If you are at all familiar with my life story, you'll know that the birth of my firstborn son completely broke me. It was a difficult pregnancy, followed by a traumatic labor, and I was ultimately awarded with a fussy and completely restless baby. I honestly felt like I lost a year of my life between postpartum depression and all the major life changes happening at the time. I would love to revisit that story now that I have some perspective and feel like myself again, however that is unlikely to happen anytime soon, so feel free to check out that current saga of a birth story.
Fortunately, that's not what we're here to talk about today.
This article is about the unmedicated birth of my 8 week old daughter, whose pregnancy, delivery, and "4th trimester" could not have been more different than my first. I have come to accept that my body must love extremes because you can't get any more different than a 36+ hour active labor and a 2 hour one. Let's start at the beginning.
My pregnancy was remarkably easy. I somehow made it through the entire nine months with no symptoms. I wasn't even tired for goodness sake! Keeping up with my 1.5 year old toddler was no sweat and I often went on 3 mile walks uphill several times a week for the first half of the pregnancy. Other than some moderate to severe SPD (symphysis pubis dysfunction) pain starting around 20 weeks, I honestly didn't even feel pregnant. I had bad SPD with my first as well, so already accepted that pregnancy hip pain was a way of life.
Not even my massive post-due bump made me feel pregnant. My abdominal muscle separation (diastasis recti) had never fully healed since my first pregnancy and my weight never bounced back either, so mentally I thought I looked several months pregnant the whole first year postpartum anyways. Having two pregnancies in less than 2 years just makes pregnancy appearance feel like your new normal.
Everything was great.
I'm on record for saying that I could have been pregnant for another month or two and wouldn't have minded. In fact, with a due date of Feb. 16th, I didn't really want baby to come early anyways in order to avoid the possibility of a Valentine's Day baby. We were also simply not in the mindset of having a baby and it seldom crossed our mind. For the past several months we were in the process of renovating the basement in our fixer upper. It wasn't until we finished at 38 weeks that we could finally unpack most of our belongings that had been sitting in storage, including all of our newborn gear.
My wishes were granted and my due date came and went.
With the basement finished and holidays passed, we finally got around to packing a hospital bag and setting up the baby's bassinet at the ripe ol' gestation of 40 weeks. It felt like we were finally free to put all our mental and physical attention towards having a baby.
My birth plan was to use a birthing center instead of a hospital this time around. This decision was based on a few different factors.
My number one priority this birth was to avoid an epidural, under the condition that labor progresses normally. With my first experience, the epidural did not even work on half my body. It is now two years postpartum and I still have what feels like a permanent bruise at the injection site. Thankfully, it no longer bothers me on a day to day basis and I only feel pain when pressure is applied at the exact pinpoint location. Epidurals are great for many women and allow them to relax and be more present during their labor. However, given my past experience, I'd rather deal with intense pain during delivery than risk further issues to my back long term. Thus, avoiding an epidural was the most critical consideration for me. The birthing center offered free movement, birthing balls, a tub, nitrous oxide (laughing gas)... and all sorts of other arrangements designed to make an unmedicated labor more bearable.
Another reason I chose to use a birthing center is because I wanted to be under the care of midwives. Don't get me wrong, I loved the OBs that cared for me during my first pregnancy. However, having only recently recovered from postpartum depression, the team of midwives I chose really emphasized the importance of maternal well-being and sold the fact that they get to know you and your story. Just filling out my new patient application and the initial hour long visit with the midwives felt really healing.
...and since I'm sure some of you are wondering, I felt extremely comfortable using the birth center from a safety perspective. Not all birth centers nor midwives are the same, so do your own research when considering where you want to give birth. In my situation, the entire practice consists of Certified Nurse Midwives and the birth center is actually one of the oldest and largest centers nationally. It is also located only a few minutes down the road from the women's hospital and the midwives all have admitting privileges which means my care could continue at the hospital under the same midwife if I ultimately needed to be transferred. The center itself is fully equipped to handle all medical emergencies, such as moderate NICU issues and hemorrhaging, except those rare few situations which require immediate operating room access. Statistically, they have numbers to prove their birthing center is actually safer than the hospital for low risk patients, and transfer to a hospital would occur at the first sign of a problem. As a low risk patient with a successful prior vaginal birth, I felt very comfortable in my decision.
At my full term appointment, we scheduled a hospital induction for Monday, Feb 24th, at 41w2d, as a last resort in case baby didn't come sooner. I went into labor only a few hours after a membrane sweep at 40w2d with my firstborn, so I felt pretty confident that I wouldn't need to be induced. The possibility didn't even cross my mind. Everything was going so smoothly this pregnancy that I had no reason to worry anything should go wrong. I was 3cm dilated and recently started losing pieces of my mucus plug. I figured a membrane sweep sometime during the week would put me into labor shortly afterwards this time too.
On Tuesday, February 18th, at 40w2d, I requested a membrane sweep. My husband and I took a long walk around the city aftwerwards. We got lunch at the mall and it was a nice day full of hope and excitement that we'd be holding a baby soon.
The hours started passing by... 6 hours... 12 hours... 24 hours... it eventually became evident that the sweep didn't work. I was disappointed, but still hopeful that I'd go into labor naturally over the next few days. It was actually really easy to avoid obsessing over labor and instead I focused on spending quality time with my son and husband. We took lots of trips to the playground and tried to do as many fun things as possible as a family of 3.
Part of the reason that I was not panicked was because the midwives said that I was welcome to call any day during the week and request some natural induction methods. This could range from a membrane sweep, to pumping, to taking caster oil, to even potentially having my waters broken if the conditions were favorable. Part of the reason that I was so relaxed was that I figured by Friday I'm sure one of their methods would work. They do not do inductions on the weekend though, so having my water broken on Friday was my fail safe before the Monday hospital induction.
As the days passed, I found myself on in bed on Friday morning still pregnant and knowing that it might be my last chance at a guaranteed birth center experience. I debated for a long time throughout the week wondering whether it was worth taking caster oil or risking having my water broken before my body was truly ready, or if I should just wait it out and give my body the longest chance possible to go into labor spontaneously.
I ultimately decided to make the phone call and see if I could get induced at the birthing center on Friday.
...Unfortunately, the birthing center was uncharacteristically packed that day and no one was available to induce me. In fact, if I went into labor naturally I would have needed to be sent to the hospital anyways since all the rooms were occupied. This is not typical of the center and it caught me and my pregnancy hormones off guard. I saw my perfect birth experience slipping away. There were only 2 days left to possibly go into labor to avoid the hospital and I had yet to have a single contraction.
While I wasn't able to have an induction, I was due for my 41 week appointment and was seen that day. There wasn't much to do other than take my vitals and listen to the baby. However, this appointment led to a major realization which I believe might have been the root cause to my prodromal labor last pregnancy.
Both the midwife at my 40 week appointment, as well as the one I saw that day, had mentioned that I should wear a belly support band since my bump really hangs out over my pubic bone. She wondered if this was the reason that my baby was having trouble engaging. She even mentioned that during labor they sometimes tell women to (gently) lift and hug their bellies inward while having contractions to help put more pressure on the cervix. This led to some Dr. Google about "pendulus bellies" and I realized that I carry my bump so outwards that pressure might not be applied to the right areas. This could very likely be why I was in labor for so long with my first, at least according to Dr. Google.
I took the advice to heart and spent the rest of the day wearing my belly band. The type of band I had access to was not particularly supportive, so I just manually lifted my bump gently upward and inward with my hands most of the day as well. I bounced and swayed on my birthing ball while holding my bump, and wouldn't you know that within a few minutes I started losing big pieces of my mucus plug and even having some extremely mild contractions?
This was exciting.
I have no idea if my outward hanging belly was truly the root cause of my problems, but providing better support seemed to be doing something.
I decided I was going to do everything in my power to try and get labor started for the rest of the day. I went from feeling extremely discouraged in the morning, to being hopeful and determined by the afternoon. I tried to keep the baby's position in mind all day as I altered my movements to keep the baby supported inwards as much as possible.
Over the past week we had tried various old wives' tale methods of induction without avail, but decided to give one of the most scientifically endorsed methods one last go that evening.
I immediately started feeling crampy afterwards.
I remembered this feeling with my first pregnancy right before labor started; it was the same sort of cramping I had after my membrane sweep. I knew this could be the start of labor and I was excited that my endeavors from the day proved to be successful. That being said, it was also 10 o' clock at night and I knew the importance of being well rested for labor. I subdued my excitement and went to sleep.
I woke up at 3 am for what I assumed was my usual restroom break, but then realized I was having some mild contractions. This was both exciting and disappointing, since I personally knew contractions like these could last for days. Nonetheless, I felt pretty confident I would be able to use the birthing center so all my worries were relieved. I got up and used the restroom and attempted to go back to sleep. However, the pains were strong enough that there was no way that I could sleep through them. I resorted to relaxing in bed and began timing them.
The contractions were about 8 minutes apart and over the next hour or two increased to 5 minutes apart. There was still a bit of variance and a few outliers, but the trend was looking good. At 5 am, the pains were obviously more intense while laying down to the point where I would rather not stay in bed, so I strolled around the living room and ate a bagel with cream cheese. To the average person, this sounds very promising. However, I was so accustomed to the false hope that comes with prodromal labor that I knew all those contractions could really mean nothing.
At 7 in the morning, my contractions were still strong and roughly 4 minutes apart. They had been like this for 2 hours and I was in enough pain that I decided it was worth calling my mom and giving her a head's up that today might be the day. I woke up my husband (who had been sound asleep all night, unaware of the whole situation) and we called my mom to tell her to come over. The contractions would fizzle out come the morning last pregnancy, so we figured she should come over for an hour or two and watch my son while I dealt with the contractions and waited it out to decide whether or not I was in active labor. By the time we got dressed and my mom arrived, contractions were now approximately 3 minutes apart and stronger. We decided to call the midwives at 7:30 am, and they told me to go ahead and come in at 9 o' clock. They needed to get dressed and drive to the birth center, as it was the weekend and no one was there at the moment.
The next hour at home was a familiar experience. As the morning sun rose, my fears of prodromal labor returned. I got up and walked around and my contractions had nearly faded to 8 minutes apart. There was even a 15 minute period where I didn't have a single contraction. Things were not looking good. I was prepared to call the midwife back tell her it was a false alarm, but my husband said we might as well go in at this point and see if they could potentially just induce me today, given my history. So, I sat back down on the birthing ball, gently hugged my stomach up and inward during contractions, and they picked back up again to around 3 - 5 minutes. We were committed to going to the birthing center at this point so my mom took my son home with her.
Right as we were about to leave our house at 8:30, I was having a particularly strong contraction and urgently asked my husband to press on my back. He had no experience with giving counter pressure, but I knew it was supposed to help so I figured we could wing it. In the moment and call for urgency, my husband made a fist and quickly pressed on my lower back, probably harder than intended. At the exact moment of impact, I felt a pop and a gush.
Essentially, he punched me and my water broke!
This was great news though! It meant that baby was definitely coming and I no longer felt silly going to the birthing center despite the fizzling contractions.
We were about to walk out the door anyways, but we now quickly grabbed some towels to sit on in the car, loaded our bags into the trunk, and were out the door and on our way to the birthing center in 2 minutes flat. It was a half hour drive to the the birthing center and contractions are always more painful while stationary, especially when confined to a car seat. I had 3 or 4 contractions along the way and I was eager to hop out of the car as quickly as possible when we came to a stop.
I learned pretty quickly that it's true that contractions are way more painful after your water has broken. Most of the morning the contractions were about a 5 out of 10 on the pain scale. Half an hour after my water breaking, as we were arriving to the birthing center at 9 am, contractions were a solid 7 or even 8.
There was no doubt this was labor.
The midwives ask me a few questions, checked me for dilation (I was at 6 cm), and other routine health assessments. They needed to listen to the baby's heart rate for several consecutive contractions to get a baseline, but due to positioning, it was hard to get all the information they needed in a row. It took about half an hour to get all the data they needed. No sooner than finally getting the data, I was in quite a bit of paint and they suggested I tried getting in the birthing tub. It took several extremely long minutes for the tub to fill up, but it was worth the wait. A huge wave of comfort passed through me as the hot water relaxed my muscles.
The water felt amazing and made me feel calm and peaceful. While the contractions were so painful I might have been unintentionally screaming as they peaked, as soon as the wave was over I was able to relax again and enjoy the warm soothing water. It was the most intense yet relaxing bath I have ever taken.
I was only in the water for about 20 or 30 minutes when I started feeling the urge to push. It felt like we just arrived and got situated; there was no way I was actually ready to deliver a baby! I asked the midwife if she thought I was in transition, especially since I arrived at 6 cm. She said it looked like I was definitely in transition and that I should listen to my body. If I felt the urge to push, it might be time to have a baby. So, I got out of the tub and was checked for dilation. To my surprise, I was 10 centimeters! It was only 10:30 am, a mere hour and a half since arriving and since truly painful contractions began.
I pushed for a little while, but baby wasn't making any progress. During a short break, the midwife checked me again and noted that there was a small portion on one side of my cervix which wasn't fully dilated, preventing the baby's head from passing through. She said I could wait it out and it would eventually stretch out, or she could reach up there and tuck the piece behind the baby's head during the next contraction. She felt confident that after doing so baby would be out in just a few pushes.
I had never heard of such a scenario, but I trusted the midwife's opinion and let her help guide the baby through during the next contraction. Immediately over the next few contractions I could feel the baby descending. Within 10 minutes, our baby was born!
Baby was born at 11:05 am, 8lbs 3.5oz, a perfect little girl!
I still can't believe how quickly and smoothly everything happened this time around. My first labor was 72 hours, from first contraction to birth. This one was 8 hours, although it was really only 2 hours of actual pain. I am so happy to have experienced my ideal birth, and honestly the whole situation was very healing and empowering. I'd like to say I got lucky, but I had such a terrible experience the first time around that I like to think I already paid my dues.
This was the happy ending to my "birth" experience, but there was actually a little more adventure ahead due to a retained placenta. If you'd like to read about my ambulance ride and the anti-climatic resolution, click here for my post-birth story.