I was due on October 11th, and while I knew that baby would come when he/she was ready, I was growing tired of working and waiting and having Braxton Hicks contractions…Read More
My labor began Super Bowl night with real contractions and spotting, into Monday morning. I called my doctor, and took an Uber into the city to visit with him. He said I was 3 cm dilated (I had been 2 cm for 2 weeks), station -1 and 80% effaced. He swept my membranes (the most painful thing ever) and off I went home to relax and wait for baby.
Tuesday rolled around and I was feeling very tired that morning. I decided to nap around noon, when I felt an intense kick/pop inside, got up from bed, and down gushed water. My husband was luckily home in anticipation of baby arriving, so he helped me clean up. I took my time, showered which felt so nice and even did my makeup! We then called my doctor, who told me to gather my things and eventually head to NYU. We decided to grab pizza on the way to store up some energy! Lots and lots of excitement through my contractions. The car ride was, surprisingly, a breeze.
We checked into the hospital and were really surprised by how BUSY they were. I was one of four laboring women in the waiting room alone! It was hours until they placed me in a triage room [admitting room before checking into a labor & delivery room]. Laboring in the halls and amongst strangers and visitors was not pleasant at all, but I managed to stay really calm and work on breathing techniques with David. Those massages you taught us in class really worked for me. :)
We presented our birth plan to our administering nurses, who kindly ran through the entire thing word for word and said they were on board. We later came to realize that your birth plan in a hospital setting kind of means nothing! There are so many nurses and doctors that sift in and out that all gets lost in translation. I think because my water broke there was this immediate need to convince me to dilate as soon as possible. I was only 4 cm dilated so my doctor wasn't happy. I kept sticking to my guns though, and kept kindly pushing off the pitocin.
They finally ushered us into a private laboring room and I breathed a sigh of relief. David and I continued to work on breathing, sitting on a birthing ball, and whatever felt good in the moment. My contractions kept intensifying and we found out through a vaginal exam that I was around 7cm dilated. My OB was still not satisfied that my contractions were 4-7 mins apart. They never got to 2 and 3 mins like he wanted. Again - pitocin. I told him to come back in an hour and if I wasn't making progress that I would agree. This was around 2 am (My water broke at 12:30 pm the day before).
The nurses gave me a pitocin drip and kept assuring me it was the slightest "hit" of it. I felt like a failure in that moment but I was also so determined to meet our baby.
A few more hours passed of laboring in bed stuck to my IV when my OB came in to check on me and saw that I was 9.5 cm dilated. I was in shock because, somehow, the entire time spent in the 58hospital flew by for me...time has never moved so fast. He said he would be back in 20 minutes and that we'd get ready to push. My adrenaline flooded in even more if that's possible. David and I were so excited it was hard to imagine meeting our baby so soon.
I was given some pushing coaching and as soon as I had my next contraction we started. I pushed for 1.5 hours and I have never felt more determined or worked so hard for something in my life. The beginning to me felt as if I was faced with climbing Mt. Everest - pushing baby out felt like an impossibility to me, but as we kept going and David and OB were cheering me on (which I didn't think I wanted AT ALL) I was given so much motivation to meet our son. David said he saw me enter another realm almost and that's kind of what it felt like. My mental state superseded any pain I was probably feeling. After some really gallant pushes, baby's head came out and then his body slipped out. It was the most exhilarating feeling of my life. Roman and I met heart-to-heart and he latched on almost immediately. We were parents! My entire 20-hour labor, Roman's heartbeat never dipped once - he was such a champ.
When I was riding those crazy contraction waves, I thought it was crazy that women would willingly put their bodies through such pain, over and over, but I would do it again in a heartbeat. :)
Next baby, I would definitely consider a home birth or at least a water birth...I'm so curious about it after birthing in a hospital. We had an overall great experience but David and I both agree that hospitals need to work on owing more empathy to their patients.
Roman was born 2/8 at 9:20 am, 7 lbs and 8 oz...right on his due date!
[Birth Matters NYC] class really did provide such an honest lense into what to expect, we felt ahead of the game, so thank you so much for that!
We arrived for ultrasound and NST on Monday, March 20th, at 9am. Yuli had the non-stress test first and it went very well. Then we had the ultrasound and the tech seemed a bit concerned and said she needed to show it to the doctor (which no one said at the ultrasound on Friday), which was concerning. We then overheard doctor Ashford telling Jo that fluid is low and it's an issue. Then he came in and nicely, but frighteningly, told us directly we should go now to triage and get ready to have an induction. Noah asked if we could speak to our midwife first. He said that’s fine, can I trust you to go upstairs after?Read More
My estimated due date of Saturday, April 1st, 2017 came and went. On the 3rd, I was 3 cm dilated and the midwife said she wouldn’t be surprised if she received a call that night from us saying I was in labor. That didn’t happen. All I did that day was have a non stress test and biological physical profile as I was now past 40 weeks. On the 6th, the midwife was surprised I hadn’t given birth and that I was still walking abound at 3 cm. She also told me that 1 midwife left the practice and that the doctor would be on call that weekend. That was disappointing, as I really wanted the midwife. She assured me that the doctor was a big supporter of natural birth so that I was in good hands.
Labor began on Friday, April 7th, 2017 around 10:30/11pm. Contractions were far apart but regular enough for us to know that it was finally happening! I did my nails for the fourth time as they kept chipping waiting for the arrival of Elijah. The contractions continued the next day, Saturday, April 8th, 2017 and started to get a lot stronger around 2 pm and Greg called my parents and sister to come over. They were going to go to the hospital with us and my dad was Greg, Simone (my doula) and my ride to the hospital. I was with them in the living room for a little while and my contractions started to go away/less painful. My family was distracting me too much so I went back into the bedroom with Greg and the contractions returned. Simone arrived around 3pm and said that my contractions weren’t consistent as of yet. My contractions rapidly got closer and between 6 and 7 pm they were lasting coming around every 4.5 minutes, lasting about 1.5 minutes for an hour. At that point, I decided that I wanted to leave for the hospital.
The ride to the hospital took a little over an hour. The unpaved streets of NYC were unkind! I was admitted into triage after 15 minutes of waiting in the waiting room. The vaginal exam revealed that I was 5cm dilated. That was enough to be admitted to labor and delivery, which required 4 cm dilation but not the birthing center, which required 6 cm. The staff wanted me to leave and walk around and return in an hour. That was something I was not even contemplating! But first, they did external monitoring for 20 continuous minutes. The device kept slipping so they had to restart the monitoring about 3 times. Then, I received an IV of fluids because the baby’s heartbeat wasn’t doing exactly what the doctor wanted it to do during the contractions. Around 1030ish pm, after the fluids were given, the heartbeat looked good enough for them and upon the second vaginal exam, I was 7 cm dilated. Off to the birthing center we went!
Loved the birthing center rooms. Got into the hot tub and it was AMAZING. The nurse did intermittent monitoring with her Doppler throughout the night. The doctor said that I could labor in any I wanted but for the birth I would have to be on my back due to estimated size of the baby (8 lbs 9 oz). I labored using the birthing stool for a short amount of time (uncomfortable), on the medicine ball, holding acupressure balls from Simone and the hot tub as aforementioned. My favorite position was lying on my side with my body pillow. I labored for a couple hours and when the doctor checked me, I was 9.5 cm dilated. Two hours later I was still 9.5 cm dilated and my water still hadn’t broken so she broke it using the hook. (At first she was just going to break it without me responding. Greg told her to wait and asked me if that is what I wanted). About 30 minutes later, the nurse and doctor returned and wanted me to start pushing with the contractions. The technique used was coached/directed pushing as opposed to spontaneous pushing. I had to wait for a contraction, hold my breath for 10 seconds and push. They wanted me to do this about 3-4 times per contraction. I generally had 2 good pushes in me; by the third one I could feel myself losing energy and forget about the fourth one! This part went on for a while with the baby’s head almost getting out but then returning to its position in the canal. The doctor wanted to take me to labor and delivery to give me Pitocin as my contractions started to get more spaced apart. I felt myself getting discouraged due to this and the fact that the doctor was saying I wasn’t progressing far enough fast enough. Nipple stimulation was performed by Greg making my contractions come back quicker and stronger and as time passed, I could feel the actual urge to push, which helped the process immensely. The doctor stretching my perineum felt worse than the actual pushing. Finally, the baby’s head came out and I found out later that it was a compound presentation. The baby’s hand was resting on his cheek when his head came out. Greg said that the doctor and nurse stated, "Ohhhhhhh” when they saw this, as if finally realizing why it was taking a little longer than they were used to.
It’s interesting that many of the comfort techniques I thought I would want during labor, I did not. I didn’t want people massaging my back, didn’t use the rebozo or the heat pack (which I liked to use during the uncomfortable moments in my pregnancy). The only comfort measure I used during my contractions was the acupressure balls and, during labor, squeezing Greg’s hand.
Having my parents, sister and doula with me were good. My sister held my hand when Greg needed to eat. They left and returned when I asked them. Simone (doula) was very supportive and helped Greg and me to make decisions.
We brought so many things with us which was okay by me as I'd rather have something and not use it than not have it and wish I did. The most useful was my body pillow and the straws. Not having the straws didn’t seem like a big deal but during those contractions and the different positions you are in, for me it made a huge difference not having to move to drink something. Great idea, Lisa!
Elijah was born April 9, 2017 and 4:55am. He was 8 lbs. 10 oz. and 22 inches long.
One of the smartest strategies for a healthy labor and birth for baby and mother is for a low-risk, healthy person to spend a lot of time laboring at home. How long, you ask? This will vary among individuals, as most things do, and will depend on whether or not the laborer is hoping to get the epidural or other pain meds. In general, I recommend laboring at home until the labor gains some good momentum. When this is done, we're strategically positioned for labor to progress in an optimal way because this momentum should help prevent labor from slowing down to an undesirable and unhelpful extent, which tends to happen as a simple result of leaving the safe space of our home and getting in that highly unpleasant car transfer. In general, this means staying at home until it's impossible to speak through contractions, contractions are lasting at least 1 minute and have been that way for over an hour. Let's go over the top reasons laboring at home is a wise idea.
1. First-time labors take plenty of time!
This 100% rocks the boat of everything we see in movies/tv, I know. So much of dramatized birth does, so let's get real here. Did you know that a first-time labor--from start to finish--usually takes an average of 18 hours? (You can read a more detailed breakdown of stage of labor with time estimates here, though it doesn't cover the pushing stage, which for first-time moms can take a while as well. You'll see there's a huge range of normal!)
Before you panic at this lengthy number and look for the quickest escape route, I want to point out that the vast majority of the time we spend in labor is the time spent in what we call "early" or 'latent" labor, which is the time when -- for the most part -- 1) the breaks in between contractions are much longer than the contractions (=the intense part), and 2) the contractions are quite manageable for most of early labor. It's also helpful to realize that, when you hear about the difference between, say, a 6-hour labor and a 26-hour labor, the difference can be attributed to the wide variability of time spent in early labor, when the sensations of labor are pretty manageable. Another factor is how early we notice: perhaps the 26-hour laborer just paid attention sooner than the 6-hour laborer. That 26-hour mama wanted the credit for all that hard work she and her baby did, and I don't blame her one bit! So, it's encouraging to point out that when we get into range of normal time ranges for active labor and beyond (read: when things get intense), the window of variable is much smaller.
Now that's we've established that there's no need to panic or rush when you think you're in labor, let's go over the good reasons to labor at home for a significant period of time:
2. Reduces chance of unnecessary intervention
The longer you can delay putting yourself on what tends to be a fairly arbitrary and impatient hospital "clock"--in which a cervix is expected to dilate at the rate of 1 cm an hour (unrealistic for organic and unique human beings)--the more wisely you position yourself strategically for avoiding unnecessary intervention. Unnecessary interventions are, logically, not healthy for anyone, tend to be unpleasant, and are more costly for you and/or our troubled U.S. healthcare system. There's something called the "Friedman's Curve" that propagates this trend. Read this article from Evidence Based Birth on how Friedman's Curve leads to unnecessary cesareans. Many hospitals -- particularly here in overpopulated NYC -- need to turn beds, too, which compounds the unfortunate sense of impatience.
3. Helps labor progress
In order for labor to progress in a healthy, unhindered fashion, we need to feel safe and have a sense of privacy. This is a physiological / hormonal fact that we go over in great detail in class. We tend to feel these things most readily in our home environment.
In Ina May's Guide to Childbirth, well-known midwife Ina May Gaskin details her hypothesis on the ways in which the cervix--while not technically a sphincter, as it would require having circular muscles to be defined as such--behaves similarly to our anal or vaginal sphincters, and how we need to be strategic toward helping the cervix to open effectively in labor. These points are:
- Sphincter muscles open more easily in a comfortable, intimate atmosphere where a woman feels safe.
- Sphincters do not respond to commands.
- The muscles are more likely to open if the woman feels positive about herself; where she feels inspired and enjoys the birth process.
- Sphincter muscles may suddenly close even if they have already dilated, if the woman feels threatened in any way.
So, because we do see these things occur in labor when a woman doesn't have a sense of privacy, this is another good argument for laboring at home.
4. No one telling you not to eat or drink
We know, we know, we know that it's an evidence-based course of action to eat and drink in labor. For heaven's sake, your body needs fuel for your indeterminate length! No marathon runner would ever not eat or drink for their whole marathon and be able to go the distance, and we know that labor is even harder work for the body. The main reason for restricting food and drink (known as "NPO" -- Latin "Nil per os" meaning "nothing by mouth") for so many years was mostly due to a very small risk of aspiration for anyone going under general anesthesia for a cesarean/surgical birth. This risk has gone down to almost nonexistent due to a) advances in anesthesia and b) the fact that it's rare for a pregnant parent to go under general for a cesarean. You can read the American Society of Anesthesiologists' November 2015 statement indicating laboring individuals should be allowed to have food in labor here. The other reason we commonly hear of withholding food and drink from the laboring woman is the risk that it will cause her to vomit. I believe a) most women will listen to their bodies and only eat when they don't think they'll be able to keep it down and b) if we miss that instinct and do eat and vomit, it actually can help labor progress and baby descend to a lower station, so we can cheer for progress if it happens a time or two! (I wouldn't recommend doing that in an exuberant way, though, partners, or you may get a swift kick to the groin.)
5. More flexibility for pain-coping techniques
You almost undoubtedly have more furniture, tools, food, and space to support you in comfort measures than you will at the hospital or birthing center. Immersion in a tub of water is called "nature's epidural" and can be powerfully effective for handling labor well before the water breaks; many hospitals don't have tubs available. The power and helpfulness of this and other tools you have more readily available at home cannot be underestimated, and can very often lead to reduced or eliminated need for pain medications.
6. “Safe” bacteria vs. “mean” bacteria
It's wise to minimize your exposure to the meaner bacteria that resides in the hospitals. Your body has built up antibodies against the meaner bacteria that exists in your home. Not so of the meaner bacteria in hospitals.
7. Save unnecessary trip(s) to hospital
The longer you labor at home, the less doubt there will be that you're in labor and the less likely it is you'll be sent home. You can skip the super un-fun experience of showing up a time or more and being sent right back home because you're not actually in labor or it's too early!
I repeat: First-time moms have plenty of time!
Just repeating that again for reinforcement...since the opposite (falsehood) is so ingrained in us through our westernized culture. Those stories you see in the news about people having babies in a cab/car, on a bridge, on the sidewalk are almost NEVER first-time moms! It drives me crazy that the news always omits this important detail.
This won't be an exhaustive list, and you will want to check with your care provider for your specific case, but here are a few:
- If you get to a point in your labor when you feel that you won't relax into labor until you're at your birth place, maybe you should go. This will a safer bet if you're with both a patient care provider, and one you fully trust to not pressure unnecessary use of technology (monitoring and the like) or medications.
- If you have a deep gut instinct that something is wrong, definitely listen and heed this instinct. The trick here is that we first-time parents tend to not know the vast range of normal so that we tend to get that wise instinct mixed up with simple fear of the unknown (but most likely healthy). This is where professional labor support (aka doula) can really help to normalize the scary and identify if there really is some reason to call your care provider or go to the hospital/birthing center sooner.
- Along similar lines, the last thing we want to do is to make any decision (including laboring at home longer than is right for you) based in fear. We want to make decisions based out of a place of peace, trust and love, whatever that means for you. Aligning yourself with a care provider and birth place in which you have a high level of trust and sense of calm -- specifically, in terms of not pushing unnecessary interventions or being impatient. This is critical toward reducing fear about unnecessary interventions. Aligning yourself with a measured, calm provider who trusts birth as a healthy, normal process also could mean that the laborer doesn't necessarily need to labor at home quite as long.
- There will be other exceptions in which it's not advisable to labor at home for long. A few of the more common examples: if your water breaks and a) you are GBS+ (in the U.S. they'll want you to get 2 minimum rounds of IV antibiotics spaced 4 hrs apart to reduce the very small risk of harm to the baby), b) there are specks in the fluid, or c) if the fluid had a foul odor. Any of these would be indications to head to the hospital. Your care provider should give you a heads up in advance about anything that would be an indication to come to the hospital. You can always call your care provider to ask if you're unsure in the moment.
Okay, but HOW do I labor at home patiently?
"How in the world will I confidently labor at home as long as possible," you might ask, "when I've never done this before and every little thing seems scary?" I totally get it as I've been in your shoes! Let's talk specific strategies as we wrap things up.
- Ignore it (until you can't). Are you serious? Yes. Of course, ignoring labor is often easier said than done, but at first the contractions will be fairly mild (unless you ignored it and didn't realize it, which is pretty ideal!). You can plan ahead some "early labor activities" to have at the ready when the big day comes to help take your mind off labor. Make a list of half restful, half active things to do. Think along the lines of the more "normal" pastimes/hobbies -- i.e. things you like to do on the weekends or in your free time -- and prepare whatever items you'll need to have on hand for this. I will write a post on this in the near future, but here are just a few examples: taking a walk, walking the dog, some gentle yoga or exercise, making out or having sex if you're in the mood and waters haven't broken, cooking, baking (take treats for the nurses!), watching tv/movies (comedy would my top recommendation to promote oxytocin/endorphins, both of which help labor progress), etc. Oh, and if you wake in the middle of the night and think you're in labor, I highly recommend not waking your partner (if applicable). That's the quick route to not ignoring labor. Instead, do everything you can to go back to sleep--while you can!
- Build trust in and educate yourself on the process and the wide range of normal by taking birth classes (if you are in NYC, check out my birth classes!), reading or listening to positive birth stories (please note this podcast includes all kinds of birth stories, so judge for yourself based on the title whether or not it might build trust and calm for you). I also have several positive birth stories on my blog, so check those out (a couple of examples are here, here and here). Please note: "Dr. Google" is not your friend and will not build trust/calm for you! Find the trustworthy and evidence-based online resources and only refer to those.
- Consider hiring a doula, who can normalize the process, help you relax and boost the labor-promoting hormone, oxytocin, help you successfully surrender to the good work your body and your baby are doing toward birth, and ultimately labor at home much longer (read here to see the many more reasons this is a good idea!). A very smart investment toward a healthy birth.
Remember that you'll always be able to, if it helps you feel calmer laboring at home, interface with your care provider periodically. They'll probably appreciate having a heads up that you're in early labor. They will also appreciate that they don't need to come to the hospital or birthing center as early and should be happy to support you by phone to some extent. And, if they say to come to the hospital or birthing center before you feel ready--and in the absence of some legitimate medical reason to do so--you can simply say, "Thanks, but I think I'll stay home a bit longer." Your body, your baby, your call!
Patience, my friend. You can do this!