I have been told by friends who have had babies how quickly the sharp edges of labor fade in one’s memory. Obviously this serves a biological purpose, because otherwise why would a woman give birth twice? For that reason I wanted to put down my memories as soon as possible, before they soften or blur too much. It’s not that my labor was some 100% lovely experience that I want to chronicle for the good memories. It was the hardest thing I have ever done. It was far harder than I could ever have imagined it would be. It was toward the end, scary and confusing. I pushed for FOUR HOURS. There was blood and sweat and profanity. But I want to remember it, because for as hard as it was, it was also the best thing I have ever done that culminated in the most incredible moment of my life, meeting my daughter for the first time. So without further ado, here is the story of Ryland’s birth.
It started on Wednesday, March 30th at eight in the morning. To be even more accurate it kind of started the evening before. I had been having contractions on and off for a couple of weeks (effective enough to actually dilate me to 4cm as my OB informed me at my most recent appointment). They weren’t painless, but they also were never painful enough that I thought they could be true labor. On Tuesday evening I had a couple of contractions with a little more oomph behind them, three of them about ten minutes apart. But as soon as I was getting ready to do something about it, they stopped. I went to bed and all seemed calm.
The next morning I woke up early for a day off, around seven. I got up and started my morning routine with coffee and breakfast. (Just a little warning: this is an honest birth story, and as such it will mention various bodily fluids and events that some who have not had a baby might find gross or terrifying, that kind of talk starts about now, so if you are squeamish or easily embarrassed you probably shouldn’t be reading a birth story at all). My in-laws were due to come stay with us the next day, so my plan for the morning was to clean the guest room and downstairs in preparation. As I was starting this process, my water decided to break. At the time I wasn’t 100% positive that it was my water breaking. Let’s just say it can happen in various degrees, and it is not always like the movie version where a woman causes a huge puddle on the floor. At this point mine was not a puddle, but still fairly distinctive. However, since I wasn’t sure I decided I might as well finish cleaning. As the morning went on my water continued to have these little “mini breaks” and finally I called L&D. I actually had a check-up with my OB scheduled for that afternoon, and the RN I talked to on the phone said as long as I felt the baby still moving and that there was no blood or serious contractions I could wait and go to my appointment and they could confirm there if my water had in fact broken.
And so I decided to wait until around noon. As soon as I finished my PB&J lunch (and thank goodness I was able to eat that, considering I wouldn’t eat again for over 24 hours) my water “broke” in the more movie scene way. At this point there was no mistaking it or thinking it could be something else (other than me completely losing bladder function, which I was fairly positive was not the case). I texted my OB and asked her what she thought I should do. I called my mom because the husband was at work in Cville and I thought someone should be at the house in case I did need to go to the hospital. I texted the husband and told him to stand by. My doc called back and said that it sounded pretty unmistakable that my water broke and that I could come to my appointment but that more than likely I would just get sent downtown to the hospital anyway.
And so the moment had arrived. After almost ten months of waiting (and towards the end it felt like I had been pregnant for ten years), this was it, the grab your bags and head to the hospital moment that I had anticipated and pictured in my head so many times. I still wasn’t having heavy-duty contractions, so the nice part was that things weren’t super rushed. I took a shower, settled the dogs, gathered my things, and was ready to go when my mom arrived.
We got to the hospital around 2:30pm and I checked in at the front desk. A woman came up in a wheelchair while I was filling out paperwork who was actively groaning and moaning. I felt a little guilty for how good I still felt, and wondered if I was just going to have one of those mystical, pain free labors that exist in the same way unicorns exist. I was taken to an L&D room and over the next two hours a parade of people came in and out (I delivered at a teaching hospital). A resident did an exam that confirmed that I wasn’t just peeing myself (whew would that have been embarrassing). She also did an ultrasound that showed the baby was head down and good to go from that perspective. I signed various consents that warned of horrible things. An anesthesia resident consented me for a possible epidural and/or anesthesia (which at the time I was still planning to try to avoid). I got an IV and blood work done. And every hour the nurse came in, took my vitals, and monitored the baby’s heart rate for 20 minutes or so. I was definitely having contractions, just nothing extremely painful. This continued for several hours, by which point my husband had arrived.
And then this continued for several hours more. My in laws and parents visited for a while and left, assuming the baby would be born sometime in the middle of the night. The residents and attending physician popped in from time to time and they mentioned that at some point we would need to consider pitocin (to induce more active labor) if things didn’t progress by themselves. I appreciated that every time this was mentioned it was a discussion and not just a doctor telling me what to do. In a lot of ways they left the decision to us (I’m sure if it went long enough this would have changed) so I never felt pressured or rushed to start this intervention. However by about 10 or 11pm that night, things still hadn’t changed in terms of dilation or contraction regularity. I was having some stronger, more painful contractions but they would come every 2 minutes, and then I would have a 10 minute stretch without one. I was also having couplet contractions (this would be important later when it comes to why I ended up doing an epidural) which meant one big, longer contraction followed immediately by a shorter, smaller one. Apparently some women have contractions in that pattern, but it meant that when the contractions were closer together there wasn’t much in the way of non-contracting time. However at this point the pain was totally manageable so I didn’t really mind. It just meant my stomach was super tight.
And so in the resident’s words, we would do a “whiff of pit”, or a small dose of pitocin. The unfortunate part of starting this was that I would need to be on a continuous fetal monitor, hooked up to an IV pump, and hooked up to a finger pulse ox probe to differentiate my heart beat from the baby’s. And so I went from having no limitations on movement to basically being hooked to the bed. However I knew that the longer I went with my water broken, the higher risk of infection there was and that at some point things needed to happen so I was okay with the choice to induce.
There were a million things about this hospital stay that were incredibly enlightening to me as an RN. I honestly feel very grateful to have experienced “the other side” of the patient experience, because there were so many little things I appreciated for the first time and hopefully will affect my practice and interactions with patients. One was just how awkward and uncomfortable it is to be hooked up to an IV pump. I take care of kids and so of course kids complain a lot, and I am guilty of sometimes taking their complaints a little lightly (particularly when it is the 10th time in an hour they have voiced their concerns). Kids complain A LOT about IVs. They say they hurt and that they can’t bend their arms with them in. They hate being hooked to a pump. They call for help to go to the bathroom. And I sometimes get frustrated as an RN with all of these constants complaints. However after having one running for only a short time I understand they do suck. They are not the end of the world, but it sucks to have your mobility limited and when they are running at a fast rate they do kind of hurt. I had to have fluids running with the pitocin and yeah my arm hurt. I kind of feel like a jerk for all the times I mentally wanted to tell kids to just suck it up when they complained about having fluids running. And it is TRICKY to get the IV pole into the bathroom.
I don’t remember exactly how long it took, but fairly soon after starting the pitocin things started to pick up in the pain department. However things were still tolerable. Every 30 minutes or so the nurse would come into the room and turn the pitocin up a little nudge. This happened 3 times. And what felt like all of a sudden we went from 0-60. Or 600.
I think the hardest part of this birth story will be trying to adequately describe the pain of my contractions when they were at their worst. I knew labor was known as pretty much the most painful experience someone can go through. I thought I was mentally prepared for that pain. But when my contractions got “real”, it was unlike anything I could have prepared for. I am not a person who uses profanity lightly, particularly in front of people I don’t know well. But what I remember most distinctly is that when the contractions really picked up, the only words I could form were expletives (and a generous dose of taking the Lord’s name in vain, my apologies to the Big Guy). The contractions before the pitocin felt like strong period cramps, mostly in my back. The contractions after the pitocin were almost full body (minus I guess my arms and head). Almost immediately I started to think about an epidural, because I went into the experience knowing I wasn’t going to suffer through something unendurable. This was unendurable. My husband and the nurses sweetly offered pain relief measures like massage, a shower, the birthing ball, position changes, but literally all I could do was stand like a statue and grip onto the IV pole (and at one point my husband’s throat, whoops!). Moving made the pain worse. I would try to get on the bed on all fours, but the second a contraction started I could not physically move.
I managed to agree to try the fancy whirlpool tub (literally almost the size of a swimming pool), but as it was filling up (my GOD did it feel like it was taking an ETERNITY to fill up, it was probably 15 minutes but it felt like hours), I also started asking vocally about an epidural. It was such a strange out of body experience to be in that much pain. Normally I joke about everything, and try to make things light. And I remember actually thinking it must be bad because I couldn’t make a joke or say something self-deprecating. I couldn’t open my eyes. Again I just stood with a death grip on the IV pole trying to breathe.
I might have tried the tub or other non-medication pain interventions if I had anything in the way of breaks between contractions. In my childbirth class they had talked about breaks and how at least during the breaks between contractions you had no pain. But because of the “couplet contractions” and the artificial nature of pitocin contractions my breaks were about 10 seconds long. I would draw a breath and start to speak and then another contraction would crash over me. There were no pauses or moments where I could gather my thoughts. Between cursing like a sailor, this was pretty much the only other thought I could articulate, asking why there weren’t any breaks.
It is true that there is some amnesia related to the pain of childbirth, because looking back I can remember that I was in pain but remembering the actual pain itself is almost impossible. Let’s just say that the mental image that best captures the pain is me, a formerly good Catholic, cursing loudly, covered in sweat, gripping an IV pole with one hand and my poor husband’s trachea with the other.
I asked if I could have a cervical check (who knew that at one point in life that would be something I would voluntarily request) to see how far I was. Last check was still 4cm. If I was a good bit farther along and labor had an end in sight then I might have tried to get in the tub/pool (the sweet RN filling it up even had music cued up ready to go and there were fancy lights, I’m sure it would have been nice really if I didn’t feel like my uterus was going to explode) and not do an epidural. The lovely resident came in and checked me and I was 6cm. I asked between profanities what was in theory the longest I could still have to go before I was ready to push. The answer was of course it depends, but possibly several hours. As soon as I heard that I knew I couldn’t do it. I became the stereotypical movie/TV woman where the only two words I suddenly could form were “epidural” and “now.”
The nice thing about giving birth at a teaching hospital is that there are SO many doctors. At some hospitals I would imagine you would have to wait a fairly lengthy time for an anesthesiologist, but in this case the anesthesia resident was set up at the bedside 10 minutes later. It took about another 10 minutes before I could manage to sit down on the bed and stay still. They injected my back with a numbing agent before the epidural, which literally felt like a love tap in relation to the waves of pain breaking over me. Shortly after, the doctor inserted the epidural.
And then I waited for it to kick in, which probably took about 10-15 minutes but felt like hours. When it did finally “kick in” there was a very noticeable change in my contractions in the sense that the sharp, strangle your spouse, total body pain decreased. However I suddenly had a new sensation, which I now know is the urge to push (which at the time felt like a very strange and extremely uncomfortable pressure). When I mentioned this I got checked again and of course I was 10cm dilated. So in some ways I like to think that I made it to 10cm without an epidural. This was around 3 or 4 in the morning at this point, and at the time I almost regretted the epidural since I had basically made it to the end without one. However the baby did not actually come out for another 6 hours, so in retrospect thank SWEET JESUS I got the epidural when I did.
The baby was still at 0 station (which basically means her head needed to travel a little farther before I could start pushing), so instead of starting to push at that point, the head of my bed was lowered and the bottom was raised (so I was slanted and could let gravity help Ryland make her way down a little) and my nurse got me what looked like a giant pool toy (they called it the peanut) to wedge between my legs (also supposed to help baby move down). The lights were dimmed, and we were told to try to get some sleep.
I would have loved to sleep, except like I mentioned while a lot of the pain was taken away with the epidural the crazy pressure that came with contractions was still there, which while a different kind of pain was still pretty intense. I just remember lying on my side and gripping the edge of the bed and letting out a variety of interesting noises and breaths with each contractions. I also was shaking like crazy (lovely little side effect of the epidural). My husband was on the little bed next to me and I know he was trying his best to stay awake, offering me sips of water and juice or ice chips, but at one point I could hear him snoring.
After a few minutes the anesthesia resident and attending came in the room (to check the epidural) and I was still at the point where I couldn’t really talk or open my eyes and was just gripping onto the bed rail. I vaguely remember a conversation between them about what was the point in being conservative with the pain meds and within a few minutes the resident returned with a little syringe that she injected into my epidural. A little longer and that kicked in and I could have kissed that resident, because finally I felt like a human again and not a feral beast. I could still feel my contractions but I could breathe and form coherent thoughts in the middle of them. I could finally take a nice nap.
Which of course is the moment that enough time had lapsed and the nurse and resident came back to start the pushing process. So here it was, the moment to finally do the darn thing. This was the part I thought I kind of had a grasp on, exclusively because the pushing part is what you always think of when you think of labor. It was five in the morning. Ryland would be out into the world within the hour.
In my mind pushing meant that I would lie on my back with my feet in stirrups. Little did I know it more closely resembled pilates. My lovely nurse instructed me that I would have to grasp my legs and pull myself up and forward with each push (basically a modified crunch with frog legs in the air, not the most natural move). I would push three times with each contraction, starting with a deep breath and then 10 seconds of not breathing/bearing down/pushing. I listened closely to directions like the type A person I am. And then I failed miserably the first few pushes. I accidentally breathed halfway through a push. I didn’t pull myself up. I only pushed twice in a row instead of 3 times. Granted at this point I had been awake for almost 24 hours so coordination wasn’t the easiest thing in the world. The nurse and doctor were incredibly patient and encouraging, as well as my husband who took his job as eye chip/juice/water giver very faithfully.
I’m not sure how long this went on, but at a certain point the doctor had to leave to go check on another patient. My right leg was completely numb so my poor nurse had to do most of the holding of that leg while my husband assisted with my other leg.
After a while they brought out a giant steel bar to make things even more acrobatic. I put both of my legs up on top of the bar and they draped a little towel over the middle. Now when I did my “crunches” I had to pull myself up with the towel. Let’s just say that pushing is nothing how I envisioned it. There is way more in the way of physical contortions and effort than I expected. But still I pushed.
And pushed. And pushed. And pushed.
An hour passed. And then another. The doctor came in and out. Shift changed happened at 7 and my wonderful night RN requested a specific day RN who ended up being so incredible I seriously considered renaming my child after her. She had a student with her and at that point I had had my legs wide open in the air for so long for all to see that I happily agreed for her to join the fun.
And then the little extra “boost” of medicine I had gotten earlier started to wear off and pain came back, forcefully. Pushing went from a pleasant if exhausting yoga class to a yoga class taught by a sadistic psychopath. Putting my legs up on the bar to start the pushing process each time was starting to feel like a monumental task. Hoisting myself up with the towel made my arms shake. I had been pushing for over 2 hours and I felt done and utterly depleted.
Now the exact order of the next events is a little jumbled in my mind. All I know is that shortly after or during shift change, my room went from a quiet and dark (if draining and painful yoga class) with me, my husband, the RN, her orientee, and the resident on and off to grand central station.
I work in a hospital so I know that it’s never good when your room suddenly becomes flooded with doctors and nurses. And suddenly our room was flooded with doctors and nurses.
I was gently turned to my left side by my totally calm and reassuring nurse. Someone put a non-rebreather oxygen mask on my face. Someone put a surgical cap on my hair.
The night shift and day shift resident were both in the room at this point and then the daytime attending OB came in as well. He was another person in this experience that I am so grateful was there, because like my nurse he seemed collected and totally competent in a way that prevented me from every panicking. Maybe because I delivered at the hospital I work at, but I never once didn’t completely trust the people caring for me.
Apparently the baby’s heart rate had dropped dangerously low and had stayed there for a few minutes. This is not good in the world of labor and delivery. In fact it is bad enough that we heard someone in the room “readying the OR” for a possible emergency c-section. Someone also called the NICU and shortly thereafter the NICU team (at least 6-8 RNs and doctors and respiratory therapists) arrived in the room. There were other nurses in the room at this point as well.
I would have gone straight to the OR if the baby hadn’t recovered after the contraction. And so the doctor was okay with still going for a vaginal delivery but only if it could be sped up. His suggestion was forceps. A lot of doctors today aren’t trained to use forceps or aren’t comfortable with them. I am grateful the doctor present was, because if he hadn’t been I would have almost definitely had no choice but a c-section. Because it was clear that despite over two hours of pushing my stubborn little girl was not going to come out on her own at this point.
It took a little while to get the forceps ready and so I kept pushing with each contraction, only now there were about 20 people in the room, which probably should have made me feel awkward or embarrassed but I was so tired and over any semblance of modesty at that point that I probably wouldn’t have cared if the event was being broadcast over a jumbotron in the hospital lobby.
I also didn’t realize or really think about pre-labor that you only push with contractions. And so there were these 2-3 minutes pauses we were all literally just hanging out waiting, anywhere from 3-5 doctors and nurses at the foot of the bed, the NICU team by the incubator, and a variety of other people like anesthesia coming in and out. If it had been a movie there would have been loud elevator music or crickets playing during all of these weird pauses in the action.
The moment for the forceps arrived and thank GOD I had an epidural already. I’m fairly sure I would have had to have one at this point regardless, because I don’t think forceps are pleasant for a non-medicated human. The attending “taught” the resident about forceps as they used them, which again I may have been annoyed or concerned about if I didn’t feel such faith in the providers around me. I heard various words and phrases being used as I pushed and from what I gathered the main thing they did with the forceps was rotate the baby to a different position. However they did not pull the baby out with the forceps as I expected.
So it was time for more pushing. And more pushing. I still had the oxygen mask on and was actually pushing while on my left side, which in a lot of ways was an easier position for me than using the crazy yoga bar. Minutes went by. The doctors closely watched the baby’s heart rate with each contraction. It dipped down a few more times but always recovered quickly enough that they didn’t rush me to the OR.
After every push I asked if there was any progress. Initially on in the process I received clearly false reassurance that the baby was definitely progressing, when really she was just hanging out in the same position. However as more time went on I could sense that maybe just maybe there was some movement. At one point they had me reach down and touch the top of her head, which was incredibly strange but also encouraging.
A couple of times they asked me if I wanted a mirror. I tried to politely decline when really I wanted to say “HELL NO I DON’T WANT A MIRROR, WHY WOULD I WANT TO SEE WHAT IS HAPPENING DOWN THERE?”
We were nearing the four-hour mark. I knew at some point we would be at the cut-off, and in some ways I resigned myself to a c-section. Whatever it took to get her out safely I was okay with. And then just when I was positive I could not physically push any longer, she started to make her way out (aided by some lovely tearing and an episiotomy, but again I could have cared less at that point what the heck they did as long as it got her out).
All at once (and with a lot of crazy pressure) I saw the doctor lift up a baby, my baby. She was blue and covered in gunk, but I could see her stirring slightly. She seemed enormous. But she was in that moment, despite all of the effort and fear and complications of the last 24 hours, also perfect and whole and instantly the sum of all the parts of my world, my sun and moon and stars combined in one little being, my reason and explanation for everything that had happened to me and would ever happen in my life.
They put her on my chest for a brief minute, before whisking her away to the NICU team. I found out later that she was showing some respiratory distress (hence how blue she was). They only had her for about 5-10 minutes before she recovered (she was briefly on c-pap, which is a type of oxygen delivery system). Luckily at the time I wasn’t really aware what exactly was going on, largely due to the flurry of activity still happening at the foot of my bed (stitches and tearing and blood and delivering the placenta and what not).
My husband kept a careful eye on what was happening in the incubator (which probably took several years off his life) and finally I could hear loud and forceful cries. As a pediatric nurse I know that a baby crying can only be reassuring, because any child in serious respiratory distress won’t be able to cry forcefully. I used to work in the post-op unit and in some ways we loved when kids came out screaming, because there was no doubt they were “recovered” from the respiratory aspects of a surgery.
My husband brought her back to me, cleaner and pinker, and with the nurse’s help we got her skin to skin.
There’s this scene in the movie “Waitress” (super underrated by the way) where Kerri Russell’s character is handed her daughter after delivery, and suddenly a room full of chaos and shouts goes totally silent and peaceful. Whoever wrote that scene must have given birth to a child, because it’s just the best way I can think to describe those moments when you first hold a baby. There is still plenty of chaos and activity. For probably 30 minutes the room was still active with things being stitched (ouch), my uterus massaged vigorously (ouch again) when I bled too much. I was straight catheterized (epidural=no sensation of having to pee, which was in some ways the BEST part of the epidural for me, I went from having to pee constantly, as in literally never having the sense of a completely empty bladder for the last couple of months of pregnancy, to HOURS without feeling the need to urinate, that was bliss). Anesthesia was in and out. People asked me questions about using sutures that were part of a clinical trial. I may have signed things. I agreed to interventions with the baby like erythromycin eye drops. The bed was changed around me and I was boosted up.
But in all this flurry of activity and medical care, even though I was still shaking uncontrollably from the epidural, even though my legs were wide in the air for all to see, even though I hadn’t slept in 24 hours and was totally physically drained from labor and pushing (harder than a marathon by the way), I didn’t particularly care or notice any of it, because of the little being on my chest.
God I hope I always remember that moment clearly, the weight of her, the warmth of her skin pressed against mine, the explosion of emotions, relief and surprise and fear and a desperate, all consuming love that utterly and totally rearranged all of the molecules and atoms of my soul.
Labor was harder than I could have ever imagined. It didn’t go the way I had “planned.” Ryland and her mama both sustained some war wounds (we noticed a few days later these little hematomas and hard lumps on either side of her face, which our pediatrician said were “brown fat necrosis”, either from the forceps or from the prolonged labor, they will go away luckily), but at the end of it all we were so very lucky. I could not be more grateful to the L&D staff, every single person who took care of us over the 20+ hours we ended up being there. From the doctors to the nurses to the students, each and every person there was competent, professional and caring. They made me want to be a better nurse, so that I can make people feel as safe and cared for when I go back to work.
I am again reminded how fortunate I am to be able to give birth in a hospital with all the tools of modern medicine at my disposal, how much of a gift that is when so many women in this world still lack this ability. I think of what would have happened to a woman and her unborn child in my position without medical interventions like forceps and an episiotomy, and I am humbled with gratitude for a safe birth and deeply saddened that this access to a safe labor and delivery is not global (yet).
I know in many ways that the end of labor is when the “hard” part starts, and we are still very much in the sleep deprived, world just changed newborn stage, but already even after just three weeks I can’t imagine going back to life without my daughter, what a world without her would look like.
And to any expectant mamas who read this, like I read so many birth stories in the weeks leading up to my delivery, I would just say this. It’s good to have a birth plan, but more than likely your plan or at least parts of it will get tossed out the window, so be prepared for things to change. If you want a natural birth do it. If you want a natural birth and end up suffering beyond endurance, it’s okay to change your mind and get the epidural. If you want an epidural and end up having a natural birth that’s awesome too. Do what gets you and your baby through the experience safe and whole. Do what feels right. Be your own advocate about what you want but also trust your caregivers (unless they are just flagrantly incompetent, which is pretty unlikely), because they’re smart and went through a lot of school and training to be where they are, and they want the best outcome just as much as you do. Lean on your nurses (especially if they are rockstars like mine were), because they’re the ones who will be in the room the most. Don’t worry about being embarrassed, because as someone who is pretty darn modest, that just flies out the window.
It will hurt and it will be scary. It will feel like more than you can handle. But you will handle it. You will get through it. You will end up with a sweet and perfect baby on your chest whether right after birth or at some point later if more interventions are needed, and the hours that precede that moment will be instantly rendered unimportant. The edges will blur. The pain will be surprisingly forgotten.
But at the end of it, God willing, there will be a baby who alters the foundation of your world, cracks it wide open with her first breath. And with the sound of her first cry that baby instantly and irrevocably replaces your old heart with a new one that is raw and vulnerable, but bursting with unfathomable love. At the end of my labor there was Ryland, and she was worth all of it.