Part Three, In Which I Lose My Shit Entirely, and Have a Baby

Part One  Part Two

Around 4:30 a.m. on August 23, it is determined that I am ready to start pushing. I still have a cervical lip, which I am going to need to push out of the way, and I am utterly exhausted.

I push, as well as I can, with each contraction, though I don't feel the urge to do so. I have to be told. It's hard to figure out how to push, when your body isn't telling you what to do, and when that baby's head isn't in a great place to help your body figure it out. I try a few on my own, with coaching, and then one of the midwives, don't remember who, tells me she's going to try to help me push past the cervical lip.

All the pain of an exam combined with all the pain of a contraction combined with some new level of pain -- I scream for real, now, loud. I scream for whoever is doing it to stop, and I mean it. I'm not asking, at this point. She stops, tells me she knows it hurts, she's sorry. I'm going to have to push past that lip somehow, but how, I don't know, and don't especially care. I am still hoping for deliverance via surgery, though it is becoming increasingly clear that there is no reason to do the surgery, now.

My contractions have petered out a bit, rendering my halfhearted attempts at pushing completely ineffective, and the midwives let me hang out for a while, but when the contractions do not seem to return, and since the baby situation is what it is (stable, but needing close observation), Louise and Nicole C. decide that "a whiff" of pitocin, as Louise puts it, should be used. A few days later, Louise explains the tremendous amount of force required to push a baby out -- more than 50 psi, more pressure than you'd inflate your car tires. Some of that comes from the mother pushing, but a lot of it has to come from the uterus itself, and if the uterus isn't supplying the pressure, you can push until you collapse and make very little progress.

I complain mightily about the pit making things worse, and Louise points out (rightly, I find out) that at this point contractions are as painful as they're going to get, and pitocin will only make them come more frequently, and as much as that sucks, it's necessary to get the baby out. "You're very close to having your baby -- your real baby. You can do this. You're almost there," Louise tells me, again and again.

But I'm not almost there, or at least it doesn't seem that way to me. The cervical lip is proving problematic, the baby is still posterior, the cord is short; things are tough. I endure a few contractions with hands inside me, working on holding back that lip; this is unutterably painful, and I scream each time, and can't get organized to push. I am lying back at a 45 degree angle, still, and beg to try a few pushes squatting, "no fingers, please, please." The midwives consent, largely to humor me, since they know this position and technique won't be as effective. By now, I am hollering with each push, making sounds I can't replicate later, screaming wordlessly at the top of my lungs. I am worn down. "I can't do this anymore," I say. "Nothing's happening, and with the pitocin I don't get a break, I don't get a break between contractions, they don't stop! I want to stop. I don't want to do this anymore. Turn off the pitocin, I want to try without it."

I can't see that far, but I sense Nicole C. and Louise exchanging a look over my head. "Okay, we'll turn it off," Nicole C. says, and reaches over to the IV bag. Sean tells me later that they turn it back on, a few minutes later, without my noticing, and really at that point I don't feel the difference. I don't get anywhere with my pushing, though, and break down weeping, finally. "I'm going to lose my shit, Louise," I say. Strangely this is the first time (and really the last) I've sworn during labor; the strongest language I use otherwise is when I shout "Jesus Gay! in frustration, shortly thereafter. Sean reminds me: you don't have to hold back, you can say whatever you want. But my ordinary sailor-mouth seems so inadequate to the situation, so I end up not swearing much at all.

Louise is exhausted too, by this point. Progress is slow and uncertain; that cervical lip is still there, and I am exhausted, used up. "We're going to leave you and Sean alone for fifteen minutes. You talk about it and figure out what you want to do, whether you want to keep going, or whether you want an epidural and a cesarean. Whatever you decide to do is what we'll do. If you decide to keep going, though, I know you can do it. You can. But you talk about it and decide," she says. And then adds: "You'll have your baby by 7:15. If you haven't had your baby by that point, we'll have the anesthesiologist and the OR ready." A few days later, she describes this as "c-section for midwife distress," which I find hilarious, and perfectly apt.

Leaving, she tells me: "This is not the hardest thing you will ever do for this baby." I think about that, constantly, still.

The room clears, and Sean and I are alone. I am whimpering, still, and he looks exhausted, teary, but full of love. I am aware enough, then, to be amazed by his constant support, his refusal to cave to tiredness, fear, frustration. He asks me what I want to do.

"What I want to do is have the c-section," I whine. "But I feel like I have to keep going. I know it's better, but I don't want to do it. But I'm going to." It's important to get the tone right: whiny toddler, maybe. I am not accepting my duty stoically; I am complaining all the way, proceeding with much resistance. But proceeding, nonetheless. I am not what you would call gracious.

Our fifteen minutes is up, and the room fills again, slowly. I announce my intentions, and after that point the pit really starts doing its job, though I don't think they turn it up; maybe I finally allow it to work, allow my body to do what it has to. I am pushing seriously now, and in a variety of positions: semi-sitting, occasionally squatting, at one point lying with my upper body below my hips, knees to chest, all to get past that lip. Usually I am lying back with my legs pushed up to my shoulders, Louise at one side, Sean and sometimes Nicole at the other, with Nicole C. between my legs. I am holding onto the bedrails; someone removes the pulse oximeter, since it keeps falling off anyway. The next day I will have a tremendous bruise where the hep lock was. I hurt beyond pain at this point, it fills me, it doesn't stop, because the baby is finally moving down, a little at a time, and I can't unstretch. I push according to coaching, since I never feel the urge.

The crowd of hospital staff at the foot of the bed, largely invisible to me since they're out of my visual range and since the room is dim except for the spotlight on my vagina, shouts encouragement in that most cliched of ways we all know from TV: "Push! Pushpushpushpushpush!" It's funny, I always thought that would drive me crazy, but I am kind of liking having a cheering section, though one nurse says, "Get mad! Get mad and push that baby out!" which is something I've always loathed, but at the time I find it funny. I would like to roll my eyes.

With each push, two or three per contraction, my legs are pushed back hard against my shoulders by my attendants, and I push back against them, though I would rather relax there, it would help things move along. At the same time I hold the bed rails and pull, pull, so hard that the next day, I have broken blood vessels and tiny bruises speckling my arms and chest. I tuck my chin, and make a sound like a roar. I push like I'm taking the world's biggest dump; at one point I'm sure I'm crapping on the table, but I'm told that I'm not. Later I figure out that what I felt was numerous hemorrhoids popping out. (They go down surprisingly fast, afterward.) I pee all over the table, several times, and don't care at all. Louise grabs my thigh, my butt, jiggles: "Loosen up here, relax here. Push here," with fingers in my vagina. "Push down and around that pubic bone. Down and around. That's it, that's the push. That's the way." I still can't figure out how to do that, but the jiggling helps, and I loosen the right muscles.

Between contractions I ask pitifully for ice chips, just to keep my mouth wet.

I cannot believe the effort required to move this baby, and it only intensifies. The baby is still posterior, and the midwife will have to turn the baby; Nicole C. hesitates, isn't quite sure what to do. All the while Louise is teaching her, explaining a few techniques Nicole C. doesn't know, talking her through it, I think even putting her hands down there. At one point someone applies suprapubic pressure to move the baby, after NIcole C. manipulates the baby to rotate the head and shoulders. This part, this pushing with two hands inside me, this is the part that blows my mind, that I cannot do justice. I can't explain how it feels. I can tell you that I tear and don't feel a thing, that I scream until I am hoarse and breathless and that is the only thing I can do. I can't even move away from the pain, it is that enormous. And by now there is a head moving into my vagina. It feels like a fucking cinderblock: hard, heavy, solid. Immovable, almost angular. The pressure is constant, it doesn't recede between contractions.

Once the head begins to move down like that, I don't need to be told to push; I have to, even though the urge is more intellectual than physical. I realize that even if I wanted a c-section, it's far too late now; I'm in this good, and for the first time (as impossible as this seems) I understand that there is no way out of this but through. This is freeing. I push again. Sean tells me later that I look like the Incredible Hulk, putting forth superhuman effort; in between, though, I still whimper, "Ice chip, ice
chip."

Finally the baby's head is crowning. Louise tells me to reach down, reach down and touch my baby, my real actual baby, that this is the only chance I'll have to feel this. Someone pushes my shoulders so I can reach, and I touch a squishy wet scalp, covered with thick hair, wrinkly. For the first time -- really, this is the first -- I understand: I am having a real actual baby.

The baby's shoulders stick a bit, too, on the way out; more hands inside me. I'm not aware of the goings-on, and learn about this development later. Nicole C. charts it as shoulder dystocia, but Louise charts it as "sticky shoulders"; she's seen real dystocia, she tells me, and that wasn't it. Finally, incredibly, the cinderblock fills my vagina, and then slips out, is gone. There is the shock of the absence of pain. I breathe in, realize what must have happened.

I also realize I don't hear crying.

I sink back from my curled position, smiling in great relief; I am not afraid for the baby, for some reason. Down at the bottom of the bed, Nicole C. is pretending to fumble with the cord clamps, to allow the baby a little more cord blood. The neonatal folks don't feel the same way about cord blood, and are ready to whisk the baby off to the warming table; I am grateful for Nicole C.'s actions, which Louise tells me about later. Then the cord is clamped and cut, the baby is taken to the warming table a few feet from my head for suctioning, and Sean follows. "Let's get this little guy breathing," says one of the nurses. It's a boy, then, I think.

"It's a girl!" Sean proclaims; he has heard the nurse, he knows what I'm thinking. "Sophia Hazel." Sophia Hazel. She is suctioned thoroughly; no meconium past the vocal cords, thankfully, and she immediately begins to breathe, and to cry. Smart baby to wait on that breath, Louise says later. She kept herself from aspirating a bunch of mec. I am inordinately proud.

"Time for the placenta," Louise and NIcole C. tell me. I must flinch, because Louise reassures me: "It's soft, it doesn't have any bones, it won't hurt. Little push, now." And it doesn't hurt. It slides out, feels soft and good. "Cough for the membranes, okay?" NIcole C. says. I can barely cough, my diaphragm is so worn out. I look at my stomach, improbably flat, and laugh. Someone puts a fresh gown on me; the old one is dripping with sweat, as is my hair. I am soaked and cold, and then warm and cottony dry. It feels wonderful.

And then someone -- Sean? A nurse? We can't remember -- brings Sophia to me, places her on my chest. I am stunned by how gorgeous she is. A nurse opens her blanket and my gown so we are skin to skin, wipes the sweat off one of my nipples (at first I am irritated, because I think of those 1970s recommendations about cleaning your nipples with alcohol before nursing; then I realize how sweaty and gross I am, after all that exertion), and I nurse her a tiny bit. She is grunting with every breath, though, so they ask for her back, to observe. I send Sean with her, feel so safe with him watching her. And it's time for my stitches.

Nicole C. pours warm water over my perineum, changes out the padding beneath me, and apologizes for the lidocaine sting she is about to administer. All I can do is laugh; after what I just did, I don't even feel the lidocaine. Two stitches and she's done. A nurse brings me some juice and Rice Krispies so I can take some ibuprofen; they offer Percocet, but I don't want any drugs now, don't want to be altered or risk anything getting through to Sophia.

Louise bends over me now, tells me what an amazing thing I did, what a gift it was to let this baby be born without anything in her system, since she had a rough start anyway. What hard work I did, how well. Then she says, "You guys have your family, but I have office hours to get to. These folks will take good care of you. I'll see you in a couple of days, and I'll call you later." She kisses me on the cheek, and leaves.

I turn to Nicole. "You'd think I'd have been a little more graceful about this, after the whole infertility thing, after it took so long," I laugh. She widens her eyes. "No," she tells me. "You were amazing." I think this may have been one of her more intense hospital experiences, thus far.

"So, Gretchen, has this completely turned you off natural childbirth?" I ask. I remember being vaguely conscious of her, down by my feet, watching me push, watching Sophia being born. "What? No," she says, with that same wide-eyed look NIcole had. "That was just...amazing."

Sean and I are exhausted, grateful, and wide awake. I am settled into a new room, given ice packs. We hold Sophia constantly; she spends maybe ten minutes total in the bassinet. Our mothers call; both are on their way to the hospital, from different directions. The world is in the process of reorganizing; things are becoming ordinary again, and completely, irrevocably different. We have our baby. We have our baby.

* * * * *

Sophia was born at 7:14 a.m., one minute before her "c-section for midwife distress" deadline (although obviously by then we were in no danger of being sectioned, but it is pretty funny).

The stats: I went into labor around 1:30 p.m. on August 22. Labor lasted a total of almost eighteen hours, two hours and forty-five minutes of which were pushing. We went to the hospital around midnight, with fifteen minutes between the time we decided to go and our arrival. (I filed a police report about the 911 incident, too. Unfuckingbelievable, that.) Sophia was born at 7:14 a.m. on August 23.

The hospital staff was, by and large, amazing; they were kind, helpful, and respectful, and I could not have asked for a better hospital experience if I'd planned for it. Nicole C. was lovely, and I am so thankful for my good fortune, that she was on call that night, and that she was open to working with Louise.

Louise, now. Louise astonished me. I have always had such tremendous respect for her, but after that I am in awe. I could not -- or rather would not -- have done that without her. If not for her thirty years of experience, her knowledge and wisdom, her dead-on instincts about when to go to the hospital, and what I needed to hear, and her SELF -- well, I would certainly have had a c-section. I am sure of that. Not that it would have been a tragedy or anything. But Louise allowed me to do something that I can hardly believe the enormity of, even now. She's one hell of a midwife.

Nicole I adore; she feels like a peer to me, on her way to wherever she's going. I like her energy, and I'm so glad she was there.

Gretchen, man, Gretchen -- Gretchen kept our shit together, took care of the dog and the house and the details so that Sean was able to be with me, fully. I needed to have her around for other, more nebulous reasons too.

* * * * *

Now, the premonitions.

I never could imagine having the birth at home. I could imagine labor, but when it came to the birth, I would flash on the hospital, and feel at peace. I couldn't figure that out at the time, and tried not to pay too much attention to it. Now in retrospect it seems meaningful. It also seems meaningful that I felt like I had to make sure, in advance, that I was comfortable with transfer, and that I became comfortable surprisingly easily.

When I was first beginning true labor, after I'd gone upstairs, Gretchen and Louise were talking downstairs; Gretchen mentioned our father is a doctor. Sean reports (and I don't have a sense of the timeline here) that Louise, in response to that information, said, thoughtfully, "Hmm. Yeah. Hmm. Yeah, I'm kind of feeling that energy here, that hospital energy." And filed it away, and went back to her crossword.

Also, Louise said, wise and laughing, to Gretchen, "Yeah, that one's a real brainiac," meaning me. "She'll find out." Or something to that effect. And I did indeed. My mind was blown, man.

And finally: Gretchen came into the bedroom, while I was in labor, and saw, laid out on the mantel, the baby nail care set we had: little scissors, clippers, files. She told me later that she flashed on a feeling of deep unease, and the knowledge that this isn't going to happen here. She said that, as she saw us pull away in the car, headed for the hospital, she felt a great relief.

Part Four

Comments

[HC]

Let me be the first to say congratulations beautiful woman. Peace to you and your family forever. You're amazing.

HC

[Heather]

Congrats again. I really enjoyed reading about your experiences. I am 6 days from EDD and your postings tug at my heart strings.

Thank you.

[Katy]

Wow. What an intense, amazingly written birth story. Someday Sophia will read it with awe.
Congratulations from a lurker!

[lily]

um. wow. I could not have done that. you know how snarky people say you don't win a medal for natural childbirth? well, -you- do. officially.

pretty cool having an actual real live baby, huh?

[Beverly]

Wow. Just wow. What an amazing story, and so beautifully written. I'm in awe.

Congratulations to all of you!

[HollyRhea]

I bet you'd do it three more times for Sophia Hazel.

My God, woman, I felt every contraction again. And I never realized until you wrote it down, that yes, the placenta DOES feel good coming out, doesn't it?

[Natalee]

I'm having to remind myself not to cry while reading your amazing story since I'm at work. Jo, you are truly and amazing person, and I'm so glad you and Sean have Sophia. Congrats to you both!

[Erin]

I've read many a birth story. Yours, however, is the most wonderful, beautiful, truthful, intenseby far. Thank you for sharing it with us. You are incredible. Congratulations to you and Sean. Give that precious little baby a snuggle from me! :)

[Dani]

Lurker saying....

Wow! It was worth the suspense of a three part story. I'm glad the horror story had a happy ending and everyone lived happily ever after. :)

And... How the f***k did you remember all of that? All three of my births are a blur. Be glad you wrote about it because in a couple of months, you probably won't remember many of those details.

[Shanna]

Well, that about scares the pee out of me, but at 34+3 days pregnant, I don't imagine I can back out now!

Wonderful birth story -- I appreciate your honesty in telling the tale, even if it is frightening. I'm very happy that your and Sophia's outcome were good -- she's a beautiful little girl, as you well know.

Take good care of your family (and let them return the favor!).

[Jenny/Long Time Lurker]

Wow! WOW! That was AMAZING. And true.

And for some reason has filled me with an intense urge to sob.

Congratulations!

[Dee]

You and Sean have your baby...your baby. Sweetest words in the english language.

And you're to be saluted for the incredible job you did in bringing her into this world. Bone-tiring, painful, and worth every second of the process.

You're right about delivering the placenta--sweet relief at that point.

[andrea]

okay, now at 25.5 weeks i'm scared shitless! but thank you for writing that and for your honesty and intensity, clarity and vividness. what an incredible story -- my mind is blown too, just reading it. congratulations on coming out the other side with a beautiful, perfect daughter. i hope i'm as brave as you.

[Leslie]

What a beautiful and difficult birth. And you know, now, that you can do anything - it's such a powerful experience to get through something that hard. I know, my second daughter's birth, a vbac, was similarly long and hard. The debt one owes to birth attendants like yours is amazing. Congratulations on your incredible strength and your beautiful daughter!

[GiBee]

CONGRATULATIONS!!! After reading your story, I have so much swirling around in my head.

Okay ... First of all, I know I'm 37 weeks pregnant, and full of emotion, but your story has made me cry my eyes out. I'm so impressed. You were so brave and worked so hard... Job well done.

But mostly, I'm scared. Frightened to death of labor and delivery, knowing my lack of pain tollerance. I don't think I can do this!!! I'm certainly not as brave as you, and damn it... I'm tearing up again thinking of what I have left to face.

I've always said that no one really tells you the whole truth about childbirth... but you have. I think just knowing the truth helps other women prepare (at least, it helps me).

Thank you for sharing all the details, and again, congratulations on a job well done.

[wix]

amazing! thank you so, so much for sharing. oddly, i feel like your insight has allowed me to gain a little of what i missed when i had to have that c-section. and you know, i never thought i'd be glad to have had it (nevermind the fact that it probably saved my life), but halfway through part 3, i was thinking, "damn, the surgery was a cakewalk compared to jo's experience!"

[Jujubee]

You are an amazing writer. Thank you for that awe-inspiring story.

I have to ask though (and please don't take this as criticism, I am just curious as your baby's birth was different from my baby's birth): why would an epidural necessitate a c-section? And why didn't the midwives reach in there and turn the baby from posterior to anterior earlier (my doctor turned the baby before I started pushing)?

[Summer]

Jo, thank you for writing all this. I know that later on, you'll be glad that you wrote it all down, as time starts to blur the memoried, but right now it just feels like you've given us a huge gift with this story.

I love reading birth stories because they help me remember Dorian's birth. And man, this story helps me see that I had it SO EASY with him. (I've always known that, and been grateful, but this makes it very clear.) Two things really stand out for me, really bring me back to the dark hospital room and the night of my son's birth. One was that moment, that moment of searing pain as I ripped apart with the force of his head, knowing that I'd give anything to make the pain stop and yet the only way to make it stop was to keep going. The only way out is through. The only path to the end of pain is more pain. And then you wrote of feeling Sophia's head, and realizing that you were having a real actual baby... that's the most poignant of all. After the heartbreak of miscarriage (and I didn't even have the trauma of infertility) I couldn't ever fully believe that I'd get a baby at the end, not until I felt his head descend, not until I reached down and felt hair that wasn't mine. It was only then that I KNEW I was having a baby. Amazing. And you are amazing. Sophia is lucky to have you for a mother, and Sean is lucky that you wanted to be the mother of his child.

And to all the pregnant women reading: you CAN do this. Most women don't have as tough a time as Jo did. In comparison, the birth I experienced was a picnic in the park with a little bee sting at the end. And even if you do wind up having a tough birth, you still have the strength to get through it. You are a woman, a mother, and we can do ANYTHING for our children.

[Beachgal]

I am absolutely floored by this story. You are an amazing woman. The details you remember are unreal. I knew I had an easy labor, even tho it lasted for 18 or so hours, but it was nothing compared to this. I had my epi at less than 4 cm. The most amazing part of my story is that I pushed at most 6 times. I cannot imagine going through what you did. And I know for certain I would not have been able to do it. I am very happy for you and your family.
Lurker in SC.

[emma]

You're an amazing writer, it's amazing that you've shared so much detail with people you don't know.

This story has terrified me. I'm two and a half months at the moment and I just know that I'll be remembering details for a very long time... I'm praying I have it a lot easier than you - I know I couldn't have done what you did.

[Monica]

I can't imagine experiencing what you went through - it is difficult read so I can only imagine how it actually felt. And yet, I can't help but feel that it was also an enormous gift. It must be amazing to know that you are so extraordinarily capable. I am in awe. Thank you so very much for sharing.

[~L.]

I've never cried from reading a birth story before! Thanks for sharing that with all of us...

[Shamhat]

Yep, that's birth. Feels worse than you could ever have imagined, takes more strength than you ever thought you'd have. And it's only the beginning. Welcome, new mother, and a blessing for you: May you know your grandchildren.

[mijk]

What a beautifull way of telling Sophia's birthstorie. It is an earthshattering experience isn't. S hard so painfull and yet so special and in a strange way beautifull.

Mijk

[TB]

Wow. That was the most amazing birth story I have ever read. It's incredible that you were able to be so focused and aware of what was happening with your body to be able to record it all. Just amazing.