Jude’s Birth Story Part 2: The During

If you’re starting here, be sure to read the first chapter as well.

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First I have to admit that relaying this part of the story is only possible because of the timeline my doula provided and the details my husband and sister remember.  While I remember most of it in one way or another, the idea of time is completely and totally foreign to me when I think back to that day.  I also have to admit I had to let go of a lot of vanity showing these photos, but at the end of the day, I am so, so grateful I have them.

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Checking in to the hospital, they confirmed all of my medical information and verified that I was being admitted as a result of low fluid levels.  I said, yes, my fluid was a 7, so it had gotten progressively lower, but I explained that I didn’t feel that urgent.  The nurse glanced at me, smirked, and said the doctor had written fluid level of three on my forms, but that he had a habit of “fibbing a little to speed things up.”  This bothered me immensely, and it certainly did nothing to calm my nerves, but it did verify that I, in fact, was right in knowing that a seven was nothing of concern.  She completed a cervical exam though, and I was 100% effaced and 3 cm dilated at check-in, so that was good news.  At 6:30 pm, they inserted Cervadil and told me to get some sleep.  Scott and I talked, called my doula, and generally wasted time and watched television until we decided to try to get some sleep.  The hospital had offered me a mild and safe sedative, and I took it hoping to calm down, get some rest, and have energy for a Pitocin drip at 7am the next morning.

I dozed from something like 10 pm until 11:45, but some intense cramping kept waking me.  At midnight, a nurse came in and stated that I must be dehydrated because I was having contractions. (Nothing to do with my being 41.1 weeks pregnant, I’m sure.)  She hooked up a bag of fluids to my i.v. port and left the room.  I’d been drinking water all day, mind you, but on came the intravenous fluids. These pains continued to get stronger and stronger, and I certainly couldn’t sleep through them.  At 1:00 a.m. , the same nurse came in and removed the Cervadil after telling me that I was, for sure, in labor.   So my induction consisted of about 6-7 hours of inserted synthetic prostaglandins, but that’s it.  No intravenous Pitocin! I woke Scott at about 2:30 to tell him I needed help focusing and getting through these contractions.

By 3:15 a.m. things are moving along faster than I expected, and we call my doula, Pam.  She arrives at the hospital by 4:30, and according to her notes, my contractions are steady at every 2-3 minutes. By 6:30 a.m., my sister arrives as part of my labor team and my contractions are coupling, as Scott said at that time, “It’s like aftershocks after earthquakes.”  A nurse tells me to lie on my left side to regulate them.Things start to get a little hazy here, but I remember a lot of back labor and some very focused breathing.  My water breaks – in a steady drip, not a gush – at 8:30 a.m., and my amazing husband is behind me all the way. My contractions are definitely felt in both my belly and my back.

At 9:10 the on-call doctor comes in and is so welcoming and encouraging.  Her exam shows that I am at about  8-9 cm with a noticeable anterior lip of cervix. She manually breaks my bag of waters (what was left) hoping that will speed things along and help me get over that cervical lip.  The baby is a -1 station which is still a bit high for this stage of the game.  I have an awesome nurse named Tracy who is letting me go off the monitors fairly often and move around to ease the pain.  She’s also holding them to my belly as I bounce on the ball which is amazingly supportive.

I remember bouncing on the ball and saying, “Everyone leave me alone.  I need to go to the bathroom.”  I get up to head that direction and nurses in the room scream, NO. One asks if it feels like I need to poop which is usually not information I willingly share, but I assure her that yes, it does.   The nurse informs me that I could be very, very close to push time, but that I need another check before I get the okay.  They check me again and I am at, as my doctor describes, a 9.5 – that damn lip still won’t move. During my next contraction, my doctor tries to manually move the anterior lip, but it won’t budge. She tells me to open my pelvic floor as best I can, but fight the urge to push.  If you’ve been in labor, you know what this means.  It’s like saying fight the urge to vomit, not to mention that opening your pelvic floor while fighting the urge to push is opposite in nature.

This is where things get really, really fuzzy.  They catheterize me (ouch!) to move things along faster, new people come in the room with all the baby lamps and gear, my doctor places the covers over her shoes. Everyone is saying I’m almost there, and one nurse tells me that she knew from the moment she walked in hours ago that I would make it all the way.  “I could just tell when I saw you, I said, ‘she’s going to do it.'”  I start to cry saying I will meet him soon and this is really hard not to push.  I want to see him.  I just want to hold him.  I want to push. Can I please push?  I am going to push?  I’m trying so hard.  This is so hard. Then we find that we really aren’t that close as my body refuses to fully dilate.  Some time between 9:30 and 11:00 a.m., I go from feeling a little pushy to oh-my-god-I-am-going-to-push-this-baby-out-I-can’t-help-it.  The urge to push at that point is the most overwhelming physical sensation I have ever felt in my life.   Eventually I find myself lying on my side on the bed with Scott behind me, and I am kicking my legs like scissors as hard as I can with every urge to push.

The rhythm of things at this point is urge to push, contraction, rest between contractions. Urge to push, contraction, rest between contractions.  Again and again. I remember feeling the contraction swell like a wave and being so grateful for the pain, loving the pain, relishing the pain because that meant that the pushing feeling would disappear. I loved the rest between contractions , too.  But I would get scared after a few seconds because I knew the pushing feeling was coming.  I’m telling everyone I am so scared because I am pushing.  I can’t help it.  I’m pushing. The nurses start to look concerned.  My doctor comes in,  She tells me that she knows I didn’t want to go this route, but that an epidural may help to open me up.  Fighting the urge to push is keeping things tight.  She also warns that tearing my cervix would lead to major swelling and we really don’t need for that to happen.  She leaves the room, and I say there’s no way I am getting an epidural when I have made it to a 9.5. Then some more time passes, I don’t know how long, and I say I can’t do it anymore.  I get an epidural or I push this baby out.  Now.

So the anesthesiologist is called, and it seems to take her forever to get here, but she finally does and the epi is inserted.  I hate it, and it feels so weird and disconnected, but I am not trying to push him out.  I am not yelling or crying or kicking my legs like scissors, so that’s good.  Scott is relieved.  I don’t blame him; being the spectator cannot be easy.

Notice how incredibly swollen my face is. Ugh.

Time is so weird when you are in labor. For some women, they think it’s been hours when it’s only been minutes.  For me, time was racing without my realizing it.  The clock had been covered in our room since about 4am.  I honestly thought it might have been something like 11 or 12.  When my doula told me it was past 4pm and that I had fought the intense urge to push for 5 hours, I was shocked.  No wonder everyone else looked so exhausted.

By 6:10 pm , I complete dilation, so my doctor’s suggestion of an epidural, in this case, was a very good one.  She warns me, though, that Jude was still quite high, and it might be a good idea to sit up in the bed and “labor him down” for a while and make pushing easier.  I agree, and at 8:30, we finally had the go ahead to push.  The first couple of pushes, I can’t feel anything, so I tell the nurse to turn down the epi. Every time she turned it down, I tell her more, more because it is so incredibly weird to feel so much so intensely and then nothing at all.  So by the time we are really pushing, I am feeling the pain and the urge – although not nearly as strong as before.  The first hour or so of pushing, everyone is cheering me on and they sometimes say “That was a good one!” or “You brought him down.”  They give me a mirror for motivation, and soon we see hair!  Not far down; he certainly isn’t crowning.  But up a ways, we can definitely see hair.  I am so happy and relieved after almost 20 hours of labor; I know I will see him soon.

But after a while, a weird thing happens.  He doesn’t seem to be moving anymore and people stop congratulating me.  My doctor is trying to get her hand as close to his head as possible and I am bleeding from some internal tears.  No one is really saying anything.  Scott is cheering and motivating, and my doula is patting my leg and encouraging me, but I can tell something has changed.  My doctor mumbles something I cannot hear, and my sister looks at me and said, “He’s posterior, Katie.”  Okay, I say.  So what do we do? Should I change positions? My doctor explains that she doesn’t think he’ll get out “this way,” but that his heart rate is okay, so I can keep trying.  In hindsight, I know she knew where this was headed, but I am forever grateful that she allowed me to make this as much my birth as it could have been. I decide I am not done yet.  I push for another 40 minutes or so.  Finally I lie back on the bed and just say, okay.

My doctor says hold on a minute and puts her hand up me.  I know she is pushing him back up.  The urge to push is back, and I want to do it so badly.  I suddenly realize I am really, really exhausted.  I start to cry and say it hurts. My doula rubs my leg and says, “You are so strong. You’ve done so much, but we have just a little more work before the end okay.”  The doctor leaves the room.  The lights go on.  The room fills with people I haven’t seen yet.  They pull up my hospital gown and shave me.  Another anesthesiologist comes in and doses the epi really high. I start shaking uncontrollably.  Like seizures shaking, seriously, out of control.  I vow VBAC for my next baby, and I am told “They don’t do those anymore.  They are too dangerous.” I am wheeled in the hallway and to the OR.  The surgeon shakes my hand (my doctor is assisting him).  I’m just crying and I say, I tried so hard. I tried so so hard. I’m still shaking uncontrollably.

I hate this photo so much. I've never shown it to anyone. Hate hate hate it.

I feel them tugging.  I smell burning.  My doctor pulls my baby out of me at 11:46 pm. My husband shows him to me.  He is beautiful, but I cannot touch him or hold him.  I am shaking too much.  Scott tells me he has my eyelashes, and that is the last thing I remember.  I wake up 2 hours later, and my husband and son are next to me.  I am a mess. It was only the next day, that I could smile like this.

Somehow the ugliness, the disconnectedness, the unfairness of my delivery melts a little more every time I look at this photo.  I worked so hard, and I loved him so much already.

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So what caused my cesarean? I guess I’ll never know for sure.  For a long time, it was my belief that Jude was not positioned correctly and that in a few days time, he probably would have maneuvered to the right fit and labor would have begun.  No woman has ever been pregnant forever, and I would not have been the first.  I’ve read that Cervadil is stronger than it’s given credit to be and that it can, in fact, induce labor.  When I read those sorts of things, it’s my belief that my induction led to my cesarean. Worst of all, I feel like I was bullied into the induction and can remember that sick feeling in my stomach when I knew things were going down the wrong road.  It’s hard not to blame myself, to feel stupid and a little broken.

On the other hand, I’ve read – and even been told by a reputable midwife – that if my body responded to Cervadil in a few short hours, I was ready to go and in early labor anyhow and it most likely had no effect on the outcome.  I know other mothers who ended up in the operating room for a stubborn posterior baby and had no medical intervention at all. When I hear those sorts of things, I believe that there was really no “cause” and that is perhaps even more frustrating than playing the blame game.

I can question every decision made along the way.  What if they didn’t break my water?  What if they never gave me fluids? And the big one, what if they had just let me push despite the large lip?  Why would nature give me such a srong urge if it wasn’t time? Even in hindsight, there are so many uncertainties. I know a few things for sure though: I certainly didn’t grow a baby too large for my pelvis (one that was over a pound less than estimated, by the way).  I wasn’t incapable of giving birth vaginally because God made me some odd way.  I don’t think my body is a lemon, but I did for a really, really long time.  The road to healing was pretty long, and for more on that, read the third chapter of my experience.

Jude’s Birth Story – Part One: The Before

It’s about time.  Jude turns 9 months this week- which is so hard to believe, by the way.   And I can’t believe we are nearing the one-year mark.  This year has been full of so many surprises, and when I reflect on who I was 12 months ago, I realize I have learned a lot. I’ve learned life is not always fair.  Choices are not always easy to make.  I’ve learned that motherhood is amazing, challenging, and in a weird way, also healing and redeeming.

I went to visit my friend last week after she had a baby in the same hospital where Jude was delivered, and so many details of Jude’s birth came racing back for me.  Then this week we have ventured to Seattle to tag along with Scott while he works, and I actually get some time to reflect and write while Jude naps (instead of racing around the house to clean or deal with something that needs attention).  Writing is healing in ways, and this has really helped to end one chapter and move on to some more exciting things with a growing, active boy.  It’s taken me so long to sit down and write this, and even now, I’m not totally ready.   There’s always something in the writing of things that makes you see everything more clearly, though.  So here we are.  I’m dividing this in to three pieces.  The before, the during, and the after.  It makes sense to me, and it avoids the Longest Post Ever that I won’t even want to read myself.

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So let’s rewind.  My pregnancy.  It was totally uneventful as I felt pretty good (comparatively), and my round belly displayed all the signs of a growing, healthy baby.  I was at the same OB practice I’d gone to for something like 5 years, and I found my doctor through his ASTOUNDING reputation in the Atlanta area.  I will spare you the details of my sister’s second delivery, but I’ll tell you he treated her during a difficult pregnancy that could have ended at least three times as she was in and out of the hospital for premature labor; he vaginally delivered a large baby who was positioned in a way many doctors would have shied away from and preferred the OR.  It was actually my doctor who first said to me when I had my introductory prenatal appointment, “Pregnancy is a wellness.  It’s natural.  It’s not a sickness.  Relax and know your body knows what to do.”   It was his attitude that led to my interest in natural childbirth, and I enrolled in a Bradley course where I learned a lot of specific and useful information, and my birth plan revealed my preference for no induction or pain relieving drugs. I wanted to do what was best for the baby, and I also wanted an experience that would allow me to feel everything in labor and fully experience childbirth as I was created to do it.

Me at 20 weeks, the day before we found out we were having a boy!

Fast forward to October 3rd, 2009.  I finished my last day of work before maternity leave, and I was 4 days out from my “due date.”  From the beginning of my pregnancy, I had always proclaimed that I knew he would arrive late.  I don’t know why, I always  knew.  Family, friends, even strangers affirmed this as they’d tell me I “looked too good to be that close.” I felt too good, too.  I’d walk up and down my driveway and around my hilly neighborhood everyday to “walk that baby out” as I’d been told.  My driveway is a small mountain, and this task leaves even a fit man exhausted, but I walked and walked and walked without a second thought.  I was relishing these last few days off work before Jude’s arrival and taking it easy with energy to spare. Minimal anxiousness, total confidence in my body. Having taken my Bradley course, I knew precisely what would happen in each stage of labor and how my body should react.  I knew that modern interventions are usually unnecessary.  I knew that birth is natural for the female body and that I was created for this very thing. My original due date according to my period was October 1st.  My practice later changed that date to October 7th after looking at an ultrasound and understanding that I wanted to avoid induction.

The morning of October 7th, I awoke feeling great but dreading being “overdue” and answering the questions that came with it.  I went to my weekly ob visit, and my doctor was very calm and collected.  He informed me that he had a family emergency he had to attend to and that he would be gone the following week.  He also assured me that I was 80% effaced and that many women go in to labor within a week after their “due date,” and that would probably happen to me.  If it didn’t, I was in the care of the practice’s senior doctor the following week, and he knew my baby was healthy and delivery would probably go very well.  With a smile and a vote of confidence in me, he was gone.  I left the appointment feeling so impressed and grateful that there was NO mention of induction on the date I was due. I knew most Atlanta practices would have scheduled an induction already, and I felt both affirmed in my choice of practice and confident in my body. That evening, Scott and I went out for eggplant parmesan (third time!), and I even indulged in a glass of red wine – a first for my pregnancy.  I mustered all the patience I had and waited on Baby Jude.

40 weeks

As great as I felt, I also wanted to avoid induction so badly that I had been doing everything in the world to get this baby out since about 38 weeks.  Walking?  Check.  Pineapple? Check, everyday.  Eggplant?  Check, three times.  Sex?  Super awkward and check.  Nipple Stimulation?  Used the breast pump, check.   Herbal teas?  Check.  Full moon?  Weekend before my due date, check.  The only thing I refused to try was castor oil since I’d read a few things linking its use to meconium issues.  Nothing was successful, and let me assure you that there is still nothing more frustrating to me than wanting so so badly for your body to do something when it won’t. It’s torture. As the days after my due date went by, I began to fear induction and get nervous.  I was never worried about Jude’s safety; I felt good and he was active and moving.  I just worried about having to be induced if I went 14 days over since I knew that even very lenient midwives usually act at that time.

On the morning of Monday, October 12th, I was 5 days “overdue” and went to the doctor for my weekly check-up.  I had a vaginal exam, and there was no change in my dilation, and the new doctor (whom I’d never met before prior to this appointment) explained that Jude was still quite high.  He stripped my membranes without asking “to hurry things along” and chatted with me in a way that seeped arrogance.  With an ultrasound, they discovered that my fluid levels were at a 7 which is certainly a drop from my previous reading of 15.  I knew from my research that normal levels were 5-25, but when we went in for the conference with the doctor, he explained that his anecdotal experience told him that 7 is definitely low, and that I needed to be induced that very night.  I questioned him on this, and he informed me that he was a doctor who had been delivering babies since I was born, and that a healthy mother and baby were of his concern.  When he asked,”You don’t want to risk stillbirth for the sake of a ‘birth plan’ do you?”  I really began to freak out.  He also told me that Jude was “at least 9 pounds” and that I was a small woman with an unusually narrow pelvis, so a cesarean was a possibility.  I knew in my gut that I was not carrying a 9 pound baby, but the mere mention of a cesarean sent me to ridiculous levels of anxiety.

I left the office in such a crying mess, I couldn’t even talk.  I felt so betrayed by my doctor. I knew deep inside that there was no problem and that I didn’t need to induce, but what if I was wrong? He had a point that he was certainly experienced, and I could never forgive myself if my stubbornness led to problems for Jude.  The word stillbirth hung like a rock in my stomach, and I couldn’t shake it. I called the office back and asked for a few more days. The doctor himself called my personal phone, which apparently he never does, and told me that he wouldn’t feel comfortable letting me go longer and that his conscience would not let him be negligent on this.  I asked for a non-stress test to assess Jude’s health more closely.  He said “okay but only if it is early tomorrow a.m.”  So on Tuesday the non-stress test was performed, and everything looked fine.  As I used that for an argument against induction, my new doctor explained that it was just the point he was trying to make; Jude was fine now, but I was playing with fire by staying pregnant any longer, and those test results could soon change.  He argued for an induction that night.  I was incredibly torn, stressed, anxious, and conflicted.  I did my reasearch on which doctors were on-call in which days, and I finally succeeded in convincing him to wait until Thursday, even though he was “not entirely comfortable with that.”

Looking back, I knew things were heading in a terrible direction. I spoke with my family, cried to Scott, chatted with my closest friends, all the while making it clear that I didn’t want to do this but felt pressured to do it. My friends, bless their hearts, were trying so hard to be supportive and reminding me of all the successful inductions they knew of.  Nevertheless, I was so so nervous as we drove to the hospital on Wednesday evening.

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To continue where this leaves you, click here for the next part and then on to chapter three.