Speedy Delivery

Note: The following is a posting about Oliver's delivery. It contains certain details that might freak out, say, a guy. You have been forewarned.

I frequently said going into Ollie's delivery that I didn't know what it was going to be like, and I was prepared for that. And I didn't know exactly how it would unfold, but I found that I was prepared for it. I was worried at times that not taking a class would mean I wasn't really ready to handle labor without meds, but since I wasn't 100% committed to being unmedicated, I tried to embrace that. As it turns out, I think I just knew my own "learning style." All the books and fore-flection (as opposed to reflection) on what could happen left me open to whatever, but knowledgeable enough to feel calm about the situation.

Contractions started around 3am on Friday the 12th. I woke up to use the restroom and notice cramping that felt similar to what I'd heard described as contractions. They weren't terribly uncomfortable and were pretty sporadic. When Wes got up for work, I told him, "I may or may not be having contractions." After he left I fell back to sleep for about another hour before the alarm went off for me, too. When I used the bathroom, I passed my mucus plug and knew then that I was within 24 hours of meeting my son. It was exciting, though I was nervous about what lay ahead.

I called Wes, who nixed my idea of going to work for as long as possible, and then the midwife (at Wes's behest), who confirmed that I was fine to stay home for as long as I wanted (unless my water broke). I talked briefly with my mom. Wes was already on a 6-3 shift, and since things were moving seemingly slowly, there was no real reason for him to use sick call and come home. I'd always believed I would labor better by myself early on, without him watching and worrying, and I think that was in fact the case. Not that he didn't know what to do, but that there wasn't really much, in my mind, that could be done.

I did, in fact, go to school for an hour to drop off some materials and talk to the teacher who would be taking over my classes on Monday. I saw some neighbors and then a bunch of teachers at school who couldn't believe I was up and about. I don't know what it's like for other women, but for me, those first few hours were just like intense menstrual cramps. I had to stop and stand still for some of them, but there was no need to breathe through them or anything like that.

When I got home from school, the nesting instinct everyone talks about really kicked in. I decided, as was only reasonable, that I needed to clean before the baby came. I took all the linens off the bed and started cleaning the bathroom between contractions, which by 9am were a little more uncomfortable and regular. I talked to my sister once or twice, who, when I had two on the phone with her (and that I had to stop talking for), forewarned me that labor was picking up. Wes called to update me on when he would be home and make sure I was okay. I rocked in the rocking chair, tried to get comfortable on the couch (the rocking chair made my lower back ache), and walked some. Kneeling didn't seem to do much for me. I think in that period of labor, I felt okay about being without drugs. I was still nervous about how much had to still happen (and I didn't know if I would be able to feel if I was dilating), but I was mostly focusing on the next contraction. I didn't really time them except for two 10-15 minute periods. I had a general sense of how often they were coming, but mostly I was thinking about the pain level.

Wes got home at 3am, took Lucy to the vet, and jumped in the shower. While he was in there I called the midwife, thinking it might be close to time to go in. I was getting to the point where I couldn't find any relief from the pain. She told me, though, that it sounded like I was doing well, and she would encourage me to stay home another hour or two if I wanted, maybe try the shower, and call her back. I did get in the shower for 30 to 45 minutes, which helped me get some relief before the contractions picked up even more. When I got out, I threw up pretty hard, which made me a little nervous and confirmed my desire to head to the hospital. It took at least another 30 minutes, though, for me to get dressed, to talk to the midwife again, and to get downstairs with our stuff.

By this point, I was groaning through the contractions. I was in our lobby for at least 5 minutes on my knees on the couch moaning while Wes tried to hail a cab -- during rush hour -- on Friday -- while it was raining. The cab driver seemed pretty calm, even with me moaning and groaning in the back seat, though Wes said he was clearly looking nervous when traffic was totally stopped on Lakeshore Drive. It took over 20 minutes to reach the hospital, which is 1 1/2 miles from our apartment. I could feel my water break and leak with each contraction in the cab (which, fortunately, I had foreseen and taken precaution to manage without damage to the cab). When we got out, I had 3 contractions between the taxi and the door of triage, a total distance of maybe 200 feet.

The triage people got me to see a nurse right away. I passed something else (more mucous plus, amniotic fluid, I don't know), and then she examined me between contractions. At that point, I thought I was maybe 7 or 8 cm dilated and had decided that, if so, I was going to get an epidural. I couldn't imagine another 2-3 hours or more in the state I was in. Fortunately, I was 9cm and baby was +2 station. We moved quickly up to labor and delivery, but, for reasons unclear to me, the midwife was not there. Instead, I was greeted by one of Wes's and my good friends who is a 4th-year OB/GYN resident. I had joked with her prior to the delivery that if she was in the delivery room, we could never be friends again. After she checked me, too, I looked at Wes and said, "Brook and I will never have the same relationship." There was some concern by the triage nurse and Brook that the baby was presenting weird, so an attending came in to have a feel, too. I begged to get off my back, which was horribly uncomfortable, and they let me squat on the bed. The contractions were at their most painful and most frequent at this point, and I was 100% dilated and effaced. They broke what was left of my water and encouraged me to start pushing. I tried, but there was no urge to push and it was horribly painful. People kept telling me not to make any noise and hold my breath, but it just didn't feel right.

At this point, I was offered an epidural. I was skeptical that it would work fast enough, but I couldn't fathom pushing through what I was feeling, so I said okay. A nurse got my IV going, which I needed for the penicillin (for Strep B) anyway, and the anesthesiologist did a fast run-down with me. Just about that time my midwife came in. She wanted to check me, too, and got me more on my side to do so. After she looked, she told me I didn't need an epidural, I was ready to push and doing great, and she cleared the room but for two nurses.

And then it just happened. I finally felt the urge to push, I was able to get a bit of rest in between contractions, and the midwife and nurses just encouraged and coached me through it. It's amazing how much difference it makes just to have someone there say, "Hey, you can do this. You're doing great." Wes stood by the bed and held my hand and let me pull against him while I pushed. I could feel the baby's head and the aptly named "Ring of fire." There was almost some comfort, literally and figuratively, in the realization that I was just going to have to do it, regardless of how I felt. That baby was going to come out. Wes asked if I wanted to see or feel his head come out, but I was doing much better just focusing on the pushing without associating it with any product. I know that sounds weird, but I didn't care if I was birthing a watermelon at that point -- I was going to push it out!

If there's one thing that recommends going without an epidural, it's the last 10 seconds of the delivery. I don't know what you can feel if you've had meds, so maybe it's not much different, but feeling that baby come of you is totally unbelievable. That was the moment when it all came together and I realized what had just happened. They put him on my chest, and I just smiled and laughed and rubbed his back. He was yelling up a storm (working for that 9 on his Apgar) and, save for the spots on his head, looked great. About 10 seconds out, he pooped meconium all over my chest, but I seriously could not care. They let me be with him for a minute before taking him to weigh and measure him and inspect his head. I passed the placenta with one easy push, and the midwife got me some meds before putting in a few stitches. It took a few minutes for me to be able to relax my pelvis, and I miraculously felt pretty good. I guess that hormone rush really does happen.

The nurses let us both hold him for a few minutes before taking him to the NICU to see a neurologist for the aplasia. I wanted to be with him, but I felt good knowing he was going to get seen.

The recovery has, thus far, been very good. Wes has been really cute about everything -- he seems so proud of my "performance," if you will, and tells everyone about it. I was in the door of triage around 6:45pm, baby was born 7:30pm, with about 20 minutes of pushing, and I was up and walking within a few hours of that. I know full well that most of what happened is just nature -- some women labor longer, suffer more painful or frequent contractions, deal with complications, etc. I'd like to think that my activeness during the pregnancy and labor helped some, and I am proud of myself for trusting that I could make it through, but mostly I'm just so grateful that things went the way they did, knowing that I owe it to biology and luck.