I believe that a woman should get to choose how she births her child. If the pain is too much to handle, then do what your body says and ask for pain relief. If you want to deliver in a tub at your house, kudos to you!
Why I Wanted A Natural Birth
Since I got pregnant with my daughter, I dreamed of having a natural birth. There were three reasons why I decided I did not want get an epidural:
- To give my new baby the best chance at nursing and bonding during our “golden hour” and believed the best way to do that was to avoid having drugs in the baby’s system at birth.
- I did not want to risk the complications associated with a catheter or the aftershock of pain from where the needle that can linger for weeks, months, or years down the road, which can sometimes happen.
- I felt I like I was given a wonderful opportunity to experience the birthing process like women have for thousands of years and I wanted to fully embrace that experience.
How I Prepared: The Bradley Method
My husband and I took the Bradley Method course to learn everything we could about the pregnancy and the birthing process and how we could best prepare ourselves to get through the birth naturally. I had a beautiful, healthy pregnancy with my daughter up until my 40-week checkup, when my blood pressure shot through the roof out of nowhere and I was diagnosed with severe preeclampsia, a potentially life threatening condition that occurs in about 5% of pregnancies in the US. This was devastating because I had to be admitted to labor & delivery right then and there for an immediate induction. My labor was 30 hours long and included Pitocin, Magnesium, and breaking my bag of water.
When I got pregnant for the second time with Leo, my husband and I took a few refresher courses from our Bradley Instructor and hoped that things would be different this time. We’d lay in bed talking about how wonderful it would be to have my water break in the middle of the night and be able to labor at home instead of being constrained at the hospital.
At my 32-week checkup, my doctor recommended that I do a 24 hour urine test that would give us a baseline of my protein levels, as she explained that I was at an increased risk of getting preeclampsia again with this pregnancy since I had it in that last one. My protein levels came back severely elevated. The doctor said this didn’t indicate that I had preeclampsia yet, but was another risk indicator that I could get it as time went on in the pregnancy. My doctor wanted me to start coming in for weekly checkups to watch for signs of preeclampsia.
I called my husband in tears as I explained to him that it was likely I would have the same condition as last time and that our dream of a natural birth probably wouldn’t happen yet again. We contacted our Bradley Method Instructor and decided to come up with an induction birth plan to be better prepared this time. It was comforting to know that I could be better prepared in the hospital this time.
We also researched natural ways to prevent preeclampsia. I had been seeing the chiropractor throughout my pregnancy, which was one way that could help prevent it. Check! I also began seeing an acupuncturist twice a week and made some changes to my diet.
However, at my 36 and 37-week appointments, my blood pressure began to elevate. I was sent to labor and delivery to be monitored for a few hours and was thankfully sent home both times. At this point I was happy that I made it full term.
How It Began: Leo’s Birth Story
Just before my 38-week checkup, I went to the acupuncturist. He checked my blood pressure before my treatment and it was 132/74. No bad. After the treatment he checked it again and it was 139/78. “That’s weird” he ponders out loud. Relaxing during acupuncture is supposed to help decrease blood pressure so it’s not normal to see if rise afterwards.
When I got to the doctor’s office 20 minutes later, the nurse took my blood pressure and sure enough, it had risen yet again! I was now at 152/80. “This is it!” I thought.
Sure enough, when my doctor came in she said that my protein levels hadn’t risen but due to my blood pressure I now had gestational hypertension, which is the last stop before getting preeclampsia. She explained that because I had severe preeclampsia with my last pregnancy and I was at an increased risk due to my blood pressure readings being high the last 3 weeks, she wasn’t comfortable with me leaving the hospital and recommended that I go upstairs immediately to get induced.
I was disappointed that I had to be induced again but was thankful that I had been given more of a heads up this go around and had a few weeks to prepare myself mentally for this. Per my discussion with my Bradley Instructor, I didn’t want to start Pitocin until I was at a 6 on the Bishop score, to increase the chances of it working, and I was currently only at a 3. I asked my doctor if we could start with a Foley Bulb to help ripen my cervix and she agreed that was a good first step.
After a signed my life away with all the paperwork and got hooked up to the IV, my husband arrived and we talked through out induction plan since we had both left our birth plan at home. We were nervous but excited to be meeting our little guy soon.
Induction Attempt #1: The Foley Bulb
My doctor arrived at 5:00 to insert the Foley Bulb and this is the time that I considered my labor started. I closed my eyes and did my relaxation breathing and got into the zone. I felt immense pressure for about 30 seconds and then…nothing at all. I peeked one eye open to see what was going on. This method was supposed to be uncomfortable for hours, so what was going on?
My doctor said the Bulb came shooting out as soon as she began to inflate it. She checked me again and I was now 4 cm dilated, 75% effaced, and still at a -3 station. My doctor was very surprised that I had progressed that much in a matter of a few hours since she had checked me at my checkup. She said she wasn’t sure if it was the Foley Bulb that had made me progress that quickly or if I was going into labor naturally.
Induction Attempt #2: Pitocin
Either way, I was excited because my Bishop score was now a 7, which meant that I was comfortable starting the Pitocin. My nurse started the Pitocin at level 2 and said she would increase it by 2 increments every 15 minutes until the contractions started getting more consistent.
I wanted to do whatever I could to help my labor progress but at this point, which the baby still being at -3 station, all I could do was rest and prepare for what was to come.
The Waiting Game
Around 11 pm, the nurse insisted that she had to check my progression at that time. Not much had changed. I could certainly feel the contractions at this time but they weren’t strong enough to stop me in my tracks. My husband looked exhausted after a full day of work so I told him to lay down on the couch and get some rest and that I’d wake him up if I needed him.
I tried lying on my side to get some sleep. However, I was hooked up to a blood pressure cuff that went off every 15 minutes. That was annoying. On top of that I had 2 monitors strapped around my belly to monitor my contractions and Leo’s heart rate. Any time I practically took a breath the monitors would shift and the nurse would come running in to put them back in place.
My husband woke up around 5 am. I was tired, grumpy, and frustrated that my labor seemed to be stalling. When the nurse came back in I told her I was ready to have my water broken since my contractions weren’t consistent and so that we could speed things up before I got too exhausted.
Unfortunately it was a holiday and not my doctor’s weekend to work. The nurse said that the on call doctor would arrive around 7 am to start her rounds and would probably get to me around 8 or 9 am. Great, another 4 hours of limbo.
Induction Attempt #3: Breaking the Water
The on call doctor finally arrived at 9 a.m. She said that she needed to check my progress again before breaking my water. I took that to mean that she would tell me where I was at and then she would tell me when she was breaking my water. Instead, she checked my progression and immediately broke my water. I was caught a little off guard as I wasn’t expecting it at that moment, but I got through it. Not much had changed in the last 10 hours. I was at 5 cm, 80% effaced, and -2 station.
Dealing With Intense Contractions
After the doctor left, my contractions picked up in intensity almost immediately. I lay on my left side for 30 minutes to allow the fluids to gently trickle out and get my body prepared for what was about to come. After the 30 minutes, I was determined to get Leo into position. I got out of bed and sat on the birthing ball again. This time, with every contraction I did the “Captain Morgan,” meaning I stood up and put one foot up on a chair and circled my hips through the contractions.
During my breaks, I sat down on the yoga ball again and rested by upper body on the foot of the bed. I did this for 10 contractions on each side. My pain level was at a 9 by this point and standing up for the contractions were almost unbearable but I was determined to help him move into position.
I spent another 30 minutes on the birthing ball doing figure eights and taking deep long breaths to get through the contractions. Suddenly my contractions were lasting longer than a minute. I began to get double and triple peaking contractions (something I wouldn’t wish on anyone!). I couldn’t take being on the birthing ball anymore and got back into bed and laid on my right side.
Focus on Breathing
My poor husband tried to help me through the contractions by doing the massages we had learned about in our Bradley Class. Any time he touched me, I’d bark “no!” or “get off me!” His job now was to count me through the contractions and let me know if they were going to plateau and last longer than a minute. I needed encouragement to get through each of them. I took long deep breaths and blew out a low “ahhhh” with each exhale, trying to keep every muscle in my body as relaxed as possible. My pain level was now at a 10 and getting through each contraction took my entire energy and focus. I just tried to keep focusing on my breathing.
Finally Reaching 10 cm
My moaning and “ahhh’s” must have got louder because the nurse insisted on checking my progress again. In between contractions I rolled onto my back so she could check. “You’re 10 cm and ready to go!” she said. “I’m going to notify the doctor.”
I rolled back onto my right side and told her “I’m not ready to push!” I made the mistake of listening to the nurse with the birth of my daughter. When I was 10 cms dilated she told me I could start pushing, even though I didn’t feel an urge. I pushed for 3 hours to the point of exhaustion with my daughter and barely got through it. I was not going to make the same mistake this time.
“Well I’m going to notify her that you’re ready so that she can head over. We don’t want you to start pushing without her here. Let me know when you feel a change in your contractions.” She got on the phone to call the doctor. All of a sudden my stomach started lightly feeling like it was convulsing and a strong pressure started forming in my pelvis. This wasn’t quite the feeling I was expecting. I had been told when you’re ready to push it will feel like you need to take a bowel movement. To me it was the convulsions I was having that let me know I was ready.
The Urge to Push
“I think I’m ready!” I screamed. “Tell her to come now!” The doctor arrived a few minutes later and my convulsions started getting more intense. I couldn’t just breathe through the contractions like I had before. Instead, I pretended like I was blowing out candles on a cake with each exhale and giving just the slightest push with those exhales.
I told my husband I thought I wanted to turn around and push on all fours. The nurse said that I would have to push on my back. “What? My doctor said I could push from any position as long as I’m on the bed” I exclaimed between contractions. “The protocol with the on call doctor is to push on your back” the nurse replied.
This was beyond frusterating. I did not feel like being on my back was a natural pushing position at that moment. The doctor arrived a few minutes later and suited up. “You can roll over on your back now and start pushing when you’re ready” she said.
Pushing Through the Pain
That’s when the waterworks started. “I don’t want to!” I cried. Words couldn’t describe what I was feeling. First of all, I didn’t want to push on my back. Also, I just didn’t want to push period! The terrible memories of the pain of pushing for 3 hours with my daughter came flooding back to me in that moment. “I don’t want to! Just a few more contractions” I pleaded. My impractical logic in this emotional state was that maybe if I stayed on my side long enough, Leo would just come out on his own and I wouldn’t have to push. It could just be over without having to do anymore work. Obviously that doesn’t happen so after another contraction the nursed rolled me over against my will.
My husband wiped my eyes and told me that I was almost there and that I got this. Another contraction came and the nurse told me to grab my knees and push. My husband got behind me and helped by supporting my back as I grabbed my knees. I pushed harder by blowing out the imaginary candles with all my breath.
Figuring Out How to Push
“Don’t blow out,” the nurse said. “Hold your breath and push. I need you to try to push for a 10 count, take a deep breath and do it 2 more times for each contraction.”
“Oh yeah,” I thought, “I’m doing this all wrong.” I refused to try it during that contraction and waited until the next one. “Hold your breath and push!” The nurse said. I took a deep breath in, closed my eyes, and pushed with every muscle in my body as the nurse counted to 10. “No, no, no!” I shouted. This wasn’t right either. I wasn’t using the right muscles to push and ended up bursting the capillaries in my eyes, face, and chest (not a pretty sight!). I was frustrated with myself that it was taking me this long to remember how to properly push.
Push like you’re making a bowel movement, I had heard before. So that’s what I did during the third pushing contraction. Focusing on only using those muscles, I didn’t waste energy using any others. I managed to push for two counts of 10 during that contraction.
The Ring of Fire
Everything felt so raw and sore. Pushing felt significantly more painful than the last 21 hours of contractions I had just been dealing with.
“Are you seeing any progress?” I asked the doctor after that second push. I needed reassurance and confirmation that I was pushing correctly. “Yes, you’re doing a great job, but we need you to do that third push during your contraction to really help get him out.” That sounded next to impossible but my body was in so much pain that I was determined to get him out as quickly as possible now.
The next contraction started in less than a minute. There wasn’t enough time to rest. The nurse just told me that meant I was at the end. I had no choice but to push again and this time I was able to get 3 pushes in. Just as I thought it couldn’t get any more painful, I felt the “ring of fire” as his head finally descended and I was crowning. I let out a scream after that push.
There was excitement in my husband’s voice as he told me I was almost there. My mom and my mother-in-law being my cheerleaders from the back of the room. “Way to go Kaley, you’re almost there!”
I was determined to get him out with this next contraction. During the first push, his head came fully out. What a relief that I was almost there. I took another deep breath in and pushed again.
“Stop!” The doctor shouted and I froze. “There’s a nuchal cord. The umbilical cord is wrapped around the baby’s neck.”
My heart fell and I felt paralyzed. The room fell quiet. “Kaley, I need you need to do exactly what the doctor says,” the nurse instructed. Unable to say anything, I nodded. I was terrified that something was going terribly wrong.
We had wanted to do delayed cord clamping. I remember hearing the doctor tell my husband, “Sorry dad, I have to cut the cord now.” My husband told her to o what she needed to do.
It took about a minute for the doctor to unwrap the cord and do everything she needed to do to ensure the baby was ok. I was in highest amount of pain at this point but didn’t care. I just wanted my little guy to be ok. After a minute, the doctor told me to push as hard as I could and that he needed to come out now.
Unfortunately my contraction had ended. It is incredibly difficult to push without a contraction but I gave it my all. I yelled at the top of my lungs with the doctor pulled the baby out.
The nurse immediately rushed him to the baby station and began suctioning the mucus out of his airways. My mom later told me that he was completely purple when he came out due to the lack of oxygen.
Thankfully he was completely fine after the medical staff took a look at him and did what they needed to do. They put him on my chest just a few minutes after he was born and we began our golden hour. He latched almost immediately and it felt great to begin to bond with my sweet little guy.
The afterbirth was incredibly painful as well, probably because I had a second-degree tear. My nurse pressed down on my stomach every 5 minutes for the first half an hour and then every 15 minutes for the next couple hours after that. I wanted to cry out every time she pressed down on my stomach and had to ask for a Tylenol to help deal with the pain.
Overall Leo’s birth was easier and less painful than Evalyn’s since I didn’t have to be on the magnesium for preeclampsia and I had the previous experience to learn how to push properly (20 minutes instead of 3 hours!).
It’s also been wonderful to know more about newborn sleep this second go around. There is such a difference in both Leo’s and my energy levels and allowed us to enjoy more time bonding while he’s awake and happy.
To healthy sleep,
Kaley Medina, Your Houston Sleep Consultant & Dallas Sleep Consultant