Joan Bea was born on a Monday morning after twelve hours of serious labor. The labor began on Nantucket and ended in Cambridge Hospital in a room with enormous windows, their curtains pulled back to show first the stars watching us all night, and then the sunrise. It took me three hours to push her out after I had completely dilated and at times I believed I did not have the energy to do it. But I did do it, and the low moments only further buoyed my final high—a euphoric satisfaction fueled by the endorphins racing through my bloodstream, and a brazen pride in myself and what we had done.
….Twenty hours before that moment I woke up on Nantucket to a contraction that was more serious than I’d felt over the previous three days. One appeared every hour which made them more consistent than before too. As much as I wanted to stay for another day of ocean breezes, I knew we had to go.
We called the airport, but all of the short ten minute hopper-flights back to the Cape were booked for the day.
We called the fast ferry, but all of the one hour ferry boats were booked for the day.
So we bought tickets for the slow ferry, a big steamship of a boat that takes its time across the ocean at 2 1/2 hours. Waiting for the boat, I moved quietly from place to place, settling in wherever I found a bench or a seat to rest on, but Joe was fluttering around me packing bags, grabbing Lux, bundling us into the car, concerned that my tranquility meant we were going to have an island baby for sure.
I learned from my last labor not to pay any mental attention to contractions until you absolutely have to. This is because your brain gets exhausted from tracking these things, and you start to feel like you’ve been doing it for a week instead of a few hours, and by the time things get serious, you’re sick of it. Now that we were safely headed home on the boat, I breathed them away as they came, and then forgot about them.
Once we made it back to the mainland and our car, we stopped at Wendys. Joe and I had an odd spat over whether to order french fries, a sure sign one of us (me) has forgotten their ability to be polite. I ordered a twelve piece chicken fingers and ate the entire thing. Lux and I split the fries and a frosty too. I didn’t know it then but that was my fuel for most of the labor. Wendys, you did well.
Then we sped on to the highway, where we encountered an epic three hour traffic jam. I felt calm–we had eaten, we had plenty of gas, Joe is the best car dj ever–and I never worried that we didn’t have enough time. I continued to breath deeply through the contractions, occasionally imaging the waves I’d seen from the boat as a way to distract myself.
We finally got into Boston at 4pm and I called up my doula, Lorenza. Though I had initially hired her thinking I would want her to be there for majority of my time at home, I decided I was having a nice time just laboring on my own in my bedroom, with Joe and Lux playing outside. Lux would come in occasionally and I was always so pleased to see her, but I wasn’t able to relax very well. I would close my eyes for a contraction and she would try to get my attention, saying “mama, mama mama! mama! mama!….” so I asked Joe keep her entertained. The week before I checked several books on tape out from the library with the intent to distract myself (books, far more than music, take me away from whatever is going on around me) but I was really enjoying the book I’d been reading all weekend, so I read that as a way to rest. At each contraction I would glance at my watch and vaguely try to gauge how much time had passed, but no way was I going back to the “Joe! start the timer!” days of yore. A quick way to bore and weary yourself at the same time.
Lorenza had suggested that I probably wouldn’t labor very seriously until I knew Lux was settled and taken care of, and that was true. Once she was in bed I was able to focus much more clearly. I was having contractions every five minutes and sometimes they felt really productive–my bones were widening, my uterus was cramping and expanding for a full minute; but sometimes they felt weak and lasted for only 30 seconds or so. I called the midwife to check in and she encouraged me to drink water. Unproductive labor is usually a result of dehydration, and is a really good way to wear your body down fast. I knew I was well hydrated so I simply hoped the labor was progressing and took the easier contractions as a nice break.
Time flies a bit in labor, especially when you’re just taking it in five minute ebbs. Soon it was 10pm, and I wanted Lorenza to come help me relax through the contractions. At this point I was jumping out of the bed as soon as they came and asking Joe to press against my hips, and then laying back down after the passed. The air conditioner was gushing over me, the lights were off and a candle was glowing in the corner. Lorenza arrived at 11pm along with our friend Birgit. That night was the one night we had not pre-scheduled someone to come over if we needed it: it was the weekend after the 4th, so most people were out of town, and my mom was set to arrive the next day, my due date. Completely out of the blue we called up Birgit who lives about a ten minute walk away, and asked her to come over, fortunately she was free and willing!
Shortly after they arrived I started throwing up (this always sounds shocking to people who haven’t had it happen, but it really doesn’t bother you and often makes you feel better). The trouble was, when I threw up, I felt a sharp pain in my incision scar. Shortly after a caesarian, many women feel incision pain when they cough or sneeze, and it felt like that. With a VBAC, the primary concern is that there might be a rupture in your incision that causes the baby’s heart rate to drop and hemorrhaging for the mother, very very rarely resulting in the brain damage for the baby. Statically this is very rare, but inevitably it’s on everyone’s minds. Though we hoped to stay home and keep things progressing, we decided to go into the hospital anyway, just in case. Other than the baby’s heart rate, there’s no way to know exactly what’s going on inside. Thus how the mother is feeling is very important.
I felt confident that the baby was fine, and that nothing was wrong.
Joe and I drove down the dark Cambridge streets, through MIT’s quiet campus, passing restaurants closing up and groups of girls waiting for cabs at the end of their night. I have fond feelings for the hospital’s neighborhood–a wonderful coffee shop, a gorgeous library, a favorite ice cream spot–and I liked driving through it. The hospital entrance was quiet but for a few security guards, and I waited outside with our bags as Joe parked the car, leaning against the building’s pillar as contractions came and went.
All three of us were concerned because if you get to most hospitals too early and your labor slows down for three or four hours, this can put you on track towards an intervention–a drug via IV to increase your contractions, or an epidural if you get really worn down, or both. However I had been assured through my research that Cambridge Hospital was particularly patient and believed in a less-is-more approach.
“I don’t want to check in here and stall in two hours” I said to the midwife as she checked me. She reached in…”you’re at four…you just switched to five. You’re not going to stall.” She smiled at me. Everyone was relieved that despite the incision-flare-up scare, we were here and it was fine. Shortly after we were led to a room at the end of the hall far away from the buzz of the nurses station.
The nurse assigned to us showed up, and to my dismay she was classic Boston: a little brassy, flipping on lights, announcing herself, noisily apologizing as she pestered me with IVs and belly bands. I was relieved that Lorenza was there so Joe and I could mostly ignore her. Fortunately because it was a busy night and since we had a doula already she left us alone for most of the labor.
I felt calm and confident. After laboring on Piticon for my last labor, I was delighted to have a labor that had breaks between contractions with two or three minutes to sit down and relax my muscles. Additionally with my first labor I had mentally exhausted myself wondering if I should be sitting, walking more, or climbing stairs. This time I asked Lorenza those questions, and she shrugged and said we were doing great. So I settled in and just let the time pass. Usually I would stand up and hang on Joe’s neck for a contraction with Lorenza pressing on my back, and then settle back down on a medicine ball. She would get washcloths for my face, squeeze my arms, rub lavender lotion on me, turn on music, tell the nurse if I needed to go to the bathroom, heap blankets on my shoulders in between contractions. Essentially she had a rotation of nice things that distracted me and made me feel at peace.
We moved from sitting on a medicine ball, to standing, to swaying, to hands and knees, each working for a bit and then I would feel the need to move around and try something else. As the hours passed (from about midnight to 5am) at times I would moan and say “this really hurts” if it did, and Joe and Lorenza would agree with me that it did. Though it seems impossible to me now, at times I thought “I am never doing this again.” Other times I was completely in awe at the force and strength within me, operating outside my approval, so strong, so intense. Post natural-birth women will often say it didn’t hurt, but it was intense. Never has that word seemed more apt to me. I circled words I wanted for myself in my mind—calm, confident, brave, blessed, dwelling. “You’re doing it!” Joe or Lorenza said throughout the night, “you’re doing exactly what you hoped to do.”
The end of dilation, before your body can start to push the baby out, is known as transition. I knew I was in transition because though I had been relishing Joe’s and Lorenza’s touch for the last seven hours, I was now annoyed by it. I remembered something our birth class teacher had said before my first labor: when a woman is suddenly easily annoyed and starts stripping off her clothes: she’s in transition. It sounds oddly predictable, but it was true for me! And I was suddenly desperate to take off the socks and slippers that had been keeping my cozy all that time. My senses became extremely aware and for a moment, everything was a bit too much.
There’s also something else about transition–it’s the point when you are so close to actually beginning the pushing stage, perhaps less than an hour away, but it’s also the point you begin to feel you cannot do it. A strange conundrum–you’ve made it so far, you’re almost there, and yet it’s frequently when women will ask for an epidural. This was also true for me, and for about thirty minutes I felt mentally overwhelmed by the contractions.
At that point Lorenza suggested I get into the bathtub, which was a wonderful change. But it was so wonderful that it helped my body finish transition, completely dilate, and prepare to push. For normal deliveries, staying in the bathtub would have been fine (or having a waterbirth, even better!), but they like to keep you under watch for VBAC (the all important heart-rate-monitoring). So we got out of the bath, and from that point on, I was completely naked! Though nurses will offer you those enormous hospital gowns, I had been wearing a roomy shirt, sports bra and athletic shorts. Once I stripped off those, nobody blinked or looked twice. They really take their cues from you for these types of things, and personally I have no qualms about being naked with people who see naked people all the time.
So I have no idea how this happened but at some point I came to believe that pushing called on different, fresh, hormones and energy sources, and was not that big of deal. Maybe I was imagining it would be like sprinting after all long race, when your body calls on fast twitch muscles instead of the exhausted ones? Oh no. It’s quite the engagement.
Around 7am I looked over at Joe and he looked completely exhausted. I don’t know what we were thinking not packing three cans of Red Bull for him! Here I was cheerfully Thomas the Tank Engine-ing away on hormones and meanwhile Joe just pulled an all-nighter massaging his wife’s back with nothing but some sips of water to commiserate with.
I had made a commitment to myself to always say out loud what I was thinking during labor because I didn’t want to develop my own internal world of doubts. So after pushing for two hours, on my side or crouching on the bed, I said, “I think this might never end.” Brassy Boston nurse returned, out of nowhere, “Listen honey. You’ve never had a baby before. I mean, I know you have, but you didn’t push her out, ok? Average first timing pushing is two to three hours or more. Don’t get discouraged.”
Four new people trooped into the room when they knew Joan was getting close. There was a palpable excitement, the women seemed to be getting buzzed off my energy and the arrival of a new being in the room. Though I knew I had not had any drugs, I still felt drugged because of the the natural oxytocin coursing through my bloodstream. I’d read that in an unmedicated birth your body releases a very high level endophins that produces an altered state of consciousness–a peace and alert calm despite the enormous physical fatigue. I felt exactly that.
At last! Joe got to catch her and hand her to me, a squinshy warm bundle of limbs. She didn’t cry at all and her eyes were open, looking around at the new world. She was born with the bag of waters over her face like a veil. Because this only happens once every 80,000 births, it delighted Lorenza and the midwives. We had asked ahead of time for delayed cord clamping (as a chronic anemic, I wanted more iron for Joan) so they scooped her up to me and I held her close. The nurses reached around my arms to check her heart rate and tuck a cozy blanket around her.
She was wonderful, warm, wet and squishy and soft. I cooed to her. Though when Lux was born I’d been anxious to nurse her within the hour, I didn’t worry about it right away this time and just snuggled with Joan. We stayed in that bed for the next several hours, though Lorenza made sure I immediately started drinking juice and eating. Joe walked down to Dwelltime and picked us up some of their wonderful pastries–a lavender scone, a crumbly quiche lorraine, and some of those gougères they make with extra eggs (but who was paying attention, right? : ).
well that was epic. I’m planning to write a post about pursuing a VBAC, and a post with more information about having a doula, so let me know if you have questions about either of those.