Ryan’s Birthday

A bit of backstory before getting into the birth story: I had chosen an OB based on reviews from other women in my area. Early in my pregnancy, I didn’t know what my birth preferences were, but in my second trimester, I started deep-diving into birth podcasts and books to figure out what lay ahead of me. After some research, I decided that I wanted to change where I received my prenatal care and where I would be delivering as I had decided I wanted to go a more natural route, delivering in a birth center, rather than in a hospital as I had originally planned. I started the process through my insurance of getting a referral to the only birth center in the area about halfway through my second trimester, which was denied right around the time I hit my third trimester. In the meantime, I had started asking some of the providers at the place I was receiving prenatal care about the preferences I had, and it was clear that this practice did not align with my birth vision. I then did some quick research on other hospitals in my area to see if any had policies that aligned more with my preferences and attempted to get a referral to a practice that delivered at one of those hospitals, but being in my third trimester, I was told by everyone I called that I was too far along to transfer to a different clinic. So my plan became to continue receiving my prenatal care at the clinic I’d been going my whole pregnancy and then show up to the hospital I’d picked out when I went into labor and deliver with their on-call doctor.

At 39 weeks and 5 days pregnant, I had my 40-week prenatal checkup. I was their last appointment of the day, and I was feeling fine other than being very pregnant. When I got my vitals checked, my blood pressure was high, but not in the severe range. I asked if they could check it again - still elevated. I was told to drive straight to the hospital for an induction and not to go home first. This was not because my blood pressure levels warranted an emergency, but because the on-call OB was going to be going home for the day soon and she was going to meet us at the hospital to start the induction process then go home for the night. This put me in a state of shock. I had not mentally prepared for this outcome as I'd had a very healthy pregnancy up til that point and had been preparing myself to go well past my due date and have a long labor as that tends to be more common for first time moms. My husband and I called Devin to come up with a plan. We decided to go home, buy a blood pressure cuff on the way, and monitor it that evening while taking some measures to attempt to lower my blood pressure. I called the hospital to let them know that I would not be showing up for my induction. This started a barrage of phone calls I received throughout that evening from different OBs trying to convince me to go to the hospital for an induction that night. I had not shared with them that I hadn't planned to give birth at the hospital they practiced at, but after the pushiness of those conversations, I definitely wasn't going there to have my baby. 

Over the next 24 hours, my blood pressure remained about the same, but the following morning I woke up with contractions! Not Braxton Hicks, but actual contractions. We were so excited and I spent the morning doing all of the things that are supposed to help move things along, but they dissipated around lunchtime. I continued to monitor my blood pressure which remained about the same then started to gradually increase by the end of the afternoon, so we made the decision to show up at the hospital I'd planned to deliver at for an induction. During this whole process, I'd been in communication with Devin talking through my anxieties and watching some positive birth videos, which helped to calm me down as I was still on edge about having an induction. On the drive to the hospital, I found a podcast of a birth story where the woman was induced for gestational hypertension. She had a positive outcome (though not unmedicated) which made me feel a lot better about the situation. 

When we got to the hospital, we parked and casually walked in - I remarked that the drive up and the parking experience were not what I had expected as I thought I'd be in well established labor during the hour plus drive to the hospital. I was checked into the triage area and got the monitors strapped on while the nurses questioned why I was just showing up to a hospital without seeing any of the providers associated with it. The on-call OB showed up to ask some background information and check the monitors - she said I was having contractions, but I couldn't feel them. She thought it would be best to go ahead with the induction and did a cervical exam. I was 2cm dilated, but I hadn't had any cervical exams before that so I didn't have anything to compare that to. 

We got moved back to our labor and delivery room and I received my first dose of cytotec just before 9 pm and was checked on every hour (or sooner if the monitors were not positioned correctly, which happened anytime I moved.) Devin called shortly before I took that first dose (she was just leaving another long birth), and we decided that she would stay home that night and come to the hospital the next day, but if anything happened overnight, I'd give her a call. I started feeling contractions less than an hour after taking the first pill, but they weren't intense and I could easily talk and sleep through them. I got the second dose of Cytotec around midnight. By that time I had stopped feeling contractions and they weren't picking any up on the sensors either. Between checks, I'd been trying to sleep as much as I could and for the first two checks after the second dose, I was woken up by the nurse coming in to check and didn't feel any contractions while she was there. Shortly after that second check, at 2:10 am, I woke up to my water breaking!

I hit the nurse call button and she came in and helped me to the bathroom to change into a new hospital gown while she cleaned up the bed. I realized that I was shaking. The nurse said this was common and that they called them the “birth quakes.” Somehow in all of the research I'd done, I’d either not heard of them or had completely forgotten about them. The nurse then went on to tell me some symptoms of different phases of labor - including nausea/vomiting during transition. I was told the OB would want to do another cervical exam, but I elected to forgo an exam for the time being. I got settled back into the bed hoping to get some more rest, but I was having to concentrate on breathing through the contractions which were gradually becoming more intense. Around 3 am, I made the decision to move over to the labor tub. On the short walk from the bed to the tub, I told the nurse I was feeling a little nauseous and she ran to grab a bag. As she rushed back, I started to throw up and she shoved the bag under my mouth. About 20 minutes had passed since I'd had the “birth quakes.” At the time, I did not register that this was a symptom of transition, even though the nurse had told me that not very long ago. 

At this time, we decided to call Devin. No answer. I initially had a sinking feeling as one of the main reasons I'd hired a doula was for non-medicine pain mitigation. However, the contractions continued to intensify which kept me from dwelling on much of anything and my husband and the charge nurse both jumped in with ideas. While in the tub, my husband rubbed my feet while the nurse offered me gum (since I'd just thrown up my chips & guac midnight snack,) chamomile tea, and prompted my husband to grab the essential oils I'd brought, but none of them smelled good in the moment. As the contractions continued to intensify, I began to feel more pressure in my back so I turned over in the tub to let my belly hang down in the water. At our prenatal meeting with Devin, we'd gone over a few pain management techniques and my husband jumped in with the hip squeezes she'd taught him and he pretty much didn't get to stop until the baby was born. 

I labored in the tub for a while and the contractions continued to intensify. I was told that I would not be receiving another dose of Cytotec and that I also didn't need pitocin for now (I had requested to forgo pitocin if at all possible.) I began to worry about how to continue to cope with these for what I assumed would be quite a few more hours, so I decided to get another cervical exam. The doctor smiled and congratulated me on getting to 8cm dilation. She said I could expect to meet my baby within the next 4 hours! 4 hours of these contractions felt like an eternity away. Shortly after the cervical exam, which I got in a side-lying position on the hospital bed, I had a contraction in that side-lying position and it was the most painful contraction I'd had up until that point. I decided to get back in the tub, and I immediately felt better. The tub felt so good that when I asked for laughing gas and was told I'd have to get out of the tub to use it, I replied “No thanks.”

After what felt like very little time in the tub, (according to the nurse's notes it was about 20 minutes) I had a very strange feeling at the end of a contraction. It felt kind of like the whole-body convulsions you have when throwing up, but going the other direction. This happened a couple more times before I told the nurse I felt “pushy” as I was worried I was still only 8cm dilated and would injure my cervix. She went out to talk to the other nurses who told her to get me out of the tub immediately. I was finally coaxed out of the tub by the promise of laughing gas and I got situated on the bed in a modified all-fours position, leaning over a birth ball. The laughing gas didn't provide me any pain relief, and when I used it as directed (which was to start breathing it about 30 seconds before the contraction began) it made me feel quite dizzy. However, the machine that administered the laughing gas was quite noisy when I breathed it in, which gave my husband a cue to start a hip squeeze rather than waiting until the height of the contraction when he could tell I was in pain. 

About 10 minutes after moving to the bed, one of the nurses looked down and realized my baby was crowning. She shouted “HEAD” down the hallway and the doctor came rushing in. Meanwhile, the nurses helped me turn onto my side. I was initially reluctant to change positions, especially since earlier I'd had a very painful contraction when laying on my side, but I was told a lot of women found side lying to be easier to push from, which I also found to be true for me. I was on my side for two contractions when her head came out. My husband said that her whole head started to turn blue, and the doctor told me to push. I was unaware of this and a little annoyed that I was being coached to push because I'd specifically said in my birth plan that I didn't want that, so I kind of half-heartedly pushed at first then the doctor, still calmly as to not cause me to panic, but with slightly more urgency said “you need to push.” At 5:20 am, 3 hours and 10 minutes after I woke up to my water breaking, Ryan was born. She was placed on my stomach, as the umbilical cord was too short for her to be placed any higher. After a pregnant pause that felt like an eternity, my husband told me we had a baby girl!

As Ryan and I lay there during the Golden Hour, my husband cut the cord, and the doctor inspected me. I requested not to be administered pitocin if my bleeding was under control, which it was, and my placenta detached with no issue. I received one stitch for a small inner vaginal laceration but was otherwise fine. After finishing, as she was about to leave, the doctor asked me if I had trained for a natural birth which made me feel like all the preparation I did throughout my pregnancy had paid off. About 20 minutes after Ryan was born, Devin rushed into the room and said “You had the baby?!” Turns out she had woken up in a panic at about 5 am and rushed to the hospital as soon as she saw the missed calls. She stayed with us through our transfer to the postpartum room and helped us get settled in for the duration of the hospital stay and the start of our parenting journey. 

During labor, I felt almost panicked by how quickly everything was progressing. I felt that I was not in control and was beating myself up for not being able to breathe as calmly as I’d practiced in all of the hypnobirthing meditations I’d done. But looking back and remembering what the doctor and nurses said, it now seems obvious that things went really well, even if very quickly. I truly credit all of the physical preparation I did (deep squats, inversions, side-lying release, walking, acupuncture, chiropractor, pelvic floor physical therapy, and pregnancy-specific workouts) for not sustaining any injuries to speak of during the birth when my mental preparations fell by the wayside. I was in somewhat of a daze for the first couple of days after Ryan’s birth, trying to process everything that had just happened, but I now look back on the memory with fondness and as a source of encouragement when I doubt myself.