Dana’s baby was due July 19. By July 29, after experiencing regular contractions for over 10 days, Dana was getting pretty tired of being pregnant. Her doctor scheduled an induction for Friday, July 30. The day before the induction, Dana’s doctor inserted a catheter into her cervix to try to get the cervix to start opening. That way, by Friday, her body would be better prepared for induction. I planned to meet Dana and her husband Wade at the hospital at 7:00 am on Friday morning.
The catheter was not supposed to be any less comfortable than a tampon – but for Dana it was excruciating. In most people, the procedure doesn’t cause contractions, but Dana started contracting as soon as the catheter went in. The contractions were excruciating and came right on top of each other, with no break in between to recover. Dana had to wait with her midwife after hours for her husband to come pick her up, because she was in too much pain to drive.
When I spoke to Dana at 7:30 pm, her contractions were 3 minutes apart. She had labored in the tub for a while, and wanted to try to sleep at home if she could. But about an hour later, she started noticing some bloody show and decided to go to the hospital. She got there at 9:30 pm and I met her there an hour later.
Dana, Wade, and baby Ella, born 7/30/10
Dr. Schmitz and Dana’s nurse Ashley were surprised to learn that Dana was 6 cm dilated. Dana’s contractions slowed down after she arrived at the hospital, so we tried walking the halls to speed things back up. The contractions did come faster when Dana would walk, but we could only walk for 30 minutes at a time – we had to go back to the room so Dana could get back on the monitor for 5 minutes. The contractions would slow down again as soon as Dana stopped walking.
I suggested she try sitting on the birth ball to be monitored, in an attempt to use gravity and the movement of Dana’s hips and pelvis to allow the baby to descend. But the contractions still only sped up when Dana would walk, and she was tired. By 1:00 am, Dana concluded that her contractions were continuing the pattern of the past 10 days; they were not increasing in intensity or becoming more frequent. She wanted to preserve her energy for the induction in the morning, so she decided to try to sleep. I tucked her in with her fluffy pink body pillow and set up the convertible couch/bed thing for Wade, and then I went home for the night.
Dana promised to call me if anything happened overnight, but nothing did. She hadn’t slept much for the past 3 days so she was really tired, but she still couldn’t sleep. After a Phenergan at 4:30 am, she was able to doze for a couple of hours.
When I got back to the hospital at 8:00 am, Dana was munching on banana bread and looking beautiful and completely refreshed – although she said she was still really tired. I tried some labor-inducing acupressure, which brought on contractions but did nothing to speed them up or really get labor going At 9:15, the midwife Lisa came to talk to Dana and Wade about how they wanted to proceed with the induction.
The options were pitocin or breaking the bag of waters, also called AROM (artificial rupture of membranes). Dana wanted to avoid the discomfort of the baby’s head against her cervix that AROM would cause. She chose pitocin because Lisa explained that they’d start it very gradually to find the smallest dose that would work. Lisa said that pitocin wouldn’t make the contractions any more painful than natural labor. Dana’s nurse Heidi started the pitocin at 9:30 am.
As soon as the pitocin started, Dana began feeling anxious. She worried that pitocin would make her contractions extremely painful, and after the ordeal yesterday, she was all too aware of how painful they could be. I encouraged her not to worry about what might happen and just deal with what was currently going on. By starting pitocin at 6 cm Dana was already ahead of many women who get induced, and she was coping very well with the contractions she was having now. So far, everything seemed to be going smoothly.
Dana and Steph
At 10:15 Dana felt a bit lightheaded. About 5 minutes later, Heidi came in and said that the baby’s heart rate was a bit low, so she had Dana lie down for a while. The baby’s heart rate immediately returned to the normal range, and Dana enjoyed the rest, so she stayed in the side-lying position for a while.
Dana and Wade were really funny, constantly griping at each other playfully. They really cracked me up and I loved seeing how Wade used humor to lighten the mood and get Dana smiling and not worrying so much. Around noon, Wade told Dana, “You know, if we want to have another one you’re going to have to execute a little better next time.” Dana just kind of rolled her eyes. Later she told him, “You try pushing a baby out of your penis hole!!” He didn’t have much to say to that.
My favorite quote of the day, though, came when Wade had to get rid of some of the photos on their camera to open up more memory for baby pictures:
Wade: Do you want this picture of this dog humping this lady’s leg?
Dana: Well, it was really funny.
Wade: Do we need all four?
We placed bets on how much the baby would weigh. Wade guessed 8 pounds, 6 ounces. Dana guessed 8 pounds, and then Wade wanted to change his answer to make it lower, but Dana and I called him out on that, so he had to stick with his original guess. I guessed 7 ½ pounds.
Until around noon, we had been joking around and chatting about things like 15 pound babies, snake handlers, Appalachian weirdos, and people who live in the New York subway tunnels. Just the usual sort of chitchat. But around noon, active labor set in, and things started to get more serious.
Meeting Ella
Looking over my notes now, I’m amazed to see how quickly this happened. We moved around the room trying different positions that would allow me to massage Dana’s back between contractions and do the double-hip squeeze during contractions. Dana tried standing and leaning over onto the birth ball, sitting on the birth ball, and sitting on the toilet facing backward so I still had access to her back. Ame, my Get Babied doula buddy, popped in to say hello during this time – she had been down the hall working with another client having an induction. Dana and Wade both said hi to Ame and talked to her a bit.
By 12:30, Dana was sitting on the ball moaning through her contractions. I encouraged her to keep her voice low and deep and her throat open, so she could relax and her cervix could open. This came naturally to her at first, but it became more difficult with each contraction. Over the next half hour, she went from moaning deeply with control to sobbing hysterically and nearly hyperventilating. I could guide her to get control of her breathing between contractions, but during contractions she was in so much pain that she was overwhelmed.
At 1:00, Dana announced that she was done. I reminded her that this was what happens in transition, when you’re almost ready to push – it’s the hardest part of labor but also the fastest. I knew Dana was ready to give up. I asked her if she’d like to get checked to see how dilated she was – because learning that you’re at the end of transition can be a great motivator to keep going.
Dana got checked; she was 7 centimeters and 80% effaced. She was discouraged and knew she was too overwhelmed and exhausted to continue to deal with the ever-increasing contractions. I asked if she could just take it one contraction at a time and see if she could get through three more, but she said no. I suggested she get on her hands and knees because that might help ease the pain in her back – no again. I asked, “What do you want to do?” Dana looked straight into my eyes and said clearly, “I want an epidural.” I smiled and said okay.
Heidi explained how the epidural would work, and told us that she had called the anesthesiologist but Dana still needed to get a bag of fluid through her IV first. So we still had quite a bit of coping to do. Dana was up for it – knowing that relief was on the way was really encouraging to her. Lisa came in to talk to Dana about the epidural too. Lisa assured Dana that accepting pain medication is not a failure; everyone’s labor is different and you never know how it’s going to be till you’re in the situation.
The next hour was very intense as we waited for the anesthesiologist, Dr. Miller, to arrive. He placed the epidural at 2:00 pm and by 2:15 Dana’s contractions were manageable. Finally she was able to get some much-needed rest. She felt disappointed that she got the epidural – she knew she couldn’t have kept going, but she wished that she could have.
At 3:20 pm, Dana’s cervical check showed that she was 8 cm dilated, 100% effaced, and the baby was at -1 station. Dana requested AROM to help speed things along, and when Lisa broke the bag of water we learned that there was thick meconium. Lisa explained that because of the meconium, they wouldn’t stimulate the baby immediately after birth; instead, they’d try to suction the meconium before the baby cried and possibly inhaled it.
"Thanks, Dad, for wearing your lucky shirt today!"
Another cervical check about an hour later revealed that Dana was almost completely dilated, and she was 100% effaced. At 4:30 Heidi explained that they wanted Dana to try to labor down as much as possible to get the baby lower without having to push as long.
At 5:05, Dana was complete and the baby was at +2 station.
We could see hair as soon as Dana started pushing. Heidi and Lisa explained how to push, and Dana did beautifully. She made it look so easy! I held one of her legs and Heidi held the other, and Ella was born in under 30 minutes.
Ella wasn’t too happy about all the suctioning, but she didn’t have to put up with it for very long. The nurses worked quickly, and in a few minutes Ella was ready to get weighed and measured. She was 21” long and weighed 7.2 pounds – so my guess was the closest! She was absolutely gorgeous, with beautiful long graceful fingers and long, thick eyelashes. I took some pictures and video of her first moments as her parents finally got to meet her.
I know Dana would like to have had a natural birth. I tried to help her understand that she was amazing for having worked so hard and gone through all that she did. She had never experienced anything as intense and painful as what she did that day – I hope she gives herself credit for that. And I hope she realizes that it takes a lot of strength to recognize that things aren’t going how you’ve planned and you’re going to have to do things differently from how you’d hoped. There’s definitely power in being able to accept that.
Doesn't that smile just melt your heart?
