It’s been a while. So long, in fact, that I had to google “how to log in to my wordpress site” to even remember how to write and publish here. But I have a pretty good reason for my absence.
His name is George.
Let me rewind a bit. Bringing Up Betty has been a passion project from the start. It takes a great deal of time and energy to produce each episode of the podcast, but it was such a fulfilling pursuit that I made it happen on a fairly regular basis. Needless to say, I was pretty shocked when it so easily fell by the wayside when I got pregnant last summer. What proved to be my most difficult pregnancy also completely zapped me of all motivation for endeavors outside of our day-to-day survival.
I know that all kinds of challenges can pop up in pregnancy, and some might not consider what I dealt with to be all that difficult. But for me, it was awful and hard. Those early weeks felt like a deep, abiding flu set in and took over my body. The kind with unyielding fatigue, body aches and a general feeling of unwellness. Then came the months of daily vomiting, migraines, insomnia, and joint and ligament pain. The last few months gave way to intense gallbladder pain, carpal tunnel syndrome (in both hands), de Quervain syndrome (in my right hand), and symphysis pubis dysfunction. By the time this baby’s due date rolled around I was more than ready to meet him.
A Love Affair with a Side of PTSD
Before I dive into the story of his arrival, I need to revisit all of the planning and preparation that went into this birth and give a little background. When I was pregnant with each of my girls, I focused almost entirely on preparing for the baby without giving a lot of thought to the birth. I considered myself so wise for my focus on the marriage, not the wedding mindset. I read up on sleep and routines, breastfeeding, and child development. Aside from having a vaginal birth, I didn’t have strong opinions about how my babies got here. I just knew I wanted them to be healthy, breastfed, happy babies, and good sleepers (they were) so that’s where I put my focus.
And you know what? I had two really great births. My body went into labor on its own, I never quite made it to my due date – just close enough to be perfectly safe and plenty ready, and I had ideal epidurals for both. After Clara’s birth, I remember saying that I could do it a million times over. In fact, I wanted to. I was so naive about the experience that I didn’t even realize how traumatic it had been. Three hours of pushing, a broken tailbone, a vacuum extraction, and a fourth-degree tear… they were merely minutiae in one of the most deeply spiritual experiences of my life. Those details didn’t even really make it into her birth story.
While intense and a little scary towards the end, Clara’s birth was more special than I ever could have imagined. I count it among my most sacred experiences; it was beautiful and transformative in every way. Since that day, I have said again and again that if I could do my life over, I would have studied nursing instead of advertising and become a labor and delivery nurse. Never mind the fact that I don’t handle blood so well. The chance to repeatedly take part in one of the most magnificent human experiences, where heaven meets earth? I couldn’t imagine a work more sacred.
Betty’s birth was far less traumatic. Aside from the week long prodromal labor that has become trademark to my births, the whole thing was less than five hours from start to finish. Despite my love affair with birth that had surfaced after having Clara, my recovery after she was born was honestly horrendous and grueling. When I arrived at the hospital for Betty’s birth, I was terrified of my tailbone breaking again (hashtag PTSD). I remember the nurse asking me about my goals for the birth when we got settled in the room. She wrote on the board: vaginal delivery, breastfeeding, no broken tailbone. But my tailbone wasn’t an issue at all! Not even remotely. Everything went so smoothly. At that point I was sure that my tailbone issues, as far as childbirth was concerned, were behind me (no pun intended…?). Between the fact that my water broke on its own, and that I only had to push through two contractions to get her out, Betty’s arrival gave me every confidence that I was ready for birth at the next level.
The medicated route had proven calm and manageable, but a big part of me really wanted to experience birth. One of the times I had felt most connected to the divine was at Clara’s birth. And Betty’s birth had given me assurance that my body knew what to do, the way was paved, and my babies henceforth would come without complication. My thought process seemed completely rational and logical. I wanted to take what had been a positive experience and make it even better by removing any and all barriers – in this case, medical interventions.
My plan was to experience the fulness of the birth process and everything that came with it: not just pain and vulnerability, but that rush of relief and love and accomplishment that come when that fresh little baby is placed on your chest for the first time. I lived for that moment. And for the quick recovery that most assuredly would follow.
I prepared for this birth. Oh, how I prepared. I read, watched, and listened to birth stories around the clock. I purchased the Hypnobabies Home Study course and faithfully did the reading, listened to the audio tracks, and practiced self-hypnosis. The pregnancy affirmations played every time we were in the car (and oddly, randomly, quite often at other times as well). I read Ina May Gaskin and Penny Simkin and Elizabeth Davis and watched every birth documentary I could get my hands on.
I walked, talked, ate, drank, breathed and slept childbirth. So much so that Spencer asked me one night what in the world I would read/watch/listen to after the baby was born. In case you’re curious: Brené Brown. I’m reading, watching and listening to as much Brené Brown as I can find these days. I carefully crafted my birth plan, hired a doula named Hannah, and polished my deep breathing techniques. I felt more than prepared. I was so excited to experience this womanly rite of passage in its rawest form.
Part of the Hypnobabies curriculum involves a visualization exercise specifically about your impending birth. It walks you through the whole experience as you imagine exactly how it will go. Here’s a glimpse of what that was like for me:
I knew this baby would come early. The same way I knew he was a boy before we found out for sure. So somewhere between 38 and 39 weeks, I would start having contractions. They would build slowly, over several nights, much like they had with my girls. At one of my last prenatal checkups, where my body was progressing beautifully towards labor, my doctor would strip my membranes and it would set things in motion as it always had.
Within 48 hours, I would get to that, “I think this is it” point I had gotten to with the girls. But instead of heading to the hospital, I would stay home until the contractions were coming at a new level of hard and fast. I would call Hannah, peek in on my sleeping girls one last time, and in the dark of night, Spencer and I would head to the hospital. I’d listen to hypnobabies tracks on the ride there and although things would get intense, I’d remain relaxed and in the zone.
When we arrived at the hospital, the contractions would be coming so furiously that Spencer would have to do all the talking and check me in at the labor and delivery desk. I’d remain calm and in control. We’d hand my birth plan to the nurse and quickly be admitted. I would be between six and eight centimeters dilated. When things got really intense, I’d labor in the tub and it would feel so good. I’d start to shake, my teeth would chatter, I’d get nauseous. This was transition, and I’d know it. I would wonder aloud if I could really do this. Spencer and Hannah would cheer me on and reassure me, and I would tap into a strength I didn’t know I had to keep going.
I’d start to feel “pushy” and they’d help me out of the labor tub and onto the bed. A nurse would check me and I’d be fully dialated. The baby’s head would be “right there.” The nurse would tell me to wait to push until the doctor came, and in an attempt to do so, I’d pant through a few contractions. My body would take over.
The doctor would come in, suiting up in a race against time. He’d gently guide me through two or three pushes and then in a flood of sheer relief and exulting joy, my boy would be here. I’d reach down and clutch his tiny body and bring him up to hold him tightly to my chest. I’d cry and shower him with kisses, and feel all the feels. Time would stand still and I’d take it all in. My heart would take a million pictures and I’d just be so radiantly happy and proud.
As I think now about how I envisioned my third baby’s birth, I laugh. Because it is so, so far from how it played out. Anne Lamott was quoted in Brené Brown’s latest book as saying, “Expectations are resentments waiting to happen.” I feel like that might be a little extreme (and I don’t know, jaded?), but I’m really not sure how to reconcile the concept of visualization exercises with expectations (and ensuing disappointments). I’m just putting that out there.
My preparation for natural childbirth brought up recurring themes of: mind over matter; the brain is in charge; and even though this is a process that heavily involves your body, the mental game is just as, or even more important than anything else. I thought that envisioning the birth I wanted was part of the essential mental game, but maybe I was just creating expectations that would set me up for disappointment.
Even as I pulled back the lens and allowed my vision to blur out the details, I still had a pretty clear picture of how I thought this birth would go on the macro level: exciting but uncomplicated, straightforward but raw and joyful. I even calculated where things might fall outside of my expectations and planned not to be let down. I was prepared, for example, to get to the hospital and only be 4 centimeters dilated when I thought I was much farther along. I was prepared to not be allowed to labor in the tub once my water had broken, in case that was the hospital’s policy. I was prepared to push for longer than I did with Betty, or to face blinding pain in the end stages of labor, despite hypnobabies promises of a pain-free experience. What I was not prepared for was how the whole thing actually went down.
A Birth by Any Other Name…
Ok, now on to the actual story (starting only a few weeks before his arrival). A birth story needs a proper title, yes? Here are some that might fit:
How to Birth Your Third Baby Like a First Timer
“If I can do it, anyone can do it,” and Other Well-Intended Lies
Collateral Damage: One Mother’s Story
But perhaps the most appropriate would be: A Step-by-Step Guide to Dismantling The Perfect Birth Plan
Way Up There
Even though I know that early dilation ultimately means nothing about impending labor, I always consent to my doctor checking me. My body likes to start dilating (and having contractions) long before labor is imminent, but the little bits of progress help me see that my body is getting ready, things are moving along, and there is an end in sight. This time those checks started at 35 weeks, and just as I predicted, things were already starting to happen. I was nearly 2 centimeters dilated and 30% effaced. Week by week, I continued to progress slowly: 36 weeks, 2.5 cm; 38 weeks, 3 cm; 39 weeks, 3.5 cm. Each time my doctor checked me he commented that my baby was “super high” or “way up there” but I wasn’t concerned. My other babies never really dropped before labor.
Right at the beginning of my third trimester, my doctor asked if I wanted to schedule an induction. As long as it’s not your first baby, the practice I use for prenatal care regularly schedules inductions at 39 weeks. “Nope. I’m planning for a natural childbirth,” was my confident reply. “My baby will come on his own when he’s ready.”
At 38.5 weeks, my doctor stripped my membranes. I could tell without him saying a thing that my baby was still “way up there.” But based on my past experience, this would be the catalyst. I knew the effect wouldn’t be immediate, but I left the doctor’s office feeling confident that my baby would be in my arms in a week or less. Over the next 48 hours, disappointingly, nothing happened.
At my final appointments, my doctor stripped my membranes two more times in his office. By the third round he told me there was really nothing to do – the amniotic sac was completely separated from the uterine wall. All we could do was wait.
By the time I was 39 weeks pregnant, an induction sounded pretty good. I didn’t want to be induced before my due date, but I started to think that maybe it wouldn’t be so bad it if I made it past my due date. Plus, I had friends who had been induced, even while birthing naturally and unmedicated (well, with the exception of the induction) and had great outcomes. At my 39 week check, my doctor scheduled me for an induction one week after my due date – just in case. But before I even made it to my due date, he was able to move it up. An induction was scheduled for just one day after my baby was due, March 16th.
As I grew increasingly uncomfortable, I started to do everything I could think of to help my baby get into a favorable position and start and sustain labor. I walked and walked, I did many of the exercises and stretches from Spinning Babies to help the baby drop, I walked curbs, I even went to a chiropractor a few times. The browser on my phone was a cascade of articles I had at ready reference: 8 Ways to Speed up Labor, Natural Ways to Induce Labor, Tips for Labor Progress, etc.
Early Labor and the Errant Text
I knew that Hannah would have several things to coordinate in order to be at the birth, so the plan was to let her know as soon as I had any signs of labor. I assured her that my early labor had a tendency to last for days, but I promised to keep her in the loop.
On Wednesday, March 8th, I woke up and immediately sent her a text relaying the happenings of the night before: contractions all night, several strong enough to wake me up. I had timed an hours worth and they were consistently about five minutes apart, lasting about one minute each. By the time I sent the text things had started to taper off, but I was still hopeful.
She texted me every few hours, checking on me, encouraging me and seeing how things were going. And then, while I was in the middle of the produce section at the grocery store, I got a phone call. It was Hannah.
“Hey, did you get my last text?”
I hadn’t checked my phone for a while and hadn’t noticed any texts coming in.
“Um, I don’t know. I don’t think so.”
“I have been texting back and forth with you and a friend of mine all morning and I accidentally sent you a text that was intended for her. And I just didn’t want you to take it out of context. I’m really so excited for your birth, I just have to figure out who can watch my kids, especially if it’s in the middle of the night.”
“Wait, what?” I was confused.
“I sent you a text that said ‘things have started to slow down. so I’m praying she’ll last ’til the weekend.'”
I chuckled, “Oh, nope! Haven’t seen that one yet,” Laughing, I imagined the twinge of panic that sets in the moment you hit send and realize a text or email or whatever is headed to the wrong person. We’ve all done it, right?
“But no worries,” I said, “I totally get it. We have to figure out who can watch our kids too and there are various inconvenient times for everyone involved. It’s a lot to coordinate. But it’s fine! Really, don’t worry about it at all.”
And it was fine. We chatted for a few more minutes and she assured me that she would figure out her childcare situation and be there no matter what or when the baby came. Sure, I had been up most of the night with contractions, and even though I was a little hopeful that the baby was coming soon, in reality I knew his arrival was probably a few days away. When I told Spencer about the errant text later that night, we couldn’t stop laughing about it. And since the birth, Hannah and I have had a good laugh about this too, which has only endeared her to me even more.
The Moon Also Rises
That night I had more contractions. They woke me up around 1:00 and were consistently three minutes apart. But they never got really intense, and eventually, around 5:00 am I was able to fall back to sleep.
“I really hope the baby doesn’t come tonight. I just want to curl up in my warm bed, get cozy, and sleep.” File that under things not to say to your wife when she has been in early labor for over 48 hours. I was feeling sorry for myself as only a 39.5 week pregnant woman can, but I started thinking that no one wanted this baby to come except for me. Night after night, I had steady contractions. And morning after morning they would peter out. But this was nothing new. I knew from my previous pregnancies that this was just how my body worked. I was confident that after a few nights of this, one morning the contractions would not fade away. They would build. And everything else would go as planned.
I looked to nature to help sustain my labor. I waited in great anticipation of the full moon (which did nothing) and watched the weather for impending storms (there were none). The night before my due date, I was more pregnant than I had ever been. As a last ditch effort, I went to the local high school and ran twenty sets of stadium stairs. And then I resigned myself to reality: this baby was not coming early. Even worse, he might not be coming on his own.
And so it began: the birth I had envisioned started to unravel before I was even in labor. A few nights of steady contractions stretched into more than a week, and before we knew it March 16th was here.
Even though I was really anxious about being induced, it ultimately felt like the only option. To make the decision more clear, my doctor developed kidney stones and was getting them taken care of on the morning of March 17th. He would be out of commission from the 17th to the 19th. Plus, he insisted that he wouldn’t allow me to go past March 21st, for fear of my baby getting too big. Hannah wasn’t going to be available on the 21st, so the 16th it was.
I woke up that morning praying for labor to start on it’s own. I had contractions here and there, but nothing resembling a true labor pattern. I feel like I lost my mucus plug multiple times over the weeks prior, but that morning it was considerably more… significant. I took it as an encouraging sign and thought maybe my body would be ready to get this baby out after all.
Everything was ready to go, so after a shower and breakfast I sat and waited for my phone to ring. I was in a little bit of disbelief – it would likely be my baby’s birthday! By 9:00 a.m. the hospital called and told me they were ready for us. I called my mother-in-law who would manage the house for the day, and then Hannah, who would meet us at the hospital. Spencer gave me a priesthood blessing, we kissed the girls, loaded Betty on her bus and then headed to the hospital.
It was a beautiful, sunny spring day – a perfect day to welcome a new little soul to the family. Despite my apprehension about being induced, I felt like things should be pretty straight forward. I was fairly certain we’d be settling into the maternity ward with our little guy by early afternoon and the girls would come meet their brother as soon as school got out.
We arrived at the hospital around 9:40. Let me just say for the record, that it is a strange thing to check in at labor and delivery without actually being in labor. I was sent to room 10, got gowned up, met the nurse (Laura), went over our birth plan, and got settled in. Hannah arrived at 10:00 and shortly after that my doctor came in to check me. I was 3.5 cm dilated and 70% effaced and the baby was still really high. There are a few different ways to induce labor medically, but since I was hoping to keep things as natural as possible, I opted to have the doctor break my water. That would be an eventual part of the birth no matter what, and didn’t involve any drugs.
I couldn’t believe the huge gush that ensued. When my water broke with Betty, there was hardly a trickle before her head came down to plug the flow. But this time, fluid continued to just pour out of me: every time I moved or shifted my weight, when I stood up, sat down or walked around. It was the strangest sensation. The nurse even asked me if I had been diagnosed with polyhydramnios – which I hadn’t. She got me set up with a giant pad and mesh undies to deal with the unyielding flow of amniotic fluid. Hannah cleaned up my feet and flip flops so I didn’t have to squish with every step. With my water broken, Hannah and I did a few laps around the L&D unit while we chatted and got to know one another better. Nothing happened. I don’t think I had a single contraction.
By 11:00 we had a new nurse named Jessi, and it was clear that Pitocin was on the docket. I really wanted to avoid Pitocin, knowing it can mess with the body’s production of oxytocin, which is key in the natural process of labor, as well as the initial bonding that takes place with baby. But having my water broken put me on the clock, and the rest of the day would be about getting the baby out at all costs.
It took a full hour and an infared machine for the nurses to find a vein. Even then, they had to use the smallest gauge needle to get my IV going. I was on a low dose of Pitocin starting around noon, hoping that it would be just the jumpstart that my body needed to kick into labor.
Contractions were decently manageable at the start. Since I had planned to labor in the tub at some point, but required continuous monitoring (thanks, Pitocin), the nurse suggested that I take part in a clinical trial the hospital was doing for wireless monitoring. It was designed to go under water and sounded like the perfect solution for me. I had to answer a bunch of questions – again. Seriously, there are so many questions at the hospital, and it seems like you get to answer them each a dozen times. To get set up with the monitor they had to rough up my skin and said it would feel like sandpaper. It was a pretty painless process, and I commented that the sandpapery stuff felt like a cat licking my belly. The nurse was excited to use that description to tell future patients about what to expect. We all thought that maybe wasn’t the best idea.
Hannah and I did a few more laps around the unit, but I felt that the birth ball was more productive than walking. The hours passed with relative ease as we talked and ate an endless supply of Lorna Doones and graham crackers. We listened to one of my playlists on Spotify and chatted in between contractions. We talked about how we each ended up in Utah, the disappointment that was The Gilmore Girls revival, Wilco, Barcelona, Friends (funnily, I could only remember one episode from back in the day, the one that she had happened to watch the night before), our families, Portland, work, the beauty and truth that is La La Land. You know, normal stuff.
The day was unfolding as pleasant and lovely. I was honestly enjoying myself and the whole process. Hannah worked her magic with counter pressure and her hot rice pack. I mostly stayed on the birth ball, and Spencer hung back during this time. If I had a contraction while Hannah was out heating the rice pack, I would stand up and hang on Spencer’s shoulder to get through it. Spencer and Hannah each took breaks and left for a while to get lunch, and the nurse came in regularly to check the monitor and up the dose of Pitocin. She explained that the computer screen showed eight minutes worth of labor and our goal was to get four to five contractions consistently on that screen. At first I was getting only two or three contractions in eight minutes time, but eventually I was getting seven or eight – enough that at one point the nurse lowered my dose of Pitocin.
Open, Open, Open
By mid-afternoon I was in a really good labor pattern. I was having consistent contractions and they were long and intense. We turned off the music and I put in my earbuds so I could put my hypnobabies training to the test. The tracks really helped me stay focused and calm, breathe and relax. Part of the beauty of hypnobabies is that it is considered “eyes-open hypnosis.” This means you can keep your body in this relaxed hypnotic state while still moving around freely, interacting and talking, just going back into your “zone” as needed. I think I would have hated something that required me to focus the whole time to be effective. This was just the right balance for me.
One of the affirmations that I thought was so funny was, “I deserve an easier, more comfortable childbirth.” Hannah and I could never seem to figure out who I was supposed to be competing with… Easier than who? Maybe the girl in the delivery room next door?
Every few hours, the nurse or doctor checked on my dilation. Hannah prepped me mentally before each check, “It’s just a number. Don’t let it mess with your head.” I would think, “I’ve been having so many contractions, surely something has changed.” But it hardly ever did: 1:30 – 4 centimeters, 3:25 – 4 centimeters, 5:20 – 5 centimeters. I was a little surprised at how slowly things were moving, but I felt really strong. The numbers never got to me and I kept telling myself that things could change really quickly. And I believed it.
The Birthing Pool
When my labor started to pick up, a team of nurses rolled the huge inflatable pool into the room. It took up almost all of the open floor space. It must have been a slow day at the hospital because I swear, three nurses stood there watching that tub fill for nearly an hour – maybe more. At some point while the birth pool filled, nurse Jessi left and Lindsey arrived.
At long last, the glorious birthing pool was filled – although to be honest it didn’t look all that full. My labor appeared to be in full swing and I could get in the water whenever I was ready. I worked through a few intense contractions while negotiating whether or not it was the optimal time to get in. Finally, I decided it was time and remembered aloud the giant pad under my gown, “Oh! I’ve still got these undies!” And the nurse asked, in all seriousness, if I wanted to get in the tub with them on. My gut reaction was to erupt into laughter, but somehow I managed, deadpan, “No, I think I’ll take them off.”
Before I even had a chance to begin to undress, Spencer implored in a worried tone, “Don’t forget to take your phone out!” It was in the chest pocket of my hospital gown. Suddenly I was so confused – did everyone there think I was getting in the pool fully clothed?! I shot Hannah a confused-but-knowing glance and we both started laughing hysterically. I thought I was alone on the island of rational thinking, but she was right there with me.
I took everything off and put on a bikini top. When you’re having a baby, you figure everyone will see everything anyway, but your nudity generally comes in small doses. It’s a little different to walk around stark naked with an audience; it just takes the vulnerability to the next level. I know it sounds so silly, but somehow since I couldn’t see anything below my belly, I was able to pretend that no one else could either. But rather than bare all, I wore the top of a swimsuit and felt a little less naked.
On the hospital tour, the nurse kept emphasizing that if you labored in the tub, the water could only be a certain temperature. She explained it almost apologetically, so I was under the impression that the water would be just kind of lukewarm. But I got in the tub and it was so warm. It felt really good. The moment my contracting belly went under water, the monitor screen – about three feet away – started flashing a message that I was out of range. I tried to lay so the monitor sensors were above water, but it was no use. One of the probes detached and floated toward the surface. I pushed it back onto my belly, but nothing was working. After two or three contractions in the water the nurse said I was done. Ten minutes after getting in the pool, I had to get out.
The wireless monitor was fried. I got a new gown and a traditional monitor and was officially relegated to the bed. We put the birth ball at the head of the bed so I could lean over it while kneeling on the mattress. Hannah brought me some crackers and quietly suggested that we could toss them into the birthing pool along with everything else. The nurse had stepped out at this point, so we were laughing and talking about the undies incident, baffled that she had suggested I wear the giant pad into the tub. I imagined it bloating with water, like a saturated diaper with gel beads expanding into a globby mess.
We were like school girls with the giggles and we both could not. stop. laughing. Of course, that was right when the nurse came back in the room and commented that she was happy to see me laughing. Naturally this made us both laugh even harder, mostly because we were laughing at her. Poor thing.
But it was ok, because a few minutes later, nurse change numero quatro happened and Jessi was back. That’s right: during my fourteen hours in labor and delivery I had FOUR nurses with FIVE shift changes. I don’t know why I had so many nurses, but it made me all the more thankful that I had Hannah there with me. She was such an amazing support to me and if you can’t tell, we laughed a lot together too. Having her there seriously made the whole process so much fun.
A Moment of Defeat
At 6:55, the nurse came to check me again. I was five centimeters dilated.
After nine hours at the hospital, with my water broken and a steady stream of synthetic hormones pumping my body full of pain, I had dilated a grand total of 1.5 centimeters since my arrival.
My doctor came in to discuss my options. I’ve learned that “discussing your options” is hospital speak for “you have no more options.” My doctor looked tired and serious as he began, “Sarah, your labor is protracted and your baby isn’t dropping. You’re just not progressing as quickly as we’d like.” My heart sank a little.
He continued, “When this happens, we think about the three P’s of labor – passenger, passage and power. Now, we know this little boy is probably a bit bigger than your girls were, but not giant. He’s probably not the problem. You’ve also had two vaginal deliveries, so the passage probably isn’t the problem either. That leaves power. The monitor right now can tell us if you are having a contraction and for how long, but it can’t tell us how strong it is. We need to make sure that your contractions are strong enough to finish dilating and and get this baby out and to do that we need to use an internal monitor. It can be really uncomfortable, so you’ll also need an epidural. The epidural should help you relax and dilate and then we can get a really clear picture of what is going on with the monitoring too. I’ll give you a few minutes and then I’ll be back to get things going.”
As soon as he stepped out of the room, I motioned to Hannah to come over to me.
“What do you think?” I asked, “Is that a little extreme?”
“I think we need to focus on a vaginal delivery at this point. You’ve done so great and you’re so strong, but I think your body is getting tired.”
“I feel ok. I can keep going. How long has it been? Like, three hours?”
“Oh Sarah, it’s been nine hours.”
In a moment I realized I was finally coming to grips with a reality that everyone else in the room had accepted at least an hour earlier: my natural, unmedicated birth was simply not going to happen.
My body wasn’t cooperating, the Pitocin wasn’t enough; essentially the induction was failing, but we still needed to get this baby out. Everyone had moved on, and it was time for me to catch up. Realizing that I wasn’t the one begging for the epidural, but rather being gently assured that it might be the best option… well, that was hard. It felt like pure defeat. But it was also what needed to happen. I conceded and tried to move on.
Even after I gave the go ahead, more than one person asked me if I was ok with the epidural. Maybe they could sense my feelings of frustration, and wanted to make sure I was ok and really on board, or maybe I had initially told someone who wasn’t in charge of getting the anesthesiologist. I don’t remember. But regrettably, having to say yes to the epidural more than once made me a little snappy, “Yes, fine. Whatever. Just get him. It will take him forever to get here anyway, so please just make the call now.”
I took a moment to talk myself off my snarky ledge so I could keep moving forward positively. It didn’t take long for me to collect myself mentally and get back in the game. At that point, I thought the most defeating moment had come and gone.
Lest We Forget
Can I just emphasize that while all of this was happening I was in full blown unmedicated labor? Even though my body wasn’t doing what it needed to, I was still having insanely strong contractions and at this point they were practically one on top of another. I was in serious pain.
Let’s All Look Out the Window (no, not you)
By 7:40, the anesthesiologist was putting in my epidural. I curled up on my side, hugging the bedrail and moaning in pain. Hannah reminded me that low, deep moans would help me relax and open up. And they did.
I heard Hannah whisper to Spencer to keep his eye on something happening outside. She was super discreet about it, but somehow over a few minutes it drew the attention of the room. Before I knew it, my whole team – including the man putting a needle in my spine (!!!) – was looking out the window. A couple walking around outside was fighting and the man was getting physically violent. Everyone in the room was talking about calling security, but they were apparently quite slow to respond. I don’t think I said anything (remember, near-constant contractions?) but inside I was thinking, “Hey guys? Remember me?”
Before the anesthesiologist was even done taping me up I started shaking uncontrollably. My teeth were chattering and I started dry heaving. Could this be real? The epidural certainly hadn’t kicked in and I was indignant. We thought I might be going through transition and I honestly couldn’t even believe it. If only I had held out for a few more minutes! Hannah got me some warm blankets and the nurse held a barf bag near my face in case anything came up.
At this point, I was set up with an internal monitor. Which feels very much like I imagine it might feel to have chopsticks in your nether regions. Try to tell me you didn’t just cringe.
Pushing My Face
By 8:50, I was fully dilated and a little after 9:00 it was time to push. That, or get a c-section. I was a little surprised that discussion of a c-section came up at this point. It felt premature to me, but my doctor had kidney stones to take care of in the morning. I wasn’t just on the hospital’s clock, I was on my doctor’s personal timetable as well.
Even though I was pretty sure I remembered how to push from my two previous births, the nurse walked me through a quick refresher course. Spencer and Jill (new nurse) would each hold a leg, I would try to curl around the baby and push as they counted to ten. We’d do this at least three times for each contraction. I was on board and ready to get this baby out. Sure, I had an epidural and internal monitors and a catheter, but I knew from Betty’s birth that I was good at pushing. I figured I’d get this baby out in ten minutes or less.
We waited for a contraction and then I gave it my all. But something was very different about these pushes. I looked up at Hannah in a combination of comical disbelief and horror and said, “Oh my gosh, I’m pushing my face! There’s nothing to push!” I didn’t know how else to describe it. But there was literally nothing in the typical pushing zone. Normally pushing happens when the baby is fully engaged in the pelvis. But my baby was floating high above my pelvis, and he was posterior to boot. After a few sets of strong pushes, my doctor declared that he was at a -2 station.
Since my epidural was clearly not working, my baby was clearly not dropping, and was still posterior, I asked if I could try getting on my hands and knees to help things along. They said I could if I was able, so I flipped over and pushed for a while on hands and knees. I really don’t know if it helped the baby come down, but it felt better than being on my back. With each contraction my body was pummeled with a wave of intense pain and an uncontrollable urge to push. I’ve heard other women compare it to vomiting – there’s just no stopping it. And that’s exactly how it felt.
Oxygen, and Other Things That Make It Hard to Breathe
As the minutes passed, things continued to deteriorate. As soon as I started pushing, my baby’s heart rate began to decelerate at the end of each contraction. Every effort was made to keep the little guy happy as the placenta started to fatigue and the situation gradually became more critical. The nurse gave me an oxygen mask, which ironically made it really hard to breathe. I breathed through the contractions with the mask on, and then would pull it away from my face to gulp in some “real” air. It honestly felt like I was drowning with that mask on. Jill also added sugar water to the cocktail of fluids being pumped into my veins.
Any woman who has given birth knows how exhausting it can be, especially when it’s a long, drawn out process. Just holding my body up in a hands and knees position was getting difficult, so I flipped back over to continue pushing. Contractions kept coming, and everyone continued to cheer me on through each push. Everyone except for my doctor, who consistently said at the end of each round of pushes that my effort simply wasn’t enough. I actually wondered if he was trying to make me upset, like getting me angry might make me push harder or something.
My hands and knees effort wasn’t enough to fully turn the baby, so the nurse brought in a peanut ball to help me maintain the Sims position. Even though she hadn’t been with us for the whole day, I think that the nurse could tell we were a generally lighthearted crew who could appreciate a good laugh. As she put the peanut ball between my knees she told us of a time she misspoke as she was explaining its purpose to another mother-to-be, “It’s just something we put between your knees to help open your pelvis so the baby can turn. It’s just like an exercise ball, but it’s shaped like a giant penis. I mean, peanut.” We couldn’t contain our chuckles and it was the perfect little anecdote to ease the intensity for a moment.
Snap Crackle Pop
About an hour into pushing, my heart dropped as we all heard the very audible snap of a bone.
I honestly couldn’t even believe what was happening, but suddenly I knew exactly what lay ahead. I knew from my broken tailbone at Clara’s birth that there was a long, painful path before me. Not familiar with a tailbone break? Here’s what hurts: sitting, getting up from sitting, laying down, walking, and sneezing… among other things. I also knew from my first break that it would be a good 18 months of excruciating pain doing any of those things, followed by a lifetime (or at least six years) of more subtle discomfort. So when I said, defeated, “I’m going to spend the rest of my life recovering from a broken tailbone,” and everyone laughed, I wasn’t sure why. Because I was completely serious.
And so began the stream of incredulous commentary in my brain, along with a heated one-way debate with God about what was happening. This is so stupid. I curled into the bedrail, closed my eyes, and silently screamed at heaven. What the heck is happening? Please help me! To be honest, spiritually, I felt completely abandoned. Why won’t you help me? The closeness to divinity that I thought would be a part of this process suddenly felt ridiculous, not to mention unattainable. Maybe I’m dreaming. This is so stupid. (Can you tell that my mental vocabulary was really flourishing at this point? Pain and disappointment sure don’t have a tendency to make you sound smart.) Amid the chaos and cords and contractions, I pulled back into my own quiet world for a few moments, hoping to feel strengthened and heartened. I felt nothing. Only deep disappointment settling in. From all outside accounts I know that I remained collected, strong, determined, and even funny through the crazy two-hour pushing process. But inside I was hurt and sad and a little bitter.
Even though I didn’t feel heavenly help in the way I anticipated, I opened my eyes to see that I indeed had loving support. Hannah was a saint, bringing me warm blankets, feeding me ice chips, encouraging me, and keeping my spirit light and brave with her calm encouragement. Spencer was right there, reassuring me and cheering me through each round of pushes.
I was in a ridiculous amount of pain with no relief from the epidural. I wanted desperately to push the button that would administer more medication, but Hannah and Jill both encouraged me not to. They said that even though feeling contractions at this stage of labor was intensely painful, it was also key in making any sort of progress. I never did push that button, but by 10:15 the anesthesiologist was back to give a half dose of the meds in the epidural that would hopefully take the edge off.
I continued pushing through contractions, giving every effort that my exhausted body could muster. We would aim for three pushes each round, but sometimes I would go for a fourth. It just got to a point where I was so desperate to get the baby out of my body. Finally my doctor issued what felt like a threat, “You have ten minutes to get this baby out, or we’re going to the O.R.”
I don’t know why a doctor even mentions a c-section to a woman who is doing everything her body is capable of to get a baby out. But it came up several times. It came up in the discussion about my protracted labor. And again when I was fully dilated but the baby was not engaged. It came up after I started pushing and we could all tell that there was a long road ahead. And again when my baby’s heart rate started to have decelerations at the end of each contraction. It came up when my doctor noticed a bump of scar tissue so significant from my previous tailbone break that he thought my baby wouldn’t be able to get over it as he came down the birth canal. I may not have gotten the birth I wanted, and had every unanticipated complication in the book, but the concessions stopped there. My resolve to get this baby out vaginally was firm, and I responded again and again “I am not getting a c-section.” Unless my life or my baby’s life was at stake, there would be no quick trip to the operating room.
In between contractions my exhaustion was so profound that I would almost go to a semi-conscious state. During my very short rest periods between contractions I would fall back to the bed and close my eyes while everything inside and outside of my body felt like a slow motion haze. The chaos buzzed around me in a blur and for the first time, my mind went to a c-section. I have fought hard enough. I’m over it. Cut me open. I don’t care anymore. Let’s just get this baby out. In retrospect, I’m so glad I didn’t say anything aloud, because I know my doctor would have happily wheeled me in to the operating room the moment I consented.
At 10:35, my doctor announced that he could see the head, but I still wasn’t convinced that it was a sign of imminent delivery. As my doctor started suiting up in more heavy duty delivery gear, I couldn’t help but question him, “So the baby is going to be born? Here?”
He teased back, “You don’t think this baby is ever going to come, do you?”
“No, but seriously. Is he going to be born here?”
My doctor may have responded, but I couldn’t catch what he said before I was wrenching through another contraction. Spencer and Hannah and Jill cheered continuously through my pushes, “Push, push, push! Oh you’re doing so great! Keep pushing! We can see the head! Push!” Their verbal guidance was exactly what I needed to keep going.
My Ears are Up Here
Finally, I knew the end was near. My mind flashed through the two final items on my birth plan: delayed cord clamping and immediate skin-to-skin. Maybe, just maybe, I would at least get that?
In the same moment, my doctor turned to my nurse and asked her to page the NICU team. And just like that, the last piece of my birth plan crumbled to settle in appropriately amidst the rest of the rubble. “I think we’re going to have a shoulder,” he said. I couldn’t believe we could be facing yet another complication, but here we were with possible shoulder dystocia. By this time, I was just mad at the whole process. “A shoulder? Are you kidding? What a little punk!” Nice Sarah had officially left the building.
Frustration aside, the situation was worrisome and my doctor needed to take charge. He quieted my cheering section, telling me, “You’re only going to listen to my voice.” Which, coincidentally was the least encouraging voice in the room. “I’m going to guide you. So listen to me. We’re going to get head and shoulders out all in one push, ok?”
“Ok,” I responded. “Head and shoulders… And knees and toes?” My humor was falling a little flat at this point.
As he continued to give instructions, his voice quieted until finally it was a merely a whisper between my legs, “ok, push.” Then he paused, and then his voice murmured some incomprehensible (to me) additional guidance. I looked up at Hannah, who, following my doctor’s insistence, was quiet at this point. “Can you hear him?” she asked. I shook my head no, so she started repeating his instructions – loud enough so I could hear, but quiet enough to hopefully not cross him. All of this was quite comical: my doctor muttering instructions with long pauses in between. Maybe for dramatic effect. Or perhaps just to keep us all guessing.
Those final moments were intense. Everything was a hazy blur. NICU nurses filed in and stood around the warming table. A blinding spotlight flooded the room with light. The nurse tap-tap-tapped codes into the computer. Hannah and Spencer encouraged me with their eyes and their hearts when words were no longer permitted. And I bore down; my neck, back, arms, hands clenched in complete exertion, my oxygen mask fogged and sultry.
And then, in a moment of stillness, ever so brief, he was here.
I wasn’t in the spiritual, empowered, joyful place I thought I would be at that moment, but even I was caught off guard when the question that came to my brain (but not my lips) was, “Is he alive?” I didn’t even need to ask. As soon as he was out, he gave a lusty cry and didn’t stop for twenty minutes. It was incredible how instantly relief washed over my entire body. The nurse told me to push my epidural button twice. I fell back to the bed as the doctor quickly cut the cord and handed my baby off to the NICU team. He had, apparently, the longest conehead in the history of coneheads. As they examined him, he peed all over himself before they could get a diaper on. Hannah came over to tell me how cute he was. Spencer was busy taking pictures.
I was still in a fog and in the fifteen minutes I had to wait before getting to meet and hold my baby, I had a little chat with my doctor. He was working hard down below, stitching up the extensive damage (yet another fourth degree tear, if you’re curious). He gave a quick explanation of the extent of my injuries and looked up briefly to ask, “Am I fired?”
“Yup,” was all I could muster.
Finally, baby George was determined to be healthy and whole, weighing in at eight pounds, five ounces and measuring 21 inches in length. They diapered and wrapped him in a blanket and brought him to me just after 11:00 pm. He cried and cried and I couldn’t seem to calm him for several minutes. I was happy to have him here safely, but so disappointed and in shock over the whole situation. I was drained, but relieved. There were so many strong and competing emotions at that point. Of course I was content to finally meet my baby, but I was also so disillusioned with how the birth had played out. As I held, nursed, and enjoyed my baby, I felt like I was in a vague cloud of disbelief for the rest of the night.
Feeling The Feels
Thankfully, three months gives you some time to gain a little perspective. For about six weeks, those last five hours of the birth – from epidural to arrival – were constantly on my mind. I had a steady stream of questions running through my brain. Medical questions, hypothetical questions, spiritual questions. I wanted to figure it out, to have someone or something to blame, or at least understand why things went the way they did. It probably seems ungrateful to feel sad about my birth when I have a perfectly healthy (and adorable) baby. But if I’ve learned one thing about emotional health, it’s that you’ve got to feel the feels when you feel them. You can’t fight them, bury them or pretend they’re not there. So for a few weeks, I let myself feel what I felt about the birth, which was mostly bewildered chagrin.
I may never have answers to most of my questions, but three months out I’m ok with that. As perplexing as those final five hours were, the first nine were pretty fun and that cannot be dismissed. I’ve been able to pull a lot of good things from this experience as a whole. I could probably write another 9,000+ words on those lessons alone, but perhaps I’ll save that for another day.
I really don’t know if more children are in our future… but if I could do birth again, I’d say yes in a heartbeat. Partly because I kind of want a do-over… but mostly because even a traumatic, emotional, disappointing experience is still miraculous, magical and powerful – even if only in retrospect. I could do without pregnancy. Ok, maybe I’d agree to twenty minutes of feeling the baby kick and roll, because that’s pretty amazing. But the whole donating-your-body-to-discomfort-and-illness-for-nine-months thing? Yeah, I could do without that. But birth, ah, glorious birth. I can’t help but look back on my births (all three of them) with a kind of sacred analysis and complete and utter awe. As imperfect, complicated and traumatic as my births have been, I can’t help but want for more. And my babies? Well, they’re pretty amazing too.