For the beauty of the earth
For the glory of the skies,
For the love which from our birth
Over and around us lies.
Lord of all, to Thee we raise,
This our hymn of grateful praise.
I was on my way to an OB appointment and my 50 millionth session of monitoring when I got a phone call from St. Vincent Medical Center. It was an OB confirming that I had preeclampsia--something that had just developed in the last week or so. "Since your baby is full term the best thing for you is to be induced. We don't want this to develop into full blown toxemia," said Dr. Overbeck. "What's the time line?" I asked, "Are we talking about
today?" I had been praying the night before and had a feeling things would go this way. "Yes, I'm at St. Vincent now and I'd like you to come to Labor and Delivery as soon as possible." I told the doctor that it might take me a couple hours to get my children settled and my husband from work but that I would be there soon.
We got to the hospital at about 2:30 pm. My doula, Melissa Brewster, met us there. We all felt very excited. Dr. Overbeck came in and introduced herself. I told her my concerns about being induced and shared why I wanted to avoid pitocin. She was agreeable to other methods but wanted to check my cervix and the position of the baby so we could determine which method would be best for me. I was dilated about 2 cm but my cervix was soft. The baby was still very high. We decided the best thing to do was give me a cervical ripening agent called misoprostol that would also start uterine contractions. I would be given one dose (1/4 of a tablet) and then in 4 hours we would either give a second dose or break my water depending on how my body responded. The doctor seemed certain that I wouldn't need more than 2 doses.
I was given the first dose at 3:30 pm. Within an hour contractions started. They were mild but regular. Geary, Melissa, and I chatted and made estimates on what time the baby would be born. Mel and I were rooting for a Thanksgiving baby but Geary was convinced the process would take much longer. We watched TV for a little bit, the nurse brought in a deck of cards, we all took the opportunity to eat some dinner.
At 6pm there was a shift change in the hospital. My doctor and nurse were both off duty so I got to meet my new medical team. A midwife who I'd met before and didn't really click with, a resident who immediately made me feel comfortable, and a nurse who was way too chatty. I was a little nervous about this change in staff but simply repeated my concerns and made sure they all knew about my birth plan. The midwife and resident really validated me but the nurse took about 20 minutes to share all three of her own birth stories and tell me what I supposed to be feeling. When she left, I stared wide-eyed at Melissa, who knew exactly what I was thinking. "We can always switch nurses," she comforted.
One thing the new team brought up was giving me an IV of magnesium sulphate to keep my blood pressure down and prevent seizures. They would start the IV now and I would have it continuously in my system until 24 hours after the birth. I had never heard of this and Melissa asked if I could have a minute to think about it. The doctor and midwife agreed and left the room. Melissa was prepared and had brought along several birthing books. She was able to look up magnesium sulphate and we learned that it's often given to stop labor when babies are pre-term. When the doctors came back in I was able to say, "I'm not comfortable with having magnesium sulphate now because I'm concerned it would slow labor and then you would want to give me something else to speed it back up. I'm refusing the IV for now but once the baby is born it's okay with me if you still want to use it during that 24 hour post-birth risk period." I really thought it would be a big fight but the resident simply nodded and said, "Okay. It's your decision, I just need to make sure you know why we suggest it and what the risks are. I understand why you're deciding this way and it's perfectly fine." I felt very respected and was so thankful that Melissa had brought resources so we could make an educated decision.
At the end of the 4 hours my contractions were getting stronger and closer together. The baby had moved down a station, my cervix was much softer and I had dilated to 3cm. I was so excited! My body was doing it! It was taking over labor on its own. I agreed to let the doctor break my water. I also made it clear that I wanted to be able to move around as much as possible so could they please let me off the monitors. Instead of being completely released from monitoring they suggested an internal fetal monitor hooked up to a telemetry unit so that I could go "cordless". That way they could still keep an eye on the baby's heartrate but I could have the freedom to change positions and walk around if I wanted to. I agreed and once everything was hooked up the contractions really started coming!
I tried sitting in a rocking chair and bouncing on my balance ball but sitting upright just didn't feel good. I really wanted to be able to curl my body around the contractions. Geary and Melissa spread out a blanket on the floor and I got into a kneeling position with the ball in front of me. When a contraction came I would lean forward into the ball and then stretch with the contraction until it peaked and come back to a kneeling position as the contraction went away. The whole process was really relaxing and I could imagine myself as a wave, rolling into the pain and then rolling back out. After a while though it wasn't so comfortable on my knees. Also, I was cold.
The contractions kept getting stronger and closer together. At once point I rolled into the pain and had to push the ball away and almost put my face to the ground because it was just lasting so long. I heard Mel say, "Look at you! You were off the charts!" When I could sit up again I looked at the monitor and saw a line that went up, disappeared for a couple minutes, and then came back down.
After that the baby's heart rate went down. The midwife and Nurse Chatty came in and asked me to lay on the bed on my side to see if we could make the baby happier. There was talk of giving me oxygen if his heart rate didn't go up. I, on the other hand, was miserable. Laying the bed meant I simply had to endure the pain. I couldn't move with it. I knew I had to trust my body and I told the midwife, "I really need to be able to rock with the contraction. I need to get up." She said, "Well, I want you to be comfortable but I also need to make sure the baby stays happy." I suggested being allowed to get back on my knees and lean forward on the ball while on the bed. She agreed as long as I didn't sit back on my legs. As soon as I got up and in position the baby's heart rate immediately improved. As long as I was on my hands and knees he felt good and I felt good. It was amazing to see the instant results of trusting my body.
The contractions kept coming and at this point I really had to focus through them. I would lean into the ball and hum each breath. Huuuuummmmm, huuuuummmm. I tried to imagine myself as a wave again. I tried to imagine my cervix opening and chanted in my head, "I am opening." Geary and Melissa were super. Geary rubbed my back and told me I was doing a good job and that I was beautiful and strong. Melissa sat in front of me and her voice was so gentle and soothing. She would say, "You can do it. You are doing it." Sometimes she would just hum along with me which was very comforting. The constant encouragement and validation that I was laboring well made such a huge difference.
Pretty soon I was no longer cold. I asked Geary to remove my slippers and Mel brought me a cold wet washcloth. I wiped down my sweaty face and placed the cloth on my neck. "You're doing hard work. You're getting closer and closer to baby." I needed those words. As I continued to roll in and out of the pain I ate up every encouraging word from my husband and doula.
At about 11 pm I felt like I needed to use the bathroom. Melissa helped me to the toilet where I had a bowel movement and then the contractions just started coming right on top of each other. I didn't realize it but Melissa told me later that I would stand up and sit down through each one--an instictive motion that laboring mothers do to help get the baby down in the birth canal. I was in the bathroom laboring like this for long enough that the midwife and Nurse Chatty came in to say that I had been off the monitor long enough--they needed to check on the baby so I needed to get back in the bed. In fact, it seemed that the internal monitor had maybe fallen out so they needed to readjust it.
I could barely take a step before another contraction would come. At one point I was just hanging onto a bar on the bathroom wall. I wanted to give them what they needed but I just couldn't get myself there. I took one step out of the bathroom and immediately fell to my hands and knees. Everything inside me told me I was done. The end of labor was here I had to be done. The resident came in and graciously offered to fix the monitor where I was on the floor. I could only nod. She stepped over me into the bathroom and told me she was going to check my cervix first. I was sure I had to be complete.
"It feels like you're about a 6," she said. And that was it. With the nurse nagging me to get into the bed, a place I knew I would be doomed to intense pain with nothing I could do about it, and then being told I was only at 6 when I felt like I should be at 10, something snapped in me. It was a mental block. I felt like "if I can't get in bed then I can't do this. I can't complete this labor. I need to be done one way or the other." And then I shocked the room by saying, "I can't do this. I want an epidural."
"Do you really want an epidural?" Mel asked gently. I didn't. I really wanted to be done but I was a six! A six! I couldn't get past that. I couldn't endure any more if it going to be harder. I should have been done. I was done. So I said, "Yes, I really want an epidural." And I hung my head.
The doctor was still sitting on the floor behind me and said, "Well, let me fix the monitor here." And I hummed through another contraction and then, "Aaaah! I feel pressure!" The baby was in the birth canal and I could feel him coming. I could hear voices all around me, "Try not to push!" Well, of course I shouldn't push--how could the baby fit through a six! I was still mentally blocked by that thought. It wouldn't occur to me until later that my feelings of defeat were simply because I had reached transition. I knew I might feel like I couldn't go on but I didn't recognize that I was entering the very last stage of labor. And then hearing that I was only a six just added to that defeated feeling. In reality, I either was complete and my cervix probably just closed up a little when the doctor checked, or those last couple strong contractions opened me all the way. Either way the baby was coming.
Someone opened the door and called out, "I need an emergency table now!" and I heard several people rush into the room. The doctor behind me said, "I have the head!" I wasn't pushing. I was simply on my hands and knees halfway in the bathroom, halfway in the room, humming my head off. I didn't push at all but I felt a gush and heard a splash and Geary said, "He's here, Isha! Miles is here!" But I thought he meant that Miles was on his way out. How could he get out through a six! I was still hung up on that. Geary said again, "He's out! You did it." And I couldn't believe it! I stayed in my position on all fours just breathing calmly. I did it! I knew I was done and then I really was! My body hadn't betrayed me after all! Geary told me later that the doctor had a giant grin on her face when Miles basically shot out of me and she caught him.
Geary cut the cord and the baby was handed to a different nurse. Someone helped me up and took off my hospital gown. I remember that the floor was wet and I almost slipped. Suddenly my hormones surged and I started shaking uncontrollably. I could see my baby being wiped down and examined. I wanted to hold him but I couldn't stop shaking. The doctor came over and delivered the placenta. Geary and Melissa were cheering around me and telling me how well I had done. I was still just trying to wrap my mind around what had just happened. And I was thankful, so thankful that I had the natural birth I wanted, that I had a perfect, healthy son, and that even though I thought I had been defeated, I wasn't after all! I will be eternally grateful to Melissa for the role she played in this birth. Her gentle words and quiet wisdom were exactly the encouragement I needed. I don't think I could have done it without her.
I got a new hospital gown, warm blankets were placed over me, my IVs were hooked up (the magnesium sulphate and a small dose to pitocin to control some slight hemmoraging) and soon the shaking died down. I was able to hold and nurse Miles and marvel over his amazing birth. I was convinced he would be a Thanksgiving baby but he showed up 15 minutes earlier. Just 8 hours of labor and now I am rewarded with a lifetime of joy.
For the joy of human love,
Brother, sister, parent, child,
Friends on earth and friends above,
For all gentle thoughts and mild.
Lord of all, to Thee we raise,
This our hymn of grateful praise.
Amen.
Or how you pout at the breakfast table because I've offered you cereal instead of the requested pumpkin pie. Trust me, I wish we could have pie for breakfast, too.
