After trying everything in the book to get my labor going, it was good old fashioned nipple stimulation that got my contractions started. In about 45 minutes they went from the normal Braxton Hicks, I had been feeling for weeks, to something I had to walk around and breathe through. And once they got going they kept getting stronger. At 11:00 pm August 17th, as I was on my knees leaning over my birthing ball, one contraction was strong enough to break my water. JC and I knew this meant we were going to have our baby within the next 24 hours and he rushed around gathering last minute things for the hospital and calling the midwife while I tried to breathe through the increasingly intense contractions. The midwife told us to head in to the hospital but I wanted to wait as long as I possibly could, which didn't end up being very long. By 12:30 I was already worried I wouldn't be able to walk to the car. So we headed out and I sat backwards in the passenger seat hugging the back of the seat the whole way.
When we got to our hospital room I wanted to get in the warm tub as soon as possible. The nurse checked to see how dilated I was but only told JC because I didn't want to know, and I got in the tub. The contractions were so strong the thought of relaxing through them was far from my mind. The pressure felt like my stomach would explode if I didn't fight against them. JC kept reminding me to relax everything. For the first few hours this sounded like a preposterous idea and the last thing I wanted to do. But after several hours of tightening and nearly yelling my way through them I decided on the next one I would really try to let go. Instead of envisioning the intense pressure making my stomach explode, I envisioned all the pressure pushing my baby out and I just let it happen. I relaxed everything from my face to my toes and let my body do what it needed to do. What a difference! It still hurt terribly and I still had that inner desire to scream like mad, but I felt in control and safer somehow. JC was so encouraging as he could see that I'd finally clicked in. I thought, I can do this. I've got this. When I found it difficult to keep control I'd have JC put more hot water in the tub and I'd focus on my muscles relaxing to that hot water. I looked almost asleep through each contraction. Then came the first urge to push. A completely involuntary grunt escaped me as my body made me bare down. I still had no idea how dilated I was but JC and the midwife did and immediately told me not to push, that I was not ready. I thought, okay I must be somewhat close. I can fight these urges for a while. But with each contraction the urges got stronger and stronger. I was still able to fight them off but every now and then I would lose focus and another grunt and push would escape me. I thought, this has to be close to transition and in an hour, maybe two, I could finally give in and push. Boy was I wrong. I would find out later that I was only dilated to 4 cm. The midwife was having a difficult time getting my baby's heart rate and needed me to get out of the tub "for a little while" and lay in the bed so she could check it. Once I got out of that tub it became increasingly difficult to focus on relaxing and the urge to push became so intense I had to tighten every muscle in my body to hold the baby in. Contractions hurt. Fighting against them is 10 times worse! My contractions started coming one after the other without much time for me to catch my breath. Now through each contraction I was tightening stiff as a board and blowing air through my lips and then gasping for a big enough breath to do it again. I wondered to myself how this was productive labor with me holding back with every ounce of energy I had. I asked if I could get back in the tub but the midwife told me I couldn't until the baby's heart rate went up. I wasn't the only one having difficulty recovering from these contractions one after the other. The only way I could lay to prevent my baby's heart rate from dropping was on my left side, which was excruciatingly painful and made it impossible to relax.
When I could catch my breath I said to JC, "I don't know how much longer I can do this." As soon as I said this I thought, this HAS to be transition. He looked concerned but tried to encourage me. After what seemed like an eternity of this, I finally I broke from my birth plan and asked how dilated I was. He told me I was a 6. My heart sank. They tried to be encouraging and said I was obviously making progress. I thought, oh. My. Gosh. How in the world am I going to last? But I just tried to focus on one contraction at a time. The next contraction brought on a whole new level of push power and I could not stop myself from pushing with everything in me. As soon as I could catch another breath I said, "I need some relief! Not an epidural but something just so I can control the pushing." They gave me fentanyl, which was a joke. It made me relax between contractions but when the contraction came it was just as powerful and push-crazy as ever. And it only lasted through two contractions. I was pushing with almost every contraction at this point, despite my fighting it with every voluntary cell in my body. I was completely out of control and just trying to get air. The midwife said to me, "Rachel, I am watching this and it does not look like it is productive labor because you are unable to relax. It seems like it is just torture for you. I know you didn't want this but would you consider and epi..." "Yes!" The words I had tried so hard not to say, that I had built up every defense against, burst out of me in desperation and nothing could have stopped me. Once it was out I became focused on how soon it could happen. I had been slipping in and out of consciousness and don't remember signing a form with all the risks of an epidural listed, which JC read to me. JC asked if it would slow labor. We were told that it would only affect the baby in rare cases and that an epidural "does not slow labor" and "that is a common misconception." Both JC and I knew this was not true. I knew I was opening the door to more interventions but we would deal with those as they came. JC continued to look me in the eyes and tell me I was doing great. They had to give me a shot to make my uterus calm down on contractions long enough for me to hold still to get the epidural. I have never been so grateful for someone in my life than I was for that anesthesiologist.
Once it started working the urge to push left and contractions spaced out. The midwife told me my baby's heart rate looked better than it had since she arrived. I was so out of it I had no idea they were so concerned about her heart rate. Because of the epidural I had to get a catheter and they put two internal monitors in. One to monitor the strength of my contractions and one to monitor baby's heart rate. Then they left JC and I to get some rest. A few hours later the nurse came in to check how far I had dilated. I was still a 6. When she told me that I thought, well, it's gonna take a while to dilate but that's okay. The doctor came in with the nurse and midwife. They explained that because I had the epidural my contractions were too weak and I would need to be put on Pitocin to help speed things along. Surprise, surprise... Epidurals do, in fact, slow labor. They said they would be back in an hour to check my progress and talk more about Pitocin. When the doctor left the nurse explained to us that because the baby seemed to have such a difficult time recovering from contractions when they got close together she suspected there was a problem with the placenta. She said what would most likely happen when we start Pitocin is that the contractions would get stronger and closer together and baby would not be able to tolerate it and we would have to do a C-section. I wanted to cry. It was exactly what I didn't want and here it was being laid on the table as almost my only option. I tried to have a good attitude and accept that labor is unpredictable and all that mattered was a healthy baby, even if that meant weeks of recovery and decreased chances of having a future vaginal births.
Another hour went by and I had progressed to a 7! This lifted my spirits because it showed that I WAS progressing without Pitocin. They also found that the baby was cocked sideways and that this meant at least two hours of hard pushing when the time came. I didn't care. I just wanted the nurse to go tell my midwife and the doctor that I had progressed! To my dismay, the midwife and doctor were not as thrilled as I was about this news. The midwife still felt the progress was not enough to count and she would come back in to talk more about Pitocin. JC just said, "We're going to wait another hour." The nurse told us we would have to sign a form saying that we are going against medical advice. We said, "Okay." I felt tired and confused about why we needed to rush this. Was it really for my baby's benefit? Was I being ignorant and stubborn? I asked JC for a blessing and in the blessing he asked that we would spiritually be directed about what to do and that we would feel good about the decisions we make, that we would know it was the right thing. I felt so much better after that. When the doctor came back in and was going on about starting Pitocin I just said, "I'd really like to avoid Pitocin." She jumped back, "Well yes but you are not going to have a baby with contractions as weak as yours. They've done research and people just don't have babies at this level." I said, "I just feel like we're going to try Pitocin and it's going to stress her out and leave me no option but a C-section." The doctor said, "Well yes! It would be your last option. You came here to have a baby so whether that's vaginally or a C-section, you came to have a baby so what reason is there in prolonging it?" I said, "Peace of mind." I looked at her and said, "I really do respect your knowledge and I'm listening to everything you say. We are not trying to be annoying or difficult. I just feel that if we jump the gun on this Pitocin and I end up with a C-section, I am the one who is gonna have to live with that." JC pointed out that I was progressing and as far as the concern about infection he pointed out that it had only been 11 hours since my water broke and we get 24. The doctor said, "Well we can wait another hour and maybe miraculously you will progress enough in that time." I said, "I believe in miracles." She said, "Well, so do I."
In that next hour JC and I watched the monitor like hawks. My contractions were averaging a level 30 and they needed to be 50 or 60 to make any progress. I had asked if we could lower the epidural because I didn't need to be pain free. I just needed to be able to control that urge to push. They immediately said, "Oh no. That will just put you in pain and stress the baby out." I was thinking, wont Pitocin stress the baby out and I just said I didn't mind being in pain. It didn't make a lot of sense to me but they seemed adamant. The thought came to me that I needed to change positions to help the baby's head descend and me to dilate better. I asked to sit up in bed. The nurse helped me sit up but told me she didn't want to keep me there too long because epidurals are affected by gravity in the body and its effects would start to lessen. Bing! I was so glad to hear that and when she left I did feel the contractions start to come on again. We also found, by watching the monitor, that when I bent my knees contractions would lessen and when I straightened my legs they would intensify. So for the next hour we watched the baby's heart rate and the contraction level and frequency and with almost exactness were able to balance their strength with what the baby could tolerate. I would breath through some hard contractions and then we would back off a little by bending my knees and let baby recover. I tried not to make it obvious that I was feeling the contractions when the nurse came in because she would then firmly tell me to push the epidural button. I pretended to push it a few times. I did push it twice overall. In an hour I was checked and was an 8.5 cm! And the baby had turned to perfect position! The nurse was amazed. She gave us another hour, which we spent glued to the monitor, controlling contractions. In the next hour I was 9.5 cm and I could feel a head. Later we found out that the nurses were all gathered around our monitor watching and cheering us on. When Lydia's heart rate would drop they'd start yelling "Pull up! Pull up!"
Then it was time to push. I could feel the contractions coming and knew where to push. I could feel her head descending. With every push she moved visibly out and in 3 contractions she was on my chest. I couldn't stop the tears from coming and coming. Looking at her for the first time I felt like I already knew her. Dr. C-section came in to congratulate us. I was so overjoyed and proud of us. Even though it was fast, I only had a very small tear. Fifteen hours from the time my water broke we had our little girl and the next day we were home. I've learned some things I want to do differently the *gulp* next time around, but I couldn't be more happy with how it went. Just like my blessing said, I know that we made the right decisions and we felt the spirit guiding us every step of the way.
She was 8 lbs 2 oz 21 in and born August 18th at 2:25 pm.