WARNING: Do not read further if you are uncomfortable with hearing lots of details about labor and delivery. I carefully considered whether or not I wanted to post this, but ultimately, I want to remember this for later, and I think my story offers a unique perspective, given that my preferences for labor are not popular and my complications are not that common.
I had my baby at 38 weeks and 4 days. In the week leading up to birth, I had begun having increased Braxton Hicks, and on Friday March 30th, I started to have some uncomfortable cramps with BH, but resolved to not be too excited. I lost a few bits of mucus plug that evening and was very happy my body seemed to be heading in the right direction (despite being told my cervix was high and closed at 37 weeks).
Saturday morning, I lost more of my mucus plug, but also had a lot of bleeding. I tried not to panic and thought perhaps I just have a very bloody show… but then I bled some more. It was heavier than a first day of a period for me, so we went in.
Everyone thought that yes, it did seem like a lot of blood, but my vitals and baby’s looked great, I was 2-3 cm dilated with scattered contractions, and I told them I knew it wasn’t active labor, but I was worried about the blood. They agreed I shouldn’t go home, so I was admitted. For some reason, the cervical checks were EXCRUCIATING! Everything else was fine, but I hated those and they literally made me cry each time.
The doctor on call came to see me once I was admitted and said he was very concerned about all the bleeding. The most likely cause was my low-lying placenta being irritated by early labor. He asked if he had my permission to break my water and start me on pitocin since I was only a 4. I declined, saying I wanted to walk around and see if labor would pick up since my water was still intact and I felt sure contractions would pick up if I were allowed to move around. He finally actually examined me, said it wasn’t as bad as he thought, and reluctantly allowed me to at least try to walk. I did, and just as I had thought, contractions picked up. They were uncomfortable, but doable. They became more intense over the course of the day, but I had no problem managing with my husband and my friend (a doula and an RN who works at the women’s hospital at which I was giving birth).
I was still bleeding profusely, with large clots, but I still felt all right. My platelets that morning had been a 90, but a second round of blood work in the evening showed them at 102, so that looked good too. This meant I was still eligible for an epidural if necessary.
As the evening wore on, my contractions began to fizzle out around 1 AM. I was dilated to a 5. I thought about a kick start of pitocin at that point, but they didn’t want to administer it when there wasn’t full staffing for the OR just in case. We resolved to sleep, so we all took a rest. At 4 AM, contractions picked up and were much more uncomfortable. Just before 7 AM, my water broke on its own!
Things picked up from there, but I was stuck at a 6 for the next 3 hours or so. The pain was horrible and I wasn’t making progress, so I asked what IV pain meds were an option. They told me there were options, but said my baby would have to go to the nursery to be observed for 4 hours after birth since the drugs would go to him too. I declined, and after awhile, asked for an epidural because I was frustrated at the lack of progress and was having difficulty coping knowing that I wasn’t moving forward.
The doctor wanted to redo my blood work, and of course my platelets were at an 84 (and apparently I have large platelets which means naturally I’ll have fewer to begin with). The anesthesiologist told us if it were his family member, he would still do it, but he wanted us to know the gravity of the risks. It was basically a 1 in 500 chance something could go wrong, although he had never seen a spinal epidural hematoma before. I could tell he felt badly for me, and he said my husband and I should talk it over. Apparently this risk extended to any kind of sedation, should I need an emergency c-section. We both felt as though I had been incredibly lucky to have made it this far and felt like if something abnormal would happen, it would happen to me, and we weren’t prepared to take that risk.
So, in the greatest pain of my life, I told that nice man that we were going to pass on the epidural. Once I knew the risks, it reinforced my determination to avoid a c-section or further interventions with everything I could. I may or may not have said, “This baby is just going to have to come out the same way he came in.” It’s a lot easier to labor when you decide there isn’t a doable out except to keep going.
Luckily, while waiting on all of this, I had progressed to an 8, and soon after that, a 10 around 11:45 AM. Y’all, I couldn’t not push from 8-10, so I was pushing to alleviate pain and half breathing it out when I could control myself. My doula was very supportive and told me to push if it felt like it was productive! At pushing time, I tried on my own for maybe half an hour and then accepted coaching.
I couldn’t stand any pressure on my pelvis, so I was holding myself up on the squat bar on the bed with my legs and putting the rest of my weight off on the bedside handles. In between pushes, I was almost out cold, literally gathering strength to focus on making it. I hadn’t expected to labor lying down, but I wasn’t able to rest between contractions very well propped up on the squat bar as I had been. My contractions were never consistent; even at the end, some of them were 1-2 minutes apart and others were more like 7 minutes apart. I was terrified I’d run out of energy because of all the blood loss, and at this point I hadn’t had a meal since Saturday breakfast (although we had been sneaking me light snacks throughout; I highly recommend). I told God he was going to have to get me through this since an epidural wasn’t an option, and then I lied to myself internally, looking at the clock, saying I just have to make it another half hour… and I did that about 5 times.
2.5 hours of pushing later, I finally was about to meet my little man! They kept asking if I wanted a mirror, and I kept saying, “NO! I can’t un-see that!” I finally did reach down and touch his head (they were all remarking on the amount of dark hair) and exclaimed, “OH MY GOD!” That same male doctor on call came back and began stretching out my vagina with KY Jelly, despite my requests for a warm compress. It was uncomfortable because he did it during contractions. He also asked for a tray preparing for an episiotomy, and I just looked at my husband and friend who both strongly advocated my wishes to tear rather than be cut, so he went back to stretching and complimenting my roomy pelvis. We still aren’t sure why he chose to compliment my pelvis, but perhaps he was surprised I had room? Then he started trying to tell me what could happen with a shoulder dystocia, and I had to keep interrupting him to push. Honestly, the possibility that my son wouldn’t fit was not even an option in my mind. I’m not a very large person, but my petite mother had 4 kids vaginally, one of them over 9 pounds, so I suppose I assumed if I could make it to a vaginal birth, I could absolutely birth a baby!
Finally, at 2:12 PM on Easter Sunday, my baby boy entered the world! Once his head was out, the rest of him came easily. They put him on my chest immediately, waited to cut the cord, and then let my husband do it. With the slightest gush, my placenta came out intact, and it was over. Apparently I asked what it was that came out after the baby, probably worried it was another massive clot, but I have very little recollection of that! My dear friend and doula took pictures for me that I finally had the guts to look at a week or two after birth; it is incredible awe-inspiring and moving to look at your own reaction to welcoming a child into the world.
My son was 8lbs, 3oz, and came out strong and screaming! The bleeding afterwards was less than it had been during labor, and I had no problems/pain with the fundal massage. I was up and moving later that day (albeit feeling like a train had hit me) and only had one 1st degree tear with minor stitching.
My Rowan had a rough start at feeding because he swallowed some amniotic fluid on the way out. Unfortunately, my amniotic fluid had some blood in it from all the bleeding, so after breastfeeding him, he vomited up a scary amount of dark brown bile. Additionally, my milk didn’t really come in until Thursday, so little man didn’t get that much to eat, although his output was still okay, so we knew he was getting something! It was very stressful going back for weight checks repeatedly and having him still lose weight. The first week he lost over 10 percent of his birth weight and got down to just under 7 pounds, but with supplementing extra breastmilk and lots and lots of feedings, he returned to birth weight in just under 3 weeks.
When reflecting on this experience, I am most grateful for the support of friends I had throughout a scary pregnancy. It wasn’t too rough on me physically, but emotionally, it was a mountain to climb. My two good mom friends had collectively experienced c-sections, breech babies, home birth, blood transfusions, and are doulas, so I felt confident in their ability to help me prepare for whatever birth outcome I would have. Ultimately, I made my peace with however birth would happen just before my previa resolved, but I know I wouldn’t have gotten there without their counsel. I also can’t recommend having a doula enough! Both of my friends helped me know what to ask for and how to advocate for my wishes. This is extremely difficult to do when you are in a vulnerable position; my doctor actually asked me to make medical decisions while I was lying down, legs spread open before him, and I couldn’t shake just how imbalanced the power was! I felt a bit rebellious declining his suggestions of how to proceed, but it was also incredibly empowering. You have a choice! You do not have to do everything they tell you, especially if your choices pose an inconvenience to them, but not a risk to you or your child.
Finally, this experience was humbling. I had a lot of faith in my body and my ability to have a vaginal birth, and I wanted to go unmedicated if possible, but I now have an incredible amount of empathy for anyone who chooses an epidural or other pain medications. I was right there and probably would have had one if it were less risky! At the end of the whole process, holding my son, I was amazed that my body is capable of birth and completed it without intervention, even with weird hiccups. It definitely could have ended differently, and every single healthcare professional let me know I was still an increased risk for c-section, so I am incredibly grateful that Rowan was excellent throughout the whole pregnancy and birth and that God did sustain me through the whole thing. I’m a little less eager to try for siblings at this point, but I’m hoping that maybe, just maybe, the next pregnancy will be a little more boring!