- November 2016
- First baby
- Mom’s Age: 29
- Born at 38 weeks, 3 days
- Unmedicated/Natural Birth
- 16 hour labor
- Philadelphia, PA
- LifeCycle Woman Care, Bryn Mawr, PA – Prenatal care, planned Delivery
- Pennsylvania Hospital – Delivery
- Amanda Jacobs – Prenatal and Postpartum Doula
My pregnancy was not exactly enjoyable (fatigue, nausea, vomiting well into the 2nd trimester), but baby and I were healthy. After some research and one traditional OB visit, I decided that a free-standing birth center would be the environment most compatible with my goals for childbirth. I hoped for very little intervention during my pregnancy, labor, and delivery. Apart from the fascinating and exciting anatomy scan at 21 weeks, my prenatal care and visits were uneventful – blood pressure and baby heartbeat checks, weigh-ins, and the standard tests.
I managed pregnancy thanks to prenatal yoga 2-3 times week and weekly chiropractor visits (Webster technique) – plus prenatal massages when I could swing it! With these practitioners, sessions with my wonderful doula, and the childbirth and breastfeeding education classes at the birth center, I felt mentally and physically prepared for labor and childbirth. There was no shortage of traumatic stories and worried words from friends who insisted an epidural was a necessity. Seeing as there was no way to control what would happen, I found it much more pleasant to focus on the path of manageable labor and an unmedicated, natural childbirth. I spent a lot of time visualizing what my body was going to be doing. I half-listened to hypnobirthing guides and fell asleep reading euphoric and pain-free birth stories. I crafted and protected my bubble of optimism.
Around 37/38 weeks, I sensed that labor was near, but everyone I told dismissed my intuition as being wishful thinking from a first-time mom – no matter how much I insisted that I wasn’t in a rush since I was feeling relatively good. I often second guessed my body’s sensations based on the opinions of professionals who “knew” much more about this than I did. My son was due December 4, but I felt very sure that I’d have a November baby. As I wrapped up work for the Thanksgiving holiday, I was all but certain that I wouldn’t be back the Monday after. I had my regularly scheduled appointment on Tuesday evening and there were no clear signs of labor. My husband and I were planning on going out to eat for Thanksgiving dinner, but as I finished up a half day on Wednesday, I decided that I wanted to get ingredients for a simple dinner at home on Thursday. I am convinced that the moment I picked up the turkey breast, the baby decided he was ready.
Wednesday afternoon, minutes after I logged out from work, I lost my mucous plug. I spoke to my brother that evening and told him that I thought I’d have a baby in the next 24 hours. Still, no contractions or signs of early labor. Just a feeling. I awoke at 4am on Thursday thinking that my water bag had broken. I reached out to the midwife on call a few hours later and she asked me to come in at 10am to confirm whether it had broken. I had tested GBS positive, so if the water broke, I’d need to begin doses of antibiotics to minimize the risk of the baby contracting Group B Strep. The birth center is 45 minutes away, so we packed up the car with everything we’d need in case we needed to stay.
When I arrived (on Thanksgiving Day), the birth center was very quiet. The midwife on call was across the street at the hospital with a woman who had transferred, so I was seen by a nurse. She did a pH swab and confirmed that my water hadn’t broken. She couldn’t reach my cervix easily, so she didn’t check me for dilation and sent me home. Before we left the house, contractions were manageable, consistent, and far apart. After packing up and driving over, they were occurring randomly. The nurse suggested that the best thing I could do whether I was in labor or not was to eat, drink, and rest. She suggested that I take Benadryl to help me rest in between contractions. My husband and I stopped for bagels and drove back home. He went to pick up Benadryl and Gatorade and I laid on the sofa and ate my second bagel. Once he returned, we started timing contractions again. They were around 8 minutes apart and I would doze off between them. Around 12:30pm, I became much more uncomfortable and couldn’t find a position to alleviate the pain of the contractions. I went upstairs and began a blurry routine of laying, swaying, showering, bathing, crying, projectile vomiting, lots of moaning and perhaps a bit of screaming. My husband did his best to time contractions and communicate with my doula and midwife. I suspect the birth center was understaffed on the holiday, as it took a while to get the midwife on the phone. Each time he or I spoke to her, she seemed to suggest that this was prodromal (“fake”) labor, and that I should just keep trying to rest. As the day progressed, the pain became unbearable and I kept thinking that if this wasn’t labor, I was totally unprepared for what was to come. I had prepared myself for the very intense pain that came with contractions, but I had also anticipated breaks between them – however short – to eat something, take a sip of water, regroup, breathe deeply, reposition myself. But for the last few hours of labor, my contractions were a 9 or 10 on the pain scale, and the periods between them were at least a 5-6. There was no respite and very little opportunity to use the pain management tools I’d practiced.
My doula said she’d come over in about an hour, but my semi-traumatized husband asked her to come over as soon as possible. Once she arrived, she tried to help me using some of the comfort techniques that we’d discussed, but I couldn’t find any relief. Once she saw me in person, she began asking very seriously whether I felt the need to push or poop. I said I thought I’d been feeling that for hours. As I felt like my body was splitting in half, the midwife suggested that I drive over to get a dose of morphine (which would reach the baby as well) so that I could rest and be ready for when labor began. My husband, doula, and I scrambled to get ourselves in the car. As I walked outside and eased myself into the front seat, I imagined throwing myself out of the moving vehicle to escape this pain. Before my doula closed the door for me, I asked her if we could regroup, because things didn’t feel right. I asked her if they have morphine at hospitals, and she confirmed that they do. After some back and forth, she and my husband reminded me of what I wanted and I agreed we’d try to make it to the birth center but would stop at a hospital if I couldn’t do it. By the time they’d walked around the car and got in, I scrapped that plan and demanded that they take me to the closest hospital and drug me up.
We arrived at Pennsylvania Hospital at approximately 8:10pm. After 46 minutes of mind boggling hospital procedures, my baby was born. I was 8cm when the hospital’s midwife first checked me, then 9cm and +2 after one more contraction. The nurses were trying to get an IV in me to get the antibiotics started for GBS (even though it was almost certainly too late). I was pushing a little bit, out of necessity and defiance, as they made me change clothes, move rooms, and move beds (all of this seemed completely insane and tortuous to me at the time). I felt defensive and paranoid in the hospital setting – my senses were completely flooded after leaving the quiet, calm, candle-lit comfort of my home. However, hearing that I was 8cm and most certainly in labor was rejuvenating. Once I was in the bed that I was permitted to give birth on, I pushed with the support and perfect instruction of my doula for just a few minutes, and then pulled my baby boy up onto my chest. I loved pushing. It was so purposeful and clear compared to the need to bear and endure contractions.
From the moment Xavier’s head was born, I felt better than ever before. The wave of hormones was intoxicating. Aside from getting a few stitches from my first-degree tear and lots of shaking/quivering, I felt incredible. We delayed cord clamping, and then my husband cut the cord and my placenta was placed in a cooler for encapsulation. Time flew by, but we had lots of skin to skin time and X was latched and nursing within the first hour. Once I soaked up every ounce of him I could, I let them do the weighing and measuring and vital checking. His temperature was a bit low and he was small (5lbs 6oz), but everything seemed fine.
We wheeled over to the recovery room and I waited, consumed by elation and adrenaline, for my mom to arrive at 2:30am. We spent the next day or so trying to check all the boxes so that we could go home. I was desperate to get out of the hospital and into my bed with my perfect little boy. They insisted that we stick around to monitor him for GBS since I wasn’t administered antibiotics in time for the baby to get them. I showed off my baby to all the nurses and anyone who stopped by. I felt proud of how strong and healthy I was feeling and how well he was eating. I adored him and doted on him, diligently using the bulb syringe to remove the bubbles from his mouth and nose after learning that they were probably the result of amniotic fluid he swallowed during a precipitous delivery.
On Saturday morning, 36 hours after Xavier was born, we were preparing for discharge (finally!). The nurse who’d just started her shift checked his vitals one last time and was a little concerned with his breathing. She wanted to bring him to the nursery for a quick check. I insisted that I feed him before they go, but she said she’d be right back. A few minutes later, the Chief of the NICU came to visit my husband and me and explained the birth defect of the esophagus and trachea that she suspected my son had. Whether she was correct or not, we would need to transfer to the Children’s Hospital for imaging.
The next time I saw my baby, he was in an incubator surrounded by medics prepping him for ambulance transport, with a breathing tube and seemingly endless wires and tubes. We followed him to CHOP and were greeted by an enormous surgical team who confirmed the Chief’s suspicions (Esophageal Atresia with Tracheoesophageal Fistula) and explained what would follow. After the two longest, most excruciating hours (I was longing for the good old days of contractions), we met the surgeon who explained with confidence the “beautiful” repair of both the esophagus and trachea. The bubbles that I’d been helping Xavier to clear were occurring because the top half of his esophagus ended in a pouch, meaning that the milk he’d been eating since he was born came right back up. In surgery, the top and bottom sections of the esophagus were connected and the hole in his trachea was stitched up.
The week that followed was the happiest and hardest of my life. Each day was filled with new stresses and pain and trauma. And yet, having a baby who is healing from a successful surgery with the most treatable type of an understood and isolated birth defect is a good as it gets in the NICU. We felt like the luckiest parents on the planet. Xavier LeMay was released from the hospital on his due date, without so much as a band-aid (but with two badass scars).
Looking back, my only regret was not attempting to deliver in a more natural feeling position (laying in a bed while pushing felt counter-productive). Everything happened so quickly and decisively once in the hospital, I forgot that this was even an option. I am disappointed that I felt so unheard by my health care provider, one I chose with such intention. My confidence and management of contraction pain was clouded by the voice of a professional telling me that I wasn’t in labor. In the end, my birth story was very close to my vision in all the ways that it mattered. And to answer the question that most people ask me: If the post-natal amnesia is strong enough that I ever decide to do this again, I’ll plan on a home birth.