest, periodically alternating sides.

Rachel was right. I hated it. But I was determined.

I started pushing a little, but Rachel and Michelle were concerned my body might not really be ready. Around 11:50 p.m., Rachel did an exam and found I was still at 8 cm, but the pushing was causing the cervix to swell. I had been screaming, too, at a relatively high pitch, and Rachel firmly reminded me that kind of vocalizing only did me harm. I needed to get control of my vocalizations and pushing, or I might work myself right into a C-section. That was the last thing I wanted, so I resisted the urge by softly chanting “relax” over and over to myself.

While the labor was still intense, progress had stalled since 11:15, though Daddy and Michelle continued to vigorously rub my back. Once I surrendered to the contractions, progress picked up again. By 12:20 a.m., the swelling had disappeared and I was dilated to 9 cm.

Rachel had been trying to hold the fetal monitor in place on my belly as I rocked on the bed in the runner’s stance, but finally acknowledged she couldn’t get a good reading. She was worried Dr. M might push for a C-section if she didn’t have data on whether or not your heart rate was dropping at any point, so Rachel asked if she could have the resident place an internal monitor on your scalp. I agreed. Since the contractions were so close together, of course it meant that I experienced a couple while it was being inserted, which was quite possibly the worst feeling in my world at the time.

Earlier, Rachel had asked if she could hook up some fluids to my hep lock. She promised it would be fluids only; she respected my desire to avoid medications, but she was worried about my hydration and stamina. I had agreed to that, too. Rachel was such a blessing. She honored the wishes we had expressed in our birth plan and was always considerate when she needed to discuss something with me, making sure to wait until I was in between contractions so I could focus on making an informed decision.

By 1:20 a.m., dilation was complete and I was feeling lots of pressure. It was time to start pushing! I wanted to begin immediately, but Rachel was scrambling: “I need to have a doctor in the room before you can push!”

As the team helped me turn onto my back, raise my legs and lift the head of the bed into an angled position, the room flooded with people. I didn’t know any of them, but I was grateful to see they were all women, as requested in our birth plan. The resident on call arrived pretty quickly, which allowed me to begin pushing in earnest. I assume the rest of the new faces were more nurses and probably some medical students and/or lower-level residents. Dr. M showed up some time later.

I pushed hard with each contraction; I was so ready for the ordeal to be over and finally meet my baby! It was only in retrospect that I remembered that position is pretty much the worst position for mom and baby to accomplish what they need to do. Dr. M had agreed to let me use the squat bar, and it was in our birth plan, but in the moment I got swept up by the momentum, I guess, and nobody else noticed the discrepancy, either. At least, nobody said anything if they did.

Everyone was encouraging me as you got closer and closer with each push. They were commenting about how much hair you had and cheering me on.

I heard Dr. M say “we’re really close! I think we’re just waiting for the skin to tear” once or twice. Then I heard her suggest an episiotomy, which I explicitly declined in our birth plan. I was tired, but not that tired! I ignored the suggestion at first. A little bit later she worried out loud that I would have a nasty multi-layer tear if we didn’t do an episiotomy, maybe even more than one. One or two pushes later, she said it looked like it might even tear the clitoris.

Now that scared me. “Do it. Just do it.” I consented. She had worn me down.

Not long after, at 2:03 a.m., you were born.

Preparing for Munchkin’s Arrival          Munchkin’s Birth Story, Part 1

Munchkin’s Birth Story, Part 3

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3 Responses to Munchkin’s Birth Story, Part 2: Labor

  1. Pingback: Preparing for Munchkin’s Arrival | Notebook of Memory

  2. Pingback: Munchkin’s Birth Story, Part 1: Induction | Notebook of Memory

  3. Pingback: Munchkin’s Birth Story, Part 3: Immediate Postpartum | Notebook of Memory

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