“I’m not going to have pain meds when I give birth!” I said.
“Sure you’re not, you just wait,” they said as they laughed and proceeded to tell me their horror story of childbirth. Everyone wanted to tell me what I was going to do, to need, to want, and inevitably have. Those who know me understand that when my mind is set on something, little will sway it. If you want to tell me something is inevitable, you have just challenged me. I did not want pain meds, period.
As I started to think about the process of giving birth, I could not get over the idea of having a nurse there, a stranger, checking on me constantly. Why should I trust this nurse, because of her job title? What if we don’t get along? Will I be able to stand my ground if a situation arises during my labor?
So I bought a book which asked me to draw a picture of what I thought my birth experience would be. I drew, yes with crayons, what I expected my hospital birth to look like. I was both amazed and appalled. Aside from poor drawing skills, I realized that a hospital birth to me would feel like a conveyor belt of women, bound up in bed, giving birth with beeping and monitors overpowering the rooms. That was NOT my idea of how I wanted to bring our first child into the world.
***
“Steve, get that contraction timer app ready. I think we should start counting these,” I said to my husband. We had gone hiking at Lapham Peak State Park early in the day to help things along. Contractions were coming three minutes apart consistently, and lasting on average a minute. But they didn’t hurt. Aren’t they supposed to hurt at this point? We called Jan who recommended that I try to lie down for half an hour, and even drink a wee bit of wine to slow them down. If it’s not really labor, they should stop. A tiny glass of wine and 30 minutes later, contractions were still coming. After we called her back, she decided to drive out to see us. My husband and I were excited! I was most excited that I had started labor and the contractions didn’t even hurt, could it be, was I lucky enough to have a less painful labor than typically expected?
The minute Jan walked through the door; the contractions came to a halt. I’ll admit, I stopped counting them once I knew she was driving out. I had just a few sporadically while she was at our home. She checked me, and I was only 2 cm dilated, the same dilation as our last appointment. How disappointing! Looking back, I’m sure she did not actually think I was in labor, but I certainly did not sense any frustration from her. She drove all the way from Kewaskum to Brookfield, just to check on us, around midnight, no less! She never once gave me the impression of being annoyed or irritated. In fact, I was relieved to have her here, even though I was just having Braxton Hicks contractions. She left later that night, once we all knew labor was not in the cards.
***
The due date came and went with no signs of any progression. We saw Jan again for another appointment at 40 weeks and 2 days. I was only 2.5 cm dilated. Really?! It was a whole week of infrequent contractions, and they only did half a centimeter of dilation? Sigh. Work had already taken me off the schedule. I was glad for the freedom, but felt like I was wasting time, just waiting and hoping to go into labor. Our due date had been pushed back from July 19th to the 28th around week 18, and now she couldn’t even come out by her due date. I didn’t realize at the time, but I was far more stressed about going into labor than I thought. Jan asked me during that visit if there was any stress I might be holding onto. Though I like to present myself as a very confident, strong-willed individual, I just started to cry. I didn’t know why, but crying really did help. From that visit up until I gave birth, I think I cried every day. Some days I cried more than others, but I must have had so much tension built up and not even known it.
***
A few days later, we had another appointment with Jan. I could finally share a change: I was starting to see some blood tinged discharge. (Not to be graphic, but at this point in your pregnancy, that’s pretty exciting!) She did an internal exam and told me I was dilated a little more than 3cm. Although I wish I had made more progress, I was content to at least to be moving in the right direction. Later that day, again, I began having some pretty regular, stronger contractions. I started getting excited, but just as the last time, they subsided. Jan was so wonderful though, she came out again that night and stayed overnight. I woke up once that night from a pretty intense contraction (or so I thought at the time). But once morning came, I had not dilated anymore. Jan checked the baby’s position, and I was instructed to work on bringing her anterior rather than posterior. All those contractions were doing nothing since the head was in the wrong position on the cervix. This information gave me some consolation, but more importantly a task. I was getting a bit discouraged up to this point, and very nervous for the potential visit to my back up doctor for a non-stress test soon. So the next few days I worked diligently on exercises to help the baby flip around so she would be in an anterior position (her back up against my belly button, not against my back).
***
We might as well go to the State Fair, I thought. Thursday August 5th, we joined a couple hundred people on the opening day of State Fair. There was a lot of walking, and I was fortunate enough to know where the less frequented bathrooms hide. After a few solid hours of exploration, and a cream puff of course, we returned home. I was able to see my massage therapist for a 30 minute massage where she focused on labor inducing points. While out and about, we bought some castor oil too. Jan had said earlier in the week that if by Sunday our daughter was still not born, I could try drinking some castor oil to help induce labor. My non-stress test was Friday morning, and I knew that they would want to schedule an induction date. I was really anxious to have the test done. The test itself did not concern me, it would be the emotional stress of having to talk with a different Dr than the one I was working with throughout the pregnancy. It is hard enough to find doctor’s that will work with a midwife. I was going to have to discuss the non-stress test result and possible induction with a complete stranger, who may not be as comfortable working with a midwife. I made up my mind. Sunday was just a few days off, what harm could it do? I mixed the 4 ounces of castor oil with apple juice and some baking soda. As it fizzed up, I gulped down as much as I could. (I recommend mixing it with a far stronger beverage than apple juice – the after taste was awful!) To be honest, I didn’t finish it, but I gave it a great effort and was proud enough that I kept it down. I think I ultimately drank 3.5 ounces of the 4 original ounces. I couldn’t stomach one more sip. If it was going to work, a half an ounce wasn’t going to make or break the deal. I drank that around 9pm on Thursday. (Hindsight, I should have woken up early the next day and drank it after a goodnight sleep. Can you tell, I really did not want to have to go to the non-stress test?) Around 11pm Thursday night, I had the unpleasant side effect of the castor oil, while having some intense contractions. Earlier Jan had told us not to focus on timing the contractions, but to concentrate on the intensity. I tried lying down a little in bed, but found that really uncomfortable. I made a bed up on the couch and called Jan. She told me to try and get some rest and call her when they reached the next level of intensity. I felt bad for calling her so late again (each time I called Jan, I woke her up), but she never made me feel as though I was an inconvenience. I was able to lie down for a little while, dozing in and out of sleep. At 3am, early Friday morning, I work up on the couch from an intense contraction. So this is what she meant by real contractions. All the other contractions earlier in the week were simply Braxton-Hicks contractions. I woke up my husband and asked him to call Jan. Meanwhile, I used the bathroom countertop to hold my upper body as I swayed my hips back and forth. I focused on breathing slowly and deeply during these contractions.
Steve started filling the birth tub; by the time Jan arrived (4:20am), the tub was full. Apparently our water heater is a superstar, the temperature in the tub was 112 degrees; optimally, the temperature is kept around 100. Steve and Jan had to drain water out and run cold water into the tub, however, the temperature had not dropped enough. Any ice from our freezer melted instantly, while our ice packs bobbed in the scalding water until the temperature finally decreased. Meanwhile, I worked through the contractions in the bathroom working with my hips swaying side to side while in a squatting position. When Jan and Steve told me I could get into the tub, I was really excited (4:50). Instant relief! I was able to float in any position during a contraction, and the heat of the water felt so good. I found that during the contractions I would place my hands on the pool bottom, while the rest of my body floated in a frog-like position.
I never asked about the time or what stage in which I was. I focused on my breathing/moaning during each contraction. I remember Jan telling me to think of the image of my cervix opening, which seemed to help. It gave my mind a way to stay motivated, focused and visually busy. I remember needing to get out of the tub a lot to urinate. I’d have help out of the tub right after a contraction, get to the bathroom between contractions, urinate, have a contraction on the toilet, and have a few contractions swaying back and forth in the bathroom while doing squats, and then return to the tub. I never liked leaving the tub, but I did enjoy the change of position for a few contractions. Not that one can enjoy a contraction, but contracting in the tub and while squatting were the two best positions for me. Another plus for leaving the tub, once I reentered the tub, the water felt warmer again. (Jan, Steve, and Pam would drain some of the colder water out and fill it with fresh hot water. The heater was not working on this particular birthing tub. It wasn’t really a problem, at least not for me, since everyone really helped to keep the temperature up – and it was August.)
I have always participated in endurance sports, cross country running, cross country skiing, endurance mountain bike racing, and playing soccer. I took the same approach to labor as I did with these sports. I learned from mountain biking not to look at the top of the hill, but just the path directly in front of you. This way of concentrating helped me not to wear out emotionally. I never thought to myself, When will this end? How much longer? I just want this baby out! Ultimately, I knew she would come when it was time, I was already in labor, it was happening. I was also sipping on the sports drink, Cito-max, which is what I used while mountain bike racing. I think drinking it helped my body associate with an endurance event.
Since I never knew what time it was, I didn’t realize how long I was not progressing. I was told to try and rest on the couch for a little while, so as to regain some strength. I don’t know how I did it, but I fell asleep while still having contractions. I remembering waking up to the most painful contractions (I hated the contractions while lying on the couch). Jan informed me that the baby was not in the proper position. We tried to rotate the baby a few different ways. I stood in the hands and knees position on the floor, while tilting my pelvis. I tried lying with my bottom up in the air, while my head was on the floor.
We then tried to rotate her and help with my back pain by a new position. During a contraction, I would lean back (straddled) onto Jan’s leg, in a resting back position, with my back against her, while she lifted my belly up during a contraction. It took the back labor pain away, but I really wasn’t a fan of the pain in the front of my belly. I don’t remember how many contractions we did this, but I was looking forward to when I could get back into the tub.
According to my labor notes, I was at 7-8cm dilated from 11:30am until 3:30pm when Jan decided to break my water. I was so proud that my water was still intact to that point; I was making sure to eat a lot of protein towards the end of the pregnancy. I was disappointed as I saw meconium-stained fluid drop to the floor, but really, what did I expect? I was laboring a week and 3 days past my due date. Once my water broke, I began progressing again.
I returned to the tub. During the contractions, I began to have involuntary urges to push. Jan told me not to push with them yet (I wasn’t fully dilated). Truthfully, she didn’t have to tell me, it hurt far too much to push with them anyway. But as labor progressed, my cervix was stretching (9cm at 5:00pm), and the pushing urges became more intense. I remember my husband next to the tub stroking my hand. Later he told me he didn’t know what to do for me; that was all he could think of to help at those moments. I only let him touch me after the contractions finished. I needed all my concentration to get through each contraction; someone touching me during a contraction would definitely not have helped. Finally, at 5:20pm, I reached the second stage of labor.
Soon the pushing urges became so intense that I was involuntarily pushing two-three times each contraction. At this point, I remember Jan kneeling by the tub telling me that if I wanted to birth in the tub, I’d have to empty my bladder there. I can do that! How many times as you grow up do people tell you “Don’t pee in the pool?” The tub was warm, I wasn’t embarrassed, and believe me I tried. But for whatever reason, I could not pee. So I asked to go to the bathroom. I couldn’t even pee in the toilet! But I wasn’t going anywhere once I sat on the toilet. Jan told me that she had caught quite a few babies in the bathroom. It felt as good of place as any; we all know how to push while sitting on the toilet. With each contraction, I was now pushing with all my might. If there was a breaking point for me, it was now. I didn’t tell anyone, or say anything, but there in the bathroom, pushing on the toilet, I felt like enough was enough. I then tried a new position, facing the back of the toilet. That just didn’t work at all. Then I tried one leg up on the toilet seat. Nope. Then I went back to my trusty squatting position, still in the bathroom. Jan and Pam were constantly checking the baby’s heart rate with each contraction. The baby’s heart rate was slowing down during the contractions while I was in these upright positions, so Jan asked me to move to the couch.
I had no idea at what point I was in the pushing stage. It felt like her head was hanging out, and I’m sure as I walked to the couch, my gait exposed those sensations. It wasn’t, of course. At this point, I had been pushing about 50 minutes. Once I reached the couch, I tried lying on my right side. Our baby’s heart rate didn’t tolerate that after a few contractions. So I tried the hands and knees position on the couch. That didn’t work either. Then I switched to lie on my left side. Again, the baby’s heart rate was still having decels during contractions. (By the way, I hated having to lie down during a contraction. I felt the best when I could move during them.) Ultimately, I had to lie on my back with my aunt and husband holding my legs up, as I pushed. I wasn’t paying attention to what people were saying at this point. But I did focus my attention when Jan said, “Tracy look!” At that moment, I had just pushed my daughter’s head out, and she was facing me! No wonder my labor lasted so long, she came out sunny-side up! My husband was crying with joy and I was so happy to finally have this little girl in my arms. I expected to cry, but never did. I was so focused on getting her to latch on to nurse. Actually, Jan was doing most of it, I was enjoying having her on my chest.
Although I didn’t plan on having back labor, and originally I wanted a water birth, everything turned out great. Jan and Pam gave me enough distance when I needed it, and yet were also there when requested. It was a good thing I never asked what stage I was in. It turned out that I was in transition for five hours. If I had known that at the time, I would have been so discouraged. Thank you guys for keeping me in the dark on that one!
Emryn Elizabeth Peters, at 1840, weighing 6 lbs 12oz, and measuring 20 inches was born on August 6th, 2010, intentionally, at home!