Birth is a baptism of fire into motherhood. Your body wrenches and opens in an incongruous symphony as a new life forces its way into the world. During this process, a "wilding" descends upon the mother. There is no escape from labor and the process must be faced head on, despite fear or uncertainty. I am transformed each time into my baser form, connected to women who for centuries delivered children in the same way; standing on the stones, sitting in birthing chairs and laying on filthy floors. With this in mind, each time I head to the hospital, I put on my pearls. Pearls are uniquely feminine. Pearls are for weddings, funerals and anniversaries. They are treasured jewelry, pulled out on special occasions.
Birth is my special occasion. This is the day I will meet my precious baby. After all, a pearl's beginnings are not as ethereal as their smooth, rounded surface belies. They begin as an irritant. It is only through time that they are transformed. The trials that I face will all be covered and transformed as well. Just as my birth story will fade from my memory, and all I will remember is the first time I saw her little face.
This was my fourth un-medicated delivery. I feel like I survive the trial of childbirth just before I would have broken. Because of this, I do not question any other mother's methods for bringing a baby into this world. It is hard work no matter how the baby takes its first breath. Each time I start to consider an epidural, it is too late and the baby's time is upon us. In my case, the benefits of foregoing medications are mostly felt after the birth. I avoid the medical charges of an anesthesiologist, can take a shower immediately, and after the initial shock of birth I am completely present without side effects.
I was group b strep positive for all of my births. Because of this, I felt a strong responsibility to get to the hospital for antibiotics at least four hours before the baby arrived. I did not get to the hospital on time with my first or second birth. For my first, I had come to the hospital early in the morning with strong contractions, but was sent home and told to return when in true labor. My shame and anger were overwhelming. I felt at fault and was terrified at the intensity of the pain. I was certain that I was in labor. My contractions never became consistent. They paired and would come at strange intervals. When I arrived at the hospital that afternoon, I was 9cm. He was born with a compound arm (hand near his chin, under the umbilical cord, with his elbow sticking out). My precious, 6lb 5oz, brand new baby received IV antibiotics to ensure his health because I didn't get there in time.
At 11 Am on January 11th, 2016 my midwife stripped my membranes. I was already at 3cm. I was hoping that this would kick start my labor and I would be able to arrive at the hospital long before birth in order to receive two bags of antibiotics. This would take a total of four and a half hours prior to birth. I started feeling consistent, strong contractions at around 6 pm. These were far apart, but I recognized them as true contractions. I had agreed to pitocin if I arrived at the hospital and was given antibiotics, but labor did not progress. Knowing this, I arranged childcare and headed to the hospital feeling certain that I was not returning home. When I arrived at 8pm, I was checked into triage and monitored. My contractions were 5 minutes apart, lasting around a minute at a time. When checked, I was still at 3cm. They asked me to go walk the halls for an hour and then they would check my progress to see if I was in "true labor." This is when my anxiety started to rise.
I was breathing through contractions as we walked because the contractions were strong and consistent. They had started to pair. I knew this pattern as it has been the same in all of my births. But somehow it didn't feel strong enough. I began to question my certainty that this was the beginning of labor. Somehow I knew that I wasn't progressing; That these contractions were not leading to the big changes I needed to show within an hour. This was going to be a repeat of my experience with baby #1. I complained that we should have stayed at home; That we should have waited to come until I was completely certain. That I should stay at home and just have a baby in the bathtub like I almost did with number 1.
When I returned to triage an hour later, they again monitored me and rechecked my dilatation. I was still at 3cm, just as I had feared. I was told that it wouldn't be fair to administer the antibiotics, despite my agreeing to pitocin, because they had already rescheduled two inductions as a result of a full ward. Horrified at my inability to identify true labor after three previous births, I was sent home with a sheet detailing when to return and told that I could have contractions for up to 24 hours as a result of my membrane sweep.
We got home at 10:30 pm. I was unraveling into an unstable state of uncertainty, shame and anger. I announced that I would not be having a baby and that I did not care if she ever came. Asinine in retrospect, of course; but I assure you that I meant it. I went to bed sobbing.
I slept through the night. When I woke the next morning at 8, I was certain that the membrane sweep had confused my body. I had never had a membrane sweep with my previous pregnancies. I had never been able to sleep through contractions in the past because I always have terrible back labor. The nurses were right. I wasn't in labor. I was just a confused, foolish woman who didn't understand her own body. I decided that my eagerness to get antibiotics had foiled the natural process and I was therefore forced to spend time in a hellish purgatory of "Braxton Hicks" contractions as a result.
That's when I realized that my husband hadn't gone to work. He was due to go to work at 7 and it was already 8. I started berating him for embarrassing me. I felt he was using me as an excuse not to go in. I was ashamed that he would need to tell them that I had been sent home from the hospital the night before. I was horrified that I didn't know what was going on, and that I was a fool. I insisted that he go to work. After this tearful tirade, my husband secretly went outside and called his co-workers to tell them that he thought he should stay home because I needed him. Well played husband...well played.
I got into the shower and tried to calm down. I was still having strong, consistent contractions. I tried to tell myself, "These are all fake. They will go away. They aren't real. You are an idiot." I got out and used the bathroom. There was blood. And blood. And more blood. It was a lot. I didn't know what to do. I re-read my paperwork. It said to come to labor and delivery if you have vaginal bleeding. But I remembered them telling me that I would have some bleeding as a result of the checks and the membrane sweep. I asked my Mother how much blood I needed to have before being concerned. She tried to ask me additional questions and I wouldn't answer. I was afraid of being wrong, of not knowing my own body. I knew that this had never happened before, but I had never had a membrane sweep...
Somehow, my mother and my husband convinced me to go back to the hospital. I wept all the way there. I was so confused about what my body was doing. I tried to convince them to take me to the office or the psych ward rather than the birthing unit. They told me no. As we took the painful, slow walk into the hospital, I realized that we would have to wait at the elevator with other people. I was breathing through contractions and thoroughly embarrassed about it because I wasn't in real labor. I turned around and took the stairs so I wouldn't have to face other people.
Upon our second visit to the birthing unit, I tried to remain calm and collected. I didn't want the nurses to see me as weak or unstable. Here I was a 4th time mom, coming in for her 4th un-medicated childbirth. I needed to save face and appear confident. I said, "I was here last night. Before I check in, I want to know how much bleeding before I need to return; I don't want to be sent home again..." and I had descended into a slobbering, crying mess. They calmly and compassionately asked me how much blood. The nurse asked if I had soaked a pad. I didn't know. I was wearing one, but I hadn't checked it. They took me to triage and asked me to undress. The nurse asked if I had a low lying placenta. I did not. She said she would have to call my doctor to see if she could check me. If they didn't check, I knew I was going home again. (please note: I was told later that if a nurse checks a woman with a low lying placenta and punctures it, the mother can bleed out in minutes. She was doing her job by not scaring me with details and also being a conscientious care giver. I just didn't understand that at the time.)
When I took off my clothes, I saw that the pad was a brilliant white. I opened the door to tell my mother and husband that we had to go home. I couldn't bear the emotional turmoil of being sent home again. I laid my head on the door and sobbed bitterly. I begged them to take me home. I told them this was a waste of time. I felt defeated. I'm not sure that either one of them knew what to do with me. I think both of them were just hoping the nurse would return to save them from my insanity. Eventually, I changed my clothes and tried to provide a urine sample. All I could collect was blood.
When the nurse returned, she informed us that she had consent to check my dilation. I choked back tears as she checked me, knowing I was still at 3cm and would be sent home once again...
5cm! I wasn't being sent home! I was actually in labor! I was going to get the antibiotics! While I was still extremely emotional, I knew this was the time to set my intentions and face this birth with the same grit and determination I had faced all the others. Now I knew where we were headed; I knew what to do next. I knew how to prepare myself. I knew how to conquer this trial. Uncertainty is the most fearsome devil I know.
Once we were in the delivery room, the IV antibiotics were administered and I was connected to the monitor. I requested to walk, as my back had started throbbing with an increasing intensity. I was asked all of the necessary hospital questions about the baby (do I want antibiotic ointment on the eyes, triple dye on the cord stump, etc.). My nurse was calm, empathetic and patient. I appreciated her attitude as she helped me to ground myself and prepare for the path ahead.
Back labor makes it very difficult for me to labor while laying down. The best advice I received from childbirth preparation class was to change positions every 20 minutes in order to receive the most pain relief and to give the baby the greatest opportunity to shift within the pelvis. I try to consciously shift positions until I get lost in the pain and require outside encouragement. My goal was to give birth after 2:15. This is when the antibiotics would have been administered for at least 4 hours and would mean that my baby was statistically safe from any side effects of group b strep.
I was removed from the monitor and told I could walk freely around the room with my "dance partner" aka the iv pole. I decided to put on light makeup to help me feel more in control of the situation. Looking at myself in the mirror, struggling through contractions, the situation seemed surreal. I knew it was foolish to put on makeup, but it seemed like the thing to do with a birth photographer present. Pure vanity reigns supreme, despite the fact that I knew soon I wouldn't care about anything but birthing a baby. I always fear the intensity and the pain of birth. Yet here I was, living in the thing, doing an every day task, willing myself to succeed, praying that I wouldn't be surprised by an emergency.
At some point, I asked that talk cease during my contractions. As the contractions strengthen and the back labor intensifies, I become frustrated if there is outside noise. I find it distressing if someone is talking, or the TV is on, or there is music. I do not concentrate on the pain, but I need to be present in the moment. I focus on each second as it passes, like I am on a tight rope. I do not look to the end, I try not to think of the future. All I focus on is right now. I start this process with prayer, but the words are not completely formed. It is more a state than a specific prayer that brings comfort. I slowly descend into a trance as labor progresses. I live within myself, in another place that I can not describe. It does not lessen the pain or take me outside of the events. The only way I can describe it is to say that I am gone from this place and living within the moment.
Around 11:30, I decided to take a shower, hoping it would provide some relief to my lower back. My mother had been placing pressure with her hands during each contraction to help create counter pressure. This had been helping, but I needed to try something new and the shower had really helped in the past. The warm water didn't provide the same amount of relief that it had provided in the past. I didn't spend long there. In the past, I had returned to the shower again and again. It wasn't the solution this time.
I returned to the room and proceeded through 45 more minutes of contractions. I got on my hands and knees, tried the birthing ball and started to retch from the pain. Most people will say that when you start to get sick, you are in transition and the baby will come soon. I knew this internally, but wouldn't allow myself to consider it. I was going to make it to 2:15. I tried to concentrate on keeping my hands loose, because I previously gripped the side of the bed and my husband's hands, creating additional tension during contractions.
I moved to hang on my husband's neck during contractions. He had eaten French fries because he was hungry and he had missed breakfast (please note: If you are a husband, you should not mention any physical needs while your wife is in labor. We do not care if you are hungry. We do not feel bad that you missed breakfast. We do not care that there are starving babies in the world. Quietly slip out, eat something before she notices, and return like a ninja. Do not be my husband). I took no pity on him and was immediately disgusted by the strong smell of grease. Luckily, there were wipes handy or he would have been ejected from the room. I would have regretted that later because he is always the light that leads me home during the most intense moments, just before the baby arrives.
At 12:25, hanging on my husbands neck, I felt the baby move downward. I wasn't going to make it to 2:15. My baby would be given the antibiotics. My midwife and nurse could see the horror on my face. They asked me what was wrong. It took me a moment to form the words, but I whispered, "She is coming." Just a moment later, my water broke.
I was helped onto the bed for a final check. I knew that it wouldn't be long. I detest laying on my back while in labor. For my first two, I delivered in the standard lithomy position. This was incredibly painful because the back pain intensifies while laying down and no counter pressure can be offered. They waited for my contraction to pass and checked me. 8cm ;That sounded so far from 10. I was unaware that 8 can become 10 in a matter of minutes.
I didn't want to lay there, but I also couldn't move. I felt trapped and started to panic. I was asked if I needed help, but I couldn't get my body to cooperate. I didn't want to go through another contraction lying down, I had to somehow get up and away from the torture. Somehow, with two people helping me, I got up from the supine position.
The details get a bit blurry from here. I may or may not remember them in the exact order or detail. I walked around the room briefly, and then went to the bed. I requested (or more likely made some noise that my mother interpreted correctly) that the head of the bed be raised so that I could face the wall, kneeling on the bed in an elevated all fours position. This was the way I had delivered my third son. This position allowed me to rock my hips and I could still receive counter pressure on my back. My midwife placed her hands on my sides and pressed during each contraction, This helped to provide a new counter pressure that did not alleviate the searing pain in my lower back, but offered a new type of pressure that was helpful.
I started moaning as the contractions fell one after another. My midwife asked me to come back. I was gone. The pain was taking over and I knew I could not escape. The moaning quickly crescendoed into a yell. For my first two labors, I barely made a sound, for the third I whimpered like an animal, this time I roared. Of course, I am embarrassed by this now, but there was no other alternative at the time. It fell out of my mouth without thought or care. My baby was descending and I could feel her stretching my lower body. I wanted it to be over. I wanted her to come.
There were likely seconds between my scream and her arrival. She came out in a sudden, but completely controlled way. I could not see her, but I heard the nurses cheer; I heard my husband gasp, and I could hear my mother choking back tears; then I heard her cry. I couldn't turn around. I just cried into the pillow. I was so relieved. I had survived. My baby was here. I heard them say, "It's really a girl!" I turned to take her little body, to see my first little girl. I couldn't see her through the tears.
