Birth Story, Part II

Read the first part of our birth story here.

Ah, the rain on the window, the gentle sunlight streaming in, the view of our favorite New York building fading in and out between the clouds— and a couple of monitors that no one could seem to get to work.  The gorgeous view was not meant to be, and I moved down the hall to a room with windows that opened to a wall— and not, like, a wall that was a foot away, thus letting in some light.  The windows were a good centimeter away from the wall, a wonder of institutional architecture.

I remembered a line from my favorite birthing book, The Big Book of Birth by Erica Lyon: “If you still care about the wallpaper in your birth room when you get there, you are there too early.” Sure, I was going to be induced so there wasn’t a technical ‘too early’, but the sentiment was the same; very soon, there was going to come a time— the important time— when I couldn’t care less about the quality of light in the room or the Chrysler or any other building.

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I chose not to write a formal birth plan, as I had discussed all of my preferences and options with all of the doctors in the practice (who would be the attending physicians during my labor) and I wanted to discuss face-to-face those same topics with all of the providers I hadn’t met (the nurses and residents with whom I would be spending most of my time).  I worried that a written birth plan would become a shallow substitute for real conversation throughout my labor, and I wanted to be forced to have those conversations,  to confront them in real time.  And despite all the books and articles I’d read, classes I’d taken, and questions I’d asked of each and every person who might have any insight whatsoever into the birthing process, I knew that I had no earthly idea what I was in for.  Best to play it by ear, stay flexible, and know that Mike and I could make informed decisions at any stage in the game.

That said, I’d be lying if I said I didn’t have any preferences going into the process, and I’d be lying even more if I didn’t admit that already, barely into the process, I was watching so many of those preferences fade in the rearview mirror.  I had chosen a Pitocin induction, and I had solid reasons for doing so (and I truly believed that it offered me the best route to an uncomplicated vaginal delivery), but that induction meant scratching off a number of items from my ‘Dream Birth’ list.  Intermittent fetal monitoring rather than continuous?  Because fetal distress is more common with pitocin, continuous fetal monitoring is standard.  Skipping an IV? The pitocin wasn’t going to magic itself into me.  Laboring at home until the last possible minute?  Clearly, that ship had sailed.

But knowing these things were off the table forced me to dig deeper to understand why I had checked those boilerplate natural childbirth boxes in the first place.  I didn’t want continuous monitoring or an IV not because I was afraid of them, or because I didn’t trust my providers to make judicious decisions regarding any information the monitors provided— I favored those options so that I could MOVE.  I didn’t want to be tied to a bed, on my back, in a way that prevented me from coping with the pain using my own body.  Even though my mobility was more limited— I couldn’t go walking the halls— it wasn’t eliminated, by any means.   Once the Pitocin kicked in and my contractions began in earnest, I was moving: on my birth ball bouncing or doing hip circles, pacing the room, on my hands and knees on the bed, and hanging onto Mike’s neck for dear life.

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Mike and Jillian, our amazing doula, were right next to me through each contraction— grabbing smaller birth balls that I could squeeze during particularly strong contractions, doing Rebozo sifting to relieve some of the back labor from my stubbornly OP babe, and gently reminding me of the breathing and relaxation techniques I had been practicing for the last few months.  Sure, some of the visualizations and relaxation exercises I had planned to use flew out the window as soon as I knew that the whole oxytocin-positive-feedback-loop I’d been banking on wasn’t going to happen, but our practice of Hypnobirthing and Mindful Birthing techniques was incredibly valuable, as were the breathing exercises I’d worked on from The Healing Power of the Breath.

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But as midnight drew near, I was running out of steam.  I swear I’m not involved in some sort of hilarious bet to see how many times I can say the word Pitocin— but, y’all, that stuff is a game changer.  I’d heard and read that Pitocin-induced contractions were wildly different than those experienced during spontaneous labor, and I was quickly finding out how true that was.  My contractions were coming fast and strong, with almost no rest between them.  I thought I surely had to be in transition, because I had hit a wall.  I was exhausted and in pain that— in addition to being the worst of my life— did not quit.  I couldn’t catch my breath between contractions, and the techniques that had worked so well earlier in my labor were ringing hollow.  I tried every position, every breath, every visualization I could, and while they got me through those contractions, I was left with little time and even fewer emotional resources to help me recharge before the next excruciating pain hit.

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I told Jillian and Mike that I only wanted to talk about pain relief between contractions, when my head was clear and I wasn’t being swayed by what I felt in that moment.  And when I stopped being able to differentiate when that time was, I knew that I needed to explore my pain management options.  Again I was forced to dig deeper and ask myself why I wanted to avoid an epidural: I was afraid of a loss of mobility, I was afraid of a loss of control, and I was afraid that I wouldn’t be able to push my baby out.  But I couldn’t be mobile in the pain I was in— it was all I could do to start to change positions after the end of a contraction before the next one hit.  More than once I was caught with one leg off the bed and one leg on or just out of reach of the ball I’d been lunging for when I was consumed with pain.  The pain was impacting my mobility, rather than the other way around.  And if this kept up, there was no way I would have the energy to push; I was already falling into a nightmare-like state of exhaustion in the seconds between contractions.  After several fifteen second chunks of conversation with Jillian and Michael— and after more than a few ‘Let’s just try one more contraction’— I knew that either I had to be getting close to the end, or I needed more relief than I was able to give myself.

Jillian found the attending physician, and I asked her to perform a cervical check to see how far along I was before I decided to have an epidural.  I had come in two and half centimeters dilated, so after twelve hours of labor, I expected to be at least six centimeters.  If this was the last stage of active labor, and I was close to full dilation, maybe I could power through.  She checked, and I waited with bated breath.

I WAS THREE AND A HALF ARE YOU KIDDING ME.  One centimeter’s progress in TWELVE HOURS.  I swore profusely, so profusely and so skillfully, in fact, that one of the doctors had to retreat to the corner to get her laughter under control.  Please, someone, find my new best friend the anesthesiologist AND FAST.

I got the epidural— during which I was certain I was going to render myself permanently incapacitated by wildly flailing during a contraction, which you’ll be glad to know I avoided (as an aside— what kind of horrible joke is it that you have to endure horrendous contractions and hold perfectly still while you’re having the medicine administered that you need to get those thrash-inducing pain-nadoes under control?).  I had two more killer contractions, and then magic happened.  Blissfully, I started to feel only pressure.  I could still move my legs, still sit up, still feel that a contraction was happening— but now I could talk, I could focus on the fact that BABY was near, and WONDER OF ALL WONDERS: I could sleep.  I slept on and off for the next six hours.  Six delightful hours of rest, interspersed with conversations not laden with expletives about things other than crippling pain.

After six hours, at which point I might have appreciated the beautiful sun currently rising above the skyline in my previous room (HEY GUESS WHAT I CARE ABOUT THE WALLPAPER AGAIN), I started feeling some discomfort that required those same pain management techniques from earlier.  As the pain in my tailbone grew stronger, I asked a doctor if we should think about turning up that epidural.  Yes, I drank the epidural koolaid, and I would have drunk the epidural straight from the bag if they’d let me, too.

As she checked my dilation, her eyes grew wide.  ”No way,” she muttered.  ”NO WAY.  Oh my god oh my god NO WAY.”  All kinds of situations ran through my head. If my three and a half centimeters of dilation, my blood sweat and tears three and a half centimeters that I had been working on for WEEKS had disappeared, I was definitely going to take off an appendage from someone, and soon.  ”You’re fully,” she said, because as I learned, nobody says fully dilated, maybe because they’re too used to people shrieking with joy once they get to “You’re f-“.   I surely did.

Just to recap, for those of you keeping score:  twelve hours of painful, intense, oh-god-kill-me-now-in-a-metaphorical-sense-of-course-but-actually-that-last-contraction-made-me-reconsider-my-qualification-of-metaphorical contractions? One cm dilation.  Six hours of blissful rest, including some solid honest-to-goodness sleep? ALL OF THE OTHER CENTIMETERS.  Which is six and a half, and that’s a lot of damned centimeters.

Perfect.  Now all I had to do was get this baby out.

Welcome, Winifred Eleanor! + Birth Story, Part I

First things first:

On Saturday, June 8th, at 11:04 am, in the warmest room at Beth Israel Hospital, we welcomed our daughter, Winifred Eleanor Guinn Anderson, with her wide eyes and mess of silken hair, into our arms.  She weighed 8 pounds, 10.5 oz, measured 21 inches long, and had the softest skin and most wonderful smell I’ve ever smelled.  She snuggled on Mama instantly, and was nursing within a half an hour.

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If I were to write about every moment of the week of prodromal labor leading up to the birth, my birth story would give Homer a run for his money.  Instead, suffice it to say that I contracted for hours on hours- but the contractions would be regular but not painful, or painful but not regular, or regular and painful but not frequent enough, and at some point they would fade or something else would signal that these were not, in fact, THOSE contractions, and I would cry or sleep or throw myself into some nesting project and hope that it would all begin, in earnest, soon.

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Nope, still not twins, but thanks for your input, lady at Target.

Based largely on this review of randomized controlled trials, as well as conversations with our providers throughout the pregnancy and the fact that my cervical changes and other signs deemed me a good candidate for successful induction, we decided to begin induction at 41 weeks.  The evidence demonstrated, to us and to our providers, that expectant management past 41 weeks carried a small (really, very, very small) risk and didn’t appear to improve our ability to avoid a C-section.  I feared induction more than almost anything else during the pregnancy, but felt confident in the literature and my doctors.  Further, my doctors didn’t pressure me in the slightest to induce— we calmly discussed my situation in light of the evidence, as well as their experiences, and they reiterated many times that I had the option to choose whatever date I liked to schedule induction (as the scheduling needed to be done for logistical reasons) so long as my 40 week biophysical profile was reassuring.  It was, and above all else, I felt in my gut that this was the right thing to do.

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The first of many, many walks, during which it appears I’m trying to jiggle the baby out.

In the days leading up to labor, I tried every gentle, natural method to get things moving that we could: I ate multiple whole pineapples daily, gobbled licorice by the handful, went for five-hour walks, and engaged in a few other activities I’d rather not mention in a space that my grandmother may read.  We didn’t go for castor oil, evening primrose oil, or blue cohosh or any of the other more intense herbal induction methods because in my mind, those were induction methods just the same as the one I feared— and they were in some cases correlated more highly with pregnancy complications that would undermine my desire for a vaginal delivery.  I know that those methods have helped many, many women, but I knew that they just weren’t for me this time around.

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In which I unsuccessfully attempt to hide, on our last walk at Brooklyn Bridge Park.

I took time each day to quietly observe Winifred’s movements to determine her position.  She remained occiput posterior throughout the week before she was born, and I was convinced that her position was preventing further descent, as an OP presentation makes it more difficult for the head to fit neatly within the pelvis.  When I wasn’t walking or chopping up another pineapple, I was glued to Spinning Babies, trying all manner of inversions and hip circles, along with Walcher’s and abdominal lifts when I was contracting.  I knew that most OP babies turn in labor, and I also knew of plenty of mamas who delivered their babies OP with no problems at all, but I wanted to do everything I could to help make Winnie’s trip to meet the world easier and, well, sooner.

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This what an inversion looks, in case you were wondering.  It’s super flattering.

Try as we might, this little one was snug and cozy in mama’s growing belly and it turned out she needed more than a little coaxing to come and join us.  In the wee hours of the morning of Friday, June 7th, I lept out of bed to meet Mike— and bacon, eggs, and coffee— in the kitchen, where we puttered around making sure all was in order while trying not to wake my mom.  We watched the sun rise from our kitchen window, double (triple and quadruple) checked our list one last time, and slipped out the door to head to the hospital.

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Mike diligently reviewing the dogeared pages of Penny Simkin’s The Birth Partner.

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My little nest in the corner of the waiting room.

We arrived two hours before our scheduled induction, and spent a few hours in the waiting room watching terrible morning shows abuzz with news of the Cronut while I scarfed granola bars like each would be my last (24 hours of hard work on an empty stomach is no joke!).  Finally, a nurse lead us back to a labor room with a view of the Chrysler Building and the torrential rains of Tropical Storm Andrea.  Soon enough, my IV was in and, after a chat with the attending physician, the Pitocin drip began. We texted our wonderful doula Jillian, and she made her way in from Brooklyn to meet us.  One way or another, after months of waiting, we were going to meet our sweet bean.

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Our last photo as a family of two.  

Birth Story, Part II

The Scary Stuff

For all the close calls and near misses that we’ve had in this pregnancy, not one single less-than-stellar thing that’s happened so far has been something I anticipated or feared ahead of time.  Don’t get me wrong, I have PLENTY of fears, but I never for a second was afraid of placenta accreta, or getting the flu while away from my husband, or falling off a curb in my 35th week.  Dealing with each little stumbling block— and to be clear, we’ve been very, very lucky this pregnancy, as mom and baby are both healthy and whole— has been an exercise in who we are and how we cope.  The day after I fell, I was all sunshine and rainbows until I walked into the bathroom to get dressed to go home (and eat after 36 hours, hooray!) and I burst into tears, finally admitting to myself that I had been scared beyond belief by the fall and the subsequent contractions, that I had been afraid for my baby, and simultaneously felt guilty that a tiny part of me actually just couldn’t wait to meet her.

There were good parts, too, of course— we discovered that our hospital team is truly fantastic, that Michael and I work well together in that environment and that we’re on the same page even when in a stressful situation, that Michael’s actually been reading the Birth Partner and not just slipping the New Yorker in behind the cover, that I won’t start eating him if I can’t have food for 36 hours.  We learned that our hospital team shares our birth philosophy, that they will explain absolutely everything along the way, and that they will ask first thing if I plan to have an epidural, and when I saw, no, I don’t think so, they won’t raise their eyebrows and tell me it’s going to be worse than I think it is.

At our first childbirth class, our instructor asked us to share what we were most afraid of.  It wasn’t that I didn’t have any fears, of course— I had plenty of fears about the pregnancy— but I had been so focused on preparing for the birth that I hadn’t stopped to think about what I was supposed to be afraid of, only what I was supposed to know and do.  ”I…. I… um… I haven’t figured out what to be scared of yet,” I stammered.  And it was true!  In the subsequent weeks, I grappled with a number of fears, most notably induction, now looking like a real possibility as the days past my EDD tick by— but none of them has overwhelmed my intense desire, bordering on an almost reckless giddiness, to just DO THIS.

I can’t wait.  I can’t wait to meet my daughter.  I can’t wait to see her father with his daughter in his arms for the first time.  I can’t wait to be her mother.  I can’t wait to watch my body do crazy and really, truly, actual-meaning-of-the-word awesome things.  I can’t wait to hit a wall of difficulty and come out on the other side, with my family.  I know the scary stuff hasn’t even begun, that I’m looking at a lifetime of gasps and worries, but I just can’t get over how much love we’re going to get and give over the years to come.

On a side note, do you think they’ll let me play The Final Countdown in the delivery room?