And then I had a baby!
That’s what I felt like, anyway, after months and weeks and days and hours on hours of waiting. I was fully dilated! Here comes baby! I mean, all I had to do was push her out. That was it! That’s all! Just use some sort of some kind of muscle-y thing, some special combination of squinching up my face and calling upon my inner tiger/lion/bear, right?
I’ve admittedly avoided writing this segment of my birth story only because this last phase— the most painful, utterly exhausting, downright gross (and shortest!) phase of labor yet— was my absolute favorite. I would go through that handful of hours over and over and over again just to have that single moment of hearing sweet Winifred’s voice for the first time. I hope I can do those hours justice in the retelling.
I was ridiculously excited to labor, particularly in the weeks before my induction. I viewed the labor process as an endurance feat, an excruciating, overwhelming, ultimately rewarding experience. I was, and still am, wowed by all that your body can and will do to protect and deliver another human from safe and snug inside of you, into a bright, bustling world.
I always found it funny—and difficult to remember—that pushing was the second of three phases of labor. Surely it had to be third or fourth or maybe twentieth, what with all the prodromal labor and early labor and active labor and transition phase and whatnot. But no- everything until now had been one, cohesive phase, despite its ups and downs and stops and starts. It was only now that we moved into stage two. Looking back, this makes so much sense. Even though each moment between when I was ready to meet that darn baby already and when ol’ Doctor Fully’s eyes got wide seemed so singular, so distinct, once I reached full dilation all of the hours previous ran into one another and the task before me suddenly came into focus.
Enough with the hippy-dippy pontifications— I was about to push this baby out. This is the point where I apologize to my family members and friends with more delicate constitutions because it’s about to get rather real up in here, with a whole lot of colorful language and some fairly frank discussion of bodily functions. So if you’re the kind of person who’d rather skip all of that, here’s the short version: I pushed, it hurt, and I fell in love again with my dearest Winifred Eleanor.
But if you’re not squeamish, here’s how it actually happened:
There we were, at ten centimeters of dilation, fully effaced. This babe, though, still wasn’t in any hurry to meet the world. She was hanging back at a -3 station, meaning she hadn’t yet begun to descend into my pelvis. This wasn’t particularly surprising, since she’d been ‘floating’ during all of my previous exams, not yet engaged in my pelvis at all, but it wasn’t exactly great news, as it meant she had a bit of a trek ahead of her. The actual great news was that Winifred had corkscrewed herself from the occiput posterior/face up position (which causes back labor and puts the skull in a less desirable position for descent) to occiput anterior/face down— the perfect position for descent.
In all my hippy woo-woo books about natural birth there were about a thousand warnings about how my doctor was going to want to give me a routine episiotomy for kicks, give me an emergency c-section so that he (she, in this case) could go play golf, force me to lay on my back, and generally ignore all of my preferences in favor of the opposite kind of birth that I’d hope for, all with the BUT DON’T YOU WANT A HEALTHY BABY line hanging over my head. Nope. Not my doctors, not a single one of them in a practice of seven. I knew that in my gut before I went in, but of course I hadn’t been able to get a single doctor to say, “Sure, Sascha. No-way no-how are we going to give you a c-section even if the most wild, crazy, dangerous thing happens to you or your baby!” They would say, though, that their wish was for me to have a vaginal birth, and that they were going to advise every single thing in their power to make that happen— and, as I’ve stated before, that my voice would be a part of all decisions. At this point, I had been in labor for 18 hours, in their care for 21, and not once had anyone made me feel like I was rushed— when they broke my water (yes! AROM! in my hypnobirth!), they told me there was no 24-hr clock to race against; when I had only dilated a centimeter after twelve hours, at the max dose of Pitocin, they told me to get some rest and that they would check back in the morning. Literally the only time anyone mentioned a c-section to me was well before I was induced, at one of my last OB appointments when my doctor said, “Hey, by the way— there’s this thing called shoulder dystocia, and it’s wild. If we think it’s happening to you, someone’s going to mention the possibility of a c-section and I’d prefer if the first time you heard those words wasn’t in the heat of the moment.” And that was that.
So, with all that said— here I am, babe waaaaaaaaaaaay high up in her little cocoon, with a fully dilated cervix. I was giddy, high on adrenalin, and finally ready to DO SOMETHING. When the doctor came back in, she had me do a test push while she conducted an internal exam, and I eagerly awaited her instructions. ”So— what do I need to DO?” I asked, quite possibily squealing, probably panting, with my eyes likely twice their normal size. “Just go ahead and hang out. Sit up, and kind of bear down a little if you feel a contraction. You don’t have to push— just tense your abs and hang out.” Wait, what? My assignment is to sit? To chill? To wait? And no one is freaking out about that except me?
It turns out this was awesome, effective medicine— the practice of laboring down or passive fetal descent shortens pushing time, reduces fatigue, and results in fewer decelerations. And passive fetal descent, for me, was just… hanging out.
I thought for a few minutes that maybe they had forgotten about me— or worse, given up. But every so often a doctor would come in, ask me how I was, and then just leave. No fiddling with the Pitocin, no internal exam. Just a quick check-in and then back out. My epidural was turned off once I was fully dilated, and I was feeling plenty, but I couldn’t have cared less. Bring on the baby!
Hours passed, and finally Dr. M, who had been with me throughout my 20+ hours of labor thus far, was headed home. Dr. R. was taking over, and I was pumped. Dr. R had been my GYN prior to my first pregnancy (when I switched docs because she was on vacation and I had those first weeks jitters). She was brazen, dry, hilarious, and a total badass. The perfect push coach.
It had been nearly four hours since my last exam, so she checked me again to determine any change in station. Sure enough, Winnie had wiggled down to a zero station, with her head in the middle of my pelvis. Eager to get this show on the road and meet my baby already, I asked again, “So, can I do anything to help from a zero to a +3?” I expected her to suggest the birth ball or changing positions in bed or some sort of pelvic rocking. ”Yeah,” she responded. “Push.”
Look, I knew this stage was coming and I was crazy, over the moon excited for it. But I hadn’t the slightest idea what it meant to push. Sure, yeah, push— just, what is that again? The thing where I squish up my face and scream a lot?
I must have watched a couple dozen birth videos, the last dozen or so just of the pushing stage, to get myself ready for this. I had learned a few things about myself, like that I will cry like an actual baby during any and all birth videos, but I hadn’t actually learned HOW to push. What muscles are those? And are you sure I have them?
So she coached me, and I practice pushed, and felt like I was expending a lot of energy and accomplishing exactly nothing. I wasn’t quite ready to begin in earnest, so she gave me a minute to hang out and wait for a stronger urge to actually push.
As soon as Dr. R left the room, it hit me. It had been over a day since I’d had anything to eat, but I knew that feeling. I needed to take the biggest poop of my life.
I knew going into this, of course, that the urge to push might feel like the urge to have a bowel movement— that stuff is all quite close down there, especially with quarters being so cramped those last nine months. But I was certain that this wasn’t the same. No, even though every sign pointed to TIME TO PUSH, I was reading all of those signs as TIME TO POOP. NOW.
I told four doctors of this need, convinced someone just needed to get me to the bathroom, bring me a bedpan, just SOMETHING YOU GUYS I AM TELLING YOU I WILL PUSH AFTER YOU LET ME POOP. Dr. R came back in the room, and I explained my predicament to her. She nodded calmy, and said, “Okay.” Finally. Someone who listened. “Then poop,” she finished.
Even to begin with, I’m not an overly modest person. I knew I was going to lose whatever modesty I did have as soon as I went into labor, and I certainly didn’t have any qualms about leaving the door of my absolutely sweltering room open during my roughest contractions in order to catch a breeze. But even I— she who will write the word poop several times on her family blog— wasn’t about to just, you know, right in front of two doctors, my husband, a nurse, and my kind doula.
But of course, I didn’t need to— I needed to push out my baby, the sensation of which just so happened to correspond quite closely with the most intimate of bodily functions. And finally, that clicked in my brain. I asked for the squat bar (which, by the way, despite being CERTAIN that I wanted to push squatting, I forgot to even ask to have them bring over to the bed, because squatting was the last thing I wanted to do once I started pushing.)
I pushed. I pushed, and I pushed, and I groaned, and I used every fiber in my body to do something that I wasn’t sure was working but oh boy, was it ever taking it right out of me. The uncomfortably warm room had leapt right on into unbearably hot territory, so I ended up shoving giant bags of ice under my arms and on top of my head to keep cool. I was running a slight fever, but Dr. R wasn’t concerned, since Winnie’s heartrate was stellar, and it was about a thousand degrees in the room. I pushed with each contraction for a count of ten, with the whole team cheering me on, and then crashed out for 30 seconds of sleep before gearing up to do it all over again.
I must have pushed for the better part of an hour thinking nothing was happening, that all of my effort was futile. I threw myself back from my sitting position and declared that I was doing NOTHING and that if this kept on, I wouldn’t be able to do it anymore. So there. Looking back, there’s no way I would have possibly abandoned pushing, but there is something about an exhaustion so deep, so consuming, that pushes you to say those things as a matter of protection— all I need to do is say this, and then I’ll feel better, and I won’t actually have to quit.
Dr. R knew this, of course (see mention above of badassery), and she looked at me with a glint in her eye and practically guffawed. “I absolutely love it when women say that,” she said, “because it means they’re almost there. Now get angry and meet your baby.”
And I did. I pushed every bit of me that had every existed, every good and bad decision, every feeling, every thing I had ever done or left undone. I used the time between contractions to scream at the room, “It is absolute crap that only women have to go through this.” And then it got a little essentialist and gender normative in there for a minute, but hey— it worked for me, and my doctor called me a goddess, which doesn’t happen every day. At least not to me.
Before I knew it, everything was on fire, and I pushed through that fire and the most amazing thing happened. The room changed, and everyone seemed on the verge of tears and euphoria, and I reached down and felt my baby’s sweet, soft, squishy head of hair, and like that— one push, two pushes— she was here.
She screamed a hearty scream and within seconds she was on my chest, in my arms, snuggled right in, and we were a family.
Within the half hour, she nursed, we cried, and all of us were ready for a nap. We waited for my blood pressure to come back up to normal (I maybe tried to leap from the bed a little too soon and maybe almost passed out a couple of times), I got a good look at that impressive placenta Winnie had gotten so friendly with over the last few months (Seriously, excellent work, placenta. Hope you don’t mind that we told Winnie we sent you to a farm upstate when we actually tossed you out like yesterday’s news. Nice knowing you!) and we headed upstairs to recovery.
It was the best day of my life.