Our birth story didn’t start out as perfectly as I had imagined, in fact it was very far from what I had been envisioning for my entire pregnancy. I had been planning a water birth at Valley Birthplace, and had imagined that we would give birth in a serene, calm, loving environment. Fate had other plans though, and we met our child in an unexpected and sudden way. Josephine Rae was born on March 4, 2011 at 8 pounds, 1 ounce and 22 inches long. She had APGARs of 9 and 9, nearly perfect!
On Thursday March 3, 2011, I was 41 weeks pregnant, one week past my due date. Our midwives routinely do non-stress tests and amniotic fluid index (an ultrasound) to make sure that the baby is OK being past due. We got to Montgomery Hospital ON TIME (a big deal for us!) for our 10:00am appointment. We were taken to room 3, where a nurse wrapped the foam bands around my stomach and connected the heart monitor and contraction/movement monitor for 40 minutes. They monitored baby’s heart beat, looking for signs of distress or for a drop in the heart rate during any contractions. Ideally, baby’s heart rate would rise when the baby was moving around. Baby performed beautifully and all was well with the non-stress test. George and I breathed a sigh of relief, and were happily led downstairs to await the AFI.
A technician with a very noticeable eye problem (kind of crossed or lazy) welcomed us, and she performed the ultrasound rather quickly. I was upset because, from my position and the positioning of the monitors, I was unable to see anything. George didn’t know what he was looking at anyway. I was pretty upset about not being shown anything at all, and the technician didn’t have much to say about the AFI, so we went upstairs to wait until our midwife (Melicia Escobar, the one that I liked the most) was able to see the results and speak to us. We assumed nothing was wrong, but a nurse came in and said that the fluid was a little low, and that Melicia would be in to speak with us. Melicia never came in to speak with us, instead another nurse came in and told us that Melicia wants to induce and I needed to strip down and put on a gown and we would be taken to a labor and delivery room.
My heart sank as I heard the news, and I stared at George hoping to find comfort or reassurance, but instead he looked as scared as I felt. I was terrified of being induced, I had wanted a water birth in the birth center, and the thought of interventions and the possibility of them escalating to a c-section situation scared me more than anything. I wanted to run and hide, but there was nowhere to run to, so instead I cried. I cried for myself, mostly, but I also cried for my beautiful little one who was stripped from the opportunity to make an entrance for herself. I begged my baby to come out right now, before they started the induction. But baby had other plans.
I don’t remember being taken into the labor room, but I distinctly remember telling George that room 317 didn’t look or feel right, and it wasn’t the right time or place to have this baby. Everything was wrong and nowhere near close to my birth plan, and I panicked and cried (again).
A nurse came in and wanted me to sign a bunch of consent forms and wanted to start an IV/heplock in the back of my hand. I was freaked out, and didn’t agree to what was written on the consent forms, so we asked to speak to Melicia first. She had been at the hospital the entire day as well, as there were 3 births that day and had been a few others earlier in the week.
Melicia came into the room around 1:20ish and told us that she wanted to induce with Cervadil, which was inserted near the cervix for 12 hours. It contains prostaglandins which are supposed to help soften and cervix so that it can dilate easier. It is usually followed by more aggressive induction techniques, like Pitocin. I asked her what would happen if the Cervadil didn’t work, and she told me that they would do another round of Cervadil after that. I agreed because I didn’t know what else to do, and she explained the dangers of low amniotic fluid to us (ingestion of meconium, distress during labor contractions, etc.). She told us that since I was only dilated about 1 cm and 80% effaced (little change from my check 2 weeks prior) that Cervadil was the best and least invasive induction method to start with.
The Cervadil was inserted around 1:45pm. I asked Melicia how long she would be at the hospital, since she was midwife I liked the most. She told me she would be there until the baby was born. She also told me to get some sleep, which was difficult since I had to be on the fetal monitors for 2 hours after the Cervadil was begun, and then monitored for 20 minutes every hour until it was taken out. Being monitored so frequently was very frustrating for me, and I spent the rest of the day in the hospital bed because I was too tired from the night before (having only slept about 3 hours) and I was too sad and scared about the entire situation to make light of it. I wasn’t happy to be induced, and I wasn’t ready for my baby to come, and my baby wasn’t ready to come either.
The day wore on, and the stress of it all really started getting to us. I spent most of the day crying because of the entire situation. I texted my mom and sister to let them know that I was being induced, and my whole family came to see me around 6ish. They brought us hoagies from the Churchville Deli and tried to lift our spirits, but I was a tired, cranky, scared, crying mess. I knew I was being rather ridiculous, but I couldn’t help but hate the entire situation and feel sorry for myself and for my baby. I also felt sorry for George, who wasn’t as prepared for the situation as either of us had hoped he would be, and it was definitely very far from how either of us had envisioned our first birth.
The rest of the evening and early night went on like this, with me bursting into uncontrollable tears and asking for tissues (which took nearly 10 hours to get!). At one point, George went to go get me some water from the nurses’ station, and saw Melicia leaving, and she told him that she would be back around 1:45am to take out the Cervadil.
A nurse came in around 1:45am to take the Cervadil out and do a check. Her check hurt a lot, and I remember telling her so. She told me I was at 1-2cm, and my heart sank yet again. She also said that Melicia had told her to start me on Cytotec, and I freaked out. My research while pregnant had shown me that Cytotec is not approved for use in labor and during pregnancy because it is associated with hyperstimulation of the uterus and has an increased risk of maternal or fetal death. I was NOT ok with being induced with Cytotec, and I told the nurse so. I asked the nurse what the AFI showed and how much fluid was left, and she said 4.7cm. I knew that 5-25 cm of fluid was considered normal, so I because rather pissed about being induced due to 4.7cm of fluid. It was too close to the normal range in my mind. She said she would go call Melicia, and George told her that we didn’t want to consent to any more induction methods and we just wanted to go home. I cried and mumbled agreements, and we tried really hard to persuade everyone to let us go home and come back for another AFI in the morning. The nurse didn’t know what to do, so she called Melicia and Melicia told her that she would come in. She didn’t show up until after 4am (at least, as I remember it), at which time we told her all of our concerns about Cytotec, and I told her that I didn’t feel like the Cervadil was working and I didn’t think it was the right time to have the baby.
Melicia seemed a little ticked off to be at the hospital at 4am (she was 36 weeks pregnant herself and had been there all day, but that really wasn’t my fault). She listened to our concerns and told us our options. She told us that we could sign out against medical advice and just show up at a hospital when we were in labor to have the baby and see whatever doctor was on call, we could have an unassisted homebirth ourselves, or we could proceed with the induction. We weighed all the options, and she explained that she wouldn’t feel comfortable being my doctor anymore (and Barbara, the other CNM at the birth center wouldn’t, either) if we signed out against her advice because she worried about the dangers it could cause the baby, and said she wouldn’t want it weighing on her if something were to happen in the time we went home. I understood her reasoning, but I was still really upset. I felt like the entire situation was forced on me, and all I had wanted was to be left alone, for my baby to come naturally, and to be calm, well rested, and able to think during labor so that I wouldn’t need pain medications.
Melicia told me that I could still have a pain-med free beautiful birth in the hospital, and while I didn’t agree, neither George nor I felt comfortable going it alone without a doctor, and we were too close to the end to find a new one or a homebirth midwife. I got pissed and felt like she was forcing this induction on us, and to this day I am still mad about it. She did agree to do another AFI for us, since I expressed my concerns about the fluid being close to the minimum. We agreed that if the fluid was low, that we would proceed with the induction. She brought in the ultrasound machine and did a long ultrasound looking for fluid, but she explained that she couldn’t count any areas of fluid that contained the umbilical cord or body parts. The amount of fluid that she came up with was less than 3cm. This information confused me a bit (as to why her numbers were so much lower than the ultrasound technician’s number) but it was low enough to concern me nonetheless.
Melicia put in another Cervadil around 5:45am-ish (I am unsure of the time, perhaps George will remember) and she again told me to get some sleep. I told her I can’t sleep in public places, and there was no way I could sleep while on monitors and scared out of my mind. She suggested again the I take an Ambien, and I agreed because I realized that I needed the rest to be able to handle labor once it started, especially if I wasn’t interested in pain medications. I asked Melicia about pain options other than an epidural, and she suggested Nubain for the pain, which wouldn’t take away the pain, but would “take away the edge” and help me relax a bit more. I stored that information in the back of my mind for later, just in case, but had no intention of asking for it.
I finally was able to doze off for a bit with the heart monitors in the background of the room. I suddenly awoke around 7:30 (and woke George up too) to a strong contraction. I didn’t know what to do, as it seemed to come out of nowhere and was suddenly really strong. I jumped out of bed saying “oww, oww oww!” during it, and George rushed over to rub my back. I was having back labor! I was angry about the back labor, but was scared too because I had taken 2 Ambien and woke up about 1 hour later! I was literally seeing doubles of everything, and no matter how hard I concentrated, I couldn’t think clearly and couldn’t see straight. I was terrified of what was happening to me all of a sudden, since the pain was so strong and I had no mental clarity or ability to think about or control myself. All I was able to do was tell George to squeeze my hips together, since that was the only thing that seemed to help at the time. I got back in bed, ready to reflect on the pain of the contraction and plan for the next one, but wasn’t given the time since another back contraction started right away (at least it seemed like it was right away, George said they were about 3 minutes apart and lasted about 1 minute).
The morning flew by like this, a long whirlwind of blurred vision, strong, close-together back contractions, and George squeezing my hips. He ran out of the room between contractions to fill my water bottle. At some point, he let everyone know that I was in labor (at least I think he did, I don’t remember being the one to tell them). I do remember just yelling and moaning with each contraction, and all I wanted to do was stand up and lean on something, but every contraction made me stand up, which caused the heart monitors to lose the baby’s heart rate and a nurse to come in and readjust them and make me lay down. I chose to get back in bed and lay down between contractions because my mind was so fuzzy from the Ambien, and I was also quite tired from it as well. I was ashamed of myself for handling labor “like a pussy,” or so I kept thinking. I’m not sure if I said that too, but I would assume that I did at least once. I felt like a failure, and I felt like I was letting both George and my unborn baby down because I was acting so crazy.
George was my rock though. I have to say that he was the support that I really needed, and even though I could tell he was scared and didn’t know what to do, he wanted to be there and wanted to help. During our first round of Cervadil, he filled out all the paperwork that we needed to have done and just made me sign my name. He also made sure all the other paperwork was completed and handed in to the nurses, since I was in no mental state to do it myself. He put my bathrobe on and took it off every time I said I was hot or cold. He brought me water to drink every time my water bottle was empty, and he let me lean on him or hug him or do whatever I needed to do to get through a contraction. He even held the monitors in place on my stomach so the nurses wouldn’t come rushing in when the monitor lost the baby’s heartbeat.
At one point, I tried laboring kneeling on a chair facing backwards, and I tried laboring on the toilet. The toilet hurt, and when I went pee it felt like my insides were going to fall out and were being ripped apart at the same time. I tried pushing a bit on the toilet, and it felt good, but the thought of my baby popping out in the toilet made me cry. I sat on the toilet and cried, and had another contraction and stood up and cried some more.
I don’t remember the pain getting worse, but I remember at one point just feeling like I couldn’t continue on anymore, and I asked for drugs. I told George that I wanted the epidural because I couldn’t do it anymore, and he flat out told me “no.” He wouldn’t bargain, he wouldn’t listen, he just told me “no.” I told him that I wanted the Nubain then, and he kept saying that I didn’t want it, and I cried and cried and told him I just wanted a break, that I needed a break because I was too tired to go on anymore. He told me later that one of the nurses kept telling me that I could have the Nubain whenever I wanted it because Melicia had left it at the front desk for me, and I don’t clearly remember anyone mentioning it, but I know I wasn’t mentally sound enough to remember the name of it or to ask for it, as tired as I was, so I’m sure someone was mentioning it.
I don’t know what time it was when I was given the Nubain, but George said it was effective almost immediately. I was suddenly able to sleep in between contractions. I was sitting on the edge of the bed, leaning on George’s shoulder. He was squatting on the floor and just let me lean on his shoulder. I fell asleep on his shoulders between contractions, and would wake up, put my arms around him, and just moan loudly/yell during contractions. At one point, he tried to switch my head to his other shoulder, but I got really angry and switched my head back and told him “no.”
I remember leaning on George, and looking to the side and seeing my mom and Kristine, but it didn’t register that they were even there. They were helping in any way they could, and apparently Kristine even brushed my hair and braided it for me. Looking back, I feel terrible that I didn’t even know that they were there. I apparently started asking for “my mommy” during contractions, and she said all she could do was rub my back, assure me that she was there, and cry.
Shortly after this, a nurse came in to check me. She said that I was at 8cm and told the other nurses to call Melicia and tell her to get there quickly! She also told me not to push. I didn’t have the urge to push yet, but when I resumed my sitting position on the edge of the bed with George, I got an overwhelming urge to push. I couldn’t help it. Right at that time, Melicia had come in, and she had seen me push too. She told me not to push, and told me that she needed to check me. She checked me, and confirmed that I was at least an 8, and asked me if I wanted her to break my water. I didn’t, and I thought I had told her so, but George says that I didn’t say anything. She didn’t break my water, and I labored for a few more minutes before getting another pushy sensation. She told me not to push because I could tear my cervix, and while this terrified me, I continued pushing because I couldn’t control it. I didn’t push with the feeling, but my body did anyway. I was yelling now with every contraction, and Melicia told me “you’re in transition Chasidy.” I knew that was true, but it didn’t make it any easier to deal with! She checked me again, and told me that I was a 9 and my water was bulging so she broke it. I remember feeling some of the warm liquid on my legs, but at the time didn’t really realize that it was my water breaking. I didn’t want her to break my water, but I apparently never said so. At some point during all of this, George said that Melicia removed the second Cervadil.
My body let me know when it was really time to push, and I was sitting on the end of the bed and started pushing. Melicia started squatting down, and I wanted to push on the bed, but I thought about it and couldn’t see how I could stay sitting on the bed and push at the same time, and I didn’t want Melicia to have to be on the ground to catch the baby. I threw myself back on the bed, and was in a half sideways half on my back position. I started trying to push in this position, but Melicia told me it wasn’t effective and suggested I push on my side. I just scooted onto my back completely and pushed that way. At one point I said “I don’t want to push like this” and Melicia said “how do you want to push?,” to which I don’t think I responded because I really didn’t know. I decided to stay on my back and push (actually my body decided to push anyway). Pushing didn’t hurt, but it didn’t feel good as I remember some people saying. It did feel productive though, and no matter what I did, I couldn’t control it if I wanted to. I pushed and the baby started crowning, and Melicia asked me if I wanted to feel her head. I felt her head, and I distinctly remember how squishy and soft her head felt, unlike any other baby’s head I had ever felt before. It was surreal.
I reached my hand down where I felt burning, and Melicia pushed my hand away and told me that she had it, and she rubbed tons of mineral oil on me as the baby was coming out. I pushed a few more times (2 or 3 times with each contraction) and she didn’t come out any further after 2 or so contractions. I remember everyone getting concerned about the baby’s heart rate dropping, and everyone was telling me to push! George and my sister each held a leg for me, and I scrunched up and pushed with all my might. “It hurts!” I yelled as her head was coming out, and Melicia responded with “that’s the ring of fire.” George told me later that I was reasoning with myself at this point, saying that I didn’t want to push but that it was the only way the baby was going to come out, and it had to come out somehow.
I remember feeling done pushing, but everyone told me to keep pushing to get her shoulders out. I pushed HARD and felt the sting as her shoulders came out, then the rest of her slid out, and she pooped on the way out, while her legs were still in me! Melicia plopped her on my stomach. She was bluish in color, but screaming her head off, and her little cry let me know that she was OK. The nurse was rubbing her really hard with a blanket to wipe her off and I guess to make her cry, and I was really mad because I couldn’t see her face. I tried to turn her so I could see her, and Melicia told me not to pull her because her cord was still attached and it was short. I was able to see part of her face, and Melicia told us that we didn’t even see whether it was a boy or a girl. Someone said “it’s a girl!” but I don’t remember who. I remember saying “camera” when she was on my stomach, because I knew I wanted that moment on camera. Lights were flashing as my mom and Kristine took turns with a bunch of different cameras and phones.
George got to cut the cord. When they asked him if he wanted to, I remember saying that we wanted to delay cord clamping, and Melicia told me they did and that it had stopped pulsating. I didn’t believe her, because to me it seemed like she had just come out. I held her and looked at her for a few minutes, still in shock about what had just occurred.
George put his arm around me, and we both just stared at our daughter. She was absolutely beautiful! George kissed me and told me he loved me, and we just stared at her some more. I unsnapped my hospital gown and attempted to put my breast in the baby’s mouth, but she wasn’t latching and I didn’t know what to do so I stopped and covered myself back up. I had wanted to breastfeed right away, especially to help with the placenta, but I was suddenly embarrassed as I realized that my mom and Kristine were there, and had been there the entire time I was pushing her out and had seen everything. EVERYTHING! At one point, I had reached up and touched my hair and asked “who braided my hair?,” only to find out that Kristine had braided it for me, and brushed it too. I really didn’t realize they were there until that point!
Melicia told me that I needed to push out the placenta, and I geared up for a strong push and pushed as hard as I could (which was nowhere near as hard as a birth push) and it apparently came out. Melicia told me to push again, and I remember the feeling of something coming out of me, and George told me that the placenta was kind of stringy as it came out at the end. I asked to see it, and they assured me I could and put it in a bowl.
I felt really good after the baby came out, and the stinging from the “ring of fire” was gone completely. I think I was just numb from all of the pressure down there, but I felt like I could get up a do a dance. Melicia cleaned me off with iodine (I think that’s what it was) and told me that I didn’t tear my perineum, but that I had a few small tears in other unusual spots, some of which were around my urethra, which was really painful and was where I had felt the pain as she came out. She said it wasn’t too bad, but didn’t tell me what degree tear or how many stitches I got. The pain from the needle that she inserted to numb me was intense. I yelled and swore as she numbed me in a few places. Unfortunately for me, the medicine didn’t work well, and I felt every needle insert into my body, and passed the baby to George after the first few because I was afraid I was going to scream in her ear or drop her because of the pain. I watched Melicia pull the stitches through, and the nurse was helping hold me apart. It was excruciating, more so than giving birth, and that’s the pain that I remember the most too.
I watched George hold her for a few minutes, and I will never forget the look on his face. He looked so relieved to be holding her, and he looked so in shock from it all, but it looked like the most natural thing in the world, him holding her.
After awhile and while I was being stitched up, George passed her to the nurse to get all of her stats and measurements. The nurse cleaned her up, said her time of birth was 1:21pm on Friday March 4, 2011 (and I remember looking at the clock and it was 1:38ish and I wasn’t sure where the time had just gone). They stamped her feet and measured and weighed her, and announced that she was 8 pounds 1 ounce and 22 inches long! Her head was 13.5 inches in diameter, and her chest was 13 inches.
The entire time, she was screaming her head off, and I just wanted to be able to comfort her and I wanted them to leave her alone. If I wasn’t being stitched, I probably would have snatched her off the table and cursed at the nurses for letting her cry like that! After she was done being cleaned up, they handed her back to George, who took pictures of and held her until I was done being stitched.
While I was being stitched, they started to wheel out the cart that had the placenta on it, and I said I wanted to see it and my mom told them I did as well. Someone put the bowl with the placenta in it down next to me, and it didn’t look anything like I had expected. I had expected it to be bigger or less bloody. It was neat to see though, it was definitely awesome to see what had provided my daughter with everything she needed for those 10 months she was in me!
At one point during all of this commotion, I heard George’s dad at the door (which had been left open, another thing that kept frustrating me with everyone coming and going), and I yelled “NO!” because I was still sitting there being sewn up with my legs wide open. Someone ran out to tell Skip and Debbie the news (I don’t remember who). The whole thing was over relatively soon, and as soon as it was over I felt better and sat up. The nurse covered my bottom area with a blanket and handed me the baby. I held her, and really looked at her, and was in love. George was already calling her Josie too, and I think he was as in love as I was. I was finally thinking clearly, and the events of the last 24 hours were all a blur to me as I held my daughter closely. George’s parents came in, and Debbie was smiling profusely and said “congratulations!” I asked my mom if she would like to hold the baby, and handed her to her grandma. Since only 3 people could be in the room at the same time, everyone took turns coming and going to see the baby.
During all of this, I apparently asked for and ate the other half of my mixed cheese hoagie that was from the evening before. I remember sitting and watching everyone hold her, and thinking to myself how very lucky this little girl was to have so many people there to see her and hold her and love her, how very lucky indeed.
JOSEPHINE RAE
