There is so much to say about the birth of our son Hugo. For some context, I wrote here about my desire for an unmedicated birth and here about how I trained for it.
The day before my labor starts, we do some mellow climbing at White Rock. I feel more tired than usual after and think that my third trimester energy is transitioning to the fatigue of pre-labor. In the evening I experience increased pelvic pressure, though I feel like GJ (our nickname for baby before he arrived, short for Gabriel Junior) has been lying low for awhile. But nothing feels drastically different, just part of the process of moving forward towards our due date in less than a week. Still, I do the laundry in slight anticipation. That evening G humors me by watching the Baby Sitters Club TV series with me, and he’s very touched by the episode about Stacey’s diabetes. I go to bed after my usual pre-labor routine, feeling grateful for a day on rocks and a cozy night with G.
Around 1 AM, I’m woken by cramping low in my pelvis. I’ve been having a ton of Braxton-Hicks, but this is different in where it is and in that it is actually painful. I then need to have a bowel movement, which never happens to me in the middle of the night. Then I have a couple more in the next half hour, and recall that this can be a sign of labor from increased pressure. But like with everything in labor, there’s a spectrum and it can mean it could be hours or it could be days. I go back to bed, feeling like if I’m in early labor I should try to sleep through the initial contractions, as I’d read that most often they start out mild. But these quickly require me to breathe through them, and I can’t sleep--partly due to the pain and partly because I’m having anxiety about not having finished prepping my work for while I’ll be away.
So I get out of bed and start clearing my work inboxes--the labs, patient messages, and chart notes. I finish preparing notes for patients who need follow-up so my colleagues can provide coverage. At the same time, I’m not sure if this is even real labor. My contractions feel like severe period cramps, but I don’t have any back pain or a sensation of a “wave” like pain moving from my uterus, like I’d read about. I do notice they are already fairly frequent and regular, 5-6 minutes apart, which is also different from what I’d read about them starting out as much more spaced out.
I still can’t sleep through the contractions, so I fold laundry, clean the kitchen, finish reading a book, and look over our list of right-before-labor to-do’s. Finally around 5 AM I’m tired enough that I’m able to sleep for the minutes between the contractions, which at that point are further apart, like 10-15 minutes.
I wait until 6:30 AM to wake up G. He asks if I’m having contractions, having sensed my movements half-awake in the middle of the night. I tell him that I think so. We stay close in bed for a while, contemplating this possibility. G makes the preparations we’ve planned. He gathers our hospital bag, makes bagel sandwiches in addition to the snacks we’ve packed for the hospital, puts a frozen meal we’ve prepared into the fridge so we can eat real food post-delivery, gets all the supplies in the car (my pregnancy pillow, yoga mat, our own blankets). I put our towels and kitchen linens in the laundry, and we water the plants. G makes plans for cat care and calls his mom.
We go to our favorite breakfast place, Opuntia, when it opens at 9 AM. As we walk there, a couple with a 20 month old boy walks alongside us and he calls out “Baby!” while pointing to us. We all laugh, impressed that he can recognize my pregnancy, the dad remarking that “usually you’re not supposed to assume…” The mom asks when I’m due, and I say, “I think maybe I’m in labor so maybe your baby is right and it’s today?” We all muse at this, as I’m still wondering if this is for real.
I have huevos rancheros and a chocolate croissant, and enjoy this private time with G in a familiar place. Now my contractions are regularly four minutes apart, though still lasting less than a minute. I’m needing to breathe through each one but they are manageable (when G asks about the pain, I tell him they’re not as bad as Charley horses). G calls his dad and step-mom, who are worried that we’re eating at a restaurant and not at the hospital. We’ve talked about walking around after breakfast, but given the frequency of the contractions, I tell G I’d prefer to go home.
At home, I encourage G to nap a bit, and while he tries I listen to music and dance around to get my body moving. He gets up after 20 minutes and takes out our sheet of pain coping strategies. I use the birthing ball to do exercises I’d learned to help labor go faster and easier. Assisted squats and side lunges really seem to trigger the contractions. It’s windy and hailing outside. G times my contractions, and asks if I want counterpressure or massage. I tell him my back doesn’t really hurt, so we don’t use any of those techniques, but light touch over my scalp and shoulders help. Along with breathing this is enough to get me through.
Since I’m hoping to go epidural-free, I’ve imagined that I will want to labor at home as long as I can, as I’d read that the transition from home to hospital can stall labor. G lets me take my time, and we joke that it’s like our approaches to the airport -- he always likes to be there earlier than me. Despite their intensity, my contractions never last a full minute and sometimes are less frequent, so I’m just not sure that I’m in active labor yet. But I also know that timing isn’t always reliable as an indication, and we both agree that it’d be nice to just settle into the hospital rather than wondering when we should go.
On the way to the hospital, which is just a few minutes from home, I joke that maybe I’m not even 1 cm dilated (I generally cope with anxiety by having low expectations). We arrive at the hospital around 1 PM, twelve hours after my contractions started. The emergency department is empty, and a labor and delivery nurse triages me right away. I didn’t realize then that she would be our nurse for my delivery, and how grateful I’d later be for our connection, but immediately feel welcomed by her warmth. She determines that I’m 5 cm dilated, says the midwife will be arriving shortly, and prepares my room. G and I look at each other, and I say, “I guess it’s real!”
Going into childbirth, there are a couple uncertainties that linger for me. They’re outside my control, so I work to let them fade to the background. One is not having a doula. G asks me early on if I wanted one, and in my minimalist way, I’m not sure that I do. Then when I consider it more and think it would be a good idea, it’s a little late to find one. So we focus energy on maximizing the support I do have, in G. It’s important to me that he be an integral part of the process, so not having a doula makes this inevitable. He spends a lot of time learning about the kind of birth I wanted, and how to support me with affirmations, meditative practices, positions and exercises, and massage techniques. I know that he’ll be great, but I think we are both a little anxious given our lack of expertise.
It turns out that having G as my pseudo doula is one of the best parts of the experience. It feels so intimate to labor with just the two of us. After laboring on my own in the middle of the night, G is with me for the next 12+ hours that it takes to deliver Hugo. Except for the last couple hours of labor after I’m completely dilated when our midwife and nurse are with us, it is just me, Gabriel and our child. It feels so special.
For all the labor up until pushing, I never feel like I need anything or anyone else to get through the sensations. We work together to figure out the best ways for him to help me through contractions, which change over the course of labor. He is great at adapting to my needs as the pain becomes more severe (for much of the contractions he uses a hypnobirth technique of counting down from ten to one, and when he continues that for the pushing phase I tell him, “No more counting, just tell me to push!” and he switches modes without blinking). As he has throughout pregnancy, he tells me several times that I am beautiful, in ways that make me know that this isn’t a strategic affirmation but how he naturally feels in the moment. During a process that can make you feel really messy, this is so helpful to me in feeling the power and beauty of what we are doing. I know that this experience gives him a sense of being a truly big part of bringing Hugo into this world.
The other uncertainty I have is what my medical team would be like. So much of what I’ve read has emphasized having the right support team. In Santa Fe there aren’t many options to choose from so I didn’t feel like I did this in any deliberate way. For my OB care I see the midwife team, which means that I see a half dozen different ones over the course of pregnancy. I don’t know which one will be there for my birth, and while they are all kind, I don’t know any one of them that well. We are extremely fortunate to have an incredible midwife and nurse supporting us, and I don’t think I realize until it happens how important they are to our experience.
We give them our birth plan, and we’ve prepared for advocating for ourselves if needed, as I’ve read about how medical staff don’t necessarily read your plan. But our nurse reads and respects everything carefully, well beyond what I’d expected. We’re never offered an epidural or medications, which is an incredible boost to my confidence that I can do it. I feel like when people ask if I’m sure about my preferences, or let me know that there are alternatives, it amplifies my own self-doubt that always lingers for me in doing something difficult. At the same time I know that I can ask for changes to my plan and they will accommodate quickly and without judgment.
More than this immediate acceptance, our nurse actively values our process. I can tell she genuinely appreciates what we are doing. She tells us how beautiful it is that we are breathing together and what a good team we make. At one point, G and I are swaying together (a technique we had kind of joked about during our pre-labor preparations but one that actually works really well). Our nurse walks in, and instead of feeling like an intrusion, she finds the moment so moving that I’m glad to have shared it with her.
At shift change, she tells the staff coming on what a beautiful labor it has been so far, and keeps referencing it as “birth by candlelight and flashlight.” We use cheap LED candles from Wal-Mart to keep off the overhead lights, and in such a moving commitment to our birth plan that asks for dim lights, our midwife uses a flashlight to monitor my pushing rather than turning on the lights. It’s not even a preference I feel strongly about, but I feel the immense generosity of how carefully they follow what we wanted. LED candles and flashlights are not what I’d imagine as romantic or atmospheric, but it is the people who make the mood.
The midwife also contributes to this atmosphere of calm and trust by not checking my cervix regularly. This wasn’t part of our birth plan, but I appreciate it for the faith it shows they have in me to listen to my body. They check when I arrive, and then tell me they will check if I want, or when I feel a change in labor, but won’t do it as a matter of course. And so it is that the only other time they check is the last, when I’m completely dilated.
A couple hours after we are at the hospital, I switch from a relaxation breath to a more shallow breath used for the transition phase of labor. I’d read this is the most painful part, the time when people start considering an epidural, but to push past it because it means you are very close. It wasn’t that much more severe for me though, so I wasn’t sure if it meant anything. After it has been going on for awhile, G encourages me to use the hot tub to see if that will help the pain. While there, I notice much more pressure and I’m naturally starting to use the breath meant for pushing (something called the J-breath which helps you breathe into the lower part of your pelvis, similar to how people say to push like you’re having a bowel movement). This is when I ask to be checked, and the midwife tells me, “I don’t feel your cervix, because you’re complete.”
I am so happy to have gotten to this point, in what feels like a manageable amount of time and effort. I’d read that transition is the hardest, and that pushing is generally easier for people, so I think that I’m almost there. Still, when they tell me that I’m almost there, I maintain my approach of low expectations by responding that I only hope so.
Compared to the maternal nurturing of our nurse, our midwife has a more direct, no-nonsense way of caring for us, and that also works really well for us because I really trust that she is honest about what is happening and what will work best. It turns out that I’m not as prepared for the pushing part of labor, and her steady guidance is extremely helpful in getting me through the incredibly painful process. At one point, I have trouble finding a pain-free rest position and she not unkindly tells me that every position will be painful and to commit to one that will help me push. At the same time, she quickly implements anything I ask for (birthing stool, squat bar) and always reassures me they will work with whatever works for me (which at one point requires her to squat on the ground with the flashlight).
Apparently I am in the minority of people who find pushing much harder than contractions. I’ve trained well to relax through contractions, but working with them to push is a whole other kind of mindset. Instead of distracting myself from the contractions, I’m supposed to coordinate with their peaks to push along with them, and I find this mind-blowingly painful. I try using the J breath but it doesn’t seem to push things along, and it doesn’t help with the pain. Our midwife places her hand where I should be pushing into, which helps me focus. The contractions are coming faster and stronger, and there’s very little time for me to rest in between. I start crying and wondering how I will be able to do this.
The midwife is right and everything I do hurts. I’d thought I’d push while squatting or on all fours, using gravity, and definitely not on my back as is conventional. But I struggle to find a good position with squatting and with the stool, so the nurse suggests that I lie down and push my legs back. I tell her I think this isn’t a good position for me. She gently advises me to try it for just one contraction and then decide, and it ends up being the position in which I push Hugo out.
I didn’t envision this stage being so primal. I’m screaming so hard with each push to get through the movement and the pain. The midwife, nurse and G all adopt the mantra I have to quickly come up for myself to continue pushing. To get through the excruciating pain I really have to feel like I’m getting further with each push, so I keep asking them if it’s working and if I’m doing anything. They keep reassuring me that I am, so in the brief periods between contractions I yell “I’m doing it! It’s working!” and they all say back to me “You’re doing it! It’s working!” After I start the mantra that I’m doing it, there’s a shift and I feel my labor is working better, but the pain is just as bad. During the contractions themselves, they all tell me to push, push, push and G keeps reassuring me that our baby is coming. At first I ask him if he’s lying to me, but then over time I hear the excitement in his voice as he can see the progression with each push.
Finally, the midwife tells me to reach down to feel Hugo’s head, and on the next contraction I’m determined it will be my last, and all of the sudden my hands are on his body as I carry him up to me. G and I obviously burst into tears. All in all the pushing lasted for little over an hour but is the most vividly physical part of labor for me, and absolutely the most painful thing I’ve ever experienced, and I can’t believe that I did it and it worked. G takes photos, and in the first capture of Hugo he looks like he’s smiling.
Our nurse stays until the end of our delivery even though her shift ends before I’m done. She tells us there is no way she would miss it, and when it’s all over she thanks us for the experience and we both get teary. I think about all the effort G and I put into preparing for this, and how much that preparation helped and also how much was unpredictable and entirely new to us, and how this layered mix of experience is the best gift as a human.
I’ve always been curious about pregnancy and childbirth as these singular, intense embodiments of the body’s power. This process has challenged me physically and mentally in a way that you just can’t recreate in any other form, and this birth experience has stretched me so far beyond what I’d hoped. I am so grateful for all it gives: a kind of intimacy with G that doesn’t exist in any of our other shared experiences; a deep connection to the women with such empathy and wisdom helping deliver Hugo; a confidence in my own power. Hugo carries all of this in his being, all of what brought him here and just a glimpse of what the world has to offer. I can’t wait to see what he does with it.
