Birth On Her Terms

First Baby
2008 MA General Hospital

I was having something like menstrual cramps close to my pelvis on and off for about 2 weeks but my due date came and passed and there was nothing substantial happening. The psychology of the due date was definitely there and I was quite bummed for a couple of days, but when I readjusted my thinking with the help of my wonderful doctor, who said that she would not do anything until I reached at least 41 weeks and after that we would think about it, I was feeling better.  Also, I learned that a study showed that the average arrival day for first-time babies were 8 days after 40 weeks! Anyway, I went to my doctor's appointment 3 days after my due date and she checked me for the first time and I was 80% effaced and 2 cm dilated, so she said she was certain that this baby was going to come by herself and no intervention would be necessary.

A side note here: although I gave birth at MGH and it is probably the biggest interventionist center in New England, the attending doctors and the labor and delivery nurses were all very supportive and professional. I asked for the advice of many people at the facility to determine what their overall attitude was (my doctor herself was just fantastic, after she learned of my choices, she did not utter 'checking, pain, induction, etc.' once, actually she was the one that supported me when I was bummed after my due date) and they were very good. One nurse even told me 'We are an interventionist facility because we see a lot of high risk cases but we will support you fully in your choices as well and they did.

The next day at 6:30 pm, my water broke. There was a mucous layer in it, which I think was the cervical plug. I called my husband and told him to come home (when I say call, it is slightly indirect because he had forgotten his phone at home and I had to call his boss, he had already left work and was biking home!). Then, I took a shower and got some last things ready for the hospital. When my husband came home, we ate dinner (since they don't let you eat anything during labor). At around 9:30 pm, we headed to the hospital. I had tested positive for
GBS, so I knew that the hospital would want me to be on IV, I was a little nervous about that because I did not want a continuous line hooked up to me. By the way, there were no contractions at this point.

We arrived at triage at 10 pm, a friendly triage nurse took my vital signs and hooked me up to the monitors for 20 minutes. Then, a resident came in and said she would check me for dilation, explained that they would need to give me an IV and so on. I told them that I did not want to be hooked up all the time so I wanted a 'hep lock' so that the IV can be taken on and off (they only need to give the antibiotics once every 4 hours for about 30 minutes). The resident was awful both in demeanor and in skill. She hurt me quite a bit when checking unlike my doctor. I was 3-4 cm dilated. So, they admitted me to the hospital, gave me a room with the jacuzzi upon my request and hooked me up for my first dose of antibiotics.

Around 30 minutes later, my contractions started. Actually, I did not know they were contractions initially because I always thought the contractions were going to envelope me around the abdomen like the Brackton Hicks ones that other people were having, but they were just escalating menstrual cramps. They started about 5-7 minutes apart. We played our hypnobirthing CDs and also another birthing imagery CD I had during the entire time and R was very helpful in not allowing me to tense up. I was hooked to the contraction monitor and the baby heart rate monitor wirelessly so I could move. The contractions were first longer in duration with a lower peak, then started getting more intense but with a shorter beginning and an end. I went into the hot shower at around 2:30 am and stayed there for about 1 hour, which was a great help. By the way, one thing I don't remember hearing is that you get the 'shakes' during labor! I was shaking so hard at times before and after the contraction that my jaws would chatter! But the nurse, who was also really good at guiding me to positions that would help me, told me that the shakes were a good sign for dilation and that bleeding was also good, meaning that the uterus was doing its job. Unfortunately, another stupid resident, chief-resident this time, came in to tell me that she just wanted to 'put the idea in my head' that they can induce me at 3 am; this was at 2:20 am and it was pretty clear from the monitor that I had had contractions for the last 3 hours and I was getting antibiotics so there would be no significant risk of infection until 24 hours. Anyway, I told her that I was taking the antibiotics, I was having contractions, there was no need of induction and to go away.

After the shower, I spent a good amount of time on the birthing ball, which was very helpful in keeping my pelvis open during the contractions. Also, leaning forward on R or on the windowsill and moving my hips front and back was very helpful. At this point, the sun was slowly making its appearance over the Charles River spectacularly but I did not really register it at the time! It was getting very exhausting and I asked to be checked. At 6:30 am, I was unfortunately 5 cm dilated. The thought of another 7-8 hours (although I knew the labor process is not a direct function of time) took the wind out of my sails and I asked for an epidural. The anesthesiologists were very efficient and smooth; I did not feel a thing. I asked for the lowest dose so that I could feel my legs and not be in a on-my-back position while giving birth. So, I slept for 1 hour and I was fully dilated! Then, the pushing came. Although I was determined to breath down rather than push, there was so much pressure, it was impossible to do it, so I pushed with the force of the contractions for about an hour and a half (in a half-squat, then sitting with my legs pushing against the squat bar on the bed, and finally, lying sideways with one leg up) and I finally did it!

Initially, I was pretty bummed to have caved in and gotten an epidural but I also knew that it was the best thing for me at the time. I also believe that my hard work for 7 hours was what kept the contractions from dying down when I did get the epidural. I think the negative side of the epidural was that even though it was the lowest dose and I could totally feel the baby's head position, it still must have prevented me from feeling my muscles fully because I did tear quite a bit despite weeks of vigilant perineal massage. At the same time, there was no pain after the stitches, which was highly unusual for a third degree tear so maybe it did help heal the perineum.

The baby was laid on my chest right after birth and she did suckle after a while. They did take her away to be weighed and tested for her Apgar scores in the same room while the attending OB stitched me. After about 1 hour, they transferred us to the post-partum room. The baby was with us the whole time unless we sent her to the nursery. One thing we had to do was to specify that she should not be given any pacifiers in the nursery. The nurses took good care of the baby and me. The only thing that they ran short of was the lactation consultant. She only came a couple of hours before we checked out and the baby had already lost 8% of her weight. But she did a fantastic job and now she is already passed her birth weight at 9 days!

Overall, I think my birth experience was pretty good. I hope that next time, I will not be as exhausted and things will go equally well with the baby that I will be able to give an entirely natural birth. Thanks again for all your help!

Sincerely, E