Baby J’s birth

Baby J is something of a blizzard baby. They say the changes in air pressure that bring big storms also bring on labors. The day before my due date, we were slated to receive record breaking snow in the NYC area. The night before the storm, my wife and I talked about contingency plans for delivery as the mayor closed down mass transit and the two bridges standing between our house and our hospital in anticipation of the snow.

The snow was no where near what was feared, but it was enough to keep offices, schools and roads closed. The morning of the snow day, I paced the kitchen, cleaning as I went. I baked muffins, and made a big breakfast. All the while, I snapped at anyone who got in my way. When my wife asked me what was going on, I paused, looked at her, and whispered, “I think this is the start of my labor.” I had been having regular but painless contractions all morning.

After an afternoon of resting, the contractions eased up and eventually stopped. The next day, I sent my wife off to work and told her I would keep her posted. The contractions started again that afternoon, but I was afraid they would stop again and didn’t want to call my wife home from work for nothing. At around 3pm, I decided to write down when they were happening and take the dog for a walk to see if they eased up. Hey we’re coming every 20-30 minutes, and by the time I got back from the dog walk, they hurt. Not a lot, but they definitely hurt. I updated my wife but told her still there was no need to come home from work.

Around 5, I went to the bathroom, and saw bright red blood. It panicked me, so I called my wife and asked her to come home. I also called the OB, who told me this was totally normal but that I was probably going to have the baby soon. Soon is so vague, though.

When my wife got home, the contractions were still 15-20 minutes apart, so I figured we had ages to go. I asked her to take me to dinner, so we went to the local pub. I ate a pizza, and she ate a steak. I told her I thought we would sleep through the night and go to the hospital in the morning. She said she thought there was no way we were making it through the night, and that she had ordered the steak because it would stick with her while I was laboring.

We got home, and my wife read me a news article while I paced the kitchen. The contractions were painful enough by now that I couldn’t talk through them. When one started, I would slap the kitchen counter and she would time it. I was surprised to see that although the contractions were only about 30 seconds long, they were already about 4 or 5 minutes apart.

I decided to take a shower while she made arrangements for our oldest daughter to spend the night across the street and called her mom to pick up the dog. There was no way we were making it through the night.

After the shower, I called the OB on call. She wasn’t my favorite of the doctors in my group, but happened to be he one I went over my birth plan with. She said it was time for me to come in to the hospital.

When I arrived, they checked my cervix and found I was 4cm dilated and 70% effaced. I had to be on the fetal monitor for about 20 minutes, and lying in the bed to labor was agony. All I wanted to do was walk, walk, walk. They gave me the option of getting dressed again and walking downstairs, or getting admitted. They assured me that once I was admitted I could walk the halls, so I opted to get admitted.

When the nurse came to pick me up, she asked if I wanted the epidural right away. I told her I didn’t plan on an epidural and wanted to use other techniques for pain management, like walking and moving and taking a shower. She seemed really unnerved by this and told me I wouldn’t be able to walk because I had to be on the monitor continuously. I let her know that I had discussed with my doctor, and the doctor was ok with intermittent monitoring. I also let her know the doctor had okayed me skipping the IV and drinking fluids. The whole thing made her really nervous, and she said she had to put me on the monitor while she contacted my doctor to make sure.

My doctor okayed the intermittent monitoring (20 min on for every 2 hours off) and skipping the IV, but the nurse didn’t agree to give me any water — just those ice chips. I had the sense that she was kind of afraid of me and my “unusual” labor plans. It seemed like she had never assisted a woman in an unmedicated labor before. Once she took me off the monitor, which was more like 30-40 minutes after I was hooked up, not 20, she didn’t return for ages. My wife helped me through the contractions and we watched TV between them as a distraction. The contractions were 2-3 minutes apart, but still short — only about 30 to 45 seconds long. I would say the pain was probably the worst I had felt in my life, and they were so close together I could barely catch my breath before the next one would come.

The nurse came back and put me back on the monitor 2 hours later, and the contractions slowed to about every 3 or 3 1/2 minutes one I was back in the bed, but I felt totally unable to handle the pain lying in bed. This time I was on the monitor much longer. Just at the time I was scheduled to come off, the doctor had an emergency and I had to wait. Also, the monitor wasn’t picking up my contractions well, maybe because I was not still enough, or maybe because it was positioned poorly. Regardless, the nurse was under the impression that my labor was much slower than it was. I told her I was having more and stronger contractions than they were tracking, but it didn’t seem to matter. After a long while, the doctor came in. The pain was completely unbearable at this point. I asked her to check my cervix — I was certain I was almost done. She checked — and I was between 5 and 6 cm. By now it was after 3 am, so I had been laboring in the hospital for over 7 hours, and all I had to show for it was 1 1/2 cm. I asked the doctor to leave and I stood up, only to double over with another contraction. When it was over, I looked at my wife and told her I wanted the epidural.

She asked if I was sure, and said she could support me through an unmedicated labor if that’s what I wanted. She said I could try a little longer. But I told her I had done the math. With 4 1/2 cm to go, I didn’t think I could keep laboring as I had been for hours more and still push the baby out at the end of it. I sobbed on my wife’s shoulder and let go of my birth plan, and instead did what I thought was right for my body and my baby in that moment.

The epidural was as scary as I thought it would be. They made my wife leave the room, and the only person there to support me was the thoroughly unimpressive nurse. I was afraid the whole time. And then, they were done. The doctor explained that the goal was not numbness, but instead manageable pain — about a 3 on the scale. This way I could still feel the contractions and the urge to push. Of course, after 20 minutes, my right side could feel everything, and my left was numb. They had to turn the epi up to give me pain relief on the right, and then I could not feel a thing on the left. My left leg was a dead weight, belonging to someone else. I slept for an hour or so, and then the best possible thing happened. The nurses changed shifts.

Patricia, the completely competent Irish nurse came in to relieve the nurse who had been afraid of me. She grabbed my sheet and rolled me over, and said, “Let’s get this baby moving down!” She took charge in a way I totally appreciated. She seemed like she had actually been present for a birth before. After receiving the epidural, I progressed rapidly from 5 1/2, to 7, to 9, to 10, in a matter of 3 hours or so. My theory about this is that those short, close together contractions didn’t give me any time to relax my body in between – I was tensed up the whole time. The pain relief allowed me to relax, which allowed the contractions to do their job and allowed my cervix to open up. When I reached 10 cm, Patricia called the anesthesiologist in and instructed him to turn down my epidural to an 8 so I wouldn’t be in too much pain but could feel to push. He followed her orders. After a bit, I could feel the contractions coming again in waves. I was fully dilated for over an hour, but did not feel any urge to push.

The doctor came in and explained that I had been I labor so long (and fully dilated so long) that the baby’s heart rate was dropping periodically. She wanted to deliver it sooner rather than later, and advocated turning the epidural off completely. Patricia stepped in, and said, “Why doesn’t she try a push or two and see how it feels?” The doctor agreed, and I agreed and that was it. Suddenly I was having my baby. The doctor broke my water, then left to change her clothes and Patricia coached me through a push. After the first contraction, suddenly it was there. I was pushing this baby out, now. I could feel each contraction coming on before it hit, and with it a strong urge to push push push the baby out.

When the doctor came back in, in between contractions she said, “I read your birth plan. I know this isn’t what you wanted, and I’m sorry. But it will be great. I promise. Would you like to lift your baby out? Once his head and shoulders are clear, you can do the rest. Just reach down and hold below the arm pits while you push, and you can lift him right out and onto your belly.” This scared me. What if I dropped the baby, or hurt it? Why was she trusting me with something so important?

“Will you help me?” I asked. She said of course she would.

My wife said the birth of our baby was the most amazing thing she had ever seen. She said there were many fluids in all different colors, and she could see the hair on his head while he was still inside me. It was amazing for me too. I pushed for a half hour or so, and his head was born, then he pushed out his own little hand, waving to the world. He and I pushed his shoulders out together, and then it was me, holding him below his armpits while I pushed out his body and legs and feet, and lifted his slimy little body up onto mine.

In the end, I am so glad I had the epidural. Because I was not in pain, I got to deliver my own son. I wasn’t distracted from our first moments together while I was stitched up. My 9lb little boy gave me quite the tear, but I didn’t care. It’s ironic that I switched OBs over the epidural, and then ended up having one anyway. But it was my choice. None of my fears about the epidural came true — he was born calm and alert, and he nursed easily and right away. It didn’t lead to any other interventions — it may even have avoided them, if I had been too exhausted from labor to push him out without help. He wasn’t overly groggy and I didn’t have any side effects. I know that all of this could have gone differently, but it didn’t. It worked for us.