8:30 a.m. on Wednesday September 4th, 2013
I was lying in bed with my eyes shut, hovering in that slippery place between wakefulness and sleep and trying to ignore my bladder. In my uber pregnant state, sleeping was not very restful. It was a nocturnal dance of insomnia, ungracefully shifting myself from side to side on the bed, arranging and rearranging pillows, and restless walks around the apartment. I was just about to sink back into sleep when I felt something warm and wet squirt out of me. My eyes popped open. Did I just pee myself?
I rolled myself out of bed and shuffled off to the bathroom to investigate.
I sat down and peed. When I finished peeing, I flushed and waited. More fluid came out. I raised myself a few inches off of the seat and shook myself from side to side and more fluid came out. I looked down and saw clear fluid with tiny white flecks. Vernix! Seeing bits of the cheesy white stuff that had been covering my baby was when it all became very real for me. There really was a baby in there. My water had broken!
I paged my midwife and was just about to call my husband at work when I walked into the kitchen and saw his cell phone on the table. Really?! Too funny that this was the day he had forgotten his phone at home. He had just started a new job and I didn’t even have his work number. So, with fluid soaking me in leaks and small gushes, I tried to figure out what to do.
Thankfully, my brain connected the dots and I used his phone to find his work number and call him. When he came on the line all I was able to say was “Hey, how are you?” before my phone rang. It was my midwife so I told my hubby I had to take the call because my water had broken. But due to a bad connection, he didn’t hear me and hung up. Ack! I spoke to my midwife, who arranged for us to meet her at the hospital in an hour. Then I called my husband back and told him the news. While I waited for my husband to pick me up in a cab, I did my best to get ready and finish packing our hospital bags, all the while leaking and gushing fluid.
At 10 a.m. we arrived at the hospital and waited in triage for a consult. I had been scheduled for an induction a few days later, but my baby had other plans. She was a frank breech and my OB was one of the few doctors skilled at doing vaginal breech deliveries. Unfortunatley, she wasn’t on call that day. So my midwife consulted with her and was told to go ahead with an induction. That gave me hope that she would come to the hospital to deliver my baby and that I wouldn’t have to have a c-section.
We were told to come back at 1:30 p.m. for the induction. We had time to kill! I kept hoping that my body would spontaneously go into labour but no such luck. We grabbed lunch and took a walk, ending up on the grass outside of a cathedral. It was a beautiful, sunny day. I had been told not to eat anything but I downed Subway sandwiches like it was the last supper (yep, I’m a rebel). I don’t recommend going against the advice of your health practitioners, but I have to say I’m glad I ate something! We then went back to the hospital and settled into our room, where we were joined by my doula.
At 2:30 p.m., the nurse started me on the pitocin induction. It took about a 1/2 hour or so to take effect and the contractions were pretty mild and very manageable. I listened to my hypnobirthing CD and practiced mindful breathing, working on releasing any build up of tension on the exhales. As the pitocin continually increased at regular intervals, my contractions picked up and I felt the need to move. I sat and rocked on the birth ball and began sounding with my doula.
Things started moving very quickly and the intensity of the contractions became increasingly difficult to integrate. I continued to practice mindful breathing and visualized myself opening more and more with every contraction. The pitocin had amped up the strength of my contractions and at this point my doula suggested an epidural. I had a feeling that I was dilating pretty quickly, and I asked to get checked. I was 5 cm dilated! It was about 5 p.m. and my contractions were about a minute apart and 2 minutes or more in length. This was by far the hardest thing I had ever done. I knew that if I didn’t get some extra help, I would go from feeling like I was coping fairly well, into suffering. So I decided to have the epidural. Once I made that decision, waiting for the epidural seemed like an eternity! And having to sit completely still during contractions while the anesthesiologist inserted the needle into my spine felt so intense and counter-intuitive. I just wanted to move! Thankfully, my hubby helped me get through it. We sat with our foreheads pressed together, breathing and sounding.
When the epidural finally took effect, the relief was incredible and much needed. Soon after, I started to shiver. I didn’t know for sure, but I kept thinking I was transitioning. It turns out I was! Birth is such a time warp, but it was about 9 p.m. or so when I was almost fully dilated. Only a small lip of cervix remained.
Throughout my labour, my support team had been talking about how my OB was planning on coming to the hospital to do the delivery. I found out right before I was ready to push that she decided not to. But the resident on call turned out to be an extremely experienced OB from Jordan. He came into the room and said to me “You’re going to have your baby tonight.” I asked him if he would do a vaginal breech delivery (I still wasn’t completely sure that I wasn’t having a c-section) and he said yes. He just looked so confident and relaxed. It turns out that he had delivered hundreds of breech babies in Jordan, where a c-section is an expensive procedure and often not an option.
By 10 p.m. I was ready to push. Because I was on the epidural, I didn’t feel any pushing urge. I was uncertain of when I was having contractions so my midwives gave me a lot of direction. They told me when each contraction began and encouraged me to push. I liked pushing. It felt productive. My yoga practice gave me the awareness to push down to a place in my body that I couldn’t feel. I thought I had lost all of my abdominal strength during pregnancy, but I could sense an amazing amount of power in my core every time I pushed. Apparently, I impressed the staff with my pushing skills. A few of them even made a point of commenting on it the next day!
I didn’t tell anyone at the time, but every time I pushed I imagined I was taking the biggest dump of my life. It really helped! The more I pushed, the more I began to feel my contractions and an urge to push. After pushing for some time with my midwives, I was wheeled into the OR for the delivery. I couldn’t even imagine trying to get off of the hospital bed and onto the operating table but everyone helped me. Once I was on the table there was a lot of busyness as the staff set up and got ready, with no one really paying any particular attention to me. I remember saying “Um…I have to push!” and the doctor (who had his back to me) saying, “Ok then, go ahead and push!” So I kept on pushing and doing my thing while everyone around me finished setting up. Apparently, there were about 11 or so staff in the room. Although, to be honest, I didn’t notice many of them. I was only aware of my husband, midwife, doula and the OB.
I remember the OB asking how long I had been pushing and someone replying “two hours”. I remember thinking “Crap, I’m on the clock!” Then the OB asked for a local, and I thought, “Why’s that happening?” It flashed through my mind that I might be getting an episiotomy. But in the moment, I thought, oh well, at least I won’t feel anything down there. (My postpartum recovery would be another story.) I didn’t feel the episiotomy at all and after a few more pushes I felt my baby’s bum emerge. Then, her legs popped out like springs, one at a time. Her body followed, and then there was a pause. I remember thinking, “Uh oh…here comes her head!” but her head came out very easily. As soon as I saw her on my belly, my first reaction was “She’s sooo big!” She definitely has her daddy’s long limbs. All I could see at first were flailing arms and legs. She lay on me skin to skin and cried loudly. Ava, our healthy, beautiful baby girl was born at 12:11 a.m., weighing 7 pounds and 15 oz.
Processing the Birth
I’ve thought a lot about my experience since that day. There definitely were many twists and turns. Even during my pregnancy, when we shifted from making plans for a home water birth to a hospital birth. I credit my yoga and meditation practice, the planning and preparation, and my support team for helping me to navigate the ups and downs of my experience. Because I was preparing to deliver a breech baby, I had the opportunity beforehand to think and process all of the myriad possibilities of what could happen, from induction to c-section. This emotional and psychological processing helped me to retain a sense of control and empowerment during the birth, and enabled me to accommodate all of the shifts and changes that came up. Staying present and honest with myself to know which birth preferences I needed to hold on to and what I could let go of helped me stay open and receptive to what was happening from moment to moment in labour. In retrospect, not being given informed consent for the episiotomy is where I felt the biggest loss of control, the repercussions of which I felt very deeply postpartum. The possibility of an episiotomy was something I had been anxious about when discussing the birth beforehand. I had talked about it with my healthcare providers and had felt reassured by the knowledge that my OB didn’t necessarily do episiotomies for breech deliveries. However, I ended up with a different OB and that was the wild card. I also knew that in order to have a vaginal breech birth, to a large extent I would have to go along with many of the practices and methods of the OB doing the delivery. What would have brought more peace to the situation would have been to create an intentional pause in the flow of events…to have asked for a bit more time, even a few minutes, to understand and process what was happening, and if an episiotomy really was necessary, to have been able to ask for more time to push beforehand… This birth was a colourful, mixed bag of experiences, full of positive moments as well as not so positive ones. It was not without trauma. It was hard, messy, and beautiful at the same time. Just like life.
I know that the alchemy of birth has changed me beyond motherhood in ways that I am still realizing. And, it has been the doula training of a lifetime! My hope in sharing the challenging aspects of my story is not to scare others about birth, but to contribute to our collective education and to reflect on how to foster a positive birth experience, as mothers, birth professionals, and loving supporters. It is not enough to say that the baby was born healthy and safely, and that’s all that matters. It isn’t all that matters. Having a healthy baby doesn’t erase what happened during birth, even though it might be something we tell ourselves and others to help us feel ok. How a woman experiences her birth counts, and we know that now.
Written typing with one hand, while rocking a baby with the other!