It’s only day two postpartum as I write this, and I fear I will forget the details of our daughter’s birth if I wait any longer. It came and went faster than I could keep up with – completely opposite of our first experience!
This entire pregnancy had been fast, too, but I was sure that the birth would be slow like our first – 31 hours, lots of hurdles and complications, the biggest of which was shoulder dystocia (baby got stuck). Those two words haunted me this pregnancy.
We do know some factors that lead to shoulder dystocia: gestational diabetes, super size babies, prolonged labors, poor positioning. Yet, my first born was not considered medically large and I did not have gestational diabetes. I was just one of the rare lucky ones to get it anyways, and because of that history, I was likely to experience obstructed labor again even though she was tracking normal size and I once again did not have gestational diabetes. Basically, I make big babies for my body.
Things that can help prevent it are avoiding the epidural so that I can maintain an active birth. Simply laboring in upright, squatted positions can give baby significantly more room than laboring on my back. Obviously, more room means less chance of getting stuck.
Unfortunately, last time, I wanted nothing to do with an active labor as I ended up getting leg labor, where the pain of contractions brutally shot down my legs. And I stalled at the most painful point after 14 hours unmedicated. So, all I could do was lay down and get all the drugs. Because of this experience, I doubted that I would be able to do an unmedicated birth this time, and I wasn’t even sure I wanted it. Getting that epidural last time was everything, but I knew that I needed to aim for this in order to give baby the safest chance at arriving complication-free.
The other big thing that can help prevent dystocia, kind of, is an induction. The evidence for an induction due to concern of baby’s size is a grey area. The only scientifically true way to prevent obstructed labor is a C-section, which my care team did not recommend. They did recommend the induction, though, despite the wavering pros and cons, at 39 weeks. At first I agreed, then I declined, then I agreed. I was a back-and-forth hot mess about this decision the entire time.
There was no win-win. Inductions can fail. They are usually more painful and long, putting me right back into a similar labor as my first where conditions could actually create the very thing we are trying to avoid. But, denying the induction and waiting too long tipped the risks too, as waiting too long could mean another big baby. They gain about a half pound a week in the third trimester, and since Ivan came at 39 weeks already close to 9 pounds, each week truly mattered. My midwives were open to letting me decide, but they were firm on not going past 40 weeks.
I ended up scheduling it for 39 and 2 days because that’s when Ivan put me into labor, and I grew anxious about facing another difficult delivery. But I was only going to do it if I had a favorable Bishop Score – something so, so important for moms to understand if you are faced with similar interventions. Things like a membrane sweep or induction are not likely to succeed if your cervix is not ready, which can then do more harm than good. My care team was on the same page, so we went in before the scheduled induction and found that, unfortunately, my body was not ready. So we had to wait, at the most until 40 weeks, when another induction was placed on the books.
I woke up on Sunday (39 and 4 days, when Ivan was born) to what felt like menstrual cramps. Just as I was complaining about her taking longer than her brother, she decided to prove me wrong.
I figured the cramps would either stop or take a long time to progress, so I just laid in bed and browsed Amazon. Fifteen minutes passed and the pain was rapidly increasing. I got out of bed and remembered all the advice from last time: once you can no longer sleep through them, get up, eat, and labor at home as long as you can. Don’t go to the hospital unless you’ve had consistent contractions lasting at least one minute, no more than five minutes apart, for at least one hour.
I tried to eat something but felt nauseated. I also had to keep stopping to grip the walls, the couch, the table. So I started tracking them, told Sean to get the dogs covered and finish our hospital bag while I called my doula, midwife, and our friend Sara to pick up Ivan. I could still talk through my contractions, so the plan was for my doula to come over and help me labor at home. No more than 15 minutes after making this plan, I could not talk through the contractions and I was keeled over on the floor of the bathroom. My back was in immense pain. How could I already be having this much pain? Why are they already so close together? If this is what the next 31 hours are going to be like, get me all the drugs now, I thought. So I told Sean to take me to the hospital. I thought I was being a baby, but I didn’t care.
As soon as we drove off, I started puking all over the car. We hit every single red light possible and got stuck behind a slow truck on the 30-minute drive there. I walked myself into labor and delivery still in my nightgown, ignoring offers for a wheelchair. My midwife was there ready to check me. I asked for the laboring tub, expecting to be 4 c.m. like I was the last time when I got to the hospital. I also asked for the epidural.
“You’re 8 c.m. You’re in transition! You will probably have this baby within the next hour, I don’t think you have time for the epidural.”
My doula arrived. We couldn’t believe it. I was a bit in denial, thinking that my labor would stall like last time. I felt so trapped by the pain, knowing that it didn’t make sense to get the epidural this late, or for the best interests of a successful delivery, so I dug really, really, really deep and completely succumbed to my doula and midwife for help. My poor husband had to helplessly watch me in the worst pain of my life. And, boy, I was a screamer. I had back labor this time, but at least I had my legs. I could move. So that’s what I had to do. I had to move.
I labored on all fours, rocking through each contraction, repeatedly telling myself that this will pass, gripping to the words of my doula and midwife reminding me to breathe, that I could do this. They were an absolute dream team. They knew where my pain was without having to say anything, riding each contraction out with me. Giving me counter pressure on my hips, my back, distracting me with cool rags on my neck and warm compresses below. I didn’t get to experience this magic of physical support as much last time, since I was bed-ridden from the drugs. They were my lifeline to staying in the fight.
I was ill prepared for this kind of “fight” the first time around. There was a lot of people who told me fluffy things like don’t fear the pain. Labor pain is progress. The pain is bringing you closer to your baby. While this stuff sounds nice, and maybe it works for other people to hear, it kind of put me in a position to underestimate the pain. I refuse to sugar coat it – sure, the pain is purposeful, but it’s still the kind of pain that breaks you down. It is a scary pain. For me, I need to admit that in order to surrender to it. So once I was able to surrender to it, I could focus entirely on staying mentally above it rather than helplessly trying to physically fight it. Labor pain isn’t something you can physically battle. It will win. It’s all about your mental strength.
I was quickly continuing to dilate to 10 cm. The only thing preventing me from pushing was the fact that my water was not breaking. My midwife broke my water for me, and quickly thereafter, told me I could push. I didn’t believe her. Fast labors are bizarre in that you don’t have time to process what’s happening.
Last time, I pushed for hours, and I couldn’t feel anything. This time, I pushed for maybe 5 minutes, and I could feel everything. The “ring of fire” is a bizarre mix between pain and relief. Your body already wants to push, so in many ways it’s a sweet escape from the pain of dealing with contractions. I could see my husband getting teary-eyed, holding my hand, and I knew she was here. Then they placed her on my chest and I just held her in shock. It was so calm. There was no emergency this time. It was just immediate, uninterrupted bonding between my baby and I. We got to experience it on our terms, with delayed chord clamping, delayed bath, (things which give baby extra immunity and health benefits). It was beautiful, and it all happened in a span of just three hours from start to finish.
I will say the reward of not getting an epidural came immediately after. I was so much more present in those after moments. I was soon exhausted and sore, but I wasn’t swollen, dealing with head aches, or crying about why I couldn’t feel my legs. She came so fast that she had a high heart rate for a little bit after birth, but it quickly settled as her lungs transitioned. Skin-to-skin and immediate breastfeeding helped. She latched like a pro, just like her brother, and she also hates swaddling so far, just like her brother did. She’s about a half pound smaller than he was at birth and one inch shorter, at 7 pounds 14.8 oz, 20 in.
Miss Elowen Grace, born Nov. 26, fast and furious, at 9:48 a.m.