Birth Story Part I, In Which I Drink My Fourteenth Ounce of Castor Oil

Really. Total was fourteen ounces. I counted.

(Seriously, nearly a pint of castor oil. I retch a little just thinking about it.)

On the morning of my fourteenth day past my estimated due date, I wake up at five a.m. for what has actually developed into a routine: call midwife at 5:30, get the okay to start on the day's round of castor oil Horrible Julius, watch Sean make that orange juice-vanilla ice cream-castor oil shake, and chug it. The first two times, I was game, and not too terribly bothered by the nasty on the way down (though on the way out, it was the Grease of the Devil); this time, I am somewhat demoralized by these unsuccessful attempts to get labor going, and maybe that is why the stuff tastes a thousand times worse than last time (though, as I find later, it's not bad on the way out). I gag, reflux a bit, complain, but finally get it down, and try to go back to sleep. I can't.

About eleven that morning I take the second Horrible Julius, and our midwife Louise arrives with her student Nicole. I adore them both; they have very different energies. Nicole is gentle and calm, mellow, young. Louise feels enormous to me, the way my mother seemed gigantic when I was tiny. She is reassuring that way, and strong and very much in control. She brings a book of crossword puzzles, and Nicole has her quilting. We go upstairs, and I spread out a chux pad on the bed, lie down. Louise shows me the amnio hook. This home induction is my last chance at a homebirth, according to their protocols. The combination of castor oil and amniotomy has the best chance of working, since my cervix is very ripe and open 2 or 3 centimeters. Anyway, if we run out the clock after the amniotomy and the baby hasn't been born, I'd have had to be in the hospital anyway by then. There's nothing to lose.

The cervical stretching feels horrible, and I whimper unflatteringly. The procedure doesn't take long, though, and there's a gush of clear fluid with a faint pink tinge. No meconium.

"There's vernix in here," Louise points out. "That's good." It means the baby isn't dysmature, if there's still that much vernix around; it hasn't absorbed back into the baby's skin. "I feel baby hair, too -- lots of it."

"The pink is probably from your cervix," Nicole says. We go downstairs, to crosswords and quilting around the dining room table. We're moving in a week, and packed boxes are everywhere; there's nowhere to sit but right at the table. A bag of diapers rests atop a stack of boxes of baby paraphernalia. The only baby things we have accessible are a drawer full of clothing and blankets, and the changing pad. Everything else stays boxed.

I eat yogurt, a little rice pudding. The castor oil hasn't kicked in yet; this time on the last attempt, I was camped out on the toilet with the September issue of Lucky and a couple of In Touch magazines, which are fit only for toilet reading, but which are also perfect for that purpose, since they require only seconds of visual attention here and there. If you're going to be trapped on the can, you might as well read about Britney's layette.

My sister Gretchen and Louise are talking about Louise's daughter going back to school, and I have a contraction. I've had them before, but this one is notable in that it's considerably more painful than the more annoying uterine irritability I know from previous castor oil attempts, and in that it actually builds to a peak, then backs down (again, in contrast to irritability, which is just sort of nonstop).

I am thrilled, and announce it to the table: I had a real contraction! And it hurt! Louise laughs a little, tells me I have a good attitude about this. "You're welcoming the pain now, huh?"

"Hell yes I am," I tell her. "After all that castor oil. I'm ready to get this show on the road."

A few more contractions -- rise, peak, fall -- and I find myself spacing out, unable to pay attention to the conversation around me. I decide to move upstairs, although it's less of a decision than some deep mammal-brain imperative that sends me to my room, which is the only place in the house clean, quiet, and devoid of boxes. The contractions are coming regularly, all of a sudden; artificial rupture of membranes will do that, rocket you into labor, sometimes. No slow buildup here; I'm suddenly very much in labor. It's not so intense that I lose awareness; instead I am trying out different positions, the birth ball, that kind of thing. I move around, lie on my side, get on my hands and knees on the bed, which feels the best. I am uncomfortable but can't say exactly how, and I am still very much trying to think my way through labor: which position will help? How is the baby lying? How far am I dilated?

Louise and Nicole come upstairs, and Louise must see in how I'm moving that I'm having back labor. She places a big hand on the small of my back, pushes and kneads with the contraction. It feels wonderful, provides a counterpoint to the pain there -- it doesn't take the pain away, just gives me a way to deal with it. Nicole does a cervical check, at my request.

"About...three to four centimeters." Shit, I think. I ought to be farther along than that, after this many hours.

"And the baby is...LOP."

Here's where knowing a little about midwifery does me a disservice: I know LOP means the baby has turned posterior, after being transverse to slightly anterior during pregnancy. I suddenly understand why the counterpressure on my back feels so good, and why dilation is moving more slowly than I'd like. And I am very, very discouraged.

"How the hell did that happen?" I demand. I'm in enough pain that I've stopped being quite as polite. Nicole looks taken aback, and then apologetic. Louise jumps in: "It happens sometimes. The baby will turn." She reassures me about my progress; this is, after all, my first time. The baby's heart sounds good, and I'm obviously in active labor.

It must be obvious how discouraged I am, and that I'm hurting. Louise tells Sean he can go ahead and start filling the birth pool, since I'll be able to get in soon. I know they usually don't like women to get in the tub before they're about 5 centimeters dilated, and take this as a good sign: I'll be halfway there before too long. Louise disappears downstairs, leaving Nicole to monitor me and massage my back during contractions. Her hands are small and gentle, and I miss Louise's large strong hands; she pushes a lot harder, which helps with the pain. I consider demanding Louise's return, but instead ask Nicole to push harder. It's better than nothing, and I am still feeling the need to be pleasant to the people around me.

I try to get on the birth ball, but as soon as I'm on I feel an intense pain I can't pinpoint, low along my pelvis and eventually consolidating at the small of my back. "No no no," I say, and get back on the bed on my hands and knees. It is the only tolerable position right now; again, it doesn't make the pain stop, but it puts me in the best position to deal with it, to let it move through me, without tensing up. I try the pain coping techniques we learned in class: bring all my attention to my next outward breath. It's a momentary distraction, and in between contractions I have to keep reminding myself to do the breath awareness next time. Eventually I move beyond the ability to discuss the matter with myself, in my head, and just let the contractions barrel through me. It's not like I have a choice.

Downstairs, Gretchen and Louise are hanging out at the table. Periodically they hear a sound from upstairs; I must have started moaning through contractions at this point, though they're still tentative, somewhat self-conscious sounds. Louise tells Gretchen she's not going up there, this is Nicole's birth, she's the one in charge, she's the one learning.

Gretchen comes into the room and starts talking to Sean about the birth tub, which is, somehow, nearly full. For the first time I am intensely annoyed by full-volume discussion during a contraction, and I shout, "Shut up!" When the contraction ends I apologize; everyone laughs at me, tells me not to worry about it. I ask for another cervical check.

"Four centimeters," Nicole says. I ask the time; it's been another couple of hours. My brain says: one centimeter per hour, in active labor. I feel like I should be more dilated by now; I'm having a hard time dealing with the pain, and find myself in the only position that feels good any more: butt in the air, shoulders and head down. I know intellectually it's the worst possible position for someone making slow progress, but I can't bring myself to try other positions.

I wonder, now, if that wasn't some deep brain-stem protective attempt on my part. We figure out, much later, that Sophia's cord was short; that, combined with her posterior position, made it almost impossible for her head to be applied well to my cervix, which made progress so slow -- nothing was forcing the cervix open. Eventually the short cord proves slightly problematic in its own right, too.

Louise appears, coaches me into a side-lying position so I can rest a little bit. I've been awake since five a.m., and it's now late afternoon, early evening. It doesn't help at all. Or maybe it does; I pass out a little, I think, in between contractions. But during contractions I am consumed. Or I think I am, anyway. Later I realize how tolerable this pain was, by comparison.

"Well, why don't you go ahead and get in the tub," Louise says.

I want to ask if it isn't too early, but I don't care at this point, I'll take a longer labor if I can just tone down the pain a little. I hop into that tub fast enough to make a splash.

Part Two  Part Three  Part Four

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