Showing posts with label birth stories. Show all posts
Showing posts with label birth stories. Show all posts

Tuesday, February 20, 2007

Filbertine: The Inside-to-Outside Story

OK, here's the birth story, actually, two birth stories: The quick rundown and the version that you should only read if you are deeply interested in childbirth and not afraid of talk of a wide variety of bodily fluids. If Nutmeg's birth blew my mind, this one blew it all the way to the moon. Enjoy.

Birth Story, the short and clean version:

Filbertine took only 6 hours to be born, and half of that was pain-free. In the second half, the labor escalated so dramatically that she may have been born in the car if it weren't for her posterior position. That position, my scar tissue and maybe just the way my body is caused a long pushing phase -- 1 and a half hours, or a full quarter of the whole labor. Our car wouldn't start when we tried to go to the hospital, and I was already ready to push, so the delay prolonged the most intense agony I have ever experienced. I didn't labor at all at the hospital and I bypassed triage for a delivery room; they were scrambling to take down my date of birth, etc., as I made the first real pushes. Filbertine's Apgars were 8 and 9, i.e., a healthy baby. As for all the measures I took to prepare myself for birth, here are the outcomes:

Midwife practice = somewhat effective, although I ended up with the most inflexible, most medical and least experience member of the group
Doula = helpful, although as I feared she did not focus on hypnosis during my labor
Hypnosis practice = helpful, possibly explanation for easy early labor and apparent pre-labor cervical dilation. however, I cannot honestly say that the mantra that the contractions would be "strong pressure sensations" and not pain was true. It hurt -- a LOT. Why else would I be screaming so much that my throat was raw the next day?
red raspberry leaf tea = apparently very effective (when I drank none of the tea, I had a 19-hour labor, with tea, 6-hour labor)
swimming and other exercises to prevent posterior baby/back labor = not effective

Birth Story, the Long Version Containing Highly Personal Info About My Va-jay-jay and Various Issues From Therein:

On Tuesday, Epu and Nutmeg came with me to my second non-stress test. I was almost 41 weeks pregnant. While sitting around in the examining room, we asked Nutmeg when she thought the baby would be born. She said Wednesday. Tomorrow, we asked, and she said, yes. Later I asked her what time she thought my contractions would start, and she said 11 a.m., and that we would have to go to the hospital “right away.” Since Nutmeg had also told us with the same kind of matter-of-fact confidence that our baby was going to be a girl, I kind of thought she might be right.

Wednesday morning Epu and I woke up before Nutmeg did, took a shower together, and had sex. It was the third time we'd tried this to bring on labor, and so far, nothing.

Just after 9 a.m. I got Nutmeg bundled up and we walked with the stroller to a public school just over a mile away where they have a toddler playtime. The other moms there were quite surprised to see me because I'd told them that last week was my due date. During the walk and the playtime I was feeling a lot of pelvic pressure, and I wondered if my bag of waters might break. I wasn't having many contractions – just an occasional light one when I stood up from sitting or otherwise changed positions. But I did feel several very strong twinges inside my vagina, which I hoped were signs that my cervix was opening. The baby would move, then I'd feel a strong cramplike feeling down there.

The day was cold and bright, without the wind that had made recent days so miserable. Nutmeg was cranky after the class, partly because we didn't get to play in the gym this time like we did last time, and I had to haul her out of the school after she had a tantrum in the bathroom. Just after we left the school I called my friend Sarah, who was also about to have a baby, and left her a message asking if she wanted to do lunch. Then we walked to Blockbuster Video and looked for a video for Nutmeg. She threatened to have another fit over renting “Lady and the Tramp,” which she already owns, but finally she decided she wanted a Ruby and Max video instead.

We walked home and had lunch, then we made carrot muffins with cream cheese frosting, and I got her down for her nap. I put in some laundry, did a few other things, and lay down to nap. I was woken up by my friend, who called to say she had actually had her baby and had just come home from the hospital. I talked to her a short while and then went back to bed and dozed, then woke up and read a little. I felt like resting more than usual. I finally got up just after 4, had half a cup of reheated coffee, and called another friend to chat while I did the dishes. I told her I wasn't feeling anything except pressure, but I still felt like this could be the day. I remember looking out the window at 5 and thinking how nice it was that it was still sunny and not dark out yet. The days were getting longer.

Nutmeg woke up just after 5, and wanted to put on her pajamas. I squatted down to open her bottom drawer so she could pick some. When I did this, I felt a trickle of something come out of my vagina. I thought, Hmm, is that something? But I'd felt this kind of thing before while pregnant so I didn't get too excited. After Nutmeg had her PJs on, I went to the bathroom and saw a large smear of mucous and bloody show. I felt excited, and even more so when it seemed like there was some fluid dripping out into the toilet. I put on a pad and as I stood up, I had a contraction and several more trickles of mucous and warm fluid came out. I wrote down the time: 5:17, and put on a PBS show that Nutmeg likes on the kitchen TV while I started dinner.

I had been worried that my water would break without labor beginning, because I feared ending up with a C section. To my relief, I continued having contractions. Within minutes of the initial trickle, I could feel that there was more wetness leaking into my underwear and pants. I put a towel on Erik's computer chair so I could grab a recipe off the Internet and made a quick post on my blog. I told Nutmeg that the baby may be coming tonight, and she was like, no kidding. I called my parents, who were scheduled to spend the night at our place anyway, to ask if they liked eggplant and to let them know that my water had probably broken. And I called Epu. He said he would leave work at his regular time, which would get him home by 7:10. My parents would be here sometime around then as well.

As I cooked eggplant Parmesan with a little help from Nutmeg, I jotted down contraction times. They were coming much more persistently than I had had them before in my pregnancy, except for maybe one other day two weeks earlier, also at the dinner preparation hour, when they had eventually petered out. This time, they were mild enough that I wasn't always sure when one was starting, and not very evenly spaced – my notes show something like this:

7 minutes
4 minutes
7 minutes
2 minutes (plus a trickle)
5 minutes
2 minutes
3 minutes
3 minutes
2 minutes (plus trickle)
2 minutes
5 minutes
8 minutes
3 minutes

Come to think of it, I probably missed recording a contraction where I have an 8-minute gap, because that's about when I called the midwife to let her know that I believed my water had broken. So those are mostly two-and three-minute gaps, not bad at all for labor just starting off. I called our doula as well. I seem to remember telling her, Epu and the midwife that the contractions ranged from five-to-eight minutes apart, which I can see now wasn't quite accurate. But since they were mostly only about 30 seconds long and not intense, no one was suspecting that there would be a big rush. The midwife told us to come to the hospital by 11 p.m., because I had tested positive for Group B Strep and was supposed to be there within 6 hours of a membrane rupture. The doula said she had just gotten a message from another client and hadn't yet had the chance to find out her situation. She said she would call me back shortly when she knew what was going on with the other person. I thought maybe I should do something later to stimulate the labor, like using a breast pump, but I was too busy at the moment.

I made some ice for my parents, and I read Nutmeg a story while sitting on my birth ball, then looked up another recipe – this one for coleslaw dressing – and mixed up some precut coleslaw. I set the table. Nutmeg asked if she could use her scissors at her table, which was a great activity for her at this point. When Epu got home at 7:11, I had just taken dinner out of the oven and was putting Nutmeg's plate together. I sat down with them and ate some buttered noodles. My mother had told me not to eat anything, because that's still the protocol at her hospital, but I told her the midwives recommended eating if you felt like it. I was also drinking water this whole time.

My contractions felt like they were getting longer and stronger, so I didn't feel I needed to do any home induction techniques. I had already changed my pad once or twice because the fluid was getting all over them and ruining the adhesive on the back. There was never a big gush of fluid, but at one point between 5 and 6 a few drops had dripped onto the kitchen floor, and now my pants were pretty damp, so I figured my water really had broken. I didn't feel too bad about having to go to the hospital by 11, since that seemed like a good time to go anyway rather than wait until the middle of the night when the temperature would be below 0. I tried lying down on the bed, with a towel under me, and listening to my “birth affirmations” tape, one of three tapes I have that are meant to be heard during labor. But I soon found that I felt uncomfortable while lying down through a contraction. The pressure seemed to be in my back, unfortunately. I tried sitting on my birth ball for awhile, and that was a little better. I had a bowel movement and thought, good to get that out of the way.

Our doula called around 7:30 and first Epu spoke to her, then I did, while pacing slowly around the bedroom. I told her I'd just had a 60-second long contraction, and that I felt like the level of intensity was going up quickly, but I still felt comfortable. She said her other client was also going to be delivering at our hospital, which is unusual because she doesn't do many births there. The other client's water had ruptured at 9 a.m., she was not in labor or in very early labor still, and was supposed to be there at 9 p.m. Tanya, the doula, said that she thought I would end up delivering first, and that she would either come to our house if we needed her first, or go to the hospital with her client at 9 and come meet me when I was checking in at 11. She offered to just come to our place right then – it's about an hour-long drive from her home – but I said we didn't need her yet. I thought it would be better if we could get Nutmeg off to bed before more people showed up. Tanya later told me she had been having a strong feeling that she really should be coming to my house right away, which was prescient given what happened next.

My parents arrived at around 8, and I came out and said hi to them, told them how I was doing and what was for dinner. I didn't think my dad would like the eggplant so I told him there was also ham with scalloped potatoes in the fridge. I sat on my birth ball and chatted with them for awhile. I was still comfortable, but I was starting to need to breathe deeply and make my body go limp during contractions. I went back to the bedroom to finish the affirmations tape, then as things intensified decided to take a shower. Tanya had advised against taking tub baths before 7 cm dilation, since you could relax your uterus too much and slow down the contractions. Since I was on the clock, I definitely didn't want to do that. I had another bowel movement – diarrhea this time – and took a nice shower, washed my hair and body. When I had a contraction, I tried going down on hands and knees with the spray on my back, which seemed to help a little. I dried off and put on the plaid nightshirt that I had wanted to wear while in labor. All this time my parents had been playing with Nutmeg and getting her ready for bed, and Epu had been cleaning up the kitchen. At 8:30 I asked him to call Tanya and ask her to come, and then come help me. I sat on my birth ball and he rubbed my back and talked me through a few contractions. I told him he had to talk faster. Then I had him put on the “hypnotic deepening” tape. When a contraction came I was beginning to moan and I kept trying different positions. Bending at the waist while leaning over the bed, with Epu applying counter pressure to my back, seemed to help. I also asked Epu to open up the Nux Vomica, an herbal remedy Tanya had suggested, because I was starting to feel nauseous. He struggled to get the package open, and once he did I sucked on two of them, but I soon threw up anyway.

This is where the story gets gross. While I was throwing up, I experienced some fecal incontinence in my underwear. I threw up my dinner into a trash can, then a little more into the toilet, then asked Epu to leave the bathroom so I could poop. I threw away my underwear and a washcloth I had placed in my underwear to soak up the fluid. I put on fresh underwear, scrubbed my hands, and then headed back to the bedroom for more moaning and listening to the tape.

Around 9:30, Tanya arrived, and Epu turned off the tape. I told her I was having trouble relaxing because the contractions were so painful. I said it was back labor. She felt my stomach and said it felt rounded, not flattened as it often is with back labor. Epu told her he'd been applying counter pressure to my back, and she said, you do that, and I'll run energy into that area. She was referring to quantum touch, a homeopathic technique that she does, which Epu and I don't really believe in and had told her we weren't interested in. We had hired her because she is also a hypnotherapist. But at the time I thought, what the hell, anything that might help me.

I yelled through a couple of contractions and pressed my back upwards toward Epu's hands. Tanya talked me through them, especially helping me notice just when the contraction was winding down and helping me calm down quickly from each one. Then I thew up again. And I asked Epu to take off my necklace, which was was getting in the way and which I didn't want to wear to the hospital. Every time one of them came in or out, I asked them to shut the door so Nutmeg wouldn't hear so much of my yells. Later my mother told me that Nutmeg was awake until after we left the house, and that she had looked concerned and asked about me. My mom just told her that this is what is supposed to happen when the baby's coming, and this reassured her.

After just a few contractions, as my yells escalated, Tanya asked me how much pressure I was feeling.

“A lot,” I said in a pitiful voice. It was true – here it was, only four hours into my labor, and I was feeling more pain than I had ever felt with my first labor, even after my water had broken the first time around. I don't think I ever yelled or screamed with Nutmeg's birth. With Nutmeg, I had gotten an epidural at 6 cm, after 9 to 12 hours of active labor, and about five hours after my water had broken. Tanya later told me she thought I as already complete when she arrived at our house, but at the time I didn't know this and thought maybe I was in for hours and hours of this kind of pain.

“I think we need to get to the hospital,” Tanya said calmly. “Let's get some clothes on her.”

My heart soared, at least until the next contraction hit. I had been about to ask if it was too soon to try the tub. I was also anxious to get out of the house so Nutmeg wouldn't keep hearing me yell. I told them I wanted to wear the nightshirt I had on and asked Epu to get me a pair of leggings. After briefly considering looking for a pair of socks that looked decent with my green-and-blue plaid nightshirt, I grabbed a pair of magenta socks and Tanya helped me pull them on. I walked out to the dining room and my mom hugged me and told me I was doing great and she was so proud. I felt kind of like a zombie. I asked that someone grab my purse out of the front hall, and my mother helped me put my coat on. I grabbed my hat and decided to wear some sandals that I keep by the back door instead of bending over to get into real shoes.

Epu went down our back stairs to the garage, carrying my birth ball and a few other things, and Tanya went out the front and said she'd meet us at the street that goes toward the hospital. My dad walked me down the snowy back stairs, saying, “Don't slip.” I told him I wouldn't. I remember holding the rails with my bare fingers. It was probably about 5 degrees out, but I have no memory of feeling cold. Partway down the stairs I had a contraction and I screamed much louder now that we were out of the house. It was the second contraction I'd had since he'd been walking me.

“That was less than a minute apart!” he said.

On the way down I asked my Dad to call the midwives to tell them we were on their way.

I got into the car and fastened my seat belt. I think I even reached over and pushed the button that opened the garage door. But then Epu turned the key and said, “It's not turning over.” Honest to God – our car would not start. My dad ran to get his SUV, which was parked on the street in front of our house. I told Erik to close the garage door so I could scream without the neighbors thinking there was a murder going on. Then my mom was there next to the open car door, seemingly out of nowhere.

“Mom, stay there,” I said, and got on my knees so she could press on my back. I didn't know until later that Mom had come down because she thought she might have to help deliver the baby. She works as a labor and delivery nurse, and she could tell how close I was. When we didn't leave right away, she figured the baby might be coming in the car.

My dad pulled up and I said I was getting in the back of their truck. But my mom reminded me that I couldn't because it was full of their samples from their postal uniform business. So I knelt on the front seat, leaning over the back of it, which was not a bad position. I closed my eyes and we were pulling into the hospital parking lot in just a few minutes since we only live a few blocks away. But it felt like a long time going around and around the parking ramp. Tanya met us when we got out of the truck. Epu was going to get the birth ball out of the back, but Tanya said don't. We walked together toward the bridge to the hospital building. It was locked. We couldn't believe how it seemed every possible hurdle had raised up in our path. Erik rang the buzzer for security and someone answered. It probably helped us get in quickly that I was screaming in the background.

While waiting for the elevator, Tanya told me, “I think you're ready to push as soon as we get in there.”

“God,” I said, “I hope you're right.” I was feeling like pushing, but I was so afraid that I was in this much agony at 6 cm and would be screaming like this all night long, or until I gave in and took an epidural. Which probably wouldn't take long, the way I was feeling.

We took the elevator to the third floor, and I went down to my knees across the open door just as it opened, so Epu had to hold the door open until my contraction was over. Someone asked if we needed a wheelchair, but I said, “I can't sit.” Then Epu picked up the phone outside the locked Birthing Center and calmly said that his wife was in labor.

The doors opened, I was screaming, and our midwife and a small group of nurses hustled us down the hall. The midwife asked me something like, “Do you feel like you're not going to make it?” I said yes.

Then I added, “Actually, can I use a toilet?”

“Do you need to go to the bathroom or do you feel like pushing?”

“Yes, I need to push. But first I need to go to the bathroom.”

“We need to see how the baby's doing first,” she said, and they took me straight to a delivery room. No triage for me.

Someone helped me take off my leggings and underwear and climb up on the bed. I saw that there was some poop on the pad I was wearing in my underwear, which was a little embarrassing, although I knew it also showed them that I was already pushing. The midwife on duty was my least favorite of all the midwives in the group, and it turns out my instincts about her were right: She was pretty medical in the delivery room and not very flexible. I lay down on my side, and she told me I had to lie on my back while they put the monitors on. Lying on my back was agony during the contractions. I closed my eyes and the midwife checked me.

“Can I push?” I asked. I did push, a little.

“Don't push,” the midwife said firmly.

“Why?” I wailed, and no one answered me.

“They're just setting everything up,” Tanya told me, which made me so happy. No one actually told me I was complete, so that was the only way I knew that this labor was really at the end.

Sure enough, moments later they were coaching me on pushing. I moved back onto my side. The first few pushes I was not settled down enough. I was still screaming at the contractions, arching my back, finding the place in myself where I was supposed to push. Unlike the pushing phase in my first labor, when I had an epidural, I really did feel the urge to push this time. Tanya told me later that she could tell that I was already starting to push back at home. But it's still not a physical activity that you do very often, so it took me some pushes to get into the sync of it.

After awhile I was doing the standard three pushes per contraction, and the pain actually stopped or almost stopped during the push. It was like, “Aiaah!” -- push -- “Aihh!” -- push -- “Aiahh!” push. Before very long the midwife asked me to return to my back. After some coaching I was curling my body properly and had mostly stopped screaming to put my energy into pushing instead. I would lock my hands behind my knees, and Epu and Tanya were each holding one of my legs up. I knew that I was going to have to finish voiding my bowels right there on the bed, since pushing out a baby and pushing out a bowel movement involve pretty much the same muscles. I felt the nurse wiping it away. Very weird, icky moment there, pooping in front of a roomful of people and having someone wipe you. Erik told me after our last birth that some poop happened then too, but with the epidural I couldn't feel it at the time.

I heard someone say at some point, “Baby's on the doorstep,” and I don't think that was very long into the pushing. Around then the pain began hanging around after the contractions ended, because the baby was low enough to put constant pressure on my pelvis. “Why am I on my back?” I moaned at some point.

“Do you want to try an upright position?” Tanya asked, and I said yes. But then another contraction hit and I focused on pushing, and I don't remember what happened but we never did try an upright position. Tanya told me later that she did ask the midwife if I could and the midwife told her that she just wanted to make sure the baby's heart rate stabilized first. I did get back onto my side, but then the midwife told me that the baby would come faster if I returned to my back, so I did. I think I also remember a nurse saying they were having trouble keeping the monitor on the fetal heart rate. I still don't understand why she would say the baby would come faster if I was on my back, but I think they mainly wanted me there so the monitor would work better. In their defense, the team had no chance to establish a baseline heart rate since I came in already pushing.

Tanya was murmuring encouragement to me during every contraction. I would have liked her to use the hypnotic techniques for managing discomfort that we learned in her class, but she didn't. She was holding my hand, which was nice, and she gave me some sips of water. At one point she asked for and got a cool cloth for my forehead. I was hot and sweaty. The midwife gave me a talk about making every push count, because she said some of my pushes weren't moving the baby forward. I tried harder. It was getting very hard to not push between contractions, because of the strong pressure, but the midwife told me that when I pushed in between, the baby didn't get a chance to rest.

One thing that Tanya did do well was to help me relax between contractions, despite the pain, and that really helped me gather my strength for the next one. And there were more “next ones” than I had hoped and expected. I'm not sure when I arrived and started pushing, but I think it was around 10 p.m. At maybe quarter to 11, the midwife gave me a talk about how I had to listen to her really closely when the moment of delivery came so she could help me ease the baby out and save my perineum, which had a fourth-degree tear the first time around. So I figured the moment was nearly at hand. Awhile later the midwife said that we really needed to delivery the baby on the next push, because her heart rate was dropping during pushes. If we didn't, she would have to cut an episiotomy. I looked at the clock at said that Nutmeg had been dead on with her prediction that 11 o'clock would be an important time in my labor (even though she had said 11 AM). There seemed to be agreement around the bed that the delivery would come at around 11. This gave me strength to push really hard the next few, and the midwife allowed me to keep pushing because the baby's heartbeat bounced back. (My doula later told me that she didn't think the baby's heart rate had ever dipped to worrisome levels.) At some point an obstetrician came in, although I didn't really notice who was coming in and out. When I opened my eyes I would see so many people looking down at me – the midwife, Tanya, Epu, and three or four nurses. I felt like a trapped animal. I also saw all the instruments laid out. I was semi-sitting, with the back of the bed up a bit.

The midwife was massaging my perineum, her fingers inside me trying to stretch out the skin. It hurt. Finally I felt the baby moving forward with a push, and I could feel her pressing on my perineum. I could feel the incredible pressure of her head in my vagina and I was pushing toward the pain of stretching, but I didn't hold back. Actually it wasn't as bad as the actual contraction pain so I kept cool. Someone asked if I wanted to feel the baby's head and I did. And then I pushed, pushed into the pain, but the baby still would not come out. Finally the midwife said she had to do the episiotomy, and in a push or two, she actually cut it. I don't remember feeling much of anything when she cut. I pushed again, hard, and the baby's head still didn't come out. She cut a little more. Finally, the head popped out on the next push, and I pushed more, and the body came out and it was the most intense feeling of relief I have ever experienced. Yes, like taking the biggest poop ever if you had to go really, really bad. But more so. In a flash the baby was on my chest, the cord still attached, and I checked and saw it really was a girl. The time of birth was 11:17, six hours to the minute from the start of labor. She came out facing up, proving that I was right when I told Tanya I was having back labor.

The moment you first lay eyes on your baby is supposed to be magical, obviously, but after both my births I regarded my child with more bemusement than anything, while I dealt with the primary feeling at hand – huge relief that the pain and the hard work of pushing was over. It was so intense, so seemingly inescapable, and just like that, it was gone. I was shaking violently, and Tanya put a warmed blanket over me even though I wasn't really cold. Someone clamped the cord and Epu cut it, and for the second time I didn't see this happen, although I do remember the nurse asking Epu if he wanted to. A nurse took the baby to a warmer just a couple feet away for some intensive suctioning – not just the bulb aspirator but the wall suction tube down the baby's throat. I asked her if she had given Filbertine an Apgar, and she said they were 8 and 9, which is great. Nutmeg's were only 6 and 8.

The midwife had the obstetrician examine my episiotomy and tear to see if it was muscle and sphincter or just skin that was damaged. The OB determined it was just skin. She gave the midwife some advice on stitching it. The midwife guided me on pushing out the placenta and showed it to me. They gave me a local anesthetic and started stitching. I could see my reflection in a television screen mounted on the wall – my legs spread, and lots of blood smeared in between.

Epu stood over Filbertine and talked to her in the warmer. Tanya held my hand. The stitching was nothing but a few little pricks, and the most painful part was when the midwife caught a pubic hair somehow and accidentally pulled it. A nurse gave me a shot of pitocin in my arm to help my uterus contract. I found it hilarious that the nurses apologized when giving me the shots, as if those tiny little pricks would upset me after what I had just gone through. I had a second-degree tear extending from the episiotomy.

They handed me Filbertine, swaddled in a blanket, and I tried to nurse her. My arms were so weak and shaky that I had to ask Epu to help me bring her to the breast. She may have sucked a little bit, not much. Tanya asked the nurses for a snack pack and some juice. I guzzled about four tiny cups of juice and ate half a sandwich. I couldn't believe how limp and wrung out I felt, and how my arms could barely lift anything.

The midwife laughed and said sorry we didn't have a chance to go over my birth plan or anything. I asked if she had gotten the call that we were on our way, and she said she hadn't. It turns out my dad had called the birth center phone number, while we were supposed to call the midwives' line. Still, I can't figure out why the midwife wouldn't have gotten the message.

Two days later, the midwife I would have liked to deliver me was on duty and she stopped by to see me. I told her that I couldn't understand why the other midwife had insisted that I stay on my back, and she said that this midwife was the youngest and least experienced in the practice and that it takes experience to become comfortable with different delivery positions. The midwife I like better is also the assistant director of the group, and she said she would discuss my feedback with the other midwife.

Thinking it over later I couldn't stop marveling at my whirlwind labor – only six hours, about half early labor and half active. But maybe an hour and a half of pushing, which is still kind of long when I hear so many repeat moms say they did “only a few pushes.” I spent 25 percent of my labor pushing!

When I compare it to my first labor – 19 hours, 3+ hours of pushing, episiotomy and fourth-degree tear – I find some constants that are probably just the way my body is. Although episiotomies are uncommon these days, especially in midwife care, I apparently need one to get a baby past my perineum. This time around the midwife told me the skin wouldn't stretch because of the scar tissue from the old tear, plus the fact that the baby was posterior and therefore her head was not in the optimum position for pushing through. The first time around, I worried that having an epidural caused my long pushing phase, but now I think it may have been almost as long even without an epidural, because I just do not have a very elastic perineum. When we talked it over later, the doula said she had seen my perineal skin holding the baby's bulging head back, something she has rarely seen before, and she agreed that I may well need another episiotomy if I ever have another child. She also said that I should definitely try to give birth standing, squatting or kneeling, something she'd been afraid to encourage due to my past tear, but now that she's seen how tough my skin is, she thought I should go ahead and do it to possibly shorten the pushing time.

I also wonder if there is something about my pelvis that makes posterior babies more likely. Nutmeg came out facing the right way, but from the description of my labor, Tanya thought Nutmeg might have been posterior and turned during her final descent through the birth canal. I had wondered the same thing. My mother told me that both my brother and I were posterior until the last minute. During both my pregnancies, in the final weeks, I did the recommended things for avoiding back labor – I avoided reclining and sat on a birth ball instead. I went swimming three times a week for the last couple of weeks. But the result was still a posterior baby. Again, I talked it over later with my doula and she said there is some research suggesting that some women are prone to repeat back labor. She personally has had multiple clients with more than one posterior baby. The theory, she said, is this: The bottom opening of the pelvis, called the pubic symphysis, is supposed to spread during late pregnancy to make more room for the baby to rotate into the proper position while exiting. But with some women, the hormone relaxin causes the symphysis to flatten out and lose its arch instead of spreading, which makes the opening smaller instead of bigger and prevents the baby from rotating. Not only does a posterior baby hurt the laboring mom by pressing its skull up against her spine, it also has trouble coming out because the head is not positioned optimally to open and move through the cervix and vagina.

One week into my recovery, I have realized that having a second-degree tear does not compare at all to a fourth-degree tear. Last time at this point I was still taking Vicodin every six hours. Today I stopped taking Motrin every six hours because I just don't need it anymore. I can see a big difference in Filbertine compared to Nutmeg – Filbertine is much, much less sleepy. The Vicodin probably had something to do with that.

All in all, I'm grateful for the short labor and amazed by the intensity of the last part of it. It amuses me that I spent so much time during my pregnancy planning and preparing for labor, and then in the rush of it I scarcely had the opportunity to use any of my preparation. After the birth, a friend asked me if the hypnosis “worked.” It's a hard question to answer. I'm guessing both all the pre-labor suggestions I'd been listening to and giving myself helped a lot when it came to remaining mellow and avoiding discomfort during the early part of the labor. But hypnosis did not offer me as much pain control as I would have liked during the short active phase. In all honesty, it was probably the worst pain I had ever experienced in my life. My throat was sore for the next two days from yelling so much. If I have another baby, I will probably use hypnosis again, and I will probably search for another doula. Although Tanya is wonderful and she did help, I feel like someone more focused on hypnotherapy could have done better at using those techniques to help cut down on the pain.


Thursday, May 20, 2004

Nutmeg's Birth Story

Here's Nutmeg's birth story! The beginning will be a little redundant to you habitual readers, but if you skip the first few paragraphs, you'll get to the juicy stuff. I'll be updating this soon with Epu's comments.

Most women are dying for labor to begin once their

due date nears, but I was actually hoping to put

off the event for at least a day past my date. My

parents were arriving from Wisconsin on Friday,

two days before my April 25 date, and I had bought

three tickets to see Michelle Kwan and other

"Champions on Ice" at the HP Pavillion in San

Jose, ON April 25. It may seem crazy, but only 5%

of women deliver on their due dates, and with a

first baby, my mom and I both figured Hazel would

be late.

But a couple of weeks before my parents' arrival,

I started to doubt that assumption. My doctor told

me I was a fingertip dilated and she could tell i

was having contractions when she examined me. I

had been feeling slight abdominal cramps from time

to time but wasn't sure if they were contractions

or what. Dr. Kamali said to make sure we had our

car seat and that we stayed well rested, because

labor could begin at any time. I went back to the

office all excited and Erik and I shopped like

demons that weekend, rushing to get ready for the

event.

Nothing happened that week. One week before my due

date, the horoscopes in the Sunday Chronicle

seemed to be sending mixed messages. Mine said,

"Cross your fingers, hold your breath,and wait a

week." But Taurus, which would be Nutmeg's sign,

said that she should "take a deep breath and get

ready to begin the first week of the rest of her

life." So it seemed like Nutmeg's said she'd be

born that week, mine said she'd be born next week.

The next day, I saw Dr. Kamali and she gave me an

internal exam and said I as 1 and a half

centimeters dilated. She told me she'd be on duty

next Tuesday, and I hoped I'd make it till Monday

or Tuesday. We talked about what to do if I went

into labor, and I asked if I would have to go in

immediately if my water broke. She said I'd have

to go in but that they would probably just give me

some tests and send me home to wait for labor to

begin. That night, I was lying on the couch after

watching that bizarre Fox reality show, "The

Swan," when I felt warm liquid flowing out of me.

It came in several pulses. My pajamas didn't feel

wet, but I wanted to get into the bathroom to

check out what just happened. Erik was in there

though, so I washed off the stove and put away

some oranges from our organic produce delivery.

Meanwhile things were getting wetter down there,

and I was feeling excited but telling myself that

this might be nothing. But when I got in the

bathroom I saw that my underwear were soaked and

my pj bottoms were getting wet. The fluid didn't

smell like pee but was slightly pungent, with the

same scent as all the other discharge I'd been

having lately. A clean scent. I came out and told

erik that I thought my water had broken. We hugged

and he stammered a little bit, wondering what we

were supposed to do. I called labor and delivery

and described what happened, and they told us to

come in. Although I figured we'd probably just be

checked and sent home, we packed everything up. It

was after 11 by the time we set out for the

hospital. I had called my mom, woke her up, and

put her on alert. She said to call back if we got

admitted.

I listened one of my tapes on the way to the

hospital. After driving for awhile, erik said

something and I opened my eyes, thinking we were

there. But we were in an unfamiliar neighborhood

-- Erik, who can always find everything, had

gotten lost! I offered to call the birth center

for directions, but he figured out where we were

after awhile.

The emergency parking area at the hospital was

closed, so we parked on the street nearby and went

in, leaving all our stuff in the car. They had me

give a urine sample and put me in a triage room in

a gown. I had started to have some bloody show. A

nurse took my temperature and put me on a fetal

monitor. Then a resident,Tina Tan, came in and

explained that she would check my vagina and tell

me if my water had really broken or not. I had

little doubt that it had, but as soon as she

swabbed it, she said that my membranes had not

ruptured. They had a chemical test for amniotic

fluid, and there was none present. I felt a

combination of let down and relief -- but more

relief, because i did not want to have to be

induced if my labor didn't start within 48 hours.

Dr. Tan brought in an ultrasound machine and had a

peek at the baby. "Looks like a small baby," she

said. We told her that our ultrasound a week

before had shown that she was 3200 or 3400 grams

(7 pounds or less). She said 3200 looked more

likely to her. She also gave me another internal

exam and confirmed that I was still 1.5 cm. She

asked if I could feel the contractions showing up

on the monitor. I could, but i hadn't been sure

that those crampy feelings were contractions. Dr.

Tan said it looked like early labor, and would

probably stay that way for the next few days.

We got home after midnight, thinking that this had

been a good dry run. I considered making some

calls to Europe for a story I was doing at work

about a security flaw in Bluetooth cell phones.

But then I remembered we don't have long distance

service on our phone. I did manage to communicate

with the Europeans briefly by email. I arranged to

talk to them by phone the next morning, and we

went to bed, exhausted.

We had our prenatal appointment with our

pediatrician, Kara Wright, the next morning. I was

having a lot of Braxton-Hicks contractions, and

plenty of bloody show. So I told the folks at work

that this might be my last day, instead of Friday,

and I hurried to finish the article I was working

on. However, a security story broke that

afternoon, so I put my story aside to cover that.

By that time, the contractions I had been feeling

seemed less frequent. I told my editors that I

would probably come back for a half day the next

day to finish the piece. My mother called at about

6 and scolded me for still being at work. She told

me to take a cab home and put my feet up. She

really didn't want me to go into labor! I agreed,

but instead I walked over to Whole Foods and

bought a couple bottles of Recharge, the natural

Gator-aid-like drink that our childbirth

instructor had recommended. I felt like I might

not have another chance to pick some up. That

night Erik helped me make snickerdoodles as a

goodbye offering to my coworkers. We wanted to

make them for the nursing staff at the hospital,

so this was like a practice batch. I sat down much

of the time, and let Erik take the trays in and

out of the oven and do much of the other work.

The next morning I felt back to normal, but I went

home after my story was edited -- about 3 p.m.

when I put on my jacket and said goodbye almost

the whole section got out of their desks and i got

a lot of hugs. It was really sweet. Then I walked

home, feeling a strange sense of freedom. All my

thoughts had been centered on the baby, and I

hadn't given much thought to the idea that I

really wouldn't have to show up for work or even

think about software for 6 months. I rested that

afternoon, but the next day I started cleaning the

house in preparation for my parents' arrival. I

organized and vacuumed the closet, one area that

had been a dust haven for a long time. I no longer

felt like I was on the verge of going into labor.

I managed to listen to my hypnosis tape and take a

nap in between cleaning and loads of laundry the

day my parents arrived, Friday. We were all so

happy I'd made it. Mom and Dad got to see the

dramatic way Nutmeg sometimes moved my belly.

Saturday, we got my parents settled in the sublet

they were renting, went to the Presidio to get our

car seat installation inspected, and then we

walked toward the Golden Gate and checked out the

old fort there. We walked up a lot of stairs to

the top level, where there were a bunch of

platforms that used to hold cannons. I practiced

the lunge our childbirth instructor had taught us

on one of the platforms, and it gave me a

contraction. The rest of the day, I had mild ones,

but nothing too attention-getting. I made the last

minute plans for getting down to San Jose the next

day to see Champions on Ice -- chose a restaurant

to meet at, printed out a Mapquest. Then we went

to bed early, since I hadn't slept well the night

before. We actually got a little frisky, something

that hasn't happened in months, but we didn't have

intercourse because I didn't want to bring on

labor before Champions on Ice.

Sadly, I never made it to the show. I woke on and

off with contractions that night, and at 3 a.m. I

got up and moved to the couch, where I listened to

a hypnosis tape and then another, trying to lull

myself back to sleep. I even drank a glass of

wine, for the first time since finding out I was

pregnant. I ate a couple of strawberries, and

tried another tape. By now I suspected that the

cramps I was feeling were the real thing, but I

kept hoping that they would go away. I should have

tried drinking a lot of water, but I didn't think

of that, or I don't recall doing that at least. I

started feeling nauseous. Finally at 5:20 a.m.,

after a strong contraction, I threw up loudly in

the bathroom -- the wine, strawberries, and

everything else hanging around in there. Erik

called to me from bed and when I didn't answer

showed up in the bathroom. The vomiting convinced

me I was really in labor, and I told him so. But I

also said I'd been trying to go back to sleep, so

I got back in bed and he read me the hypnosis

script called "Peaceful Sleep Now," which usually

knocks me out. But as he read, my contractions got

stronger and closer together, and I interrupted

him partway through to say we'd better start

timing them. I told Erik to look in the

Hypnobabies binder, in my hospital suitcase,

because I thought there was a sheet in there for

recording contractions. He got it out but couldn't

find any such page. I got in the bathtub, and at

other points remember lying on the living room

couch with the bathroom garbage can by my side. I

was drinking the lemon recharge but retched it up.

I listened to the first tape reserved for the day

of birth, "Birth Day Affirmations." I was feeling

very calm, and the contractions weren't exactly

painful, although they weren't pleasant either.

But they seemed to be less than 3 minutes apart

from when we first started timing them. It was a

little difficult because I wasn't always sure when

one started or ended, and because Erik was running

around doing things like last-minute packing and

wasn't always there with his cell phone, which he

was using as a stopwatch. But we decided to call

my parents and let them know. Hypnobabies tells

you that every 20 minutes during your birthing

time would seem like 5 minutes, and I think that

time distortion was working, because I thought it

was still around 5 a.m., and Erik told me it was

after 7, I think. My parents said they'd get

dressed and would be waiting downstairs if we

called as we left the house. Then we called labor

and delivery and described what was going on. They

told us to take our time but to come in. I told

Erik he could take a shower, and while he was in

there, I called Bert and left messages on her home

and work phones to tell her we wouldn't be going

to champions on ice, and that she should probably

call us back to arrange to pick up the tickets at

the hospital. In one of the messages i think i

sounded normal, but in the other i was having a

contraction. Mom called and i told her -- with

some pauses -- that it would be awhile longer

because Erik was taking a shower and they told us

to take our time. I gathered a few of our things

between contractions and got myself dressed in a

black maternity sweatsuit and even put a red

bandana over my hair. I actually looked kind of

cute.

I lay down and listened to the "Deepening" tape to

prepare for the car ride. When Erik had the car

all packed, I went down, carrying my pillows, some

plastic bags and toilet paper in case I puked en

route, and my little case of Hypnobabies tapes. I

was wearing my Walkman. Sitting in the car didn't

make the contractions much worse except that I

couldn't change positions. The position I had

found to be most helpful so far was on all fours,

sometimes doing the pelvic tilt, which was also

supposed to be good for positioning the baby

facing back. I felt a little nauseated in the car,

but just rolling the window down helped. In the

car I listened to the Birth Guide, the Hypnobabies

tape that you are supposed to reserve for the day

of birth. It was telling me how my cervix was

opening, how I welcomed my surges, etc. We picked

up Mom and Dad, and I turned my lightswitch to

center (a Hypnobabies tool that means switching to

a lighter state of hypnosis in which one can walk

and talk) and quietly said hi to them. They were

solemn, my dad more than my mom. I smiled and told

me dad it was ok, then turned my switch back off

and hit play again on the Walkman. They got in the

backseat, and the next time I opened my eyes we

were pulling into the emergency parking lot at the

hospital. They helped me out of the car and we

walked in slowly. Erik says it was about 9 a.m.

Halfway down the hallway to the elevator I had to

kneel on the ground and throw up into the bag I'd

brought. Good thing Erik thought of that! While I

was down there, a hospital employee stopped to ask

if we needed help. Erik said, "It's OK, she's just

throwing up." Them employee said, "JUST throwing

up!" and I think she was laughing at him. She

offered to get a wheelchair but I shook my head. I

think someone else came by with the same offer,

but my mom told them I wanted to walk.


As usual I felt a little bit better after throwing

up, and we took the elevator up to the birthing

floor, the 15th floor at the University of

California-San Francisco Medical Center. We signed

in, my signature pretty shaky, and went to the

desk. They put me in a triage room and my parents

went to the waiting room. Since Erik and I had

been there on a false alarm a week before, we knew

the drill. I went down to the bathroom to give a

urine sample, then came back to the room and

stripped from the waist down, and got on the

table. Sometime in there my water broke, but --

much like when I thought my water broke the week

before and went into Labor and Deliver -- it was

just a small gush followed by a trickle. Later in

labor I don't remember losing any water at all, or

I didn't notice it with everything else going on.

I was listening to my birth guide tape on and off

-- turning it off whenever someone came in and

said something to me. I asked for a bedpan to

throw up in and barely got one in time. "You're in

labor all right," the nurse said. Before I was

checked Erik asked the nurse if she thought we

would be admitted, and she said she thought so.

Someone checked me and declared me dilated 5-1/2

centimeters. I was very pleased with myself.

They admitted us and I still had enough presence

of mind to get Erik to follow the nurse out and

ask which birthing room we were getting. The

really good room there is room 2, the corner room,

because it has windows on both sides overlooking

san francisco. But we were assigned Room 3. On the

way to the room I think a nurse asked me how my

pain was. I told her that I was using hypnosis and

that I was not supposed to talk about it in terms

of pain, but pressure. I said the pressure was

strong but bearable.

This nurse, whose name was Sushila (I don't

remember the spelling but I had the presence of

mind when she introduced herself to tell myself to

remember her name pronounced "Sue-Shiela.")

remarked that I was really calm for being so far

along, and that a lot of women were freaking out

by this point. That made me feel really good, like

the hypnosis was really working like it should.
A few hours later, in the room, Sushila said she

wanted to try hypnosis herself after seeing it

work for me. I think she wanted to use it to stop

smoking.

They gave me a stretchy band to put around my

abdomen, which would hold on several monitors. The

monitors were wireless, so I could move around

freely. I told them I wanted intermittent

monitoring, and they said OK after the initial

baselines were established, or something like

that. Erik went to get my parents and we all went

into the birthing room, and I guess Erik went down

to bring up my things and repark the car. I had a

ton of stuff -- birthing ball, portable stereo,

suitcase, pillows, and a big shopping bag full of

snacks, drinks, comfort measures like a

microwavable hot pack, a loofah, etc. etc.

My parents were really thrilled with the view from

the birthing room -- UCSF is on a hill and you can

see all the way to the Bay. It was a beautiful,

warm and sunny day and they enjoyed watching

sailboats on the Bay. Erik pointed out about where

our apartment would be, way over in South of

Market. Of course, I never enjoyed the view much

myself, and the postpartum rooms are on the other

side of the building, with a lovely view of some

steam ducts. It's funny, the way hospitals make

the birthing rooms, where most women are too

occupied to notice what they're looking at,

beautiful, huge and comfortable, while the

postpartum rooms, where you spend most of the time

and receive visitors, are cramped and

unattractive. I guess they figure the less

pleasant the postpartum room, the less you'll want

to stay.

They started me on a fluids IV, since I had been

vomiting since 5 a.m. I hadn't wanted to have an

IV but I agreed at that point that getting

hydrated would be a good idea.

I wanted to get into the bathtub as soon as

possible, so I asked Erik to start filling it

while they put in my IV. The gown I was wearing

had shoulders that untied so I could get it off

while still wearing the IV, but I was still

wearing the tank top I had come in with and my

bra. I got in the tub with them on, and then my

mother, who is a nurse, detached the IV tube from

the needle on my hand so I could get them off. The

tub with jacuzzi jets felt very good. We put a

Hypnobabies tape on the portable tape player we'd

brought and I got back into deep hypnosis.

The anaesthesiologist came in and said she'd like

to talk to me about my pain control options. I

turned my switch to center and told her I didn't

want to talk about it, and Erik went out with her

and closed the bathroom door so she could tell

him. I could hear him through the door telling her

that I didn't want an epidural because I was

concerned that it would stall my labor. She said

that when people were already beyond 5 centimeters,

like I was, that didn't happen. My mom stayed in

the bathroom with me, and softly said, "release,"

or "relax" to me when I was having a contraction.

Both are cues from Hypnobabies; one is supposed to

send me into deep hypnosis, the other is supposed

to give me an extra wave of relaxation, and I

don't think she remembered which was which but it

didn't matter much. It helped. My mom said she

liked hearing what was on these tapes I'd been

listening to on headphones. When the tape got to

the part telling me to wake up, I'd tell her to

turn it over or put in another tape. After awhile

-- I have no idea how long because I had no sense

of time passing -- I said I wanted to get out of

the tub. My mom helped me get out and get dried

off.

Sometime in there Erik got in touch with Bert and

arranged for her to come by the hospital and get

the tickets. My dad went downstairs and gave them

to her. I later found out that she was able to

sell the tickets in the parking lot of the HP

Pavillion in San Jose and gave us the cash. What a

great friend! She had to go to San Jose anyway to

pick up her boyfriend at the airport so she didn't

mind driving down there.


I asked Erik to give copies of our birth plan to

the nurses on duty. I told him exactly where they

were: in the front pocket of our Hypnobabies

binder. I also asked him to put up the sign on our

door asking people to be quiet because we were a

"hypnofamily." But Erik said he couldn't find the

binder, which was bad because that had all the

cues, extra scripts for "change of plans" and the

transformation (transition) stage, in it, as well

as the form we filled out for our baby's birth

certificate. We later realized that Erik must have

left the binder out of the suitcase when he looked

in it for the surge recording sheet. Fortunately I

was too focused to let this little mishap throw me

much, but I still don't know if anyone helping us

ever looked at our birth plan. There were two

copies in my patient file, but I don't know if

they read it.

The following hours are jumbled in my memory. I

know I got another IV bag attached, and that I sat

on my birth ball for awhile, and that I continued

to drop to my knees if I was moving during a

contraction or sometimes even if I was sitting

down. Erik gave me some papers I had to sign

authorizing the hospital to take care of me. I

think I may have had my progress checked and told

I was 6 centimeters. I do remember they told me

they'd check me again in 2 hours, and I focused on

that as the surges became more intense. I felt

them in my back, as well as my whole abdomen, and

was feeling rectal pressure, so I believed I was

getting close. I sat in the rocking chair, facing

the amazing view of all San Francisco. I thought I

might want to look out, but as soon as we started

playing a tape again I closed my eyes instead. I

wanted to rock to help move the baby down but the

rocking chair was broken and would not rock. I got

out of it a couple times so Erik could fiddle with

it but it would not rock. We asked a nurse if we

could switch it with the chair in another room but

she never brought one. I spent much of the time

until my next check in that rocking chair, getting

deeply relaxed. I started counting down during

contractions, starting at 60 and often ending up

in the negative numbers. Once when I was on the

floor Erik rolled a cold soda can up and down my

lower back, one of the comfort measures we learned

in childbirth class. It felt good. But he never

did it again. He did heat up the hot pack and put

that on my lower back periodically, and that

helped a lot too. He also asked if I wanted to get

up and walk or try some lunges, and I told him no.

At the time I felt frustrated that he didn't

understand that I was in the mode of just trying

to get through the surges, not trying to make

labor progress, since I had already progressed a

lot. But I was really not able to communicate very

much, I spent most of my time with my lightswitch

off, listening to tapes. My mom asked once if I

wanted to get on my birth ball, saying I had liked

it before. But I said no. Later I asked Erik why

he didn't offer all the comfort measures we had

brought, or ever offer the can massage again, and

he said it was because I kept saying 'no' to

everything he suggested.

Early on I remember my mom saying, "good job"

emphatically at the end of one and I opened my eyes

to look at the monitor and saw that the

contraction I'd just had was a large mountain with

a big flat plateau on top. At some point one of

the monitors started hurting me, as if it was

burning my skin, and my mom helped me pull that

one off. I got very relaxed and almost dozed

between some contractions. At one point I heard a

baby cry in the next room and I smiled for a

moment. My mom silently touched my hand.

My parents went to lunch in the cafeteria and

brought Erik back a sandwich. I asked him to eat

it outside the room since I was still nauseating

and throwing up periodically. I had tried sipping

the orange Recharge, since the lemon was too

acidic, and water, but both caused me to throw up.

I didn't interpret the pressure I was feeling as

pain, because I had told myself not to. But

whatever they were, I was finding the surges more

difficult to bear as time goes on. I don't know if

they were getting stronger or if I was just

getting tired. I asked my mother in a weak voice

if she thought I'd be complete when they checked

me. She paused and replied, "I think whatever you

think, that's what will happen." She had obviously

been listening to the tapes, and it was a good

answer.

Finally a doctor came to check me at around 3 p.m.

I think it was Dr. Tan, the same resident who we

saw during our false alarm the week before. I got

in bed for that, with my heels touching each

other. There was something like a clock on the

wall opposite the bed, but it never told me the

time, frustratingly. It was some other kind of

meter, I guess. Anyway, Dr. Tan told me I was 6

centimeters. That was it. I asked if it was too

late for an epidural, and since it wasn't, I said

I wanted one. So I stayed in bed, where I would be

for the next seven hours. Erik asked me if I was

sure I didn't want to try something else first.

Before labor, I had said I was interested in

trying nitrous oxide. But now I felt that I was

too tired, with who knows how many hours ahead of

me, and I didn't want to mess around. As I lay on

my side in bed, the hot pack soothing my lower

back, I considered changing my mind, but when the

anasthesiologist came in, I told her I wanted to

go ahead.

Before the anaestesiologist got there, Dr. Tan

came in and said "You did great, and you're still

doing great." She said she wanted to put a

pressure catheter in me because the contractions

did not appear to be as strong or regular on the

monitor as she would like them, and that was

perhaps why I was not progressing. If the pressure

catheter read that I was not having powerful

contractions, she wanted to give me pitocin. I was

surprised to hear that, since it had felt like the

experience was getting more and more intense to

me, not tapering off. I even doubted it was

accurate, because my dad -- who was in the room

much of the time but left when someone checked me,

etc. -- had commented that some of the

contractions I appeared to be having were not

showing up on the monitor. I asked if perhaps I

had become too relaxed. She said maybe my body was

actually tensing up too much. But I said I didn't

think so, because I felt I had remained pretty

relaxed. I asked her to wait until the epidural to

put in the pressure catheter, and she agreed.

My mom came in and I muttered, "Sorry," to her.

She said, "Oh honey, you don't need to apologize,

you have been doing so great! Believe me, if an

epidural had been available to me, I would have

taken one." That meant a lot to me because she

knew that I was inspired by the fact that she had

my brother and I naturally and that I had wanted

to do the same.

The anaesthesiologist had me lean forward over

something on the side of the bed, maybe the eating

table, while she set up the epidural -- first a

local anaesthetic, which stung, then taping the

tubes to my back, then inserting the epidural. She

apologized about making me stay in the awkward

position, but I said that actually it was a pretty

good position. She explained that first a

fast-acting drug would take effect, and then the

real epidural would kick in within an hour, I

think. Once that had kicked in, I could increase

the amount of pain relief by pushing a button at

my side. I wanted to know if we could turn the

epidural down or off when it was time to push, and

she said yes. She even said I would probably be

able to squat on the bed to push if I wanted to.

The medication kicked in VERY quickly, and I was

like a different person. I looked around, noticed

that my dad was in the room, and chatted a little,

laughed. I remarked on how different I felt, and

my mom said that as a labor and delivery nurse she

had seen this transformation many times before. I

felt like, why did I bother fighting through all

those hours before? Especially now that they added

pitocin to my IV and watched the monitor as my

contractions got harder and more regular, and I

was resting, trying to look out the window -- I

still couldn't really see the Bay from bed -- and

eating jello, a popsicle, even taking a bite of

Erik's energy bar. My nausea vanished and instead

I felt hungry. Someone tested my legs with a wet

piece of paper and asked if I could feel the

coolness. In some spots I could, like down by my

feet, in others I couldn't. I could still feel the

pressure waves but the discomfort was gone and I

felt relieved and cheerful. Erik and I both lay

down and tried to nap. My mom and dad were talking

quietly, and after awhile I asked them as politely

as I could if they could go to the visitors'

lounge, because I really wanted to sleep. I dozed

very lightly, but every time I was about to fall

really asleep either I would feel a pressure wave,

usually on the side I was not lying on (the

epidural medication flows with gravity toward the

lower side), or someone would come in to comment

on my pressure waves showing on the monitor. They

said they were getting better but still not as

strong as they wanted to see. Still, I got rest.

And I listened to my birth guide tape again and

another one, hypnotic childbirth, I think, to

prepare myself for pushing. I said that I was fine

with taking a few more hours to dilate, just to

have the chance to rest. We wondered whether the

baby would be born today or the next day, which

was my grandma's birthday. The next shift nurse,

Sasha, looked at the clock and the monitor and

said that I was going to push this baby out before

midnight.

When I was done trying to nap, we chatted with

Sasha. She said she was a traveling nurse, that

she had been stationed in Hawaii and the Virgin

Islands, and that she was only here between

assignments.

The wind picked up, whipping around trees outside

the window. At a little before 7, Dr. Tan checked

me and said I was complete. I asked if I could

have half an hour to prepare myself -- I wanted to

listen to the Deepening tape and then set my

switch to center for the pushing, which would

allow me to move around while maintaining total

anaesthesia between the top of my breasts and the

middle of my thighs, even if we turned off the

epidural. They said I couldn't wait that long, so

I said I would just take a few minutes. I turned

my switch to off, got as deep as I could, and

turned my switch to center and said I was ready. I

asked if I could squat with my husband in bed

behind me, supporting me. It was a position we'd

tried out and liked in childbirth class. Erik got

in bed behind me, acting very dubious about it

despite the fact that we had rehearsed this

position. They sent in an RN who apparently was

very good with birth positions, a woman with a New

Zealand accent. She explained that I wouldn't be

able to squat because with the epidural I might

damage my knees without realizing it. But I could

get up on my knees for a few pushes, which was

just as good as squatting, she said. She also said

that she had seen the side lying position, with

birth partner holding up the upper leg, help women

push out the toughest babies. She had Erik get out

of bed and we raised the head of the bed up almost

vertical. They helped me turn myself around

without pulling out any of the tubes attached to

me, and I leaned over the back of the bed. Then

the New Zealand nurse said, "There's a

contraction, you should be pushing now!" I pushed,

and she said it was a very good push. We did a few

that way, and then she had to go, because it was

the end of her shift, I guess. Sasha also went

home, saying she was disappointed that she wasn't

going to see Nutmeg be born.

I don't remember much about the next nurse on

duty. After awhile my legs were getting tired and

shaky so I came down off the knees position, and

lay on my side. Erik stood on one side of the bed,

my mom on the other. When a surge started, I was

supposed to hook my elbow through the knee on my

upper leg, and the person on one side of the bed

would hold up the leg and push it back. I didn't

push the epidural button anymore (I had pushed it

two or three times during the hours when I was

waiting to be complete), and I could then feel the

surges quite clearly. I didn't feel that my

pushing was compromised at all, and people were

telling me that I was pushing nice and hard.

Someone said something about what I should do for

the first couple of hours, and I laughed. "Hours?!
I said. I believed I would have the same

experience other hypnomoms had, pushing the baby

out with just a few good pushes, as I had

visualized.

But it was hours. The doctor, and later the nurse

too I think, put her fingers in the birth canal

several times to feel the baby's head, and advised

me to push against her fingers, which felt strange

because otherwise people were telling me that I

should push as if having a bowel movement, which

felt different than pushing against the fingers. A

big challenge was that, much like I was before the

epidural and pitocin, I was having double surges

-- one after another, then a break, then two more.

The nurse said I should avoid pushing during the

second of each pair, or I would get too exhausted.

But the second surge, when I wasn't pushing, felt

really intense. Sometimes I let myself push gently

during that one.

After awhile I asked to get back on my knees, but

didn't last as long this time. Maybe four pushes.

My legs were too weak. I took sips of water from

Erik between pushes, and ice chips. But while

drawing in my breath and holding it for pushes, I

often found myself burping or spitting up a

little, so I drank as little water as possible.

Hypnobabies says you're not supposed to push, but

"breathe" your baby out, but I had never really

understood that part that well, and I had the urge

to push, so I just went along with the nurses'

instructions, although I did push as I slowly

released my breath at the end of each

breath-holding period. They said I should be

pushing a little longer during each surge, so they

started counting down from 10 during each one,

which I found helpful. For some reason the monitor

still didn't show my contractions very clearly I

guess, because I had to tell them when a surge was

starting. I would say, "Is this one?" and the

nurse would either say yes or just, "If you feel

one, it is one," and I'd grab my knee, Erik or my

mom would lift my leg, and I'd push. Often I kept

pushing after my mom finished counting to 10.

Hours passed. It got dark out. Eventually they

said they could see the baby's head, although only

while I was pushing, not between surges. They said

the baby had a lot of hair. This encouraged me,

and I pushed harder and longer, because people

were urging me to, believing that I would get the

baby to crowning at any time. I was pushing two or

usually, three times during each surge. And

getting tired.

After what seemed like forever, I was able to

reach down and touch the baby's head. They never

actually told me she was crowing, but I guess that

was it. They brought in a big mirror so I could

see her, but I couldn't really look because I

didn't have my glasses on and I was supposed to be

folding my chin down towards my chest while

pushing, which made it pretty much impossible to

also look in the mirror. I didn't want to waste a

single surge looking; I wanted to get this done.

Finally the nurse advised that we keep my leg up

between surges, to prevent the head from slipping

back. That worked, but it made me even more tired.

I was moaning loudly during the surges when I

couldn't push. My dad was out in the hall, reading

"To Kill a Mockingbird," and getting nervous

because 1) He thought pushing would only take

about 20 minutes, 2) He heard me moaning, and 3)

More and more people kept coming into the room.

First the nurse told someone to get the doctor,

which my mom told me, ecstatically, meant I was

almost done. Because it's a teaching hospital,

more doctors came in too, although I didn't really

notice any of them. I was lying back with my eyes

closed between surges, trying to gather up my

strength. I reminded the doctors that we wanted to

keep the baby with us for the first hour, before

any drops were given or tests done, and they said

fine.

People kept saying, "Big push, now, this is it,"

and things of that nature, leading me to be very

frustrated when push after push, nothing happened.

The only thing that did happen is that with the

baby crowning, the pressure I was feeling

increased tremendously, so it felt like I was

having one constant surge. I wasn't sure when they

were coming anymore, and it didn't seem to matter.

I said one was coming when I thought I might be

having one, or anyway when I felt up to pushing

again.

Dr. Tan said she was massaging my perineum,

because it was all that was blocking the baby's

head from coming out. It felt quite uncomfortable.

"I'm just giving you a little massage," she said

at one point, and I said, "Nice massage." The

other residents and nurses laughed at that. I

asked at one point if they wanted to try a vacuum,

and the nurse or someone said, "You're going to

push this baby out." Someone encouraged me to

reach down and feel the baby's head again, and I

snapped, "I already felt it!" provoking more

laughter. My dad said later that these moments of

laughter gave him considerable relief, out there

in the hall.

No one offered hot compresses to help my perineum

stretch. This is something we'd considered in our

birth preparation, but decided not to do, because

I didn't want Erik to be running out to the

nurse's station to microwave hot compresses and

miss the birth. "There will be enough going on at

that point," I reasoned. In retrospect, I would

have used ThermalCare packs, which don't need

microwaving, and definitely done the compresses.

Also, I wish we had done perinneal massage, which

we skipped because I read that it is debatable

whether it actually helps prevent tears. Who knew

that my whole birth would come down to having a

perineum that would not stretch??

Finally, finally, Dr. Tan said, "I could make one

small episiotomy and the baby would probably come

out on your next push." This is what I wanted to

hear. At this point, I was so desperate for a way

out, a C-section probably would have been welcome.

"Cut it!" I said, and there was more laughter.

What happened next was not clear to me at the

time, except that Dr. Tan said that I would push

as normal during the next surge, and that it was

very important to stop pushing when she said. The

surge came, I pushed hard, I stopped when she

said, and in a moment my mom was rolling up my

gown, and my baby arrived on my chest, her wet

hair looking wavy and her skin looking very brown.

She wasn't really covered with blood or anything

as gross as a lot of the babies in the films in

childbirth class; she looked like a real baby. But

she wasn't crying. I said, "Oh my god, oh my god,"

just as the woman in one of the films we saw said

at that point. It was 10:20 p.m.

I was certainly surprised and unprepared to hold

Nutmeg so soon; I had thought they would suction

out her mouth and nose while just her head was

protruding out of me, and that I would push her

body out with the next surge. But as suddenly as

she had arrived there, she was whisked off my

chest. "You already cut the cord?" I asked,

surprised. "I cut it," Erik said. They took Nutmeg

off to an isolette on the other end of the room,

under a heating lamp. "Go with her! She'll know

your voice!" I told Erik, and he went over there.

My mom went too, and I saw my dad push aside the

curtain in front of the door and go over there

too. I heard one of the doctors saying, "Where's

that aspirator?" It was lying on the bed next to

me. I held it up, and called out, "Here it is!"

and someone came over and got it.

Soon I heard Nutmeg cry, and a good-looking male

resident told me she was fine, but that she had

passed meconium just as she was coming out, and

that they were going to take her to the nursery

for an hour to observe her breathing and make sure

she hadn't inhaled any. I hadn't seen him come in.

He also showed me some of the meconium on my

thigh, and said something like, "the first time

your baby pooped on you." "Not the last time," I

joked. "Probably not even the last time tonight,"

he said. Dr. Thiet, a perinatologist I had seen

once before, was also there.

My mom came back over by me, and said that the

baby was fine. Dr. Tan delivered the placenta,

which was really easy, and let me get a look at it

-- like a big slab of bloody liver. Then the male

resident told me I had a fourth degree tear,

looking very serious. "Is that like, all the way?"

I asked, and he said yes. That is, all the way

from vagina to anus. I don't know if it was the

adrenaline, or just the relief, or the epidural

still, but I didn't care. He stitched me up,

saying that it was the smallest fourth degree tear

he ever saw. I joked that this would delay my

return to the rock climbing gym, and he said no,

that this area of the body heals very quickly. He

asked if I felt any pain with the stitches, which

I didn't. "That's a good epidural," he said.

Sometime in here Erik and my dad went to the

nursery with Nutmeg, and videotaped her there. The

resident started telling me about how they wanted

my first stools to be very soft, almost liquid, so

they were going to prescribe me a stool softener

and milk of magnesia, blah blah blah. I felt like

saying, "whatever, I could care less."


Later, my mom told me this had obviously been Dr.

Tan's first epidural. First she had tried to cut

it between surges, then she had grabbed the

scissors for cutting the cord instead of the one

for epidurals. Both times, the male resident

stopped her. Also, my mom later told me that they

had suctioned out Nutmeg's stomach to get the

meconium-tinged amniotic fluid out, and that

Nutmeg's Apgars were only 6 and 8 because she

initially didn't cry and then was doing a grunty

breathing called "abdominal breathing." Apparently

some of her breathing trouble was probably because

her body came out so quickly, that there wasn't

time for the squeeze through the birth canal to

force all the mucous out of her lungs. My mom had

been more concerned than she let on, because of

her labor and delivery experience. But Nutmeg is

fine.

They brought Nutmeg back in less than an hour, and

she was still awake. But, swaddled and in the

hospital hat, she seemed like she belonged to the

hospital, not to me. Still, we put her back on my

chest, and my mom helped me get her latched on to

my left breast. She sucked for about two minutes,

after a couple attempts, and we were thrilled. She

was so cut, with gray eyes and all that brown

hair, and skin that looked like she had a little

suntan. Oh, and she weighed 7 pounds, 11 ounces,

which was another shock, because everyone who saw

my ultrasounds had predicted she would be small,

under 7 pounds.

Three weeks later, with Nutmeg snuggled against my

still-flabby abdomen, I can't help rethinking my

delivery again and again. To tell the truth, it

dominated my thoughts during my hospital stay, a

time when I thought I'd be consumed with wonder

and love for my new baby. I did feel "love at

first sight" for Nutmeg, yet I was even more

preoccupied with the strange experience I had just

been through. At first I felt that I had made the

right choice with the epidural, since I figured I

would never had made it through that long pushing

stage without that rest. But later, I started to

think that the pushing wouldn't have lasted so

long without the epidural. But the pitocin

probably would have been too intense without the

epidural, I thought. But then I wondered what I

could have done to prevent my labor from petering

out like that -- stayed home longer? Followed Erik

and my mom's suggestions to squat and use my birth

ball? I should have walked the halls, I told

myself, but I couldn't imagine how I could have

managed that. Later, my mom told me that the women

you see walking the halls are usually in early

labor, not in active labor like I was.

I always told myself that women were silly to

obsess over their birth "experiences," because

it's having a healthy baby that matters, no matter

what the mother goes through. But now I

understand. I keep wishing I could relive the day,

do it better, so Nutmeg would have come out more

quickly and we would have both been in better

shape.

And I felt disappointed that Hypnobabies

didn't work for me as well as I thought it would.

I wonder, was I too skeptical, did I ruin it by

going to a non-hypnobabies birth class? I

certainly practiced enough. But although it didn't

get me through the experience totally pain-free or

epidural-free, in the end I'm glad I studied

Hypnobabies, because I was never in excruciating

pain, and I really did get halfway there very

quickly on my own at home.

In the end, I decided that I'd like to use

Hypnobabies again for my next birth, but I will

hire a hypnodoula. As wonderful as my husband and

mom were as coaches, I think I would have stayed

deeper in hypnosis with a professional

hypnotherapist. And now that I've been through the

experience, I can appreciate the value of a

professional doula too. I felt like my husband

should have done more, offered more, taken charge

more, but that is really too much to ask of a lay

person who is going through an amazing and

unprecedented experience himself. He was wonderful

-- he even carried an index card with a list of

comfort measures in his wallet -- and I would want

him by my side again, but next time I'd like to

put less pressure on him and allow him to just

enjoy the experience, and be there for me.