My water broke at 12:30 am monday morning May 21st. I've said before that I did not like being a pregnant midwife.
But I think the one good thing was preparing me to be unprepared for my labor and birth. I've seen enough births to know that there are SO many possibilities for how things are going to go and how things are going to turn out that there was no point in getting my heart set on only one possible scenario. I was attempting a homebirth as unassisted as possible. I had a midwife there but she was there as a friend, not as a midwife, and for the most part I wanted to be left alone to let my baby and my body do what they needed to do, but with a few friends and family there as support. So even though I was prepared for any variety of lengths and difficulties and transfers and laboring positions and delivery positions and locations and what not, the one thing I really didn't expect was for my water to break first! So, sure enough...! Birth has got to keep you on your toes one way or another!
So, yes, my water broke at 12:30am on Monday morning May 21st after a light hearted dinner at Scalini's in Atlanta with friends. No kidding. Scalini's is a family style Italian restaurant in Atlanta famous for making women go into labor after eating their eggplant parmesan. Women go there at the end of pregnancy or when they're overdue in hopes that the spicy dish would kick things into gear. If you have a baby within 48 hours of eating there, you get a gift certificate, a onesie for your baby and a photo of your baby on their famous wall of "eggplant" babies. I went more for fun and as a joke though - I really didn't think it was going to WORK!
Andrew and I had gone to bed around 11 and I woke around 12:30 right as the amniotic fluid began flowing out of me. I've never seen or heard of so much fluid in my life. It was POURING out of me, soaked mine and Andrew's side of the bed, was dripping off my side of the bed onto the floor. I didn't hop right up because I assumed after a gush it was going to stop, but it didn't - so I got up and more than dripped fluid on the floor all the way to the shower which I got in and it just kept coming! Anyway, finally it stopped and Andrew was standing in front of me, fully dressed and said "what do you want me to do??" I answered, "well, we're probably going to be going back to bed." It was pretty surreal and it took me a minute to settle back into myself and to just ask for a towel to wipe my hands on and a hair rubber band so I could take a shower and rinse off. I didn't want him to clean up the bed yet because I wanted to get a photo of it. Also, I finally realized, I needed a big glass of water. I had to get right to replenishing all that water after all! So I got out of the shower, started drinking my water, Andrew got to changing the sheets, and I called my friend Jen in Oregon and let her know it was time to get on a plane. It took me a while to fall asleep after that of course because I was paying close attention to all my babies movements and also had a few contractions that i was trying not to "time" but couldn't help counting off in my head. They weren't strong at all so when I finally quit paying attention to them I was able to fall asleep, maybe around 3 or 4 am.
Monday morning I woke up around 8:30, no contractions, so decided to just go about my day. Most women go into labor within 24 hours of their water breaking, and the vast majority of women go into labor within 3 days. So I was happy to just settle in and wait. We ate a good breakfast then ran a few errands before picking my friend up at the airport around 3. No sign of labor yet but it was nice to just have an evening with my friend and get to hangout with her and my husband and my pregnant belly. A nice dinner and a good catch up later, I went to bed early, hoping things might start in the night. And they did.
I woke up to a contraction Tuesday morning around 2am. Nothing hard but definitely something, and for the next few hours I woke up to a few contractions. Around 5am the contractions started coming about every 10 minutes and I was finding myself having to concentrate a bit and breathe through them in bed, but could easily fall back asleep in between. Around 8:30 or so I had had about enough of that and decided to get up hoping things would pick up once I was up and moving. So we got up and Andrew made breakfast, then I made a rookie mistake and called my support people ( mom and sister in law) and let them know that I thought things were starting to happen - "I don't need you yet but I just thought I'd let you know and figured you might just want to come over." - Of course they did. I was also supposed to meet a good friend in from out of town (Australia!) for coffee that morning if I wasn't in labor yet so I invited her over too. So within an hour or so I had 5 people with me at the house including my husband, and whaddya know? my contractions stopped. Ugh. So I just enjoyed the visit for an hour or so then kicked everybody out of the house. Andrew and I hung around downstairs and tried to just go with the flow, listened to music, chatted, ate some lunch... but the contractions never got into a pattern again. I was having them, but nothing consistent. So I figured it was time to stop thinking I was in labor again and so I called my mom back over to hang out and we played a few games of Settlers of Catan and ate some dinner. By dinner time I was having a few contractions again, ones that made me stand up and move, but I was still to talk and laugh and be in the room with everyone. But by about 11pm, things finally started to get real.
Tuesday evening May 22 around 11pm I finally got into an active pattern. Contractions about 6 minutes apart requiring my full attention. My experience of birth came into play here. - I was so caught off guard by my whole pregnancy, it was so much more full-on then I had expected but during the labor, I kept thinking to myself, yeah, this feels about right - I felt like it was what I expected and luckily I knew what to do. I was moving with the contractions, I was following a rhythm and a ritual, I was making the right noises, I was staying loose and relaxed, and it all helped! Everyone in the room thought things were rocking and rolling and i started hoping for a baby by morning.
I got into the birth tub around 6 am (-ish, I think... this is where things start to get fuzzy), and by now my body was giving a little involuntary push at the peak of a contraction. I was going with it- breathing through but allowing my body to do what it needed to do as well. I'm not sure when but at some point I said to my midwife friend, "I probably should wait to put my hand in to feel his head until i'm pretty sure it's right there shouldn't I?" and she said "yep." But I really wanted to feel anyway so I did. And I could feel his head! But it was way high up there. (It's funny writing this now, because at the time I had no idea who "he" was, or even if it was a "he"! But now I can't imagine him being anyone else! Also, funny enough, everyone kept calling him "he" the whole time in labor - and sure enough that's who he was) Anyway, I didn't feel for cervix or anything, and it was a tad bit discouraging but I just kept doing what I was doing for awhile. Finally I got out of the tub for a change and decided to check myself again, this time trying to see if I could feel any cervix. I couldn't, but what I thought I felt was a baby head and then a pubic bone. I said as much out loud and my poor midwife friend was trying to follow my wishes and not tell me what to do so she started asking leading questions "So what do you feel?" "So what would you suggest if you had a client who needed a baby head to get over the pubic bone?" - Not sure if this is when I first started crying but I remember through tears saying "Probably get into a deep squat" - So I tried that, supported by my husband and tried to give an actual real push, see if I could move this baby down. Not sure how many I tried, but it wasn't working. I think that's maybe when I had my first bout of discouragement, which eventually led me to wanting my midwife friend to check me for dilation for real. I *think* this was around 11am on Wednesday. So we went upstairs and she checked me and I was 7cm - classic first time mom. Feeling like she had to push at 7 centimeters. So, ok, as a midwife, i've seen this a million times before, so luckily it didn't discourage me. I knew this was a hurdle plenty of women get over, so I managed to rally - but this time I was done doing it on my own. I told my friend I wanted her to midwife me, tell me what to do, I told my sister in law and my husband and my mom and my friend that I was ready for all hands on deck! If I was going to do this I was going to need a lot of constant support and encouragement! - and then I took a nap? Maybe? Maybe it was before the check, maybe it was after, but I know there was some more sleeping between contractions on the bed and that I tried to breathe through a few but finally I was finding myself having to get up on my hands and knees for the contractions then would lay back down and sleep in between. Maybe a 30 minute nap or so I got. I was reaching exhaustion by then as the last real night of sleep I had had was saturday night. Ayayay.
So anyway, I rallied, and my support team was amazing. We turned on Motown and everybody was swaying and rocking and moaning with me and telling me I was doing a great job. I also used my "phone-a-friend" and had a great pep talk from a good friend of mine who had been through a long hard labor herself and she encouraged me and told me all my friends were wishing me the best, and they knew I could do it! And at that point I was looking around the room at the birth affirmation flags and banners I had in the living room. "Dig Deep" they said, "You Got This!" "You ARE doing it"... I had my women behind me, I was renewed, I was ready. SoI labored some more. We tried to keep it new. Change is good. I did three contractions standing, three contractions on the toilet, three contractions in a lunge, three contractions on the birth ball, three contractions squatting.... then three contractions laying down on the couch on my back - this was around 2pm (again, I think) and sometime during my couch laying, I had a CRAZY muscle spasm on my left side/back. The pain was so intense that it made me vomit. Violently. Then I kept going. Meanwhile, I'm continuing to GUSH fluid with every contraction. This was happening throughout the whole labor. At first I thought I was peeing a ton - I had been eating and staying well-hydrated the whole time, but this would've been a crazy amount of pee. At one point my midwife friend said, "that's not pee, it's coming out of your vagina." Haha. Anyway, It was totally getting in my head and once we ran out of "sexy diapers," there had to be chux pads everywhere I went. So the leaking continued, and so did the intense side pain accompanied by violent vomiting.
Around 6pm I decided I was ready to be checked again, and this time my midwife friend decided to give me a more thorough exam to gain more information. And this time she discovered that I was still 7cm (womp womp womp) and that my baby's head was asynclitic meaning he was coming down with his head tilted towards his shoulder and developing a caput on the right side of his head which was coming down first. Not a total shock to me because my midwife brain knew the fluid leaking meant that there wasn't a baby with it's head well applied to the cervix, but still disappointing after all my hard work.
At that point we had to make a decision. I think what my body really needed was a nap, but the muscle spasm/vomiting that was continuing to happen was going to make that impossible, so the next course of action was to try to get my contractions ramped up and try ALL THE THINGS to get this baby into the right position to descend. The muscle spasms had really threw a wrench in things and I think was causing a fight of hormones in my body. The oxytocin was having a hard time kicking in because of the adrenaline and cortisol from the side pain, plus my energy was dwindling because I was no longer keeping food and drink in my system. But we tried - we started the herbs and the homeopathy to try to change my frown upside down and to kick things into gear, then we tried all the things to get an asynclitic baby into the right position, and still I gushed fluid with every contraction, and still I vomited violently with every muscle spasm.
Finally, I couldn't do it anymore. We called our backup doctor/hospital midwife practice and let them know I was coming in. I believe we left my house around 11pm. We didn't have a hospital bag packed, the carseat was still in the box, the house was a disaster but we managed to make our way. By the time we left for the hospital, they said that the right side of my back looked normal but the left side of my back was swollen to the point of standing half an inch taller than the right side. Yikes.
Anyone who knows me knows that I don't think hospitals are any place to be having a baby. I think they've truly got it all wrong the way they treat labor and delivery and the way they treat babies at birth is nothing less than abuse. So needless to say I was going in ready for a fight. I knew my doctor and midwife would support me, but I wasn't so sure about the nurses and the "hospital protocol's." But what I did know is that my body is my body and my baby is my baby and I was the one who could make decisions about what happened to us, how and when. I just wasn't sure about the pushback I'd receive.
We arrived at the hospital and wouldn't you know, I had the most delightful nurse there ever was. Praise the Lord. I told her right away I wanted the epidural and she said she had already notified him and she was ready to start my IV and get that running so we'd be ready for him ASAP. Then we went through my paperwork and I LITERALLY DECLINED EVERYTHING. Except for the IV and the epidural and a mega slow pitocin drip. My contractions had to pick up, and my body needed help to do that, but I was in no rush as long as my baby was ok. I was so exhausted and felt like I was in no position to meet my baby until I had had a nap.
And then my worst memory of the whole experience happened. I was hooked up to the IV. Her first attempt was on the wrist of my right hand, too low so that it was painful for me to move my hand at all and impossible to grip anything. I also had the monitors on me and the blood pressure cuff and I was laying in the hospital bed when another muscle spasm happened, I knew I had to throw up and my husband and friend were looking for emesis bags but couldn't find any, so they pulled the gross hospital trashcan over to the side of the bed. My hand hurt so bad that I couldn't grip anything so they were having to hold me over the side of the bed while my body convulsed for minutes throwing up nothing but stomach bile. I remember thinking to myself "what the hell is happening to me?!? Why is this happening to me?!?" It was so horrible.
But that was the last of that anyway. The nurse came back and switched my IV placement. The anesthesiologist came in with the epidural, which he had to administer twice (of course) but was able to make it take away the pain in my side. I think that was around 2am. The epidural was absolutely no miracle drug that I'd heard of though. My support team came back in the room hoping I'd finally have some relief and when they said "how are you?" I said "i'm miserable. this sucks, my legs are tingling, my body is itching, I can't get comfortable to sleep, i'm hooked up to this, that and the other thing..." It was still horrible. Just in a totally different way. I still have no idea why anyone would CHOOSE to have a baby there. The lights, the beeping, the people, the discomfort. It's horrible. Even in the best of circumstances with the best nurse ever, it's still horrible.
At that point everyone except Andrew left. Went home to sleep and leave us to sleep. I was too exhausted to sleep, I was too uncomfortable to sleep. I was so out of my mind from exhaustion, and my nurse was so patient with me. I must've called her in a hundred times to help me with my pillows or some other discomfort I was either having or imagining I was having, and when I would ask her for something I was acutely aware that I wasn't making sense or making myself clear because I was so tired. But she helped me the best she could. I think I finally fell asleep around 3:15 and woke up around 5am. Then my dead right leg fell off the table. Ugh. What a nightmare. Around then Kay, the midwife, came into the room basically to say goodbye. She had delivered another baby and was going to go nap and then go home when she got off shift at 7. I asked her midwife to midwife if she thought it was a good idea to check me. Because my waters had been broken for so long I wanted to avoid multiple vaginal exams but I also didn't want the pitocin to make him just pushing down crooked on a cervix making it more and more swollen. I asked if she thought she should check me or if i should just wait to be checked until I was feeling pressure and she said wait, so that's what I did.
I must have slept again a little bit. At some point my nurse catheterized me, just a straight cath (which on the itemized bill cost something like $400!) instead of a foley with the epidural. And around 6:45 I started feeling PRESSURE. This time it was real pressure, not like the first time mom 7cm, I need to poop pressure I was feeling before. Also, I think my epidural was starting to wear off because it didn't just feel like pressure, it felt like painful pressure! So I called my nurse on the phone to let her know. Then I looked at the clock. "Yup!" I thought, "of COURSE you would decide you're ready to do this at freaking shift change!" Oh geez. But then my nurse came in with the new nurse, who if you could believe it might have been even more delightful than my first nurse. Just after 7, the midwife Kay walked back into the room. She told me they called her when she was almost out to her car, but she came back and decided to stay for my baby. She checked me and said "well, there's a baby head right there."
I told Andrew, "call my mom! I think i'm getting ready to push a baby out!" So he did. Then Kay said, "well, we can either start pushing or you can labor down for awhile." I think I noticed the epidural was wearing off even more because I tearfully said "I should probably labor down for awhile?" and Kay shook her head yes. But the next contraction came, and I pushed. So I was pushing. I quickly said to Kay, "we want to do delayed cord clamping." "ok great," she said. "At least 10 minutes." "ok, great." "And I want you to let him restitute on his own." "ok, got it." "And I want Andrew to announce the sex of the baby." "ok, great." I got all that out of the way before the next contraction. "Can I push on my side?" I asked. "Of course" So I rolled over. That wasn't working for me so I asked if I could get on my hands and knees. That wasn't working for me either, so back to my side. At this point I was getting a little out of control. And I was feeling it. I kept yelling at Andrew to pull tighter on the rope. He said he didn't want to pull me off the bed, haha. That wasn't working for me either, so back to my side. I kept saying "this is SO hard!" "This is SOOOO HARD!!!" I was pushing for awhile when I finally asked Kay/yelled at her "Is his head past the pubic bone??" "not yet" she said, then I said "I JUST want his head to be PAST THE PUBIC BONE!" (hahaha, i was acting crazy, haha) so she suggested I get on my back. Then Andrew and the nurse were holding my legs (Me- "I don't want to have to support my legs AT ALL!!!" "Rub my calves!!" "Rub my feet!!" - yelling at everybody, ayayay. and still more "THIS IS SO HARD!!!!!") and Kay was holding the tug-of war rope. I kept asking Andrew if he could see his head and Andrew at one point said "Yeah, I can, it's like a train coming through a tunnel" - which meant the head was still inside! UGH! I wanted him out! I pushed some more. Finally Andrew gave me a thumbs up and pointed at the babies head and said "I can see his head, it's staying out!" and I said "I KNoooooow!" because I could feel that ring of fire. A few minutes before that I had said out loud "My mom and my friend are on the way, if they show up, let them in." But once I started crowning I changed my mind - "DON'T LET ANYONE IN!" I yelled. I could have NO distractions at this point. Nothing could take my mind off of the job at hand. With a few more final pushes, out he came. Meconium and all.
"It's a boy!" And he was screaming when he was only halfway out. I did it. It was SO HARD. But we did it. And that was that. 80 hours after my water broke. 55 hours after my first contraction. 34 hours after active labor kicked in. My mom and my midwife friend walked in only a few minutes after he was born. "It literally JUST happened" I said to them. I didn't have that "high" feeling people talk about or the "love at first sight" feeling. I think because I was SO exhausted. But my friend said there was definitely an oxytocin rush happening because I felt SO grateful for all the help I had received. It was like Oprah's "You get a car!" moment - I just kept telling everyone how wonderful they were and how thankful I was and appreciative of their help. So I guess the oxytocin was flowing. Hard to believe that I didn't love him so much then, because it's been two weeks and I love him so much now. But I remember distinctly all the mornings I would wake up and moments I looked at him in those first few days where I could actually feel my love growing more and more. What a crazy thing. We made this guy, and he came out of me. And he's perfect. So wild.
He went straight to my chest when he was born. He did the breast crawl and latched on himself. My placenta was born without cord traction and left attached until it was done pulsing. He stayed there on me for the next four hours. They honored my wishes and no one took him away or barely even touched him. We didn't even know how much he weighed until we got home and weighed him with my own baby scale! I passed him off to Andrew for some skin to skin while the nurse helped me to the bathroom for that first after baby pee. We had such a nice conversation in the bathroom about how she'd only been working there for a few months, and she had had no idea that women could have so many options. She had been a teen mom and her experience was so opposite of so many women she was seeing have such empowered births. She was excited to do it again next time with all she knew now. How cool. Then I was discharged. We had to sign our baby out AMA (against medical advice) after a talking to from the pediatrician nurse. But honestly no one gave us much trouble. We got dressed and they wheeled me down to the car less than 5 hours after he was born. And then we were at home in our bed. As if it'd never happened. What a dream.
Because I know people will ask. I've already said that I feel like being a midwife made me a terrible pregnant lady. A worrier. But I think being a midwife did prepare me for labor in some ways. For one thing, seeing as many births as i've seen set me up to have zero expectations for how the whole thing was going to go. Being a person who in my regular life is RULED by my expectations (read: fake realities I create in my head for the future), it was quite the gift going into it feeling like nothing could happen that would make me feel disappointed. Even with all this craziness, I just went with the flow, because it was what it was. I also felt aware as it was the labor was happening that these were the feelings I expected when the contractions started and even when I was pushing him out. It's Hard. But I knew it would be hard. I've seen women do it a million times and it looks like hard work. But it's such awesome work. Women are so awesome. Both the birthers and the supporters. There were more tears in this story then I let on. I lost it more than once, but I felt SO supported through this whole thing. And it made me feel like a great midwife. Because I know I support women that well. And they need it. But if this has taught me anything, it's that we have to support each other more. Not just through the birth, but afterwards too. We've got to be in it together. The whole shebang of motherhood. It feels good to finally be part of the club.
As I was preparing my talk for the MANA conference in 2016, I was inspired by the story of midwifery development at The Farm in Tennessee.