41 HOURS OR LABOR SPECIAL “ADDITION”
I shouldn’t have been surprised when December 3rd came and went with no sign of labor—I knew the statistics about passing your due date for a first-time pregnancy. But that didn’t make me any less anxious. Every day seemed to last for years, and I religiously employed some of the tricks I’d heard of: walking, spicy food, pineapple, dates… even nipple stimulation. And yet, nothing. This baby was clearly trying to remind me that it had its own sense of timing (perhaps inherited from its perpetually-tardy father?)
At our 40-and-a-half week check-up with the midwives, I was actually eagerly looking forward to the uncomfortable cervical exam, because at least then I would know how I was progressing. At 36 weeks, I had been 40% effaced and about 1/2 centimeter dilated. Typically, most women need their cervix to efface (or “thin”) to 100% before they truly begin dilating (or “opening”). Delivery is usually imminent when you reach 10 centimeters of dilation. I thought surely a month after that first check that I should be moving quickly towards that progress, right? Wrong. I was barely 50% effaced and just 1 centimeter dilated. When Esther told me this, I pretty much broke down on the spot.
As if that wasn’t enough of a defeating feeling, I’d had an extraordinarily high blood pressure reading when I first came in. It was retaken just moments later and came out normal, but they felt they couldn’t let me leave the hospital with even one reading that high, so I was shipped off to the obstetrical emergency department for observation.
We spent four hours in the OB ED. I sat on the world’s most uncomfortable gurney while a blood pressure cuff inflated every 15 minutes and monitors attached to my belly reported the baby’s heart rate. A very friendly but totally bumbling lab tech came to draw blood and managed to mangle not just one, but both of my arms (and he had to come back later to prick my finger for more blood because the sample had gotten messed up somehow). Needless to say, I was in a mood. We were finally released when I had sufficiently proven that I wasn’t afflicted with preeclampsia or gestational hypertension, and that the reading was just a flukey product of my anxiety about being overdue.
The next day, I dedicated myself to relaxation. I had promised the midwives I would stop stressing out about bringing on labor and trust my body to do the work it needed to do. It was a productive day of eating snacks and watching Netflix, and I felt a bit of peace wash over me. I went to bed around midnight that night, with plans to spend the next day doing some fun baking projects and walking the dogs. I awoke just two hours later with a twinge in my lower belly, and I was so thrilled to realize that labor might be starting. In reality, I had no idea of the journey I was about to embark on.
HURRY UP AND WAIT
I spent the first five hours of my early labor in a Zen state. I couldn’t sleep through the cramping, but it was far apart and inconsistent, so I headed out to the living room so as not to disturb my husband, John. I wanted him well-rested if labor was starting in earnest. I laid on the couch and stared up at our Christmas tree. I took deep, restorative breaths and repeated mantras like, “My body was built to do this” and “Every contraction gets me closer to meeting my child.” It wasn’t comfortable of course, but it was manageable. I was feeling strong and motivated and, dare I say, excited.
I woke John up at 7:30 a.m. to let him know that I was pretty sure today was the day. I asked him to get us some bagels so I could fuel up for the marathon ahead. I was in good spirits and the house felt abuzz with anticipation. Around noon, I tried to lay down for a short nap, as I was focused on giving my body ample rest and energy for labor. Just an hour later, I was awoken by a contraction that doubled me over. It was suddenly clear to me that we were in new territory now. While still far apart, the contractions were ramping up in intensity with each passing wave. I shoveled the remains of a salad from Lebanon’s (protein and fiber, can’t go wrong—right?) into my mouth and went over our plans for labor with John. Every time I felt a contraction approaching, he kicked into coach mode and clocked the length of each wave and helped me focus on my breathing.
As the afternoon wore on, I became less talkative and more introspective. We knew this would happen, so we just shifted our mode and worked to find a new rhythm. I alternated between bouncing on my yoga ball and rocking on all fours, and John started his looped script of “You’re doing amazing,” “One contraction at a time,” and “You’ve got this.” By 7 p.m. or so, my contractions were four or fewer minutes apart, lasting at least one minute long and had been consistent for nearly two hours. This meets the criteria for “4-1-1” that we had been told was the signal to go to the hospital, because you were now in “active” labor (which is typically indicated by a cervical dilation of 5 to 6 centimeters).
We got to the hospital and were excited to check in. Esther was the midwife on call that night and she came in to check me in between contractions. To our utter dismay and disappointment, I was barely 2 centimeters dilated and just 80% effaced. We couldn’t believe I had been laboring for 17 hours with so little to show for it. Dejectedly, we made our way home to continue the long process of waiting for something to come from all the pain and discomfort I was feeling. We would spend the next three-and-a-half hours working through labor at home.
I sat in the tub for a bit as contractions crashed into me every two to three minutes. My back had been hurting all day, but at this point it was getting nearly unbearable. John tried to apply counter-pressure during contractions, but even that did nothing to alleviate the wrenching, searing pain that had curled up in my lower back and wouldn’t budge. I felt a wave of nausea and ran to the bathroom, barely making it to the sink before I started vomiting. I knew things were getting serious now, so we searched our minds for other natural methods of pain relief. John suggested I get in the shower and he could point the sprayer at my lower back on high heat. When I stood up to head to the bathroom, though, I felt a horrible gush. I was sure my water had broken, which—while startling—could only be a good sign that labor was speeding up!
Unfortunately, I quickly discovered that what I thought was amniotic fluid was in fact just blood. So. Much. Blood. I stumbled into the shower and figured this was just the “bloody show” I was waiting for. Another good sign that labor was picking up some steam, right? Well, when John re-entered the room and saw me standing in the shower, the look on his face told me that maybe this wasn’t normal after all. I looked at him, looking slightly bewilderedly at me, and then looked down to see blood pouring profusely down my legs and coating the floor of the tub. He called the midwife, who told us to calmly make our way back to the hospital, that it was probably just fine and it was likely not as much blood as we thought it was.
On the ride back to the hospital, I continued to bleed heavily and began shaking so violently my teeth chattered audibly. Back in the triage room, Esther worked to calm our clearly rattled selves and assured us that while this was “on the heavy side” of bloody show, it was nothing to be alarmed by. She checked me and I was fully effaced and at 5 centimeters. Active labor was finally here—22 hours after I had my first contraction.
[pullquote]The baby’s head was descending down my spinal column, placing excruciating pressure on my sacrum. It’s known as “back labor” and is pretty much the monster under the bed for all pregnant women.[/pullquote]
OFF THE RAILS
We were finally going to be admitted! I was in terrible pain, but I felt like the end was maybe in sight now. Then Esther broke the bad news to us. The hospital was full of laboring women and there weren’t enough nurses to go around. The beautiful, spacious suites of the Alternative Birthing Center that I had worked so incredibly hard to stay qualified to birth in weren’t available. And the two rooms on the regular labor and delivery floor that were equipped with birthing tubs had already been given to other midwife patients. In fact, there was only one room left at all.
I was heartbroken, but what choice did we have? We took the room and it’s a good thing we did, as John ran into another laboring woman shortly thereafter, doubled over in the breezeway suffering from a painful contraction. We would later find out that she spent four hours laboring on that awful triage room gurney, just waiting for a labor room to open up.
Esther introduced us to our nurse Julie, who helped me make it down the hall from triage to our labor room. Blood was running down my legs and I was insanely embarrassed, but she sweetly reassured me as she wiped me down with a warm cloth. When we got into the room, she turned off the lights and got me situated in a chair. As she was helping me out of my bloody clothes, a wave of nausea hit me like a brick in the face. I barely had a moment to alert her and my husband of the impending explosion, but they managed to get a bucket in front of me in time to catch the flood of leftover salad that came spewing out of me with terrifying force. I cried and apologized, because that’s what I do when I vomit (I’ve done it since I was a child, you can ask my mom). Once I recovered, Julie suggested we go to the shower and try to clean up a bit and see if some hot water on my back would help alleviate some of the pain.
John rolled up his pants legs, looking like a character out of Huck Finn, and stood in the shower, pointing the wand at my back. The unstoppable chills came back and my body tremored head to toe while my back spasmed and seized and I sobbed some variation of “Oh my God, I am dying” on repeat for 45 minutes. John, like the champ that he is, just kept telling me how amazing I was doing. I never got mad at him, but I did get pleading and desperate. It will likely go down as my least proud moment ever, but I might have asked him to kill me more than once during this period. At the time, it really seemed like the better alternative.
Esther came back in to find me wallowing in my misery and being decidedly un-Zen about the whole thing. She wanted to check me and I was convinced I would be 7 to 8 centimeters, as surely the last four hours had been part of the “transition” phase (often known as the worst and most trying stage of labor). To my disgust, I was barely 6 centimeters. In four hours of horrifyingly hard labor, I had progressed literally one silly centimeter. I felt like someone had kicked all my teeth in. To know that I hadn’t even gotten to the “bad” part of labor yet was one of the last straws. But the final one came when she confirmed my worst fear—the baby was “sunny side up” or OP (short for occiput posterior). This means that the baby’s head was descending down my spinal column, placing excruciating pressure on my sacrum. It’s known as “back labor” and is pretty much the monster under the bed for all pregnant women.
My mom had 13 hours of back labor with me (and never let me forget it!) and every story I’d ever heard of a woman laboring with the baby in this position was a horror show. When I realized that I’d endured 26 hours of this and was nowhere near the end, I had a come-to-Jesus talk with myself. I was disgusted and ashamed and crestfallen, but I had to be honest. I couldn’t do this anymore. I needed drugs and I needed them now. John pressed multiple times (as I had asked him to do) to make sure it was really what I wanted. Through sobs, with my head hung to my chest, I said “I can’t do it. I just can’t do it. I’m not strong enough. Please help me.” All my plans and dreams of an unmedicated birth went out the window and with it, some sense of my worth as a woman and a mother went too.
They made John leave the room while they put the epidural in. I apologized profusely to the anesthesiologist the whole time, as I battled the dueling factors of painful back contractions and sobs of disappointment. Julie let me hold her hand as she swept the hair out of my eyes and reassured me that I had put up a valiant fight and I had nothing to be ashamed of in asking for help. She reminded me so much of my mom (who is also a nurse) that in that moment, I leaned my face into her hand and let the tears fall freely.
I had been warned so much about how epidurals can go wrong and leave you with permanent back pain or searing spinal headaches. It’s a precise procedure and I can see how, with a practitioner who was rushed or sloppy, it could go wrong. I was lucky that the amazing doctor who put mine in was thorough and exacting, and took her time to do it right. While this slow placement was beneficial for me, it nearly killed John, who spent an hour exiled to the waiting room, racked with worry and fear.
Once it was all said and done, he was allowed back in and we both settled down in an attempt to get some rest. Numbness crawled up my legs and my mind swirled with a combination of relief and shame. At this point, it was about 5 a.m. We watched out the window as a light sleet began to fall on the city.
About an hour later, Esther came to check on me and informed me that unfortunately, the epidural had slowed my contractions down and they were now about seven minutes apart. Our next step was to augment the contractions with a drip of synthetic oxytocin, known as pitocin. I knew it was unavoidable, but it felt like yet another tick in the “Things You Have Failed At” column.
At 7 a.m., the midwives rolled over shifts and Esther bid us farewell and good luck as she handed us off to Cathy. If Esther is the soft-spoken mother of the bunch, Cathy is the sharp-tongued aunt. Her dry sense of humor endeared her to us during our prenatal care and she injected a bit of needed levity into the room, which no doubt stunk of pathos at that point.
The next 12 hours crawled like molasses rolling uphill. Running on two hours of sleep in two days, both John and I dipped in and out of consciousness throughout the day. And while I wasn’t feeling the full pain of my contractions, I wasn’t exactly in high spirits either. I was frustrated, tired, and grappling with a pervasive sense of guilt for having given up on my birth plan.
Around lunch, Cathy came to check on me and informed me that I was 7 to 8 centimeters and still progressing slowly. They continued to slowly but steadily increase the pitocin, hoping to move me towards 10 centimeters at a faster clip. The more pitocin that entered my system, the more uncomfortable I became. But I knew that if and when my water broke, the clock would start ticking. If I couldn’t deliver naturally within 24 hours of my membranes rupturing, I would land myself a ticket on the c-section express.
[pullquote]I stammered and then looked down to see this squirming little purple thing. I grabbed it by the shoulders and, as I tugged, suddenly felt the eerie sensation of emptiness in my belly.[/pullquote]
By mid-afternoon, I had finally reached 10 centimeters. In my mind, this meant it was time to push, but Cathy had other ideas. She could see how far the baby still had to travel and she was very honest with me that at this rate, it could mean 5 to 6 hours of pushing. And she frankly stated that my body simply wasn’t strong enough (what with the sleep deprivation and lack of food) to pull that off. The likely end of that scenario was also a c-section. So she urged me to be patient. She left me for two hours and said to relax and let the baby descend on its own.
The pressure was nearly unbearable and the pitocin contractions were bleeding through, even with the epidural in place. There was a button I could push as often as every 10 minutes to re-up the epidural’s strength, but I hesitated to use it. I felt like if I didn’t push that button, I somehow wouldn’t have failed quite as hard. But as the afternoon wore on, even that fell by the wayside.
Just before 5 p.m., the anesthesiologist came to check on me and found me in tears. I tried to insist that I was just emotionally exhausted, but he saw through that lie pretty quickly. He offered me some options and I chose a little boost of lidocaine for numbing, but requested that we avoid narcotics at all costs. The additional numbness took the edge off the insane pressure that was building as the baby descended and I was able to relax enough to get us to the big moment.
When Cathy returned around 5:30 p.m., she suggested that we break my bag of waters, since it seemed intent on not bursting on its own. Once that was done, I was sure it would be time to push. But she said that she felt inclined to give me one more hour of allowing the baby to move down on its own. I begged her not to leave and she acquiesced and let me try two sets of test pushes during the next contractions. Impressed with my resolve and ability to push the baby down, she suited up and we began the hard work of finally expelling my child from my body, 39 hours after labor had first begun.
At first, it was just me, John, Cathy, and the day nurse Pamela. But as the hours wore on, shift change approached and we were joined by some new faces. Our circle of support expanded to include Elizabeth and Casey, the night nurses, as well as Lindsay, who would be the baby’s nurse upon delivery. With each contraction, they all gathered around me in a semi-circle, encouraging me to push through the pressure and to breathe into every inch of my body and direct my baby out into the world. Cathy promised to coach me on when to let off the gas to minimize tearing, and I threw myself—body and soul—into the task of delivery.
I had been told that women who get epidurals “don’t even feel” childbirth. That, for me at least, was a total lie. I felt my baby moving with every push. And when it came time for the big moment, I felt the features of my baby’s face emerging from my body. So the next time someone tells you that pain medication takes a mother out of delivery entirely, you can tell them this story.
I felt my child’s head as it crowned and perhaps the angriest moment of the entire labor happened then. Cathy encouraged John to come look at his child as it emerged from my body, and I screamed “NO!” in the most forceful tone imaginable.
We had long ago discussed that when the time came for us to have children, I did not want him to go below my waist during delivery. It’s a hangup I have and he agreed to humor me. I’m not sure if he would’ve wanted to see it or not, but he didn’t budge. Cathy apologized profusely for riling me up, but at that point I was so focused on finishing delivery that I was already over it.
I was staring past everyone at a spot on the wall with laserlike focus and breathing through a push when I heard, “Erin, reach down and take your baby.” I stammered and then looked down to see this squirming little purple thing. I grabbed it by the shoulders and, as I tugged, suddenly felt the eerie sensation of emptiness in my belly. I knew they would take the baby because the umbilical cord had been wrapped around its neck. Cathy made quick work of unlooping the cord and clamping it to be cut. I quickly spit out, “Is it a boy or a girl?” to which Cathy replied “I don’t know, dad. Why don’t you lift up the cord and see?” She raised the cord slightly and we peered down to see a wee little set of boy parts.
The look on John’s face in that moment is something I will not forget for the rest of my life. I think we had all been somewhat subconsciously convinced that we were having a girl. Most of our family thought so. Most of our friends thought so. The arrival of this little boy was a true and genuine surprise the likes of which we probably won’t see again. And while I know he would have loved a daughter just as much, there was something special about him realizing he now had a son—an heir—someone to carry on the Guidry name.
They whisked the baby away to the waiting arms of Lindsay and the warmer, and within seconds, the air was pierced with a fierce battle cry. As it turns out, our little boy had quite a robust set of lungs. They placed him back in my arms and I held him, skin-to-skin, as Cathy worked to deliver the placenta. I noticed that everyone seemed to be moving with intense purpose, but it wasn’t until later that I put together why: I was hemorrhaging. John kept his cool and focused on the baby and me while the team worked quickly to get the situation under control. Thankfully, after losing over a liter of blood, they were able to do so.
Once the excitement of the moment had passed, we were left alone for an hour of family bonding. We held our little boy and laughed at the fact that we had never really settled on a boy name because we just assumed it would be a girl. We always knew his middle name would be Henry—a nod to my maternal grandfather, who I lost when I was 15—but his first name was up for debate. We had circled around a few names in the weeks before and in that moment, looking into those gigantic blue eyes, we knew who he was—who he was always supposed to be. He was our little Emmett. And with that, Emmett Henry Guidry entered our lives, changing them forever.
WOMEN SUPPORTING WOMEN
Nothing had gone like we wanted it to. Despite holding a healthy, happy baby in my arms, I remained humiliated and disappointed in myself. I felt I had given up too soon. I felt I had gotten too deep into the pain in my own head and not let my husband do his job as a coach. I was angry that, despite all my hard work to stay qualified for birthing in the Alternative Birthing Center, a simple lack of staff on a busy night had landed me in a regular room with nothing but a crappy shower and an uncomfortable bed. But then I thought about Julie and the tenderness with which she had cared for us in those hard, dark hours. It was hard to stay angry.
I had read (and been told, endlessly) that care in hospitals was spotty. That nurses could be disaffected and rude. That you might end up with someone who wanted to rush your labor and didn’t care to give your body time to do its job. They would gleefully force you into a c-section just to save time. And I’m sure that happens to many women in many hospitals, but it did not happen to me. In fact, I found such great strength and support in the nurses (and midwives) who surrounded us throughout our grueling ordeal that I couldn’t help but be thankful for their presence.
We made a list of everyone we had interacted with during our labor, delivery, and recovery, and something struck me. Barring the aforementioned anesthesiologist and bumbling lab tech, every single person involved in our care had been female. From the midwives and nurses to the pediatricians and lactation consultants, there was a powerful feminine energy permeating every aspect of our experience. And each and every one of them had treated me with gentleness, kindness, and encouragement.
I had been prepared for the “hospital” experience to be poisonous and clinical, and I was doing my best to avoid as much of it as I could. But I found that, in the end, the community of support that is so vital to successful childbirth was thriving within those walls. Having a baby is a very personal experience, but if you’re having one here in New Orleans, the only thing I will say is that you can’t lose going with Ochsner Baptist.
I’ll be the first to admit that my recovery has not been the easiest. My body suffered some pretty massive blows during the 41 hour marathon of delivery, and the blood loss I sustained pretty much turned me into a limp dishrag for the days following. By and large, Emmett is a good baby, but even good babies cry. Even good babies only sleep for an hour at a time at night, even after you spend an hour-and-a-half nursing and soothing them. Sleep deprivation is real and breastfeeding is not the “natural,” beautiful, intrinsic thing it’s made out to be.
So on we push, into the great unknown. This experience has been unlike anything else I’ve been through in my 33 years of life. My appreciation for my own mother has increased tenfold, and just when I thought I couldn’t love my husband more, I’m finding new depths to my adoration of him on a daily basis. I would be lying if I said I’m totally at peace with how my delivery went. I’m still carrying feelings of guilt and inadequacy, but I also know that they will pass with time. I will mourn the loss of the birth I wanted, and accept the reality of the birth I got. Because life as a mother is nothing if not unpredictable, right?
ERIN HALL | firstname.lastname@example.org
photos ADRIENNE BATTISTELLA; illustration VICTORIA ALLEN