For many, many reason, our original plan was to have an out-of-hospital birth at our awesome midwife's office. Among those reasons were my desire to avoid any unnecessary interventions and to avoid a Cesarean birth. Things were going along swimmingly with that plan until I was seven months pregnant, when my midwife did a routine consultation with an OB at my HMO. In spite of the fact that I did not have gestational diabetes or any other high risk conditions and my blood pressure had been awesome, my HMO decided that I was too high risk to have an out-of-hospital birth based solely on my BMI. I was told that I would have to transfer to the care of an OB at my HMO and have the baby at their hospital. After two visits with an absolutely terrible OB who clearly did not have any interest in anything I had to say, they decided that I was too high risk to give birth at their hospital, again solely because of my BMI. The OB actually told me that the toilets might not be able to hold me! Which is ridiculous. I've never had a toilet collapse under me in any setting. My HMO transferred my care to the university hospital here when I was 35 weeks pregnant. 35 weeks! Essentially giving me 5 weeks to establish care with the people who would then be responsible for helping me give birth!
Ultimately, I was very pleased with the OB to whose care I happened to be assigned. She was great and was largely unconcerned with my weight. The monitoring that I received for the rest of my pregnancy was more intensive than I would have preferred, but I never felt that I was being pushed into something I wasn't comfortable with.
My due date was November 9, and that date came and went with no indication of labor. Right before my due date, my OB and I discussed what to do if I went past my due date and how long she felt comfortable with me continuing past that date. We agreed that if I had not gone into labor by November 20, I would be scheduled for an induction that day.
I started having relatively painful contractions at around 5AM on November 19. Since I had an appointment scheduled that day anyway, we went to the hospital and I got checked out. Since my contractions weren't progressing and I was only 2cm dilated, they sent me home. My contractions continued to be painful and regular, but without increasing in frequency or intensity for the rest of the day. That night, they started to increase somewhat in frequency and intensity, and neither Margo nor I got any sleep. I was scheduled to go into the hospital for an induction at around noon on November 20. When I checked into the hospital, my contractions were five minutes apart and I was already 5cm dilated. They proceeded to give me pitocin as planned, although it was now considered augmentation rather than induction, as my labor had clearly already started and no longer needed to be induced.
We had put together a birth plan ahead of time, key elements of which included the desire to avoid the induction or augmentation of labor, the desire to avoid the use of pain medications or anesthesia, the desire not to have my membranes ruptured and the desire to birth my baby vaginally. Each of the nurses that was assigned to us (we had four shifts of nurses over the course of my labor) had clearly read our birth plan and was extraordinarily supportive and advocated with the doctors on our behalf when necessary. I labored until well after midnight, walking around the unit, getting in and out of the tub, dancing and having my head rubbed for hours. I had been at 8-9cm for several hours when I allowed them to rupture my membranes in the hopes that that would help me dilate completely.
By around 5AM on November 21, I had finally dilated all the way to 10cm. At 5:30AM, they let me start pushing. I pushed for three hours in varying positions, including squatting. Of note, the epidural rate in this hospital is more than 90%, so the nurses had to scramble to accommodate my mobility. At one point, I was pushing while squatting next to the bed, and my fantastic nurse was under the bed, holding the fetal heart rate monitor in position on my belly while I pushed. I got the baby far enough down the birth canal that the other people in the room could see hair when I was pushing. After three hours of pushing, however, the baby was not moving any further down the birth canal and the baby's heart rate was starting to drop. The doctors came in to talk to me and suggested that it might be time to consider a Cesarean birth. After talking it over with Margo, my mom and my younger sister, we all agreed that a Cesarean birth was the best decision at that point.
The next 30 minutes were absolutely the worst part of the entire experience, as I was experiencing the literally irresistible urge to push but was being asked not to push. It was so unbearable to be fighting my body's chemically enhanced and overwhelming urge while I waited for them to get the OR ready and all of the staff in place. In the months leading up to giving birth, I stated numerous times that I could not imagine pain that would be bad enough for me to allow someone to stick a needle in my spinal column. I have never been as physically happy as I was when they gave me the spinal anesthetic for the Cesarean and the urge to push disappeared.
I was so delirious from not having slept in two days and the narcotic in the spinal that I do not recall much of the Cesarean procedure. The most bizarre part of that procedure was that, while I felt no pain, I could still feel pressure. As a result, I could feel them cutting and pulling and moving my internal organs around while they got the baby out. I could similarly feel them putting things back and stitching things up. I think that, if I had not been delirious, it would have freaked me out more than I could tolerate. So at 9:35AM on November 21, 2013, Adelaide Marie made a dramatic entrance into the world, weighing 9 pounds, 7 ounces and measuring 20.5 inches long.
While the bare facts of my labor and birth sound terrible (in labor for two days, pushed for three hours, then wound up having a c-section), and exactly what I would have told you was my worst nightmare beforehand, I actually had an amazing experience. One of the questions that I had about myself before I gave birth was whether I was strong enough to endure labor, particularly without pain medication. This was something that was both very important to me, and something I was very unsure about. I answered that question, and I amazed myself with what my body was capable of doing, and with what I was capable of coping on very little sleep and food. My mom told me later that she didn't know I had that in me, and to be frank, I didn't know I had it in me either. I also got such incredible care from the labor and delivery nurses that were assigned to us. They were unbelievably supportive, helpful, encouraging and protective of us. Having worked professionally with some really terrible nurses, I had been really worried about how I would cope with possibly being assigned to a nurse that was not a good fit. I needn't have worried. In reality, we got such wonderful and affirming care from everyone at the hospital, and I felt very strongly that everyone who worked with us did everything in their power to help us have the birth experience that we wanted. And ultimately, although the facts of the situation would lead you to believe otherwise, I had an amazing birth experience. And we've got this amazing baby. But more on that later... I promise.
