(I may come back and update but at least I'll have this up)
I have a theory that most pregnant women spend the week before they give birth extra-cranky and frustrated with pregnancy in preparation for going into labor and birthing. The weekend that I turned 36 weeks, I worked 25+ hours in four days for my WAH researcher job. I usually work about 2 hours a day, but I'd taken on extra work and the deadline suddenly was right there. I worked 8+ hours each of Saturday and Sunday, staying up until 3am to finish my project by Monday lunch. By Monday afternoon, I'd pretty much finished what I needed, but I was an exhausted, stressed-out mess. For the rest of the week, I was trying to catch up on sleep, but waking constantly to pee or find a more comfortable position. I felt like a big grouch. By my midwife appointment on Wednesday, I joked that I needed an anti-cranky pill. I kept thinking that a month left of pregnancy was an awfully long time to be in a bad mood and sleeping so poorly. My midwife commented that she didn't have anything going on that weekend and I should feel free to have the baby. Ha ha I said. I make late babies, not early ones. I was 2+ cm dilated and 75% effaced, but my cervix was very posterior.
That night and all day Thursday, I started dripping something. I was pretty sure it wasn't pee, but beyond that I wasn't sure. Sometimes it was like creamy cervical mucus and sometimes it was just liquidy. It was just about as much as a pad could handle and would drip randomly at annoying times. I called the CNM and she agreed that it was probably discharge due to my starting to dilate. I found out that my GBS test had come back positive and I spent a good chunk of the evening looking up methods of dealing with that and trying to decide what I might do. I was up working until about 2am.
Thursday night I went to bed with a thick overnight pad and slept over a towel and waterproof pad. Between 2 and 8am, I soaked that pad, another one, and then a prefold. There was a bit of blood at one point, but not enough to completely freak me out.
I didn't sleep all that soundly but did what I could. At first I'd felt like I must hold the liquid in somehow, but after soaking the pads I realized I needed to just let whatever was happening happen and I'd deal with the mess in the morning. In my sleepy confusion, it began to get through to me that my water had probably broken, or was at least leaking, and I was probably in very early labor. Sometime after the sun came up I recognized that I was having some contractions but figured the best thing would be to sleep as long as I could. I didn't wake Dan, but slept lightly and started thinking about all the things I needed to do before I would be ready to have a baby in our house.
By 8am, I gave up sleeping, got out of bed, and started timing them: 5-6 minutes, lasting 45-60 seconds. Dan and Leo got up and Dan started feeding me. Ever since Peter's birth when I really didn't want to eat, he's made sure I ate while I still felt up for it. So by mid-morning, I'd drank lots of water, eaten peanut butter and honey on toast, scrambled eggs, and a banana. The contractions were low and in front, then they felt low on my back for awhile, then back to the front. After being 5 minutes apart and pretty weak until 9am, they spread out to about every 7 minutes but were a little stronger. Originally I ate through them, then by 10:30 I was stopping what I was doing to concentrate on relaxing, but I could still talk through them.
I called my mom first thing in the morning to make sure she didn't leave for the day and to put her on alert. She had just left for an hour long walk with friends but my dad must have been fairly freaked out because he drove around the neighborhood to find her and she called back before too long. I told her I'd call again when we felt like we needed her to come watch the boys, but would need her for sure by 11:30 to bring them to noon swimming lessons.
At 8:30 I called the CNM and ended up leaving a message with the answering service, but she (Kathrine) called me back within a few minutes. After telling her about the frequency and strength of the contractions and all the overnight leaking, she agreed to call back in an hour to check in with us.
By nine I called Kara, my SIL the L&D RN (who was conveniently starting her first of four days off) to fill her in. She agreed to stay by a phone and be ready to come over when we wanted her. Whether she'd be stuck at work was something I'd begun worrying about because if I'd started labor after she began a 12 hour shift, we weren't sure if she'd have been able to make it in time. She had originally planned to be 200 miles away at the cabin that weekend, but decided against going twice in July due to the difficulty dealing with a crawling baby there.
Kara wasn't the only one for whom the timing was surprisingly good. Friday was the first day of a scheduled long weekend for Dan, my sister was home for the weekend for almost the first time all summer, both sets of our parents were in town, and my next work deadline was a month away. The only frustrating thing about being three weeks early was that my blessingway was scheduled for Sunday the 25th.
I spent most of the morning bouncing on the birth ball, sitting at the computer, astonished that I was actually in labor at 37 weeks to the day. I kept thinking of ways we weren't ready and what could get done in whatever time we had left.
Around 10 I called my mom to ask her to come and my dad said she was already on her way. It turned out that she was running other errands, but she showed up shortly after 11. I was reminded of my labor with Leo, where I also woke up at 8 with contractions. That time, they were slow until noon, then things moved quickly after that.
When the boys left with Mom for swimming, Dan and I walked around the neighborhood. It was hot and I worried a bit that I'd get sunburned. The contractions had slowed to about every 10 minutes, but walking seemed to initially strengthen them. I hadn't been able to walk quickly without Braxton Hicks for months. We went pretty slowly and I found I could walk fairly comfortably at a slow pace. The contractions made me need to pee and we stopped at a Porta Potty at the park. Although I knew it was crazy, I couldn't help but fear that I'd pee the baby out into the Porta Potty. I told Dan that I felt like I was in Labor Lite because it was pretty easy to cope and things didn't seem to be moving along. The contractions seemed to get even farther apart and we continued to our community garden plot where we picked a couple zucchini and admired our corn and melons. When we got home, maybe half an hour later, I insisted that we install the bucket car seat my friend loaned me. We decided to install it in Dan's car even though it's likely going to need to be moved to my car soon, because we realized we'd need to leave my car with whoever had the boys and Dan would be picking me up in his car. We happily discovered that his car is equipped with LATCH, which made it pretty easy. I didn't want him to be installing it in a parking ramp without me after the baby came.
By the time we got home, the contractions seemed even farther apart, maybe every 15 minutes, and I decided to take a nap. During Peter and Leo's labors, I napped and woke up in transition, so maybe it was wishful thinking that I could nap myself into speeding up. I slept for an hour, waking somewhat for 3 or 4 contractions. I gathered things to pack into a hospital bag, feeling silly that I was grabbing everything remotely necessary until they couldn't fit into the bag. Kara told me I really didn't need much, but what if it was cold? A sweater might be nice. Did I want to wear the hospital's gown? I should bring my only nursing nightgown. And its coordinating robe. And all the granny underwear. And a pile of cloth diapers and going home outfit for the baby. And and and. I eventually took out the sweater and got it down to one change of clothes for me. I was excited to remember that I had a raggedy skirt I'd put in the giant to-be-sold-in-August's-garage-sale pile that would be ideal to labor in. And it fit over my hips still, yay! I figured if I couldn't move around well enough, I'd cut a slit down the side and not care because it's too thin to wear in public anyway. I was wearing a tank top and loose shorts for the time being and planned to bring my swim top.
After that, I joined Dan, Mom, and the boys to eat macaroni and cheese for a late lunch (it was about 1:30). I put baby clothes in the washing machine.
I lost something that looked like my mucus plug, although I'd been continuing to leak what must have been amniotic fluid all day.
As time moved closer to 4pm, I began getting discouraged because that's when I was pushing during Leo's birth and it felt like labor wasn't going anywhere. I knew I'd felt the same way during Leo's labor because I'd mentally prepared for a 4 hour second labor like my mom's, but took twice that. I knew, this time, that third labors are considered the "wild card" and probably would take longer than my second labor, but it was still frustrating. I stopped assuming the baby would be born that day and started getting concerned that I'd be put on a clock soon due to likely rupture of membranes. The midwife called every couple hours to see what was going on. She didn't put any pressure on me and just said things would happen when they'd happen and she'd be ready.
Despite the contractions not getting any closer, they were getting stronger. They didn't necessarily last longer -- they stayed about a minute throughout the whole process -- but I had to work harder to relax through them. That sounds so goofy.
Unlike my previous labors, the house was busier, with the boys running around, my mom getting things done, and Dan going between everyone. I wanted to be involved with the preparations so I could see things were happening and tell Mom where to put things, so I was surrounded by people. At the same time, I was handling things by myself and didn't need Dan there for constant support the way I had before. It's like I was there, but slowly turning in on myself and fogging everything out. Now that I'm writing this, I see how the late afternoon and early evening feels all foggy and the details are lost to me, but Dan says that I didn't disconnect as much as I had before. I can't even remember what we ate for supper, although I'm pretty sure I sat at the table with everyone. I know I took another nap and went for another walk, not as far this time. We waved at a couple neighbors and neglected to mention that the baby's arrival was imminent.
Kara was across town at a friend's party and I started getting anxious for her to come, but I knew things weren't moving fast enough for me to need her to ditch the party. She'd said she'd be home at 7:45 and I called at 8 and found out that she hadn't left yet. At that point I told her she should come as soon as she could, but should feel free to stop at the store and nurse her baby to sleep. At 9, my BIL called and said she was just putting the baby to sleep, was it okay if she left in half an hour and I agreed.
I was getting antsy for the boys to go to bed. They'd been dealing with things well all day and then blew up at bedtime. My mom felt bad that they'd gone crazy on her watch, but we knew it was just the stress of having unusual circumstances and didn't mind. They were finally quiet in bed around 9:30. Dan and Mom moved a dresser from Mom's car into our basement and brought the basement dresser's drawers up to put the now-clean baby clothes in. I sat on the birth ball telling Mom which clothes to put in which drawer in the living room.
At 10 pm, Kara came with Emergen-C, Luna bars, flip-flops, and peace of mind for me. The four of us stayed in the living room, me on the birth ball, all quietly talking as I bounced and contracted. She checked one of the pads I'd soaked and declared that my water had definitely broken. We'd originally talked about having Kara do a cervical check to help us decide when to go to the hospital, but due to my being GBS+ with ruptured membranes, she wanted to avoid exams and said she'd help us decide without it. Kara suggested I raise my index finger when a contraction started because I wasn't always obvious otherwise. By then I preferred when everyone stopped talking while I contracted. I didn't say much, and just stayed on the ball. Kara suggested I get on my hands and knees and lean over the ball in case the baby needed help changing position to speed things up. The first contraction it felt awful and I wanted to move, but she convinced me to stay for a few and see if I changed my mind. I put my knees farther apart to feel more stable and felt better about the position. I mostly leaned my head over the ball and hung there as the contractions came and went. We noticed that they'd become much closer since Kara had arrived. I'd stopped looking at my watch, but my mom said they were 3-6 minutes apart.
By 10:45, I said I was ready to go to the hospital. It felt like things had changed and were now intense enough that I wasn't worried about stalling or dealing with hours and hours of the hospital. Dan had put all our stuff by the door already and he pulled the car up as close as he could. I posted one last time on Facebook and Mothering that I was headed to the hospital (I'd checked in briefly around 4 but otherwise had stayed off the computer since the walk around noon) and waited until I had a contraction to head out to the car to try to minimize the number of car contractions. We got in the car at 11:07, I had contractions and 11:09 and 11:13 and we pulled into the parking ramp by 11:15. Kara was driving behind us and we waited a minute for her in the lobby. I had two or three contractions by the time we reached Labor and Delivery. I was glad to see that triage was closed and I got to go straight to a delivery room.
Our nurse Casey introduced herself and said that the midwife (Kathrine) was on her way and would be there soon. The hospital has 9 delivery rooms and they said there were a few other women delivering, but I neither saw nor heard anyone. Everything was very quiet and subdued. I sat in an armchair at first and contracted while Casey asked a few questions. It seemed she was entering things into the computer for the entire labor. Clickety clack clack. When Kathrine asked me later what could be changed to make the experience more like a homebirth, the only thing I could come up with was that the computer could have been less intrusive, ideally soundproofed in a corner somehow.
Before too long Kathrine came and they asked if it was okay to strap on the monitors. I stayed in the chair and they fiddled with them, trying to get readings during contractions. Everybody (Dan, Kara, Kathrine, Casey) thought it was funny that I asked how the contraction monitor worked. (It's a pressure sensor. I thought it was more complicated.) They never could get very good readings of the baby's heartrate during contractions. I felt like the monitors stayed on for half an hour, but my sense of time is pretty fuzzy. I asked for a birth ball and moved onto that by the end of the monitoring. They brought up my GBS+ status and asked how I felt about antibiotics. I said that I doubted there would be time for them to work and Kathrine suggested I have a cervical exam to help make the decision. She said she could check me on the bed or on the toilet. Before we'd left the house, I'd laid back on the couch for a couple minutes while Kara palpated the baby and it hadn't felt too bad, so I went for the bed. (The contractions I'd had while on the toilet at home had been unpleasant because an air conditioning vent made me shiver and I couldn't do anything about it.)
Kathrine did the exam and said I was 7-8 cm, with a lip on the right side. I'd been napping and sleeping mostly on my left side recently to try to keep the baby LOA, so that wasn't surprising. She said they'd start filling the tub and I decided to contract on the toilet for awhile, mostly because it meant I could go into the bathroom and away from the sounds of the computer and the tub-filling and all the people. I had about 3 contractions on the toilet and started feeling sort of pushy at the contractions' peak. The contractions were stronger and harder for me to cope with in that position, so I eventually came back and sat on the birth ball. They said I could go in the tub, but it didn't seem very full and I didn't want my legs to be under water while my belly and pelvis were out.
Eventually it seemed deep enough and I climbed in. It might have been around 12:15-12:30. The water didn't make the pain of the contractions all that much less, but the water was warm and it felt good to have a new coping mechanism. Kathrine offered to bring me some food and she made me peanut butter and honey on toast, but I ignored it for the time being. Pretty soon my lower back started bothering me and I had Dan push on it during contractions (bringing us memories of Peter's birth where back labor kept Dan rubbing there for hours and hours). Most of the pain seemed concentrated there and it occurred to me that the baby was probably pushing past my tailbone. The pushing sensation got stronger during contractions and I asked Kathrine when it was safe to push (I'd told her about feeling pushy on the toilet). Nobody was going to tell me what my body needed to do, though, and the most she would say was that I should push if I felt like I should push. I asked Kara what she thought and she suggested only pushing if most of the contraction felt like pushing and not just opening. I was worried about pushing too early and causing swelling. It seemed so soon to go from 7-8 to complete. I tried pushing a bit when I couldn't help but do so and was scared of making the wrong choice. After a few contractions like that, pushing suddenly wasn't frightening and it felt good to work with the contractions. I don't make much noise at all during labor, but as I began really pushing, I made low sounds. After a couple of those, Kathrine told me to feel for the baby's head. I reached in about the length of my index finger and could feel a large, round, soft thing. Part of me thought it couldn't be the baby, but of course it was. She asked if he had hair and how far in he was. No hair, finger deep. After the next contraction, she had me check again and I was disappointed that he seemed to be in the same spot. I felt like I could deal with the pushing so long as I got breaks between contractions. Sometimes they seemed right on top of each other and other times the rest was long enough that I began wondering when they would return. After nine minutes of pushing hard, a contraction came and with it came his head. It wasn't the horrible awfulness that Peter's crowning had had, but it's not something I look forward to. The rest of him came shortly thereafter -- Kathrine caught him and handed him up to me as I moved from kneeling, leaning over the tub, to sitting back against it. He was covered in vernix and goopy but not too beat up looking. Within a few seconds he started screaming and I cheered -- finally, a baby who screams and breathes! This is how it's supposed to be! I've said since Leo's birth that I sort of worry about birthing before 38 or 39 weeks because if my 41+ weekers can't breathe, how underdeveloped would an early baby's lungs be? But no, he was totally fine!
I sat there in awe of the baby I was holding for maybe 10 minutes, after Casey and Kathrine put a hat on him and wrapped him in some blankets and added more warm water to the tub. Eventually they helped me move to the bed and when I stood up, my placenta came on its own. Kathrine joked that she had to grab it by the cord to keep it from falling on the floor.
I held the baby there for awhile -- I don't remember them poking the baby at all, but they might have done something minor. They covered us in blankets because I was shaking pretty violently. They gave all of us ID bracelets. We noticed that there was a thunderstorm outside, making my births 3 for 3 on stormy days. He'd arrived at 1:08am Saturday, July 24th, and got APGARs of 8 and 9.
Casey and Kathrine checked out how I'd fared. That poking around was pretty uncomfortable. They were confused for awhile and I asked what the worst case scenario was. They said I might have a fourth degree tear and I was not happy about that prospect. I had guessed that it wasn't as bad this time. Once they took care of some bleeding (I had the oh-so-fun uterus-pushing and lost some clots, which led them to think that I might have some retained placenta, but that was later ruled out), they asked me about my tearing during previous pregnancies. It turned out that I only had a small, superficial first degree tear this time, but I'd healed in an odd way before and they thought I'd quite possibly had a fourth degree tear. They were surprised that I hadn't had any long-term issues with it (just horribly slow healing) and said that the human body was amazing for how it could fix itself. They thought about stitching my current tear but after they numbed it, it stopped bleeding so they decided to leave it be.
I finally ate my toast and they fixed me Sprite and cranberry juice to drink.
When they checked out my placenta, they said it looked like a 42 weeker's. It was starting to deteriorate and wasn't in one entire piece. I'm not sure if anybody knows just how the various hormones come together to initiate labor, but it seems like my placenta declared itself done and told the baby to get out. I wonder whether the bleeding I had in my early-mid second trimester affected the integrity of the placenta at all. After checking it out, they put the placenta in a biohazard-sticker-covered placenta pail to send home with Kara (for eventual transfer to our chest freezer until I'm up for burying it). Hopefully, that will happen before the baby can help dig like the older boys could.
At some point, we agreed that the baby's name would be Timothy Edward. Timothy had been our front-running name for awhile but we hadn't been sure we'd stick with it.
After an hour, we got curious to know what he weighed, and they put him on the scale, then under the warmer across the room to get his other measurements and clean him a bit. He was 6 lbs 14 oz (I was the closest in my weight guess we'd all made between contractions at the hospital -- I'd said 7 lbs 1 oz and everyone else thought weights higher in the sevens), 19.5", with a 13.5" head. So small compared to the older boys! He didn't seem painfully skinny--I think he was proportioned well to balance things out. He was angry at being taken away from me and we heard his lungs in action! We told them we didn't want the vitamin K shot or erythromycin eye ointment and they said ok and gave us a waiver to fill out (we had another one for the placenta). The fact that my water had broken the night before only briefly came up -- in the end we decided it had been broken for between 18 and 24 hours and no one made a big deal of it.
After an initial failed attempt, I was able to latch him on both sides using the football hold -- another first, a baby nursing in the first 24 hours!
Around 3, Kathrine got me settled into the labor tub (a deep bathtub, not the mobile birthing tub) to soak a while. It was quite hot and I got lightheaded when I did stepped out and held onto Casey as I came back to the bed. Around 3:30, they got us ready to move to the postpartum unit. I held Timothy in my lap and someone pushed me in a wheelchair. Kara said goodnight and left and we met our postpartum nurse and got settled in.
Within an hour, someone came to take Timothy for the blood workup he needed due to my GBS+ status. He was asleep and we were nearly so, so I was barely aware of when they brought him back maybe an hour later. Dan, Timothy, and I all slept until about 6am.
The first morning was a blur of vital-checking, nursing, and meeting of endless new people. We brought him to the nursery to have his first sponge bath around noon and the pediatrician met us there and declared him to be in great shape. She said it would be up to us when to go home -- they really wanted us to stay at least 24 hours in order to see whether the GBS culture was showing anything, but beyond that was up to us. If we stayed less than 48 hours, then they'd want a home health nurse to come check on us or a quick visit to our pediatrician. Everybody was amazed by our cloth diapers that I'd insisted we use at the hospital and were surprised to hear that I'd made them. Tim had nursed a lot between 8 and 9, then woke up (angrily) during the bath, but that wore him out so much that he didn't wake again until 4pm. Meanwhile, my mom brought the big boys to come visit, and various other family members came by.
Saturday night, Dan went home to relieve my mom and have a normal night with the boys. The nurses offered to bring Tim to the nursery if I got really tired, but he gave me long enough stretches of sleep that I felt like I could handle it. The tricky thing was that he would stop nursing and rest against me indefinitely, but as soon as I tried to swaddle him and put him in the bassinet so I could sleep without worrying I'd drop him, he'd wake up. Eventually I found a way to rest him on a pillow beside me so he was safe on my skinny bed and we could both sleep.
Dan brought the boys with him late Sunday morning after church, but he stayed with me and some combination of family members entertained the boys until we came home around 6pm. Our goal was to leave before the 7pm shift change. When we told that to the staff around lunch, they made sure our paperwork was in place with time to spare. Although the endless new people were obnoxious, I didn't feel like they bugged us too much. I think I was a third-time mom with a simple vaginal birth to recuperate from and they recognized that we could pretty much cope on our own. The overwhelming feeling we got from the nurses, midwife, and pediatrician was that decisions were up to us, they had a few things they needed to do, but mostly we were in charge. The pediatrician was happy to hear we weren't going to circumsize -- she said that then she wouldn't have to be a meanie. We turned down the Hep B vaccine. I was able to try on and buy a nursing bra (on the list of things I intended to do between 37 and 40 weeks) 15 feet down the hall from my room. My milk started coming in Saturday night and was definitely there before we left.
The baby seemed extra-tiny in the bucket car seat -- everything was put on the smallest setting and he still seemed dwarfed by it. He was not a fan of the car -- another time to be glad we were less than 10 minutes from home. We came home and found my mom had spent the day cleaning our bathrooms (and the previous day dealing with our yard), my sister had taken the boys to the beach, and my SIL and BIL were making everyone dinner.
This has been the birth I dreamed of and hoped for, but could no longer assume would be possible. My baby and I are both healthy, no one needed antibiotics or even an IV (the postpartum nurse commented that she was surprised my IV was out already and I surprised her by saying I hadn't had one). I never saw the inside of the level 3 NICU. We had the baby rooming in with us from hour 1. This could have been a perfect homebirth, but I don't regret choosing the hospital at all this time. Assuming the same midwife group still exists, I wouldn't hesitate to birth with them again for future children. I can't assume I'd go so early again and I'd prefer to have the ability to get stitched up immediately available. The tubs were great and I'd have to pay more for that at home. There wasn't a single thing where the annoyance was enough to negate the positives. Do I think everyone should birth at the hospital? Not at all. If it wasn't for my history of non-breathers and bad tears, I'd stay home. I feel like I lucked out, having the care of the same CNM for my whole pregnancy and labor -- this is the only place in the Twin Cities where that is possible, to my knowledge. Maybe if I'd gone into the hospital at noon, I would have ended up with interventions. Or maybe they would have sent me home or to the park to walk. Even this hospital has an 85% epidural rate (I believe the c-section rate is 20-25%). I wish more low-risk pregnant women would use hospital CNM's or birth centers. Birth centers have only opened up here this year and I believe they are maxing out on births.
I am so thankful to have had this experience and to be home now with my healthy son and recuperating body.