I long suspected that Oscar would be an October baby, but that was really the only part of his birth that I accurately predicted. Almost everything else was a surprise.
On Friday, October 3rd, Matt and I visited my clinic for my 41-week prenatal appointment. Because I was over 40 weeks, the purpose of this appointment was to check my amniotic fluid level to make sure I was at a five or higher (whatever that means). My pregnancy was really low-maintenance, so I was confident that I’d nail that five and be allowed to wait another week for labor to start naturally. I knew it was possible that we’d discuss induction with our midwife, but I thought it was so improbable that I put it out of my mind.
You see where this is going.
After one last ultrasound, our midwife delivered the shocking news that my amniotic fluid was at a 2.2, and she told us, gently, that we needed to check into the hospital that day for induction. Even typing this now, I’m shivering; in the moment, my body reacted before my mind could catch up. I started shaking and crying. After a week of not working and lounging around, napping and baking and reading at my leisure, everything was suddenly happening very fast.
So, we went home, packed a bag, called our parents, and made arrangements for Vilas. And then we made The Drive to our hospital. I’d envisioned making that drive in pain after laboring for hours at home with Matt and our doula, Justine (more about her later). Instead, the car was quiet, and it was only an hour after we’d left the clinic. Only an hour after we’d learned that our baby would be born very very soon.
When we checked into the hospital, the nurse at the front desk asked Matt if it was still raining outside. “No,” he said. “It’s stopped.” I looked up from the form I was signing, surprised. “It rained the whole way here,” I said. And we all kind of laughed because clearly, Matt had other things on his mind.
We settled into our room, which several nurses told us was the biggest room on the floor. This was because the induction could take a long time, maybe even another day or two, to work. The midwife on call, Heather, checked my cervix to see if I was ready to receive Pitocin. At one centimeter dilated and 50% effaced, I wasn’t. So we started with a drug called Misoprostol, which would ripen my cervix and which would probably take two doses and up to eight hours to work, at which point I’d be given Pitocin.
That did not happen. Within a few hours, my contractions suddenly went from uncomfortable to serious. I could no longer talk through them; I could only shut my eyes and focus on my breathing. We called Justine and asked her to join us. It wasn’t long before I moved from early labor into active labor, at which point I took off all of my clothes because, labor, but also because I was in and out of the bathtub. Laboring in water made a significant difference in my pain level, but I threw up quite a bit while in the tub, and as time wore on and my contractions became coupling contractions (two in a row with, often, very little rest in between the next set), I could no longer focus on my breathing or on our baby. Everything felt very, very dark, and all I could think about was the pain.
I’d had visions of being able to use movement and gravity while laboring, but the pain was so intense that when I wasn’t in the water, all I could do was curl up on the bed and bellow through my contractions. Bellow. I felt like I had turned into an animal. At one point, our nurse asked if I’d like a towel to bite on so that I would stop biting my own arm. I hadn’t even realized I was doing that.
I had a few major reasons for wanting to pursue a natural labor, and among them were that I would feel more present, more in control, and I’d be able to participate in my labor to help it along. But as I moved into the transition phase, I felt like it had turned into a runaway train. I did not feel in control of myself, I was hardly able to move at all, and I wasn’t able to focus any positive energy on our baby. I also had no idea how I would have the strength left to push, and I knew that was coming soon. I was back in the tub when I summoned all of my decision-making power and courage and asked Matt and Justine for an epidural. I think I said something like, “I’d like to embrace modern medicine and get an epidural.” I made sure to ask several times, so they would know I was serious.
At this point, I was dilated past eight centimeters, but I didn’t know how far past. And I didn’t care. Knowing that the anesthesiologist and his team were on their way gave me a short-term goal to focus on. I was desperate for relief, but it was slow in coming because the anesthesiologist was working with another patient. Before he showed up, Heather checked me one more time. I was nearly ten centimeters dilated.
I knew I could back out, but I was mentally counting on the relief and rest an epidural would bring, so when the anesthesiologist showed up and expressed doubt about administering the epidural at the very end of the transition phase (he recommended a different pain medication that would last for an hour or two), I made it clear what I wanted. Heather backed me up, and I gritted my teeth and tried to remain still for the procedure.
In my labor planning, I never thought I’d say this, but I can’t tell you how happy I felt after receiving the epidural. I felt like a human again. I could ask questions and talk with the nurses, with Heather, with Justine, with Matt. I remembered our sweet baby and reconnected with him. Love returned to my labor experience.
I rested for an hour, and at 12:30am, I asked if I could start pushing. I felt ready. I was jumpy and excited, the way I am at the starting line of a race. So I started pushing.
Two hours later, we’d made good progress, baby and me. Heather, our nurse Sarah, and Justine told me to hold my breath and count to ten while pushing, so I held my breath and counted to twenty. They told me to try to push three times through each contraction, and eventually I started asking to push for a fourth time. I wanted to work hard and then harder to help our baby be born. So I did.
But then, something shifted. My contractions, though still coming back-to-back, were too far apart. I’d push him down, down, down, and then in the three or four minutes between contractions, he’d slowly move back. After the third hour of pushing, Heather recommended trying a dose of Pitocin to even out my contractions. I watched the clock intently, but two doses of Pitocin didn’t change the pattern.
I started pushing again, and I pushed for another hour. I closed my eyes and focused all of my energy on safely- and quickly- delivering our baby. Finally, Heather said, “Something’s up. I think it’s time to page the OB on call to get her opinion.” I remember thinking that things were taking a serious turn, but I was on board with this plan. We all were. He wasn’t coming out, and there was a reason. We just didn’t know what it was. The other wrinkle was that the baby’s heart rate was dropping significantly during most of the contractions. He’d be up at his normal 140 beats per minute, and then suddenly he’d dip to 60 beats per minute. His heart rate would climb back up, but sometimes it took a long time for him to get back in the normal range, and it was something that Heather, the nurses, and Matt were monitoring closely.
For reasons that were explained to us in the moment but which I cannot remember now, the OB, Dr. Eckhardt, was joined by staff from the NICU. Our room was suddenly full. I pushed a few times for Dr. Eckhardt, and then she made her recommendation. We had two options for delivery: 1) we could try a vacuum extraction- this was our last chance for a vaginal delivery- or 2) we could move to a Cesarean section. Dr. Eckhardt said that she would be comfortable with the vacuum extraction, and she explained to us the hospital’s conservative position on vacuum use. We wouldn’t exceed six pulls, and if the vacuum popped off twice, we’d stop. She said that she’d never experienced a pop-off before, and she also said that she wouldn’t even put vacuum extraction on the table if she didn’t think it would work. He was really close, she said.
So we started. I don’t think I’ve ever worked my body harder in my life than when I was trying to push our baby out into the world. I just wanted him to be safely in our arms so, so, so badly. My whole physical and mental and emotional being was focused on this single goal- and in the end, it wasn’t enough. We got him to crown, but we had one pop-off, and then another. After the seventh pull, the one last, extra, whole-hearted attempt to deliver him vaginally, it was over. Dr. Eckhardt said that I could keep pushing but that her priority was to deliver a healthy baby. While he was still tolerating labor, he needed to be born. And the safest way to do that was to have a C-section.
Before our labor experience, I never, ever, ever pictured myself having a C-section. I knew it was possible, but I’d had such a low-key, healthy pregnancy that in my mind, it just didn’t fit our birth story. I do remember thinking that if I ever had a C-section, I would know intellectually that as long as our baby was healthy, it wouldn’t matter, but that emotionally I might grieve the Labor that Might Have Been.
But I will tell you this. When Dr. Eckhardt told us that our best option was to have a C-section, I did not hesitate. Matt did not hesitate. There was and is no grief. Far and away the most important person was our son; we were already parents, and we would have done anything to keep him safe. We later learned that his shoulder was stuck on my tailbone, which makes a right angle instead of a soft J shape, and which made it impossible for him- and very likely impossible for any future child we might have- to be born via my birth canal.
And so, I was wheeled into the OR. It looked exactly like ORs I’d seen on TV: stainless steel, bright white lights, many blue-gloved hands. Matt and Justine had to put on full scrubs before entering- hair coverings, masks, long sleeves and long pants, shoe covers- so Heather sat with me while I was prepped for surgery. When they entered, Dr. Eckhardt had just begun.
At some point I asked Matt, “This is going to work- right?” By then, it felt like so many things hadn’t worked. But he was positive, and I needed positive. Matt and Justine were right next to me during those agonizing minutes while we waited for our baby to be born. In my memory, I am holding my breath.
He was out, he was born, he was free. Someone’s hands brought him to our side of the curtain, and we saw him for the first time: perfect, chubby, red and purply, beautiful beautiful beautiful. And we heard him cry. He cried! I’d been warned that about half of C-section babies do not cry, but ours did, and it was simultaneously the newest and oldest and best sound my ears had ever heard. Then Matt was by his side, and he cut the umbilical cord, and within an instant, Oscar was lying between us. I don’t remember what I said to him, maybe “Hello,” but I said something, and when he heard my voice, he stopped crying, and then I could no longer speak. That first moment with him is a moment that is in my heart forever.
In the days and weeks that have followed, I have felt only gratitude for Oscar’s birth. It is a different story than the one I wrote in my head, but it is not a bad story. I can say with sincerity that it was A Good Birth because I know we did absolutely everything we could for him, and because Oscar is a healthy, happy, and whole little person. It is our greatest honor and our greatest joy to love him.
And I have never felt more complete.