Otto's birth story

Otto's birth story

• 6.11.2018

I knew it would take me a while to write down this story, but it's really important to me to do. Otto is 7.5 weeks old now. My labor delivering him was very, very different from what I hoped for. We are both healthy and doing well now. But it's still hard not to mourn the loss of a goal that didn't work out, an experience you wanted but never got to personally have. I'm doing pretty well with acceptance and gratitude, but still want to share my real feelings as I have them now.

I once heard someone quote her midwife who said most people don't get a great experience out of all three of pregnancy, labor, and postpartum. (My midwife scoffed at this, haha!) That concept makes sense to me in the sense of fairness of the universe, but because my pregnancy was so smooth I was hoping it would contribute to a great labor experience!

In that sense, I've had it pretty good. Despite lots of anxiety beforehand, we got pregnant relatively quickly once we really started trying. I had a textbook, super healthy pregnancy. I went into labor the day before my due date. Breastfeeding is going well (now--days 3-5 were pretty painful but much better now). Otto is gaining more weight than he needs to. My body is recovering well and I can wear my old clothes again. My postpartum hormones were crazy but I haven't (yet) had bad baby blues or other mood disorders. My relationship with my husband grew even stronger throughout everything. All in all, I got pretty lucky and worked really hard (successfully) with the baby stuff.

And yet, labor and birth are this huge, mystical culmination of 9 months of pregnancy, and introduction to the rest of my life and relationship with this new person. So they seem more important somehow than some of the other things. I think that's why there's so much emotion around labor.

Well, let's get into it.

Otto's Birth Story

Labor starts

My due date and planned last day of work was Wednesday, April 18. On Tuesday I left work around noon for an afternoon of prenatal care appointments. First the midwife; she checked me and I hoped she could do a membrane sweep to potentially get labor started, but I was 0 cm dilated so she couldn’t without opening my cervix. Even being checked was painful enough, so no membrane sweep. Then I went to the chiropractor and for a massage. Then I went to acupuncture. I’d been to a few acupuncture appointments at the end of my pregnancy to get to know the place, and it had been recommended as a way to induce labor naturally.

As my due date was the next day, at this appointment the acupuncturist did a little more than she had in previous weeks, and even used some electric current through some of the needles. Lying on the table I thought I felt a painful cramp, but I was pretty relaxed and wasn’t sure what I was feeling. (I did think, uh oh, this is a lot more painful than a period cramp. I hope this isn’t a mild contraction. I had no idea what I was in for!) At the end of the appointment, after the acupuncturist had removed the needles and left the room, I stood up off the table and felt water drip down my leg! (This was about 5 pm.)

I called Jason on the drive home and told him I think my water may have just broken but I didn’t think I’d felt any contractions, and that we would check with the pH strips when I got home. I kept leaking as I drove home and thought I might have felt another very mild cramp or two. We checked with the pH strip and it turned dark blue immediately, meaning it was amniotic fluid. It kept leaking and I soaked through a bunch of pads all evening. We called the midwife (6:13 pm) and told her about the blue strip, and she said to call in the morning if I hadn’t felt any contractions by then. I was still in disbelief that it was really happening and worried I might not feel contractions, so just to be sure, I said “So I should definitely not go to work tomorrow, right?” Ha!

I think we put on a basketball game and I sent some work emails to prepare for being out. I started feeling contractions, maybe 8-10 minutes apart, and tried to record them in my app but I was still multitasking so I kept forgetting to record when they ended. At 9:42 pm we called the midwife to let her know they were happening, though I still called it “mild cramping.” She said to try to sleep, and call when they were 5 minutes apart or less.

(By the way, our midwife gave me a copy of the labor report which is why I have all these exact times and more details. Good thing, because later on things all blurred together.)

I went to bed around 10:30 I think, but the contractions were more frequent and starting to get painful to where I had to flip onto my hands and knees and focus on my breath through each one. I tried to sleep in between. By 1:30 am, though, they were really painful, definitely 5 minutes apart, and lasting 45-60 seconds. I was getting worried and was ready for some help. We called the midwife Catherine again; she said to call when they were stronger and she would head over.

I went back to my flipping over and breathing, and contractions got closer together and the pain was definitely intense. (I had wanted to avoid using the word “pain” throughout my labor, inspired by one of the books I read - Mindful Birthing - but this was definitely pain. I felt a little bit of failure for not being able to focus on my breathing away from the pain.)

At 3:15 am we called again, with contractions every 2-3 minutes and feeling much stronger. I really wanted the midwife to be there! She said she had been planning to arrive around 5, but I said I thought I needed her sooner. She got there at 4:15.

The contractions were feeling really strong and painful, with pain in between as well. My birthing books had said there would be this wonderful feeling of calm in between them, but that was not happening for me. I felt a wide, low cramp around my pelvis plus a sharp ache in my low back, all the time. These pains got bigger/worse/more intense during contractions but they were always there which was exhausting. During each contraction I tried to use the “body scan” coping method from Mindful Birthing, but couldn’t focus on more than just my hands, so I would breathe in-two-three-four-five, out-two-three-four-five focusing on my pinkies, then my ring fingers, then middle fingers, etc. That way I also knew the contractions usually lasted about 4-5 breaths.

I’ll add that we didn’t have a “birth plan” written down and hadn’t even talked through everything in a linear way, but because we planned a homebirth with the midwife practice we chose, we knew that their default was basically what we wanted.

Birth team arrives

I was sure that with contractions so frequent, having started 7+ hours ago, I must be really dialated by now. Catherine checked me around 4:15 when she arrived; I was dilated to 2 cm and the baby was in -2 station, and I was 80% effaced. That was probably when I first became nervous about labor. I had been in pain for so long and made so little progress. Would it be another 35 hours of this to get the other 8 centimeters?! I didn’t do the math then but felt really discouraged, kind of hopeless. Like I could keep going if I was close, but I was so far, and just could not possibly picture how the baby would actually come out of my body at this rate.

I should add that for the last 6ish weeks of my pregnancy, he had been left occiput anterior (LOA), which is supposed to be the easiest position for him to come out in. I was hopeful that we wouldn’t have any issues with him descending, getting stuck, craning his neck wrong, or something else position-related. I was also usually in pretty good shape at my chiropractic appointments. Jason has a big head and after 36?? hours of labor, he was delivered by C-section with a serious cone head from his mom trying to push him out. I have a big head, too. I know every body and labor is different, but I really wanted to avoid bad positioning that could make delivering a big-headed baby hard or impossible. At that 4:15 am check, baby was still LOA.

While I was glad the midwife was there (and the nurse arrived shortly after), her presence didn’t make the pain any easier. They got their equipment set up and sorted through the things in our homebirth kit, and they stayed in the living room while Jason and I continued to try to rest in our bedroom.

At 7:10 am, she checked me again; 90% effaced, 3 cm, still -2 station. And he had turned to left occiput transverse. I guess that is considered a good position for starting labor and head engaging.

Then, someone suggested I try laboring in the tub, so Jason drew me a bath. I get emotional writing this thinking about him dealing throughout these hours. He is a natural caregiver and hates to see me in pain and feel helpless. He told the birth team it was so hard because usually when someone is hurting this much, something is wrong, but now, Suzannah isn’t in danger, just has to struggle through. The tub helped a little bit with the pain in between contractions, but whenever I had a contraction I still wanted to flip onto my hands and knees which was harder in the bath. We tried having Jason pour warm water over my low back when I did that, but I don’t think it made much difference.

At some point I asked if they could give me anything at all for the pain, like nitrous or something?, and Catherine said no, because then they’d have to continuously monitor the baby. She did say if I was still feeling like I needed it, “we have options”--I didn’t ask what that meant. I couldn’t believe the pain, but I wanted my homebirth!

I went back and forth between the tub and lying on my side in bed most of the morning. At 9 am I had some bloody show, another sign of progress. Then the midwife and nurse said since we seemed to be doing okay, they were going to go get some breakfast. I stepped out of my mental pain cave enough to suggest a cute bakery a couple blocks away or the coffee shop a block further.

Sometime while they were gone, I threw up. I had once dreaded that potential symptom (often of transition) but at the time I too distracted by the pain to care. I doubted that it was transition because of how slowly things were going. I thought it was just from the pain.

They say you forget how hard and painful labor is and already I can’t remember exactly what the pain felt like, but I remember my thoughts. I was really despairing. I couldn’t believe people have been doing this for thousands and thousands of years, often without the prenatal care and other support I had. I felt taken over by the pain, like I was being compressed on all sides, out of breath, like huge weight was keeping me from focusing on anything else. I really, really wanted pain relief, more than I wanted to have the peaceful homebirth I’d hoped for, and even more than I wanted to avoid big, unknown hospital bills. I wished there was some other option besides checking into a hospital to completely change our birth plan, partly because of how different that would be but also because I have money anxiety and knew it would cost a lot more than our midwife’s flat fee if we had to transfer. But in the moment I didn’t have a problem dismissing that worry. I 100% felt like there was no other choice.

Catherine and the nurse were gone till 11:30, which felt like forever. The contractions were closer together and longer than they’d been in the middle of the night--now I had to count my breaths on 8 to 10 fingers or longer, left pinky moving right all the way to right pinky, and then sometimes I ran out so I’d focus on my wrists, elbows, arms, shoulders. (We had stopped timing the contractions in the app after Catherine arrived, but I know they got longer from counting my breaths on my fingers like that.)

I’ve heard of “double-peaking” contractions, and I had some of those, and then some triple- and quadruple-peaking ones. Like they would build to the most intense pain, then relax back down only a little and rather than stopping, they would ramp back up again. Those were so hard.

I was in the tub when they got back from breakfast. I was almost in tears at this point and Catherine said something like, “How about, if you’re dilated 6 cm or more, we keep going, and if less, we talk about other options?” I said, “I don’t think I can do this for 4 more centimeters!” I was feeling pretty ready to change our plans from homebirth to medicated hospital birth. I couldn’t keep going. (I’ve also heard that when laboring women say, “I can’t do this anymore,” it often means they’re in transition, but I was discouraged enough at this point I was pretty sure that wasn’t the case for me.) Catherine checked me again; not quite 4 cm and still -2 station. At this point it had been 15 hours that I’d been having regular contractions.

I said I wanted to go to the hospital and get pain medication immediately. Apparently I also told Catherine that I was tired and afraid of feeling more and more pain. She was totally supportive of transferring, no questions asked. She made a call to the larger hospital slightly farther away where she knew some of the OBs and had attended transfer births recently. (She would stay with us at the hospital but would only be able to serve the role of a doula.) She, the nurse, and Jason got things together and coordinated for the transfer. I gave some incomplete instructions about adding the blankets and baby clothes from the homebirth kit to our backup hospital bag, adding our toothbrushes and my makeup and contact lens case, and grabbing snacks or something. Jason got some shoes and socks for me which I was not about at all (I thought they were too complicated/real shoes), but was too exhausted and distracted to argue. I think I put on a different tank top before leaving, but I have no memory of what I was wearing before.

We loaded up into the car and I was afraid to think about how long it would take. Because of the pain between contractions I couldn’t sit in the seat as usual so I got on my knees and hugged the back of the passenger seat. Thankfully I only had 3 contractions in the 25-minute drive.

Long process continues at the hospital

We pulled up to the hospital loading area at 12:45 and someone with a wheelchair was waiting for me. He took us on a quick route to the labor and delivery area, where Catherine gave my insurance card to the front desk and they immediately sent us through to the nurse’s station desk, where a friendly nurse was ready for us. There was another paperwork step here but I have no idea what it was. I had another contraction here and thankfully there was a plastic chair on one side of the desk--I stepped out of the wheelchair and leaned on it, knees on the floor. I had no awareness of people around me but Catherine later told me that everyone watched me in that contraction and understood they needed to hurry. It felt like within minutes of arriving, I was whisked back to a room and hooked up to an IV.

At 1:00 they gave me fentanyl in the IV to “take the edge off” while waiting for the anesthesiologist. It may have softened contraction pain a little tiny bit, but it also made me a little dizzy. They hooked me up to monitors, held on with a big elastic band around my belly. The computer screen behind me showed baby’s and my heart rates, both normal, and the pressure changes when I had a contraction.

I don’t remember it taking this long, but I guess I the anesthesiologist arrived at 1:43 pm and gave me the epidural. I barely remember a pinch from the local anesthesia first. I didn’t have a problem holding still while they administered it. I had felt so uncomfortable about the whole epidural practice but in the moment I couldn’t get it fast enough.

Once the epidural kicked in I was able to rest. The nurse helped me get comfortable on a peanut ball, lying on my right side with my left leg up. This nurse was great; experienced, friendly, funny, and knew Carissa, the other midwife at Catherine’s practice, well from when she had worked at the hospital. That nurse helped me with a bedpan and I tried to pee, but couldn’t really. I could still lift my butt up and use my legs in bed really well at that point. At different times she gave me two different one-time catheters for some reason, before hooking me up to the one that would stay in. We talked about what I wanted for the birth (reduce tearing and push on my knees if possible, delayed cord clamping, leave the vernix on the baby, etc.) and she was totally on board. Somewhere in there the OB on call came in and introduced herself.

At 4:00 pm they checked me again; the doctor measured me at only 3-4 cm. So we agreed to start pitocin to help the contractions along. Here we go, classic modern medical model birth! Just like I had wanted to avoid, but in the moment it made sense to go with it. (And I should add, with every decision we looked to Catherine for her opinion. I think she always agreed with what the hospital team suggested, but it was so reassuring to have her experience and support in this strange new environment.)

At 6:30 pm I was dilated to a 4-5, still not huge progress. They increased the pitocin. I had some bloody show, which they were excited about. The OB and nurse pairs changed at the 7:00 pm shift change so we had new ones for the night.

11:30 pm to 5:30 am was a blur and even Catherine’s notes don’t say much other than difficulty with pain control and some changes to drugs. They turned off the pitocin for a while for some reason. Something was up with the epidural drugs and they just weren’t working reliably.

I’m not sure what time or how dilated I was, but at one point the night shift doctor told me that because my water had been broken so long, if I didn’t progress soon, they would need to do a C-section. I really, really didn’t want that outcome, but I was feeling so desperate and still couldn’t imagine how this was going to work and the baby was going to come out, the relative ease on my part did seem appealing. I didn’t want the recovery or the surgery, but at least it would be over. I told myself, lots of people have C-sections and it turns out okay. I am not a failure if this baby has to come out through surgery. But I was also going on very little sleep and all the fatigue and despair of the pain was getting to me. None of the possible outcomes sounded good and I couldn’t really picture any of them.

2:22 am

I was able to sleep again in between checks, in 1-2 hour chunks. Every couple hours I would wake up from the pain increasing, and switch sides. They told me I could push the button on my bed for additional (“bolus”) of epidural drugs. Since I was laying on one side, gravity was pushing the drugs to that side, and they were wearing off pretty quickly.

Two other anesthesiologists came in at different times as my pain continued; they would touch my belly and legs with an ice cube and ask if it felt cold and wet. Usually it did and they had to give me more drugs. Multiple times nurses or the anesthesiologist wondered aloud if I was a redhead and if that’s why the drugs weren’t working. Apparently there are studies on pain medication or pain tolerance or something of redheads. I’m not really a super-redhead, more auburn, but I sure did need a lot of drugs.

It was so frustrating to have given up on the homebirth I wanted and have accepted my hospital birth route, for the pain relief, and have it stop working. It was agonizing to wake up from sleep with the intense back pain and cramp again - not even during contractions, just strong, strong pain as I laid there. The contractions (every 1-2 minutes now) hurt more but at least I could focus on my breath better during them. That back pain was awful and I was stuck on my back or side in the bed. At this point they were giving me bigger doses of epidural drugs so I couldn’t move my legs or lift my butt anymore.

They checked my temperature and blood pressure regularly. Once during the night I had a temperature of 100, I think, and because my water had been broken so long they said I needed antibiotics. I really don’t like taking antibiotics, but I understand the risk and said okay. Thankfully every time anyone looked at the monitor, baby’s heart rate was looking great.

At some point in my labor I reached down and felt my belly, and where the baby was felt like a concave bean shape rather than the round bump I had had for so many months. I think they said baby had flipped around and was now posterior. This would explain the pain I was feeling in my pelvis (his head pushing against my public bone), and the slow rate at which I had been progressing (his head not pushing against my cervix the right way or something). So frustrating when he had been positioned well for so long!

The next morning at the hospital - things are really happening

At 7:30 am the next day (next shift change, so third OB and nurse), the anesthesiologist suggested they give me lidocaine in the epidural, half the C-section dose. That finally seemed to really help. Also, I had progressed to 8 cm!

8:10 am

8:10 am

I don’t want to forget that several times as I progressed I started shaking. Uncontrollable, shiver-ey shaking, chattering my teeth, hard to talk, the whole bit. Like when you’re really cold, but much stronger. Apparently this is just due to hormone changes, but man, was it uncomfortable. I also threw up two more times, lying in the hospital bed, into those little bedpan things for that purpose. I hate throwing up but with everything else going on I didn’t care that much. Jason had to catch it once, though... ugh, sorry, babe.

At 9:30 am I was finally dilated to 10 cm. Baby was still not in the right position to descend easily. The OB said that she could try rotating him manually, if it wasn’t too uncomfortable for me. At this point I had the half-C-section drugs and was finally numb below the waist, so I could just feel pressure. She reached inside me to the baby’s head and rotated him, using her other hand on the outside of my belly, to slowly try to flip him to the right position. Thankfully it worked and he stayed there after she removed her hand.

The OB suggested that we could try a few “practice pushes” as she figured I was exhausted and might not be up for it. I was in disbelief that I was completely dilated and effaced, and pushing the baby out had been one of the things I couldn't picture doing. How would I know how to push with the right muscles? I had been unsure of that forever. And now that I was having a medicated birth, I was afraid I wouldn’t be able to feel what I was doing.

So I tried two practice pushes with the next two contractions (evidenced from the monitor). It was hard work, like mild exercise, but I felt great that I was finally able to do something to move things along. And it was so different than what I had been doing--I was engaging, holding my breath, working hard, rather than trying to control my breath to relax through. With those two pushes, he moved down. It was working!

A friend had told me, in the weeks before my due date, some words of encouragement and that with her last baby she had pictured her face as she labored and it helped her keep going. Again I had felt so far removed from when and how the baby would come out of me up until this point that all I’d been able to focus on was each breath. But now, with every push, I pictured having our baby out and healthy, and all the places we would take him when he was a little older. The coast, Smith Rock State Park, this nice park in our town with river access and lots of picnic spots. Each push was for a different place or activity, and I pictured our happy family of three as I pushed as hard as I could for as long as I could before needing to take another breath. Getting teary again as I write this part!

One of the things I was worried about was tearing, so even at the hospital I had wanted to push on my hands and knees to reduce the risk. But I had needed such strong doses by this point my legs were too numb. I was on my back with my legs in stirrups. The nurse or Jason stood on my left and Catherine stood on my right and with each contraction they pulled my knees back for me and, in the beginning, helped me cross my feet at my ankles (since I thought that might help my skin from stretching too much).

Somewhere in here they had to monitor the baby with an internal fetal monitor because the monitor around my belly had stopped picking him up accurately. At our birth class when they passed around the common tools I also really didn’t like the look of the baby monitor tube they put inside you, but up it went and I didn’t notice or feel it.

Once his head was getting close, they put a mirror on a stand near my feet and I watched his head appear. And I got to touch it before anyone else. In total I pushed for about 2 hours and 15 minutes. The cord was wrapped around his neck, not sure if that had any impact on how he descended.

I don’t remember the last pushes being much harder than any of the others. They were pretty surreal. In fact, when they handed Otto to me I didn’t know what was going on - I think I had my glasses off or askew and I couldn’t tell what the heavy thing they were passing me was. I couldn’t see him in focus and didn’t know why all these new nurses were around us, scrubbing him with towels. I told them to stop, since we had talked about keeping the vernix on him, but they said he wasn’t breathing and they had to rub him to get him to start, and I could help, too. I rubbed his tiny back and torso with my hands and heard him make some raspy breaths, but he was very limp. After what was apparently about a minute of this, they said they had to take him away to get him to breathe and scooted Jason in to cut the cord. (I didn’t have time or words, but in the moment I thought if we had to cut the cord he could at least cut it as close to the placenta as possible to give Otto as much cord blood as was in there, but no, he cut it near his belly button. No science behind that anyway, it was just my thought at the time.) I was scared by what they were saying and that they had to take him away from me, but I also didn’t understand why they were so rushed, since he had made some little breaths and I thought for sure he would start crying any minute--because I am an optimist and I so, so wanted him to cry.

He was born at 11:42 am on Thursday, one day after his due date and almost 44 hours after my water had broken. He was 8 pounds, 15 ounces and 21 inches long. (Bigger than both my midwife and prenatal chiropractor had predicted!)

On the next contraction, I birthed the placenta, whole. It came out easily. I was also worried about postpartum hemorrhage and something going wrong with delivering the placenta, but thankfully that part went smoothly. The OB showed us the placenta and it wasn’t round as usual, but had two lobes at the top I guess--something our ultrasound hadn’t picked up.

Otto was on the CPAP machine for 15 minutes, Jason watching with a group of nurses around him the whole time. His Apgar scores were very low (Apgar is based on heart rate, respiratory effort, muscle tone, response to stimulation, and skin coloration) because he wasn’t breathing and was limp. They were 4, 6, and 8 at 1, 5, and 10 minutes. (They later said that he was never in huge danger and the midwife team would have been able to do the same thing at home, but still, not what anyone wanted to see.)

During this time the OB stitched me up, which felt like it took forever. I had had a second degree perineal tear as well as a left sulcus tear (to the side). It could have been lots worse, but as tearing at all has been one of my big fears about childbirth almost my whole life, this amount of tearing was discouraging and I felt frustrated that I hadn’t been able to do more to prevent it.

Also, the shaking came back at some point after delivery. So uncomfortable, but no one seemed worried about it. Worst was, I started to feel the low back pain again after delivering and was afraid for a minute that this pain would never go away (even now that the baby was out!). I think I pressed the button again for more epidural drugs and the pain didn’t come back after they wore off. I also didn’t have any afterbirth pains.

Everyone came to visit right away. Like, half an hour after Otto came out or something. My parents and Jason’s parents and brother. Jason had been texting everyone throughout the whole process and they were all on the edge of their seats (and we had gone to the hospital a full 24 hours before) and were all so happy to come! I was overwhelmed and their visit was very short.

12:06 pm

Before we left the delivery room, my nurse helped me walk to the toilet and pee on my own for the first time. It wasn’t fun, but the worst was moving from the bed. I guess I was able to use my legs slowly and with help, but I had developed hemorrhoids during the pushing and I was just in pain in general.

Baby is here

They got us to a recovery room about an hour after we delivered him; I got to carry him in my arms in the wheelchair down the halls. This room was much smaller than the delivery room but comfortable, with a huge window and bench for Jason. We had wanted to leave the hospital as soon as we could, but because of Otto’s low scores and because I’d had that fever at one point Otto might have had an infection, so we knew we’d be there a while.

They had to check Otto to see if he had gotten an infection by doing a blood culture, so they had to leave an IV line in in case the test was positive and they had to give him antibiotics. Jason and the nurses took Otto to another room to have an IV line put into his tiny hand, but they couldn’t get a vein so they brought him back, and had to leave again when a NICU nurse was available to try. The culture takes 24 hours minimum and they finally got his blood sample/left the IV in at 9:30 pm. It didn’t seem to bother him but I hated seeing it on him and knew how mine felt so his must not feel good.

 

I still had two IV lines in me, one in the bend of my left elbow and one in my right hand, so I couldn’t move very much with either arm without feeling one of them poke or pull. The left one was bigger in case they needed to give me blood; thankfully they didn’t and they were able to remove that one at some point.

His head was so cone-shaped. We have a photo of Jason’s dad holding Jasn right after he was delivered by C-section (after hours of his mom pushing…) Otto’s head looked about the same. (It rounded out so quickly, though, even by the time we got home it looked more normal.) It also had some red spots including one big bruise-ey one, supposedly where he had been pushed against my public bone. One of the lactation consultants noted that sometimes babies that have had head trauma have a hard time nursing because the muscles that suck and swallow reach up to the head, and it might hurt to use them.

I don’t know what all else happened that afternoon and evening. The care we received was really great and everyone was supportive and helpful. We had continual help from our nurses, who are training in breastfeeding support, plus two visits from a lactation consultant with extra help on nursing, and they scheduled me for a follow-up visit at the clinic the next building over for a couple days after we got home.

First thing the next morning, our pediatrician came by to check Otto out. We had picked out a pediatrician beforehand and the nurses had called his office and arranged for him to come over. (He has “privileges” at this hospital so visits babies there right after they’re born, but had we birthed at home we would have gone in to his office straight away instead.) Otto was doing well, but the low Apgar scores and the possibility of him having an infection had everyone worried and our pediatrician suggested we stay for a second night.

That first full day after the birth, we were feeling much more back in our own heads, less in shock. Otto was very sleepy but breastfeeding, and he and I were both doing very well at every check. We holed up in our room but there was plenty to do… track all of Otto’s feedings and diaper changes, watch the new parent videos on the TV, get some checks done like the baby hearing test… we were not bored. Plus, it was very nice to have nurses around all day and night, especially because I couldn’t sit up without so much pain and couldn’t easily get Otto out of his rolling bassinet if he cried (and Jason didn’t always wake up on his own).

This is me after a shower :)

We also took our time settling for sure on Otto’s name. We finally decided and wrote it down about 30 minutes before we left the hospital! (Having them take care of the birth certificate paperwork was another pro of the hospital; I’m not sure how it usually works with my midwife’s practice but there might be an extra step for me.)

On the second morning, we were cleared to leave and we dressed Otto up in clothes rather than a swaddle for the first time, for the car ride home. I rode in the back with him and he slept. Then we were home! And began a whole new set of challenges!

Home, recovering, and processing

The first days were a blur, then the sleep deprivation and postpartum hormone changes really got to me. That’s another story. Also, when we came home Jason felt sad seeing the signs of the intense hours I had spent laboring here--the yogurt tub he used to pour water on me in the tub, the quiet apartment… “the last time we were here, you were in so much pain.”

My recovery went relatively well but I had to sit on the inflatable cushion seat the hospital gave me for a couple weeks. At first I thought it was just the hemorrhoids that were the problem but then the stitches really started hurting. I had a postpartum home visit from my midwife’s nurse less than a week after he was born, and then had my 3- and 6-week follow-up appointments with Catherine. Great that I didn’t have to go back to the hospital and work with an OB I didn’t know. It was also really good to talk to Catherine about my birth experience, helped me process more. At my 3-week after visit she said she had also been thinking about it a lot since, why it took so long and was so hard. She was really proud of me for sticking with it when I was so tired and had been in pain for so long. She hinted that some people might have just asked for a C-section… that hadn’t occurred to me.

Our first family photo

My feelings about the birth have changed off and on. At first, I felt so positive about the hospital experience, so well taken care of. We liked almost all of our nurses and appreciated the open attitude our hospital had (no judgment toward us as a homebirth transfer, no questions about our preferences for delayed cord clamping, etc.) and system in place for things that are important to us like breastfeeding support. Plus, despite the issues with it wearing off and not being strong enough, I was so grateful for the pain relief and that I hadn’t had any terrible side effects. Also, fresh from the pain a day or two after, I remember feeling serious doubt and lack of understanding for people who have successful homebirths. How can they do it?? Are they just much stronger than me, or did I get unlucky with the amount of pain I felt? (I usually am pretty tough and think I have a pretty good pain tolerance, though it has never been tested like this.) Part of the reason I wanted to have a homebirth was that I wanted to experience everything about this process like so many women before me, but because of whatever caused the pain and slow dilation, I wasn’t able to. I didn’t feel like a failure because I was strong through everything that I did experience, and I felt like there absolutely was no other option than for me to get the drugs.

But as time has passed and the memory of the pain has faded more, I’ve forgotten exactly how bad it was and questioned why I couldn’t keep going at home. Talking to people who’ve had unmedicated births, I just don’t understand it, and it makes me question myself. (However, writing this loooong story down has brought back a lot of my feelings and I remember better now. I feel good about the choices I made. I still do feel a little sad and confused about why my body did what it did.) I don’t feel any guilt or like I did anything wrong, but I do feel like I missed out on something (I have no idea what, and how I would have felt after it). I feel… a little cheated, I guess? I still wish I could know what it’s like to experience all of childbirth, but I really, really, didn’t think I could keep feeling that pain.

A few weeks after, I saw on Instagram some photos from one of Ina May Gaskin’s books of a woman in labor (unmedicated) with the captions in the book saying something like “Look at this first-time mother, smiling through pushing!” For so, so long I had believed that that was the kind of labor I wanted, and that it was possible for almost anyone who made it her goal. But after my birth experience, I felt frustrated by that book, like it was leading people on. I didn’t believe anyone could have a birth like that. I told this to my midwife and she said something good about how we as women put so many expectations on ourselves, and referenced something Michelle Obama said at the the 2018 United State of Women Summit. I still need to watch that.

I also at one point engaged with someone on Instagram, just found her through a hashtag, who said she’d had something like a 5-hour birth with her first. I commented how crazy that sounded to me after my long experience and she replied she thought it had to do with her exercising. I felt (perhaps an overreaction) a little insulted. I am strong, and had been strength training and working on issues with a physical therapist and chiropractor for years before getting pregnant. I believe all of that helped me in my labor and the problem was not that I wasn’t fit enough!

I know that first labors are often long. I know other people have experienced very long, hard, surprisingly painful labors before. However it took us all by surprise. 44 hours from water breaking to baby? All that pain getting to 3-4 centimeters? My midwife said she had spent a lot of time thinking about my labor and why it went that way. When I tell my story to friends who've also had babies, it seems like they think they understand, because they felt a lot of pain, too. At first I thought my case was special; then I started to question and think maybe I was just weaker. Like I feel like I have to justify that I needed drugs even with my natural birth prep and philosophy. I think I need to try to continue to think that some combination of factors made my labor uniquely challenging, and I was very strong and made the only good choices I had.

I hope that, now that I understand more and have faith that the baby will come out of me, maybe I can feel better about my options next time even if I have to change the plan last-minute. Because the idea of the baby not being in my body anymore through a process my body would start on its own was so confusing to me, I feel like I couldn’t picture it working and it didn’t work (the way I’d hoped). Discouraged that I wasn’t able to prove myself wrong. An at-home, unmedicated childbirth where I feel and process everything is still an elusive situation for me, and I’m not sure I’ll ever be able to have one.

I’ve heard a lot of birth stories and a lot of women’s feelings about what happened to them. I’ve heard the perspective that the baby is here and healthy and that’s the most important thing, but that is only part of it. Women can end up with extreme psychological distress following a difficult childbirth and there can be serious consequences, PTSD, feeling isolated, feeling without a voice, being told to get over it. Thankfully I have been very supported throughout my experience and with all my feelings, but I still have some processing to do. I hope I can read back through this next time I’m pregnant and feel good about the birth setting I choose. Right now it just makes me feel nervous (what if I have that back labor and cramping again, or what if it’s still really long).

I am so, so grateful to have a healthy baby and that my body is feeling close to back to normal. I’m amazed I was able to grow another human being, and my body did just what it was supposed to for 99% of the whole thing. Thank you, body. Thank you, world I live in. Who knows what will happen next time.