And check out the corresponding sample Birth Plan.
Update: MarvelousKiddo is no longer blogging, so I am reposting my birth story here.
Marathoning a Natural Hospital Birth
A few hours before I went into labor, we were sitting in the 3rd row at New World Stages, laughing hysterically at the Broadway show Ave Q. I was two days before my “due date,” and people looked at me as though laughing too hard would put me into labor during the show. But my body waited until my husband and I took a walk around Rockefeller Center, laughed some more at funny Halloween costumes on the way home, had some alone time, and slept for a couple of hours.
At about 5 am the next morning, I had the exact same experience as I had with my first labor. I woke up with a strong urge to urinate and was left with a strange tummy tingling sensation once I relieved myself. This time I knew it was the beginning of labor so I let my husband sleep because I knew I would be needing his support later. I stayed in bed, too excited to fall back asleep, calmly breathing big, deep breaths with my hands on my tummy, waiting for each contraction. When my husband woke up at about 7 am, I told him I was pretty sure I was in labor but let’s not tell anyone yet, just to be sure (my in-laws had spent the night). So we calmly ate breakfast with everyone, checked some e-mails, and my husband asked my Father-in-law if he could borrow his watch (we are both against watch-wearing). At 9:30am the contractions started getting suddenly strong and I told my Mother-in-law I was in labor, to which she said, “Of course you are, why else would he need a watch!” I appreciated her casualness and the space she gave me. At that point we decided to retreat into the bedroom, while my in-laws got our older son ready for a fun fall Sunday in the NYC.
For my first pregnancy, I read Ina May Gaskin’s Guide to Childbirth along with some other natural labor books and attended a very mainstream labor-preparation class through the hospital. I had a natural hospital-based labor and it went very well but I felt that I could have been more in control of the pain during the home stretch when I dilated from 5-10 centimeters in one hour! When my son was six months old, I started working in a city hospital implementing a breastfeeding initiative, which included working closely with the Labor and Delivery staff to implement changes to create an optimal environment for breastfeeding. My colleague was a Lactation Consultant and Lamaze-Certified instructor. So after watching many births, talking to staff, patients, and colleagues, I knew a lot more! Along with some excellent advice from the API NYC listserv and especially Tanya Wills from ManhattanDoulaNYC.com, I re-read Ina May Gaskin’s book, read her other book Spiritual Midwifery, and read Susan McCutcheon’s The Bradley Method, and skimmed through Penny Simkin’s The Birth Partner for some additional tips. I also read countless positive birth stories on blogs and forums, such as the PrenatalYogaCenter.com forums. The Bradley Method really resonated with me and I had my husband read most of it as well. We spent a couple of nights practicing the Bradley Method and watching and practicing comfort measures from a video my Lamaze-certified colleague lent me, Comfort Measures in Childbirth. We both felt much more prepared this time around.
At 10am, when I felt the pain was too intense and could no longer walk around, we got settled into the classic Bradley position; side-lying on the bed, fully supported with pillows. We found the correct counter-pressure spot on my lower back, and tried to stay as calm as humanly possibly between each contraction by doing a lot of deep belly breathing, relaxing all of my muscles, especially on my face and mouth, and even some laughing. During the contractions, I would use visualization techniques to encourage my cervix to open, while at the same time surrendering to the pain, remembering Tanya’s advice to “just accept, surrender, release, and breathe.” My husband applied counter-pressure which alleviated about 50% of the pain. It was unreal. We said good bye to my in-laws and our older son leaving for a walk through central park, headed toward the Children’s Museum.
After only about 1 hour of doing this, the contractions came fast and strong, about 2-3 minutes apart. We remembered that during my first labor, my husband’s main job was to time the contraction length and the space between them. This time around he was so involved with me during each contraction and we both agreed it was much better. We decided to head to the hospital after talking to the doctor. She happen to be on her way in to do rounds. At 11:15am We walked to Mount Sinai Hospital, which is around the corner from our apartment. The weather was stunning (eerily similar to the 70 degree temperature we experienced in JANUARY with our first labor) and Central Park was gorgeous and inspiring as usual. But even more inspiring was that when we got to 5th Ave., we realized it was the NYC Marathon! On our two-block walk along 5th Ave., we cheered for one of the first runners, and reveled in the fact that we had a little secret amidst all of the onlookers. We like to think that we may have even cheered for Meb Keflezighi, the first American man to win since 1982.
It was 11:45am by the time we filled out the paperwork, answering questions through contractions, and got escorted to the birthing/delivery room. I kept thinking about about how if we were birthing at home we would not be doing this... but then again, I knew that my risk-averse self (and husband!) could never truly relax unless I was in the hospital. Plus, I reminded myself that I was working in a hospital at the time, implementing policy changes to make it more breastfeeding-friendly, and I believed that I could make a natural delivery work in a hospital setting. Additionally, since the hospital is around the corner from our apartment, we pass the labor and delivery ward on the way to the playground nearly every day and it felt comfortable to us. My doctor Gila Leiter, MD was totally on board with our natural birth plan.
Shortly after we resumed our Bradley position on the hospital bed, I felt a warm sensation that I never experienced with my first, my water broke! (My first son basically started coming out in the sac, I am not sure if it broke or was broken). My husband called his parents to let them know we were now in the hospital and my parents to let them know I was in labor and in the hospital.
The contractions came even stronger now. Using coconut oil, my husband was keeping me calm by giving me massages between contractions, and applying counter-pressure to my lower back during contractions. I kept breathing slowly and trying to stay calm, riding each contraction wave. Sometimes, the nurse would make him move because she needed to be near the machines. I was quite angry that she kept wanting me to be hooked up to the monitor, even though everything looked good and the doctor said it was fine not to be. However, I get very strong urges to empty my bladder with each contraction, so I spent most of the time walking to the bathroom, not hooked up, and then refusing to let her re-attach until I was settled and the next contraction passed. So in reality, I was not monitored that much but I felt like I had to fight for that, which was not pleasant.
From our Central Park-view delivery room, we could now hear lots of marathon cheer through the window. Everyone assured me no one could see in and I believed them because it was too nice a view to close out. My doctor arrived at about 12:15pm and said it was a beautiful day to have a baby; the weather, the runners, the cheering. It was indeed. But when she told me I was only 5 centimeters, I was discouraged even though I knew it could be as fast as last time. Dr. Leiter went up to the floors to do rounds. And fast it was.
My husband kept doing an unbelievable job keeping me calm, giving me strength, massaging and counter-pressuring, and standing up for me to the nurse who was not pleased with my desire to do this without any machines attached to me, while we also insisted that the bed-rail stay down to give my husband access to me. In fact when we first entered the room and showed the nurse my birthing plan, she said “Oh, you are going to try and do this naturally? We will see...” I knew this was going to be very different from the first time when we had a nurse who delivered all four of her children naturally. My doctor initially told me she would request an experienced natural-labor nurse for me but none were working that day. Had my husband not been so amazing, I would have gotten a doula, but I knew he would be great and he really wanted to be the primary person caring for me. He wanted it to be us, doing this together.
By 12:30 pm the contractions were rolling in with full force. We were still side-lying, using visualizations, and using lots of counter-pressure, but I started to wear thin. It was getting more and more difficult to surrender to the pain, when I proclaimed “I don’t think I can do this any longer.” Dr. Leiter had just come back in the room. She got down next to my face, touched her forehead to my forehead and whispered to me, “you can do this Debra, you're already there, your’e there.” Knowing that most of her patients use epidurals and hearing her say that, gave me so much strength. I still get tears in my eyes when I think of that moment.
At 12:50, I came back from the bathroom and thought: “This is it.” There is a specific type of pressure that now I know how to recognize (Don’t ask what happened with my first son- he was almost born in the bathroom!). We did a second exam: I was 8 cm but the pain was so intense that I knew I was going to be 10 centimeters very soon. With the next contraction, I was verbalizing my visualizations quite loudly: “My cervix is opening like a flower... my cervix is blossoming... I am opening wide” and then I heard my doctor chiming in quietly at the bottom of the bed “Your cervix is blossoming like a flower...you are opening up.” After that contraction, I knew he would be out with the next one. I don’t remember if I verbalized this or my doctor saw my thought process (or the baby’s head!) but she said “Wait, I don’t have gloves on.” I responded “I can’t wait, it’s not up to me.” I felt the next contraction starting to come, feeling like the Little Engine that Could pushing up to the top of the mountain using all of my mental and physical stamina. And just before I felt like I was at the very top of the mountain, I heard more cheering outside the window, let out a huge primal roar and one big push, and my baby was out and lifted onto my chest. And then there was more cheering for me outside the window! We spent some time in skin-to-skin contact, and then some time breastfeeding. The placenta was delivered, the doctor examined me and said I looked great!
My husband called his parents and my parents to let them know our baby boy was here and no one could believe that just one hour before we had called them to let them know we just got to the hospital. This time it was 5-10 centimeters in about one half hour, instead of one hour. Total labor time was 7 hours; half of the 14 hours I had with my first labor...and double the intensity.
Looking back on my e-mail correspondence with Tanya Wills, a NYC doula who was really helpful when I was looking for book recommendations and getting nervous about going through another natural labor in a hospital, she said the following and she was spot on correct (excerpted for appropriateness):
“Second babies come faster. Sometimes twice as fast. Sometimes faster than that. But they take the same exact amount of work... it's like getting run over...It's really intense...you can do it because you are committed and strong...if you can stay home, get counter-pressure, and stay off your back in the hospital, you can do it. Make sure your doctor will let you move around. Even if they don't let you, do it anyway if you need to...only hear positive birth stories. You can do it. You will do it...But if you are worried about withstanding the labor, remember you will get breaks for most of the labor and when you no longer do, the baby is very close. You will just keep going. Have your husband talk to all the nurses and answer all questions on your behalf if you are laboring. Sometimes laboring in the hospital can really be a downer and make it difficult to cope because of the monitoring and interruptions by people you've never met...and in labor, just accept, surrender, release, and breathe.”
I thank my husband and my entire birthing community mentioned in this birth story for a great birth!