Thursday, July 3, 2014

Baby E arrives!

Baby E is fed and sleeping so this is my moment to write his birth story! He’s in his newly-set-up rocker, with a gorgeous hand-knit blanket that just arrived from my sister D, and if he wakes I’m going to try gently rocking him with my toe while I keep writing, as I read that Louis Erdrich does–she says it’s pretty easy to have a newborn as a writer. We shall see…
Eight days have now passed since the birth and I want to get this down asap–we’ll think of it as the stream-of-consciousness Blog Edition, and I will refine and perfect it later for Baby E’s consumption later in life.
So, let’s begin where I left off–last Saturday, when we were preparing to check in to UCSF. All homey methods of labor induction (acupuncture, walking, spicy food, castor oil) seemed to have no effect–I had no signs of labor at all. The delay in our check-in time to the hospital from 8am to noon to 8pm helped me make the transition mentally to preparing for this new scenario in the hospital. I felt oddly calm, and focused on the benefits of being in the hospital–sometimes all that monitoring and state-of-the-art medicine can come in handy.
I had spoken with my midwife the night before and she walked me through what to expect with induced labor. I would go through a first step of medication (Misoprostyl or Cervidyl) to soften and prepare my cervix. This would take 12-24 hours. Once ready, they would start the Pitocin.
So, we were glad to start in the evening because we could knock out those first 12 hours while sleeping. Still, we packed books and Scrabble and all of our electronics thinking we’d get off to a slow start.
We were admitted at 8pm. It was much calmer on a Saturday night than during a weekday when I had been there for non-stress tests. We were shown to our room which had a partial view of the city at dusk.
I filled out a bunch of paperwork, including papers for the baby on which I was the signatory “parent” (gasp!), and decided to start with Cervidyl, which they described as like a tampon they would stick in and then wait. OK. They checked me at this point and I was less than 1 centimeter dilated, just the width of a fingertip. I called Em, my midwife, and she said to get some rest–we had a lot of work to do the next day.
(E’s eyes just opened but he looks pretty happy. Trying the Louise Erdrich toe-rocking method. Easy.)
I felt some cramping as I went to sleep, and proceeded to get up probably once an hour to use the bathroom. My mom slept soundly on the pull-out chair/cot. The clock on the wall proceeded onward. Everything was quiet.
At 5am, (uh oh–red-faced crying baby…one diaper change later and he is now on the boob. This is a little awkward but doable, Louise.) I was uncomfortable enough that I could no longer stay in bed, although I was hesitant to say what was happening since I’d been maybe feeling contraction-ish twinges for like two weeks and nothing ever turned out to be anything. Soon, though, the nurse came back in and said, “It looks like you’re having some contractions.”
In fact, she determined that I was going into labor without Pitocin. Huge victory at this point–of course, my fear was that Pitocin-induced contractions would be way too strong and start the inevitable spiral of hospital interventions…  and I seemingly had kicked off labor without it.
I texted my doula and she said she was on her way. We were moved into Labor Room 5, a huge corner room facing the entire skyline, East Bay, and the trees of Mt. Sutro. One of the last things I did before things really got going was to take this picture of the sunrise and text it to my sister D in Chicago:
labor room 5

We set up the birth shrine, covered the TV with a sheet. My doula arrived at 6:45am with soup to put in the refrigerator, a sitz bath tea, and a necklace for me that she got 15 years ago in Benin. She told me to set my intention on the necklace (“healthy mom and baby”). I feel like I was in ‘serious’ labor pretty quickly, although throughout the day was confused about the definitions of “early” and “active” labor (and active labor turned out to be much later)–very soon I stationed myself on a birth ball and was vocalizing through contractions.
My dad and sister showed up for a bit, which was nice. By the time they left, I was entering the naked phase which lasted the whole rest of the birth process–the only thing I wore was this halter top of rough fabric that held two circular monitors, one for the baby’s heartbeat and one for contractions. It was the nurses’ primary obsession to keep these circles in place, through many baths and position changes and moving around the room, which annoyed me, but also reassured me that we knew all was well with the baby. (Baby is now back in the rocker and I’m rocking it with my toe again. He’s moving his arms around–and his eyes are open. This writing may not last long as my mom is on a walk…)
Those early hours of labor are a blur…I think it was pretty doable, but felt like real work. I was being told all day that I was progressing steadily so I just progressed steadily. We did the birth ball, hands and knees, child’s pose, the bath. (Just did the 5 S’s of the Happiest Baby on the Block and now he’s swaddled and sleeping again. Man, I picked his fussier time of day to write but I’ll keep going.)
It’s hard to say how I “felt” through these hours–I was just “in it.” I was very present and my body felt strong. It felt intense from the beginning, although you never know how much more intense it’s going to get. They asked me if I wanted to be checked but said they didn’t feel it was necessary since my contractions were obviously progressing, and I said no thanks.
Coincidentally, my good friend M had gone into labor at the same time, and because she had also engaged the services of both my midwife AND doula, it was quickly determined that since I was already in the hospital and she’d be starting at home, she’d get the midwife and I’d keep the doula. Since I was already in labor when I heard this, I just accepted it and moved on–I was so happy to have my doula and my mom and the kind nurses. I knew M needed Em.
In other coincidences, my doula had a THIRD client go into labor and check into the room next to mine. Because this client was 22 years old, she was in and out in like 5 hours, so this was hardly a blip on my screen–my doula left for 30 mins for the birth and then she was back. Around 5pm, my doula’s backup came by, and when she came in the room, I noticed that I was able to have a whole cheerful conversation with her. Which I wouldn’t have been able to do in any of the previous hours. Which seemed not good.
I’d been throwing up multiple times and they had finally given me fluids and anti-nausea medication–I kept saying I felt so much better and chalked it up to that. But it wasn’t that.
It was clear things were slowing down as we approached 12 hours. My doula suggested we dance to move around and get things flowing again. I suggested the song “Happy,” knowing that this song should totally piss me off in labor–yet, there I was dancing through the whole song and not having any contractions. And it wasn’t pissing me off.
A doctor came in the room to say that my contractions were slowing down and we should talk about “augmentation.” Oh god, I thought, here we go. I had thought I was out of the woods and nope. I asked to call my midwife and had a whole phone call with her without contractions. She said I could go one of two ways–if I felt my body needed to rest, I could take a break, rest, see if my labor started back up on its own. I’d need strength for the pushing phase. On the other hand, I was already 12 hours in and in the hospital; if I felt strong enough, I could use a tool the hospital offered: Pitocin. They’d start me off super gradually and maybe I could just pick up where I left off and keep going. I wouldn’t lose any of the progress I’d made. They checked me and I told them I didn’t want to know how many centimeters. I now know that I was 4 cm and 70% effaced at 6:35pm. I had asked the doctor to consult with my doula and my doula would ‘translate.’ I didn’t want to feel the discouragement of the number after so many hours of hard work. Ultimately, the doctor wasn’t happy about not consulting directly with the patient, and my doula didn’t like having information that I didn’t have. (After that, I let them tell me the number.)
I told Em on the phone that while I did feel sleepy, my body felt strong. I wanted to keep going. They started the Pitocin. And, sure enough, within an hour, my contractions were back to what they were and the show was back on the road. (Baby E is gumming his swaddle and making complainy noises. He started crying and his Mimi picked him up and took him into the other room.)
Then we started the long night of gradual gradual progress–by 10:40pm I was 5 cm and 80% effaced. I asked to be catheterized because I’d been drinking all day and could never pee–they first said no, you’re just dehydrated. But I insisted and they got 1.5 LITERS of urine! And I had to be catheterized a few more times through the night.
To try to get things going faster, they turned up my Pitocin a bit and broke my bag of waters with what looked like a crochet hook. It made me a little sad that it didn’t break on its own but I quickly moved on–a small sacrifice.
I kept going and kept going, the contractions getting really intense. The best way to get a mini-break was to get in the warm bath, so I did that many times. My doula was so present, her big blue eyes right there when I looked up. She helped me dive under the waves, connect with my baby, told me over and over that I can do this. My mom was a total rock, even as my suffering intensified. (Right now she is dancing the cha-cha with Baby E.)
Nearly 4 hours after that, I was checked again at 2:20am: I was 7cm and 80% effaced. Such slow progress! Ugh ugh ugh! Starting to get really really frustrated! Starting to think I couldn’t do it. Starting to seriously doubt myself and the whole natural childbirth plan. I started to become desperate. I was so tired. My UCSF midwife, the one I saw for maybe two prenatal visits, happened to be working that night and she became another important rock in the room, total strength. I wanted to get back in the bath, my only respite. She mentioned on the way in that the bath won’t slow down “active labor.” Oh, so I’m finally in “active” labor at this point, I thought, as we approach the 24 hour mark.
Sure enough, the bath felt good but did not lessen the contractions. She sat on the bathroom floor beside me as I alternated between comatose sleeping and big, hard, anguished contractions. I started to say I didn’t think I could do this. She said, “You can totally do this. You ARE doing this.”
I got out of the tub and, in my memory, I crawled back into the room. I think in reality I walked in but ended up on my hands and knees somehow, and I felt so desperate. I was saying I can’t do this, that I was frantic, that I just wanted the epidural. My audience wasn’t really going to budge on that one–they looked at me blankly for a moment, then with compassion, then said again, “You can do this.” I was furious. But I kept somehow, somehow, kept going, one contraction at a time.
The midwife said, well we do have this drug called Fentanyl that can take the edge off, it lasts about an hour to an hour and half. And I said YES, bring me that, thinking OK good, maybe this is all I needed. They brought it in, hooked it up to my IV, and I felt lightheaded for a second, then the next contraction hit. It honestly didn’t take the edge off, at all. Still, lightheadedness was something… And I kept going. By 5:20am I had progressed to “almost 8.” (Yes, that’s right–between 2:20 and 5:20am I progressed from 7 to “almost 8.”)
At this point, I just felt beaten. Em says that this is when I surrendered. I told my mom and my doula to go ahead and get some sleep–there was nothing more they could do for me. They were utterly exhausted. I got in a side-lying position on the bed, the only position I could manage, and the Fentanyl allowed me to sleep for two minutes at a time between contractions. For this, I thank that drug, because although it didn’t make it less painful, I think my body could regenerate just enough. There were almost no thoughts. No more visualizations, no more mantras, no more words or ideas. I couldn’t think of myself or the baby. The only thought I remember having was to call the nurse and ask her to bring me the nitrous oxide setup and specifically not to wake my mom or my doula–it would be our secret! But somehow I didn’t hit that call button.
That last hour was the purest, most intense physical experience of my life. Just huge waves that completely obliterated me, punctuated by sleep. And, at around 6:30am, just as the second sunrise broke across the city, I had the blessed urge to push. “Mom! I have the urge to push!” She had the nurse on the line 4 seconds later, the nurse had the doctor in 4 seconds after that, I was checked, and I was 10 cm–complete!!! Oh, hallelujah! Let’s DO THIS!!!
Everything changed–I was giddy. My doula had gone to the cafeteria and I texted her: “Ready to push come back!” I also texted Em and she was able to come. Doctors and nurses and midwives were assembling in the room and I was getting a primer on how to push–my doula said, “It’s going to feel like you’re pushing a giant boulder out of your butt.” (It totally did.) Gather all the energy of the contraction at the beginning, and, when you’re ready, give it everything you’ve got.
I ended up on my back on the bed, holding my knees in the air, and the sun streamed in, and this incredible team of birth goddesses made a U around the end of the bed–my doula, my mom, a medical student named Kacy who held up my iPad like a mirror so I could watch, a new midwife, the OB who would catch the baby, awesome/amazing nurses, and Em walked in just in time! I actually said, “this part is going to be fun.”
The mood was like a party–after the dim and dark hours of labor through the night, it felt like a different room. Sunshine and the talents of modern medicine and midwifery and family and love all gathered close.
When my first big contraction came, I gave it all I had–and the team totally freaked out, telling me I was a champion pusher and they could see the head already! What?!?! Yes! It has dark hair! Incredible! Just keep doing what you’re doing!
So I did–I was yelling in that gutteral way you see in movies and just pushing like gangbusters, harnessing the freight train that was rushing through my body, like no other sensation in the world. And the baby moved down, and down, and down. They were all so encouraging and clearly having a blast. And, honestly, so was I.
This was the high point, the whole pushing phase, I was totally empowered and animal and in my body. The head started to crown–they were pouring mineral oil over the top and holding a warm compress to my perineum and cheering like a crowd in a stadium. I could see his head emerging on my iPad and it was so motivating!
At some point, Em said, “K, REACH DOWN AND PULL OUT YOUR BABY!” and I did, and his whole body slipped out of me and he was on my chest and I was hyperventilating and laughing and saying “oh my god” a million times and he cried right away and looked at me with his EYES and grabbed my finger with his HAND and everyone was crying and he was perfect. They were wiping him roughly with towels to get him to pink up and suctioning his mouth and nose and it was a short umbilical cord so I couldn’t get him very high up but I could kiss his head and say, “I’m your mama! You’re here!” and he cried and was adorable and HUGE. He was born at 8:51am on May 19, 2014.
(He is back in the rocker sleeping peaceful now, thanks Mimi. And I’m sitting here crying, reliving his birth.)
We stayed like that for a long time, I have no idea how long, and eventually I cut the cord myself (!) and they took him across the room to do a few things and my mom went with him. I overheard someone say “10 pounds, 2 ounces,” and was completely blown away–none of us EVER thought I had a 10lb baby. In fact, thank goodness none of us knew, especially me. He came out long and strong. All his checks went perfectly and they brought him back to me. My mom went to my dad and sister in the waiting room that it would just be a little longer and they could come in–fortunately they weren’t in the room for what came next.
The docs were acting a little nervous about my placenta. Because he was so big, his placenta was also big. Then they were reassured, “there it is,” and it was born 14 minutes after the baby. And, when it detached it caused a hemorrhage. My doula got in my face with her big blue eyes as the room filled with twice as many doctors and said, “So, there’s an issue with the placenta, it’s totally going to be fine, we have the best team working on this, and you and I are going to just stay right here and focus on the baby.” I stayed calm as they put all kinds of new meds in my IV to get my uterus to clamp down and stop the bleeding, which they did quickly, but not before I lost a lot of blood.
So that was scary but because they resolved it so quickly, and I was on Cloud 1,000,000, it felt more like an addendum to the whole experience. I’m just so grateful that it was quickly resolved and I made a quick recovery.
They cleaned up the room and brought my family in and there were tears and photos and we called my sister D and welcomed our new family member. We ordered food and marveled over this little (not so little) guy who was just impossibly cute for having been born just hours before.
They moved me to a smaller room and my family left and I spent hours just staring at him, the rest of the day slipped away and I barely even slept. He was and is perfect. A dream come true. I am grateful for every moment with this beautiful human as I complete one epic journey and begin an even bigger one.
Welcome, Baby E. (and, on cue, he just woke up.)

(If you are interested in more, please check out Katie's blog at!)

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