Please note: This document describes Michele's labor and delivery without euphemisms. If you are not comfortable reading an explicit birth story, please do not read this essay.
I started leaking amniotic fluid Thursday morning or Wednesday evening, or maybe even on Tuesday after my O.B. appointment. I thought I was just experiencing late-pregnancy incontinence. But Sunday morning (the 23rd) I sat down on the bed and left about a sponge-ful on the sheets, so it was obvious to me that I was going to have the baby within a day. It was extremely important to me, for some reason, that I get a shower and wash my hair, so Tom and I hopped in the bath. Then we called the doctor, who told us to get to the hospital right away.
[For those who don't know me personally: We had decided to have the pregnancy and birth attended by an O.B., with the birth in a hospital instead of at home or in a birth center, because I'm anemic. My "normal" hematocrit is extremely low -- low enough that it would normally indicate internal bleeding! We concluded that the risk to me and the baby if I were to start hemorrhaging was great enough that we should have a hospital birth.]
We had our bag packed and the car seat had been installed a few weeks ago. We went to labor and delivery triage where they hooked me up to a fetal monitor and took some fluid samples to test. We went for a walk for an hour, to try to get my labor moving. When we came back, we learned that the fluid was indeed from the baby's bag of waters, and that I tested positive for "strep B" (about 30% of mothers going into labor will test positive). I would need an I.V. of antibiotics and saline solution; and if my contractions didn't get started, I would need to go on Pitocin since my water had broken so many days ago. Without Pitocin, there would be a serious risk of fatal infection to the baby if labor didn't start spontaneously very soon.
I had the usual panic attack while the nurse put in the I.V., but with Tom and Heather there I managed to stay a bit more calm than usual. I'd had what I thought was a head cold for a week, but the antibiotic started clearing out my sinuses right away. It later turned out that Tom had an ear infection, too, not just a severe head cold as we'd both thought. So now I was hooked up to an I.V., one of my number one "don't want it" items in my birth plan. I so totally had not wanted to start labor this way.
The triage nurse wasn't forthcoming about getting me a room until I told her, look, I'm walking around leaking a lot now, and I'd much rather do this in a room in the tub or shower or something. She sent me upstairs after a short delay. The nurse there got the Jacuzzi going and Tom and I tried some accupressure points to start contractions. They didn't work. After another hour or so, the nurse plugged in the Pitocin drip. The time was about 3:00 p.m.
She also hooked me up to two external monitors, one for the fetus and one for measuring contractions. I had to stay hooked up to them constantly because of the Pitocin I.V., but I could walk around the room and use the facilities when I needed to.
This nurse went off shift as I became increasingly uncomfortable. The new one told me that, sure, I could hop in the Jacuzzi to relax during the contractions, but she just had to get me out once every ten minutes to check the readings off the radio telemetry monitors, isn't that cool. The jets in the Jacuzzi actually aggravated my increasing pain, so I left it and returned to the labor bed after about twenty minutes.
As the contractions became harder and harder, I tried to remember the ideas and suggestions I'd read in a few books of alternative medicine. First, I wanted to let all the energy go into making the contractions work, instead of letting it go out my mouth. Putting this idea into practice meant that instead of shouting or wailing through a contraction, I consciously focused on placing the energy into making the contractions more effective. Another tactic was to keep my mouth open. Some belief systems hold that an open mouth is spiritually connected to an open vagina; and, hey, during a birth, a clenched vagina is not a good idea. (I use this also when I go in for my yearly pelvic exams. It helps some, I think.) Finally, I tried to ease the pain by remembering to breathe in and out during contractions, and not that "hee-hee-hee-hoo-hee" breathing. Just regular, deep breaths. Muscles deprived of oxygen get crampy and hurt -- I didn't need that pain added to the pain of each increasingly harsh contraction.
Did all that stuff work? Apparently I was the only woman on the floor that night who didn't have an epidural, and I've been told that it's doubly surprising that I didn't, because my contractions has to be induced with Pitocin. (No, I don't think that makes me better-than-thou; I simply know that, for me, an epidural would have been a very, very bad thing.) More importantly, keeping all that information in mind as I was enduring labor helped keep me calm and focused. I remember thinking, this is hard, this is damn hard, but it lasts a day, I can do anything for a day.
About 8:00 p.m., the Pitocin-induced contractions were becoming harsher and harsher and I had more and more difficulty relaxing for each subsequent contraction in between. I was getting into "active labor" and it was turning into "back labor." Although I'd intended to go for a completely natural childbirth experience, I accepted a few small doses of Fentanyl via my I.V. when I told Tom emphatically enough that I wanted some medication. (Intervention leads to intervention leads to intervention, doesn't it? Pitocin led to pain meds for me.) Over the course of three hours, I got three doses, and they helped me relax and prepare for oncoming contractions until I had to push.
I started to push at about 11:00 p.m. My regular O.B. had come back on call some time in the afternoon and would be able to attend the birth. It took me a while to get the hang of what I had to do during the pushing. The whole time I was still attached to the fetal and contraction monitors because of the Pitocin. More than a few times I tactfully expressed my discomfort because of the straps holding the little round devices to my belly, but they had to stay put -- the worst was that the contraction monitor apparently wasn't working very well anyway.
About 12:20 it was clear that the baby's head was having a really hard time getting through my pelvis. I was having a really hard time relaxing and gathering my strength between pushes. Hey, I'd been doing it for almost an hour and a half; my legs were sore; and I had increasingly short amounts of time between pushes. Between pushes the baby's head would press on the inside of my pelvis, down and to the right, making it impossible for me to take it easy when I needed to. I would actually look forward to the contractions because they were less painful than the times in between.
I demanded to know my options because I realized that I was not doing the work I needed to during my pushes. My O.B. suggested a vacuum extractor: not so medieval-feeling like forceps, but rather scary futuristic-feeling as far as birthing technology goes. I had to move to the edge of the labor bed as quickly as I could between contractions. One came as I was scooting, and it made me stop and almost press my knees together. The OB, nurse, Tom, and Heather all yelled at me that I needed to keep my knees up, what was I doing; but I couldn't talk or even move for the pain.
After a few more pushes, she had the cup end on the baby's head. It was quickly obvious that the problem had been that the baby was facing sideways, to the right, instead of toward my back, interfering with getting through my pelvis. My OB helped ease the baby's head through my pelvis and then released the extractor. I had a push. I got to feel the baby's wet, hairy head. I pushed again. The baby crowned just as the contraction ended. I let out the most horrible yowl I have ever produced in my life (but in fact I didn't feel the pain, it was more that I knew it was supposed to be excruciating). Then I pushed again and the baby came on out.
I'm told that the cord was wrapped around her neck. I didn't see that, and in fact I had refused to look down at a mirror even though the nurse and OB offered several times once the baby's head was visible. Tom cut the cord as the OB held the baby and found that it was a girl, and then I reminded them to put her on my belly before cleaning her off too much. She had a caput due to the vacuum extraction along with the usual cone-head shape vaginal deliveries produce, and she was nice and red all over except for her little Yoda hands. She stared at me for a good five or ten minutes while I delivered the placenta and had a "second degree" tear stitched up. The nurse had to put her in a warmer, but despite the need for the warmer and her Yoda hands her Apgars were 8 and 9. Tom stood over her in the warmer and made sure she had the right number of hands, feet, and ears.
I don't remember much more of the night. She spent a lot of time on the bed with me once I'd gotten up to urinate and the bed was modified for sleeping instead of laboring. My legs were very shaky, my belly was soft but still big, and my mouth was dry from the yelling and lack of much nourishment through the day (I had eaten a few pretzel sticks and Frookie vanilla wafers on the sly, and Heather and Tom supplied me with ice water during labor). The nurse came in once an hour to make sure that the baby stayed warm and wasn't ill from the strep B infection. She also massaged my abdomen to make sure my uterus was going down as it should.
I spent the day wandering in and out of bed, learning how to breastfeed the baby, and eating surprisingly good hospital food. My sister had gone home to sleep very soon after the delivery, and she brought my mom over to visit later in the morning. Tom made a lot of phone calls; I talked to my dad; and the nurse came in to check our vitals more times than I can remember. Tom's cousin and his wife, whom we had visited in the hospital when they had their own baby last year, visited about 8:15 p.m.
We spent all day Monday and half of Tuesday in the same suite that I delivered the baby in. I finally got a shower Tuesday morning, and the OB visited for a follow-up checkup (she had planned to visit Monday afternoon, but one or two other women in her care had gone into labor). A new nurse came in to attend to some hospital discharge duties and direct us to a breastfeeding class. While Tom and I attended the class, my mom and sister packed all of our stuff. When we returned, the nurses packed me into a wheelchair -- a blow to my pride; I'd envisioned "walking out" -- and brought us down to the front of the hospital where Heather drove the car up.
So, now I'm home and I'm sore all over from straining and grunting and gripping and tearing. Tom and the baby are asleep on the sofa and I'm demanding glass after glass of water from people more mobile than I am. After helping me through the labor, my sister is now convinced that she wants to be completely knocked out during her own labor experience instead of trying to go all natural the way I did, if she has a baby. And Tom thinks I'm Wonder Woman, even though I was scared and very much in pain.
So after that many hours of labor and 2 hours of pushing, we (me, the nurse, the OB, Tom, and my sister) brought Eleanor Boutell Grant into the world at 1:01 a.m. on Monday 24 May 1999. She weighed 7 pounds, 4 ounces (3.29 kilos), and was 21 inches (53 cm) long. She has a head of straight, black hair (for now) and only time will tell if she'll have an innie or an outie.