Friday, May 20, 2016

It's a Boy! (A Birth Story)

Disclaimer: When I wrote my daughter's birth story five years ago, I blogged anonymously and to a teeny tiny audience of people who had randomly found my blog through some links on other feminist mothering blogs (most of which are no longer even around the interwebs--moment of silence for the ghosts of bloggers past). These days, though, I share my blog under my real name and on my personal social media accounts, so I realize that there are people who will read this who will also see me in person as friends and colleagues. That reality of course factors into how I decide what to share in this space, but for the most part I've remained pretty open, honest, and accessible as my anonymity drained away. That said, this post is very personal as it has to do with the act of pushing a human being out of my body. If you know me in real life and would rather not have to think about those details, maybe skip this post? I'll go ahead and give you the too graphic, didn't read version: I had a baby boy on Wednesday morning. He's gorgeous, and we love him! Hurray!


For those of you who are still with me, the crux of sharing this story is squarely rooted in my reflections on feminism, bodily autonomy, pregnancy, and the cult of motherhood. When I gave birth to my daughter, I had to fight to maintain bodily autonomy in the face of what felt like ridiculous pressures to induce labor or schedule a c-section. When I asked for medical justification beyond my daughter's suspected "too big"-ness and received nothing that satisfied me, I politely declined those interventions, went into labor on my own, and then had to fight for everything from the right to get out of the bed to persistent nurses who wanted to give me "just a little something" for pain despite the fact that I kept saying I didn't want it. I ended up with the non-medicated birth I had hoped for, but I had a jerk of a doctor (the on-call hospital doc whom I had never met), an absolutely overwhelming postpartum hospital experience, and the lingering sense that it really shouldn't feel so hard to have some control over my own body.

This time around, I felt much more informed and confident. I had only decided that I wanted a non-medicated birth in the final trimester of my first pregnancy, but this time I picked my doctor based on recommendations with that goal in mind. I picked a hospital based on their reputation for excellent maternity care. Every appointment my OB made me feel heard and respected. She totally supported my birth plan. We were a team. I had this one down. It was going to go great!

Then around the 32-week mark, my little one wasn't measuring so little. He (though I didn't know he was a he yet) was suddenly measuring two weeks ahead of schedule. "Don't worry," my doctor assured me. "We'll schedule an ultrasound at 37 weeks and see what we're dealing with size-wise."

I was stressed about that ultrasound. I started asking her what her recommendations would be, and she talked me through possibilities but kept stressing that we should just wait and see what the measurements said. Everything else looked great. The baby was healthy and in the right position. It would be fine.

The ultrasound technician ran her measurements and estimated that my 37-week fetus was already 8.5 pounds. By her projections, he would be close to 11 pounds if I delivered on my due date. Not only that, but his head was measuring big.

I went in to talk to the doctor, and I was trying not to panic. She stated plainly that for a baby that large, she recommended a c-section. I said that I wanted to at least try but understood a c-section could become necessary. She offered to schedule an induction. I told her I really wanted to avoid Pitocin (and the famously painful contractions that come with it, likely making my non-medicated goal a distant memory). She agreed, but she didn't want me to go past 39 weeks. If this baby was to come out on his own, he needed to get moving.

And get moving he did. As was also the case with my daughter, I started having relatively strong, regular contractions for a few hours most nights. By my next appointment, I was already dilated to a three and showing "favorable" conditions (which made it sound like I was trying to plan a weekend BBQ rather than give birth to a human).

I would be 39 weeks on Thursday and had an appointment on Tuesday. At that appointment, I was dilated to an "almost" 5 and had been having contractions off and on for days. She told me to go home and walk, squat, bounce on a ball, and take a warm bath. Then we scheduled an induction for Thursday morning. We planned to start with breaking my water and seeing what happened from there. We'd use Pitocin if it was needed and turn it off and see if I could go without it. She didn't want to wait any longer for fear that a growing baby would mean a c-section for sure.

I went home and followed her directions. I spent most of the afternoon in a squat or on a ball, and I walked up and down my stairs at least fifty times. Pretty soon, I was having contractions every four minutes, but I could still walk and talk through them, which (according to every piece of advice I've read and heard) means they weren't "real" enough yet.

I started wavering between fears. I'm going to have a baby in the car. I'm going to wait too long to go to the hospital, and I'm going to have a baby in the car. What am I doing?! Then that fear would pass. I'm going to end up with a c-section. This isn't real labor. Nothing is happening.

I had called my mom and cousin just in case. My mom graciously agreed to watch my daughter, and my cousin joined my husband to make a pair of fantastic birth coaches. I asked their advice, "Should we go in?" No one had a good answer.

I reasoned to myself. If I wasn't in labor, they couldn't make me stay. I had an induction scheduled in less than forty-eight hours. It wouldn't hurt to go in and get checked. If things were progressing, I could stay. If things weren't, I'd leave.

I got checked in, and they hooked me up to the monitors. My contractions had (as far as I could tell) completely stopped. I expected to be sent home.

"You're contracting every three minutes. You're definitely in labor. We called your doctor, and she wants us to break your water. How do you feel about that?"

This was a very, very hard decision. I wanted as few interventions as possible, and I knew that breaking my water would put me on a clock. If I didn't progress, I'd end up with Pitocin at best and a c-section if that didn't work. I could end up going through the pain of labor to still end up with the recovery of surgery. This could be a bad call. Maybe I should just ask to leave and see if my water would break on its own. Maybe I should ask to just go walk around and see if things progressed in an hour.

On the other hand, my labor with my daughter never picked up in intensity until my water broke. The contractions had been irregular and mostly dull until then. Maybe breaking my water would be exactly what I needed to get things moving. Maybe I could ride this wave of contractions all the way to a non-medicated birth without any other interventions. Maybe I should just say yes.

So I did. And they broke my water, and I immediately felt a sense of dread (along with, you know, a sense of being flooded by breaking water. Gross.) Did I make the wrong choice? Am I going to remember this day by looking back at this very moment and telling myself this is where I went wrong? 

I got up and started walking the halls, but the halls were too short and there were too many people around, so I went back and paced the room. My husband, cousin, and I hung out. We laughed. We talked. Contractions picked up in intensity but stayed fifteen minutes or so apart.

About four hours after they broke my water, things got suddenly intense. I labored for 12 hours after my water broke (on its own) with my daughter. I remembered transition as a time of intense agony and puking that came after eight hours of what was by comparison only painful. I wasn't ready for things to get this painful this quickly.

When the nurse heard my cries of pain, she suggested the shower. It helped at first, but suddenly there was no break between contractions, and my back felt like it was exploding. Within an hour, I was shaking in pain and exhaustion. "I'm so tired," I kept saying, and it was somehow even worse than the pain. At least, I told myself, the worst is over. That was transition. You're almost done. 

I sat on the birthing ball and rested on the bed between contractions that had spaced back out, another sign that transition had indeed ended. I can do this. 

The nurse came in to check me for progress. Getting on my back made me sick with pain. I felt trapped and panicky. She hurried to shorten my discomfort: "You're a six," she announced.

A six?! I started losing the mental battle. A six?! That means I haven't even gone through transition! That means the worst is yet to come! That means that I have been in labor all that time and only made 1 cm of progress! That means the baby is stuck. It has to mean the baby is stuck. I went through all of this and am going to end up with a c-section anyway. I am so tired. I am so tired and it hurts so much. I made the wrong call. I never should have let them break my water. I made a mistake. 

Around that time, my OB came back on call. She called me as soon as she got the message from her colleague that I was admitted. The nurse handed me the phone just as another huge contraction hit, and I couldn't even process what was happening. She called back just as it was ending, and she cheerily said, "It sounds like your progress has stalled. I'm on my way in, but how about I have them give you some Pit and we can get things moving."

I knew how strong that last contraction had been, and I knew that Pitocin wasn't going to do anything that my body wasn't already doing. I panted out between pained breaths that my contractions were already really strong. She must have been able to hear that was the truth because she didn't say another word about Pitocin, and within half an hour she was in the room asking to check me.

I crawled onto my back again, fearing the pain before I even lowered myself onto the bed. She checked me quickly. "You're a nine. I'll be back in twenty minutes. We're about to have a baby."

I didn't have time to process this as good news because I didn't have time to process anything other than a primal and undeniable urge to push. "I need to push," I moaned. My doc was in the process of trying to change into scrubs. She had just walked into the hospital.

"Okay," someone told me. "She'll be back in a minute."

There were no minutes. "I need to push," I moaned again. People started asking me questions about what I was feeling, but I couldn't talk. I couldn't think. I just needed to push.

My OB came back. She didn't even have time to get changed. She climbed onto the bed and checked me again. "You're not quite a 10 yet. I can't let you push through that." But there was no let. I couldn't stop. "Okay," she said. "But I have to stay here until the head gets past this." And that meant I had to stay on my back. That meant that I was in the most unimaginable, searing, unfathomable pain of my life. It was like being submerged into a pit of lava and being told to hold still through it. I couldn't handle it. I screamed. I scrambled upward. I was in flight or fight response and couldn't breathe.

My doctor climbed up next to me and tried to lock eyes with me. My husband and cousin were both so encouraging. But I couldn't see them. I couldn't think. I needed to be off my back. "My side," I managed to mumble. She let me turn slightly, and I found a point of focus within the pain. I felt myself come back to my body, back to control. I breathed through that contraction.

The next thing I knew, I was following instructions for pushing. I begged to get on my hands and knees. It felt like the only thing in the world I wanted was to be on my hands and knees. My doctor hesitated. Then she said, "I'm going to let you, but when I tell you to flip back over, you have to do it fast."

I didn't know this at the time (and bless her for not telling me), but the reason things were so painful, the reason things weren't moving yet, was because my son was facing the wrong way. His head was pushing up against my spine. The feeling of my hips and back exploding were the result of this position, and she knew she needed to be able to flip him quickly as I progressed.

I was instructed to get three pushes out of every contraction, and I curled around each one with all my might. It felt like nothing was happening, but everyone was so encouraging. I tried to focus on their voices rather than the doubt in my mind telling me that if I had just waited for my water to break on its own, things would be happening. I had never quite recovered from that nurse's announcement that I was still a six after all those hours of pain. I had it in my mind that I had made a mistake. As I was trying to push this negativity out of my mind, I continued to follow the instructions. "Breathe into this oxygen mask." "Push." "Breathe." "Push." "Breathe."

Suddenly, the doctor told me to flip over. I knew that I had promised I would, and I did. I was suddenly back on my side, and the instructions became louder and more excited. "Breathe deep." "Push." "Breathe deep." "Curl and push."

I had no idea how close things were. I had pushed for two hours with my daughter. I remembered the feeling of desperation and that nothing was happening. I was prepared for minimal progress, but the next thing I knew, the doctor was telling my cousin to get the camera ready. "Curl and push." And there he was.

My doctor had seen that he was coming out the wrong way, and the cord was up near his shoulders. She needed me to flip so that she could turn him and make sure the shoulders cleared safely. He was perfect and on my chest in a matter of seconds, screaming and turning pink.

Looking back, the nurse had to have been wrong when she said I was still a 6. There's no way I went from a 6 to having the baby (after transition!) in forty-five minutes. Most importantly, though, I was in the hands of a medical professional who truly listened to me and worked with me. She gave me her expert advice, and she told me that she wanted me to deliver as soon as possible to make my goal the most realistic. If I hadn't trusted her, I never would have let them break my water, and I likely would have ended up a week (or more) later with a baby whose head (facing the wrong direction) really was too big to deliver safely or at least too big for her to feel safe letting me try. Instead, I felt like I was truly part of a team instead of a product to be prodded and treated.

My cousin told me later that while I was in the shower dealing with what I can honestly say is the most intense pain I have ever felt (that back labor is no joke), the nurse said, "If she would just get an epidural and calm down, she'd be at a 10 in no time." My cousin kindly told her not to say that to me, and luckily, she didn't. I truly believe that if I had gotten the epidural and had been unable to maneuver into those four different positions in the last twenty minutes, it would have been very unlikely that I would have been able to deliver smoothly . . . or perhaps at all. That mobility was key.

My son was 8lbs 9oz, so the ultrasound estimate had to have been pretty accurate. He was 19.5 inches long, and he came out alert and healthy. Recovery for both of us has been going along perfectly, and we're now at home learning how to be a family of four.

This is the last time I will ever give birth, and the process of this intensity and pain is an amazing time of reflection on what a great support team I have around me. My husband never left my side, and I am pretty sure he even got in a shower with his Nikes still on. My cousin seemed to know every single time I was about to give up hope and had the exact right words. She also took some amazing pictures that I will cherish forever. My mom had my daughter safe and entertained so that I had no worries about her transition into big sisterhood.

I already knew how amazing these people were because they were the same people who were with me the first time around, but there is still nothing more humbling or beautiful than being reminded of that kind of love and support.

And it was absolutely amazing to be able to add my medical staff to that list this time. Instead of feeling like I was fighting against the machine, I felt like I was part of a system of care, and that's the way it should be. That continued on to my postpartum care, where I was consistently treated like an autonomous human being with real thoughts and feelings, and there's nothing else that can make up for that.

Overall, I am ecstatic to announce that I am now a mother of two, and I can't wait to see what the next leg of this journey has in store for all of us.

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