Nothing was happening.
That’s not entirely true. We were having fun. We blew up the hospital’s gloves into hilarious balloons with the girls and my mom. We snuggled with the girls. Friends visited. We talked with the chaplain. We organized our teas, herbs, oils, books, rice pillow, massage tool, birth balls, chargers, and comfy PJs.
That night, when 24 hours on Pitocin had passed with little progress and–no joke–zero pain, the nurse disconnected me from the IV and monitors and directed us to get some food and some sleep. I shoved all of the monitor cords under my shirt, which was an excellent look. We headed to the (surprisingly good) cafeteria for burgers and fish sandwiches (I have a thing, don’t judge) and fries (and maybe ice cream and cookies). We wandered halls for a while and then headed back to L&D for a good night’s sleep.
Sunday morning, our midwife Maite joined us after we’d had some coffee and felt a little more human. We talked through options: we could go home and wait for labor to start. If my water broke, though, or if I went past my due date, things might head the way of an emergency c-section, which I was very much trying to avoid. Looking back, I’m not sure how this was different than continuing the induction. Was the benefit that I was already in a hospital setting and water breaking would be managed differently? Or that “the clock” of how long my labor could last was longer and less urgent than if I were past my due date? It didn’t occur to me to talk through this, or maybe we did, and the reasons are escaping me now. I think the excitement of meeting Hilde was coloring my decisions more than a little bit.
More Pitocin was likely a bad idea. Breaking my water, since she was still so high in my pelvis, was a gamble. They could try to break the bag of waters minimally, so that the flow was more of a trickle than a gush, minimizing the risk of the cord rushing down with the flow of fluid, but given her position it wasn’t the least risky proposition.
My cervix was ripe (god what an awful word), but Maite mentioned that Cervidil–a naturally occurring prostaglandin–might be helpful to sort of put me over the edge. The helpful bit about Cervidil was that it was localized and could be easily removed if it didn’t work out.
At this point, I was a little overwhelmed with choice. I asked Maite if we could have some time. We needed to talk it over not just between ourselves, but with others in our lives as well.
I called a family member who happens to be an excellent OB-GYN and talked over the options and risks with her. She talked us through benefits and risks to each approach, listen to my concerns, and helped me suss out that the next steps we discussed with Maite seemed advisable. I felt very much reassured.
And as luck would have it, a dear family friend, who had supported my mom through my sister’s birth AND whose professional work focuses on improving perinatal care, was available to chat with us, too. She listened to every last detail, to every extant worry, asked the right questions, and helped me think and talk through all the options. It sounded like the right thing to do.
Not everyone has their own personal team of maternal healthcare professionals ready on speed dial. I lucked out, to be sure. But everyone does have the option to ask for time and space to think, to talk with whomever they chose, to walk through options until comfort sets in.
We forged ahead. Maite placed the Cervidil, and my mom and the girls dropped in. The monitors came off, and I was free to roam the premises. We all headed down the stairs, with me walking sideways for four flights. We ate ice cream in the cafeteria together and then headed out to the courtyard. I did squats and lunged on the benches. We found a beautiful healing garden, and I walked up and down the stairs again while the girls scrambled on some rocks and ran around playing. We sat in an arbor and talked, while the girls picked flowers. And then we headed back inside (while Winnie used my phone to make a video for her forthcoming YouTube channel) and back up four flights, sideways, again.
When we returned, I could feel that something had changed. Soon, I felt the waves begin. Slowly and gently at first, growing stronger. I rolled my hips on our birthing ball, and repeated the prayers we had chosen for birthing. Things accelerated quickly. I needed some help to move through the waves as they grew stronger, and I wanted the hot water of the shower– the hottest water I could stand. The nurse (who was, by the way, absolutely, completely incredible, and a former doula!) put a glove over my IV and taped it all up so I could hop into the water, IV unscathed.
I was still wearing a binder to try to keep the baby in place, but it was thick, and I didn’t want to get it wet and have to wear it again–but I also didn’t want this wiggly babe flipping again. I removed the binder, grabbed the leggings I’d worn the day prior, spread the waistband and seat across my belly, and tied the legs tightly behind my back to replicate the wrap. There, I’d macguyvered my baby into not moving while I got some sweet, sweet relief.
The water felt incredible. As each wave grew in strength, I let the water run over my back or belly. I sat on a little bench on the shower wall between waves and caught my breath. Eventually, the waves grew larger than the water, and I dried off and changed, between the intense minutes, into comfy PJs.
Mike and I set off down the hallway as contractions grew stronger and more numerous. We walked the short hallways back and forth and back and forth, pausing when I needed to sway and moan (sorry, other people in the hospital, especially first time birthing friends). I tried to keep my vocalizations low in pitch to keep myself grounded and unafraid of the pain.
Crystal arrived and as the pressure and intensity grew, Mike and Crystal helped me to change positions, use the birthing balls, and sprinkled lavender oil to breathe in deeply during contractions. I was dilating, but slowly. Hilde was still high in my pelvis. Contractions continued to intensify.
We tried a warm rice pillow, Rebozo sifting, and pressure in every which way. Looking back, I wonder if we should have tried more Spinning Babies techniques to help Hilde engage in my pelvis and help to put pressure on my cervix, causing me to dilate more quickly with more productive and fewer, you know, wildly out of control contractions. But it’s easy to look back and what-if. What we did was exactly what I needed in the moment.
The contractions did feel wildly out of control. The nurse shifts changed, and the new nurse offered me a menu of pain control options, including narcotics, which I vehemently declined, and asked not to be mentioned again. I have lingering trauma from watching opiate addiction firsthand, and while I know they work beautifully for some, they were not for me. I continued on with breathing, meditation, massage, and the aforementioned rice pillow and abdominal/hip sifting.
The contractions continued to grow in strength and frequency. I asked to use the nitrous oxide gas, which doesn’t decrease pain but does decrease anxiety– and had the added benefit of reminding me of Call the Midwife. I used it sparingly at first and then more frequently. And then more frequently. The contractions picked up in frequency and intensity again, and I could feel my fear and anxiety start to rise. In contrast to the low moans of the hallway prior, I wanted to crawl out of my skin, to run away, to cry the loudest highest most fear filled scream there ever was.
I kept my vocalizations low in pitch, though, and I started yelling into the nitrous mask with each contraction. It wasn’t helping. Everything had turned into fear and pain. I had about ten seconds between contractions, contractions that radiated all the way down through my toes and my fingers and to the top of my head. I wanted relief.
Both of my epidurals with Winnie and Georgie had been glorious and helpful. With Winnie, I had dilated maybe one more centimeter with Pitocin and its horrific contractions over the course of about 14 hours. I got an epidural, fell asleep for most of the night, and woke up fully dilated. Without the epidural, I would have been far too tired to push. With Georgie, I had uterine tachysystole that would have otherwise required terbutaline, the aforementioned medication used to slow or stop uterine contractions. If my contractions had stopped, they would have needed to be restarted, which may or may not have been successful. The epidural slowed labor just a smidge, enough to allow me a calm progression over the next few hours until Georgie was born. Both epidurals allowed me movement in my legs and wore off by the time I needed to push.
But every epidural is different. This epidural left one leg completely immobile, and one side of my body in pain. It was not ideal. My oxygen levels dropped, and I had to breath from an oxygen mask, to which I’m averse, because I always feel a little like I’m drowning. The nurse came in every hour to change my position, using a peanut pillow between my legs to try to help Hilde move down, but because I was so numb on one side, my leg kept falling off and taking me with it. Not to mention that the hourly checks were less than ideal for rest. I found out that my midwife was bothered (not by me!) that she hadn’t been consulted before I jumped into an epidural. And I appreciated that, because I perhaps could have used even another voice, even though all of the voices around me supported me and what I needed.
I kept progressing, though, and by morning, I was getting closer to a baby. I started feeling contractions more sharply– almost at the intensity I had before the epidural. I started moving around in the bed to help relieve the pressure, and when I moved, I noticed that my shoulder was soaked. Like, really soaked. The nurse (the previous, amazing nurse who had formerly been a doula) took a look. “Your epidural is pouring onto your shoulder,” she said. Something in the tubing around my shoulder had come apart, and the medicine was streaming out, not making into the catheter in my back. “Do you want me to call the anesthesiologist?” Sure, why not. This hurt like a … a thing that hurts really bad, and I’d already gotten the catheter placed.
The new anesthesiologist arrived. And told us about how he was leaving the hospital in four days. Which, you know, inspires a lot of confidence. Do doctors phone it in in their last days? Probably not, right?
He looked at the tubing, and determined he couldn’t repair or replace it. We would have to place a new epidural. Sure, why not, again. In hindsight, again, I wonder why I had him replace it. How dilated was? The pain must have been intense enough that I would want to go through that again. Or was it because I knew I was mostly immobile from the previous epidural, which would make it harder to move and relieve the pain without analgesic. I can still feel the place in my back where the epidural was placed, though I don’t know if that’s just my ambivalence about this particular experience or not.
He started to place the catheter, paused, and asked, “Are you feeling that more on one side?” Yep, I was. He worked for a few more minutes, as I sat hunched over. Things improved, but the medicine was still uneven. Oh well, four more centimeters to go. I tried to get more rest. There was much work ahead.
And soon, things progressed more rapidly. I started feeling more pressure. I sat upright in the bed to move Hilde down. The midwife checked, and I was dilating more quickly as Hilde moved down in my pelvis. It was happening. We texted my mom, and I made a gametime decision to text a dear friend. She had told me many times about how her own friend had dropped into her room during labor, getting everyone in gear, changing the tone of the room to empower her to cross the finish line. I wanted that. I wanted a badass lacrosse player to tell me I could do it as Hilde came into the world.
Just after the messages went flying into the cell phone ether, I suddenly felt incredibly nauseous. YES! I thought. I’m in transition! “I’m gonna puke! I’m gonna puke!” And then I did, and I was so excited. The midwife checked. Nine centimeters. Almost there.
And then everything sped up again. “It’s coming, it’s coming!” I was fully dilated. Suddenly, I wept, completely overwhelmed. Overwhelmed with momentary grief for the loss of my four person family, for the last minutes of Georgie as the wee baby of the family. With fear of how I would manage mothering three and not two, since so many days I felt so terrifically overwhelmed with only two. And the huge, overpowering wave of anticipation of meeting Hildegard. It was like being at the top of the highest arch of a rollercoaster, waiting for that drop of joy and fear and excitement.
And then, we dropped.
I couldn’t wait to push. It’s my absolute favorite part of labor. Georgie had come out in a push and a half. I knew what to do. I yelled at Mike and Crystal to grab my legs, and curled myself into a perfect C. The next contraction, I pushed with all my might. I could feel Hilde start her way out into the world. I pushed again, and felt her head at a precipice of life. How do we even determine the moment of birth? That liminal space where a baby lives her last moments inside of a closed, comforting space. What did she feel? What did she know?
I pushed again. Slow down, they said. I pushed again. Her head. I pushed again, and I met Hildegard, covered in vernix, screaming with her whole person. I love that newborn scream, so full of power, but somehow so comparatively quiet to the screams she will later scream as she grows. Oh, the screams to come.
Onto my chest she went, her own singular person, but with echos of her family dancing across her face. We snuggled. We nursed. Mike held her skin to skin, marveling. My mom and the girls arrived, newly welcomed into our expanded family.
Hildegard was born.