Consider yourself warned: this is LONG. Potentially graphic. Includes just about every bodily fluid you can imagine.
The night of Monday, January 11 was different than most other nights, but only because we stayed up way past our bedtime having dinner with new friends. I flouted all sorts of pregnancy rules and ate sushi and drank a tiny bit of champagne and listened to my friend’s birth story. Short version: her water broke two days before her due date; her midwife (who also happens to be my midwife) put her on a castor oil and vodka regimen, her contractions started, and the next morning her son arrived, happy, healthy, and at home.
“Well,” I joked, “if I follow your example, I guess I’ll be having Moonshine tomorrow.”
Just a few hours later, I woke up at 3am to pee (no surprise there), walked out to the kitchen to get water (totally normal also) and then felt myself peeing all over my legs, unable to control or stop the deluge (big surprise there).
It was, of course, not urine but my water breaking. Moonshine had clearly been taking notes during dinner.
20 minutes later, my parents were on their way to the airport, I had marching orders from my midwife, and I was back in bed, doing my best to fall back asleep despite the overwhelming awareness that sometime in the next 24-ish hours shit was going to get real real.
I spent that day waiting for labor to start on its own, and to cross off all those last minute things on my work transition list. I was grateful to have a few hours to tie up loose ends before labor really kicked in, and the looming deadline amped up my productivity into an exhilarating frenzy.
By evening, I was still contraction free, still leaking amniotic fluid. I knew that as recently as a few days before, I hadn’t been dilated or effaced at all, so my body had a lot of work to do to get this baby out before time ran out.*
Time to jumpstart this process.
Around 6pm, I started my prescribed regimen of breast pumping, stair climbing, and herbs. My mom, good sport that she is, climbed up and down the dreary emergency-only stairwell in our building with me.
After having taken it easy on the exercise front for 9 months, and with an extra 40 pounds to lug around, those stairs were hard. My 20 minute sets of climbing left my legs shaky and burning, in an almost-pleasant, remember-what-exercise-feels-like? kind of way.
At 9pm, it was time to pre-party: I shot two ounces each of castor oil and vodka.
Having exhausted all my labor-starting tactics, I woozily watched a Jennifer Aniston rom-com with my family, kept downing electrolytes in anticipation of the castor oil’s powers of dehydration, and waited for contractions to hit.
I’d been advised that the best way to handle early labor was to take on some kind of project: to make a meal, take a walk, go to the movies. Basically, distract yourself until the contractions draw you in and blind you from everything except that moment and that sensation. I’d imagined my project would be to take a very slow walk along the lake with Nathan, or maybe take Tigger out for a hike. Something in nature, but not too far from home, sounded perfect.
Reality was a little different from that vision, and not just because it was 11:30pm: my unchosen but absolutely mandatory beginning of labor project was to station myself on the toilet, leaking from just about every orifice. There in my tiny cubicle, as my insides liquefied faster than I could chug electrolytes, I had some bloody show, and the contractions sprung into action at a brisk 5 minutes apart, lasting between 45 seconds and a minute each. In under an hour, they were 2-3 minutes apart and lasting at least a minute each. Meanwhile, I was still toilet-trapped, practicing my yoga breathing as my body did its best to turn itself inside out.
When the castor oil had finally exhausted my body’s capacity for elimination, I draped myself over my yoga ball and called my midwife.
She arrived around 1am and checked my cervix. I was a 3.
I was disappointed by the results; even though I’d only been in labor for an hour and a half, it had been a gung-ho hour and a half. Since the contractions had leapt right over those warm-up hours, into the frequency you expect in active labor, I’d (foolishly?) hoped my cervix would keep pace. She suggested I get into the bath, and let me know that even though she usually goes home when a woman in labor is only a 3, she was going to stay with me.
At that point, I realized, without admitting it to myself, that something wasn’t right. We’d talked extensively about the bath for relaxation and pain relief, and she had consistently told me we’d save that luxury for transition. But I hopped on in.
That was when the back labor reared its ugly head: a searing, vise-like pain in my lower back that intensified with each contraction but, unlike the contractions, didn’t release in between, and was only made bearable by the counter pressure dutifully applied by my mom or Nathan as each contraction ramped up. No matter what position I tried—kneeling over the bed, sitting on the edge of a chair, leaning on my yoga ball, hands and knees, etc—there was no escaping it. More often than not, one of my support team would take my back while the other held a trash can or towel for me to puke in. God knows how there was anything left to puke up after my castor oil adventures, but time and again, my stomach reliably delivered back its contents.
My midwife checked me again. I was a 5, and starting to be effaced.
Again, disappointment. She was really encouraging about the progress I’d made and suggested I get back in the tub to help me relax and get energy to keep going. She assured me I’d come very far in very little time, but I couldn’t help but think, only halfway there, and I’m already feeling pretty ragged.
A while later (who knows how long?! Time was unintelligible by that point) I got back out of the tub, and sat on the edge of the bed, knees wide, leaning forward so that Nathan could have access to my back, and the trajectory between my throat and the trash can was short enough to reasonably ensure successful deposits. My midwife checked Moonshine’s heartbeat and heard some deceleration she wasn’t comfortable with. She had me lie on my side in bed, where Moonshine’s heartbeat picked back up, but where I crossed into a new threshold of pain.
The sounds coming out of my mouth were at a pitch and urgency I didn’t know I was capable of making. Nothing that I’d read about or practiced seemed to help. Yogi breathing, hypnobirthing breathing, vocalizing, counterpressure, surrendering to the pain: it all felt inadequate to the unrelenting and pulverizing pain in my back. I needed a way out of my body. With each contraction, I felt myself tensing and curling and begging for a change in position, a way out. As much as I tried to surrender to the sensations the way all my childbirth books had taught me to do, I simply couldn’t. I was stuck in the intensity.
I had all too recently been pronounced only halfway through this first phase of labor, but I took that feeling of desperation as a glimmer of hope: maybe I’d made it to transition? Maybe this hitting the wall was a sign that I’d arrived at the worst of it, and if I could just moan and bear it for a little while longer, this would all be over.
She checked me again. A 7. Not in transition yet. That meant it was only going to get worse.
My midwife started an IV to help replenish the fluids I’d lost over the last few hours, and not too long after, she was kneeling beside me, gently but firmly telling me that we needed to transfer. In the least alarming way possible (I can’t for the life of me remember how she communicated the message so gently, but she was a master at it), she let me know I was too dehydrated; Moonshine’s heart rate decelerations were alarming; and we weren’t close enough to the finish line for her to feel comfortable proceeding at home. She asked Nathan how much longer he thought I could go on. When he estimated 6 hours, I wanted to scream, fuck no, I do not have another 6 hours in me! but the contraction mangled that sentence into yet another primal wail.
By that point, I had zero preference about how it happened as long as I could get this baby OUT. “Let’s go,” I said, never more certain of anything in my life.
She suggested we call an ambulance but Nathan insisted he could get us there faster.
The driving time to the hospital was mercifully short: 4 contractions, 7 minutes. The only position I could handle contractions in was on my hands and knees, so our trip was punctuated by me sinking to hands and knees to groan through another wave in all sorts of unlikely places:
- The hallway outside our apartment, waiting for the elevator
- Inside the elevator (much to the confusion of a FedEx delivery person)
- On the ground in the parking garage, halfway between the elevator and our car
- 4 times in the backseat of the car (even my safety-officer husband let me slide on not wearing a seatbelt)
- Inside the revolving door at the hospital (a crawling and contracting two-for-one)
- In the hospital lobby
- In the hospital elevator (I lurched out of the wheelchair, elbowed some space for myself, and made my unfortunate fellow passengers hold the door at my floor until it passed and I could get back into the wheelchair).
- On the labor and delivery bed, as the anesthesiologist stood behind me, needle poised for entry as soon as the contraction passed
Let me tell you, crawling in a revolving door, then lurching into a hospital lobby and immediately falling to your hands and knees while moaning will get you the speediest attention and care you can imagine. They even called a code for me over the loudspeaker: “Dr. Stork to the lobby!”
As I waited for the epidural to kick in, I once again had to be on my back. Nathan and my mom held my hands as I groaned through each contraction. My mantra between contractions became, “Not as bad as the last one. Not as bad as the last one. This is almost over. Almost over.”
At last, the drugs and the IV worked their magic, and I found my body relaxing into itself again. I watched the contractions happening on the monitor, blissfully unaware of their impact in my body. They had me lie on my side with a big pillow between my legs to try to encourage Moonshine to rotate; apparently she’d wiggled into a new position again and that was causing the back labor.
The next time they checked me, I was an 8, and 90% effaced. The easiest centimeter yet.
I continued laboring for a few more hours, the only reminder of the pain a hotspot in my lower back. It was just a shadow of what had once been, a continual reminder to be grateful for the epidural.
The nurse checked me again and said, “Oh! There’s the baby!” I’d labored her down to station 3 (basically, right about to crown).
The pushing started almost immediately. That was the strangest sensation: I had 4 or 5 people holding my legs, giving me instructions on how to push, and I had zero feelings below the waist, so it was all physical guesswork. But eventually it all worked out, because suddenly there was this baby being handed to me, a baby with a head full of dark hair who promptly pooped on my chest and then was whisked away from me.
I’ve lost the memory of the next few hours almost entirely. I remember being stitched up as sensation slowly returned to my legs; I remember the nurse in my postpartum room hustling to get me to the NICU before they closed for shift change; I remember my mom waking me up at 1am and wheeling me through the hospital because the NICU team had just given us the green light to hold Mackenzie.
Seeing her in the NICU was the most surreal experience: here was this human whom I’d created and then evicted from my body, only to find her on a mechanical life support, covered in tubes and tape and breathing apparatuses. I could scarcely believe she’d come out of me, could scarcely fathom why she was there, could scarcely connect the dots of the last few hours.
It took me several days to piece together how it all happened, and to come to terms with the major change of plans. I’d wanted a home birth not so much because I wanted to be a martyr, or because I particularly relish pain, but because I found the idea of letting a natural process take place so beautiful. I read everyone from Ina May Gaskin to Ricki Lake and eagerly lapped up what they were selling. I wanted what biology intended: that cocktail of hormones that help prepare you for birth and that help you bond with your baby and help your milk come in. I didn’t want a cascade of interventions that may or may not be necessary. I wanted the experience to be on my terms, not on a malpractice-shy and policy-and-procedures-driven doctor’s terms. I loved the thought of never leaving home, but just snuggling up with our newborn, in our bed, with all our creature comforts around us.
As it turned out, the things I most feared happened:
- I ended up in the hospital
- I delivered on my back, with my legs in stirrups
- I had the ‘cascade of interventions’: an epidural, pitocin, stitches
- I had a second degree tear
- Mackenzie was taken away from me after just a few seconds of skin to skin; it would be hours before I would see her again, and days before we’d go home together
And it all turned out for the best, despite all those things I’d wanted to avoid happening. I had the most incredible support team, and I’m so grateful the NICU doctors were right there to help Mackenzie start breathing. (Apparently it took her a good 45 minutes and a lot of effort on their part to get her to pink up).
The question I haven’t answered for myself is what I would (or will) do differently next time. My midwives gave me the most beautiful prenatal and postnatal care: personal, non-interventionist, holistic. I’m grateful that I experienced at least part of a natural labor. That edge, where I was convinced my pelvis would shear in half, was one I wanted to experience (though I probably would have been fine with a little less time spent there!). I wanted to know what my body was capable of, and I wanted to know what I was capable of. That said, I’m honestly not sure if I could hack it all the way through, or if I’d want to. Maybe if I’d eased into labor rather than slamming right into that intense frequency, I would have made it to the finish line?
I don’t know. In any case, that epidural was fucking magical. I’m not ruling out a repeat just yet.
And, of course, the most important thing is this: we all made through the experience healthy and happy. Mackenzie had her own agenda in birth, just as she did when she was in the womb, and she must have known that she’d need a little extra support once she made her debut, and she found a way to make it happen.
*Hospitals will usually give you about 24 hours from rupture; the midwives were comfortable with about 36. Either way, my deadline for a natural delivery was fast approaching.