Birth day

Laurel turned one year old on January 8, 2010! I celebrated the weeks leading up to her first birthday with a series of posts about her birth. I meant to post the conclusion of her birth story on her actual birthday, but things were busy. So now, finally, you are reading the second part of Laurel's birth story, which I began in installment number four. (That makes this post installment five of this series; here are links to installments one, two, and three.)

So far in our story: my active labor started with a massive contraction at 1:15 a.m., and after about 30 minutes and a total of three contractions, I was scared and confused. I called the midwife, who told me she thought it was still early in my labor, but she arranged to send her assistant to my house. Meanwhile, Craig woke up my parents, who were sleeping in the guest room; three-year-old Isaac was still asleep in his room; and my parents called my sister Erica.

Thursday, January 8, 2009
1:45 a.m.

We were in my bedroom: me, Craig, and my mother.

The contractions had started out hard, and they never got easier. Each contraction was a shocker, nearly too intense to process. I never got a handle on them; I was clueless about how to cope, and none of my pain-management strategies helped. Unlike with Isaac's birth, I never went into that dream-like hypnotized state, nor did I feel the sense of being in control of being out of control. Instead I felt helpless, confused, and apprehensive -- and that was even worse than the pain.

2:15 a.m.

The midwife's assistant arrived; she listened to the baby's heartbeat, and thankfully everything was fine. She didn't perform an internal examination, in part because my water had already broken, but there was really no need. My contractions were from five to eight minutes apart, and I told her that occasionally one would be "half-strength," meaning it was actually bearable. We were planning a homebirth, but as a point of reference, most hospitals won't even admit a laboring woman until she is in active labor with contractions that have been less than five minutes apart for an hour. So at this point the assistant called the midwife and agreed that she also thought it was early on in my labor.

Me, I just knew that things were much harder than I had expected, especially considering my labor had begun only an hour before. I kept trying to relax and open up, which had worked with Isaac's birth, but I simply could not do it. Even between contractions I often didn't lose the pain and tension in my lower abdomen; the intensity would lessen, but the cramping continued. I was making noise, but I couldn't keep my vocalizations low or round; sometimes I found myself doing something that sounded a lot like shrieking. I scared myself.

However, after it was all over, my mom said it looked and sounded just like my previous labor; she didn't realize it was any different. Craig could tell it was different, but he didn't know what to do about it. Later he said he felt like we were always three contractions behind -- as soon as we got into a coping routine or a technique, the labor ratcheted up another level, and we were left behind again.

It was hard. Yes, it was very painful, but it wasn't the pain that was the problem, exactly -- it was the sense of not knowing what I should be doing with the pain. So in addition to the physical intensity, it was overwhelming both emotionally and psychologically. Maybe if we'd had a doula, a professional labor companion, she could have helped me develop a better coping routine. All the techniques we had practiced were relaxation-based, and maybe what I needed was something more active, like pulling on a rope or rocking. (Or listening to Metallica.) Or maybe, as I noted previously, nothing would have helped.

The midwife's assistant was only intermittently involved with the labor at first, at least as far as I remember. She checked on the vital signs, but she was also busy setting up for the birth. She said later that it seemed like I was dealing with the contractions amazingly well; she didn't notice my emotional distress and had no idea that I was struggling.

3:15 a.m.

I was still laboring in my bedroom, alternating positions quite frequently. Sometimes I stood and leaned on something; sometimes I knelt on the bed. I kept moving because I was trying to find some relief, but no matter the position I tried, the cramping in my lower abdomen was unrelenting. Around this time the midwife called, and the assistant left the room to take the call. We later learned that the assistant told the midwife she thought things were still early, that she didn't need to come yet.

But it turned out the midwife had left her house 30 minutes earlier. She was nearly at our house, and was just calling for final directions. Later the midwife told us that she hadn't been able to get back to sleep after I called at 1:45 a.m., and she just had a feeling she should come.

I was kneeling on the bed, leaning forward on a giant yoga ball, when I had a double-long contraction. At the end of it, I felt something twist into place in my lower abdomen. It was like the burrowing of a drill bit. Suddenly, irrationally, I felt like I wanted to go to the bathroom, and I decided I would ask the assistant about it when she got back from her phone call. In the meantime, I lay down on my side on the bed.

3:30 a.m.

In the middle of the next contraction I suddenly could not stand it any more. I leaped to my knees, clapped my hands between my legs, and cried out, "I don't know if I can do this!" The pain went on and on, and the pelvic pressure and burning were unbearable. I think I screamed.

At this moment the midwife walked in the bedroom door and said, "Looks like we're about to have a baby!"

No one believed her, not even me.

I was still on the bed on my knees after the contraction ended, and I was extremely confused. The midwife asked me if she could examine me, and did I want her to do it right then, or wait for the next contraction. I laughed humorlessly, and told her not during the next contraction. While we were talking, she checked the baby's heartbeat, and it was fine.

As it turned out, I didn't have a choice about the timing of my internal exam, because I had another contraction at that moment. Somehow they got me off the bed and into a standing position so they could get my pants off, because throughout this I had been fully dressed! Standing felt wrong to me, and I mumbled befuddledly, "I don't know, I don't know." I think I meant I didn't know what to do, or in what position I should be, or even whether I could cope any longer.

But somehow the midwife must have examined me, because she announced, "I can see your baby's head!"

Everyone was surprised, except for her.

Myself, I was neither surprised nor relieved. I was just having a very bad time, and I wanted it to be over. It was extraordinarily, amazingly uncomfortable to be standing there with the baby's head poised to emerge. I didn't feel the urge to push, as far as I can remember -- just that pelvic pressure and burning.

The midwife helped me lie down on my right side along the edge of the bed, facing outward. My head was on the pillow. Craig stood at my shoulder, and I wrapped my lower arm around both his thighs. I used my other arm to slightly raise my upper thigh, and Craig helped hold it as well; I wasn't pulling up very hard, since I didn't need much leverage. The midwife was on the floor beside me. Even without any pushing, I could feel the stretching as the baby's head moved down slowly.

But I guess "slowly" is relative. Even with the side-lying position, which is meant to slow a fast delivery (and protect pelvic organs from prolapse), and even without pushing, that baby was coming out pretty quickly. After I lay down, they told me later, the baby's scalp was already showing clearly, and it never vanished; the entire delivery phase only took ten minutes.

The midwife never once asked me to push; instead she told me to go slow, which I did. I gave a few little pushes, the burning grew more and more intense, and then I absolutely couldn't stand it. I cried out, "Help me! Help me!" at the peak of sensation, and then the feeling grew less overwhelming, although still terribly intense. I was too confused to understand it at the time, but the baby's head had been born.

Then the midwife told me to stop pushing and to blow, which she demonstrated. I was actually grateful to stop: not pushing meant less intensity, and I was in favor of anything that let me avoid intensity. Although it was still extremely uncomfortable, it was no longer overwhelming. Why did I need to stop? I had no idea. If I thought about it, which I'm not sure I did, then I assumed the midwife was trying to prevent me from tearing. (Which she did -- in the end I had only two tiny superficial lacerations. What a difference that makes in recovery!)

I didn't know what was happening, but they told me later that after the baby's head had been born, the midwife discovered that the umbilical cord was wrapped around her neck. However, when she tried to unloop the cord, it was too tight or too short to come over her head. So she had to internally clamp the cord in two places and cut it, without being able to see what she was doing, and with just the baby's head sticking out -- all while preventing me from trying to push out the rest of the baby! Craig and my mother were incredibly impressed with the midwife's skill; her voice never stopped being calm as she told me not to push, but her hands moved very swiftly and surely.

Then the midwife gave me permission to continue. She also asked me if I wanted to reach down and feel the baby's head, and I said emphatically, "No. No." I stopped my blowing and started breathing deeply. I don't think I pushed any more; I gave maybe a little downward pressure to get things started, but it really felt like the baby made her own way out as I breathed.

3:40 a.m.

I felt her shoulders being born, with another moment of increased intensity and accompanying unhappiness on my part. Then the rest of the baby's body slipped through the birth canal, emerging slowly and deliberately. It didn't hurt, exactly, but it felt very strange to feel her wriggling along. And then she was out, and the midwife handed the baby up to me, and my first thought was, "Thank God that's over!" I felt more traumatized than ecstatic.

The midwife explained to me why the umbilical cord had already been cut, but I was only half-listening; even though I was somewhat shell-shocked I was pulling aside my garments (remember I was fully clothed, besides pants) to press my baby to my bare breast. She had been breathing well from the moment she was born, and she was calm and not crying. She hadn't been cleaned at all, and she looked all slimy and gray and puffy, so coated with white sticky vernix that it was impossible to tell the color of her hair.

Since the bedroom was a little chilly for a newborn, although it was normal room temperature for a cold January dawn, it was imperative to keep the baby warm. I rested her naked body against my warm skin and covered us both up with blankets; we immediately added a hat and a heating pad. In fact, we covered her up so thoroughly that I couldn't see much of her, but it didn't matter. I had her where I wanted her, and I think she was also where she wanted to be. I nursed her a little bit, but she mostly wanted to rest. So for her first hour I just held her close and held on tight.

The Aftermath

In retrospect I realize that the midwife must have performed a medical check on the baby while I was holding her, but amazingly I didn't notice at the time. When I recently watched the post-birth video, for instance, I heard the midwife asking me if the baby really was a girl, a question I don't even remember. And of course I eventually had to deliver the placenta, and I am sure my medical caregivers made sure I was doing well. But for the first 40 minutes of the baby's life I had tunnel vision, concentrating only on her, and I knew no interruptions.

Then about 40 minutes after the birth, around 4:20 a.m., Isaac and my father came in, and my sister arrived from out of town, and I had something to eat, and we started taking pictures, and everything became sociable and celebratory. About 4:40 a.m., an hour after the birth, the midwife suggested we might want to weigh the baby, and I finally, reluctantly let her go. She weighed seven pounds, two ounces, and measured 20 inches long. Her entry into the world had taken two hours and 25 minutes.

Then at 6:00 a.m. it was time for bed. The midwives cleaned up and went home; my sister went home to celebrate her wedding anniversary; Isaac went to bed (but not to sleep!) with my parents in the guest room. And Craig and I tucked a tiny baby between us in the master bed, a rolled-up towel serving as a protective halo around her head, and fell asleep.