Caprice's First Birth Story

Tuesday, February 23, 2021

By the time I was expecting my first son, I’d been in the birth space for 8 years. I’d attended many births. I’d supported tons of families. I’d taught hundreds of pregnant folks as they anticipated their babies’ births.

So I had preferences, but I knew enough to know that I didn’t really know how my birth would go. I contemplated homebirth but based on midwife availability, our finances/insurance, and my history of pelvic injury, I went with a hospital-based midwifery group whose practices were closest to my preferences. I expected to go past my due date (although that expectation did not save me from being royally pissed off that my baby was taking his time).

At 41 weeks, I went in for my scheduled appointment with the midwives. My plan for the day was to go to this appointment, be told nothing was happening, go get a pedicure (because I stopped tying my own shoes a few weeks prior), head to Dyker Heights to get my BPP (biophysical profile, a high-level sonogram for checking the baby), and then watching more tv.

Instead, we found that my blood pressure was very high when I arrived at the midwives office. I’d run for the G train to get there with my husband, so we waited for awhile, I drank water, I did some breathing exercises, and my midwife Shannon checked my BP several more times. No change. My fundal height measurement hadn’t increased at all and the low-level sonogram in the office showed pretty low fluid levels. The fundal height and low fluid weren’t enough on their own, but combined with the high blood pressure were pretty concerning. Shannon suggested further monitoring at the hospital, and we both knew that this would likely mean induction. I was mad, and cried on our walk from the office to the hospital, but I knew this was medically indicated. I’d had a typical, healthy pregnancy up until this point, so high blood pressure that had skyrocketed was something to pay attention to.

I spent two hours in triage, and thankfully my labs came back normal, meaning no pre-eclampsia. But my blood pressure did not change, and even as I hydrated tremendously, my fluid remained low. I made the decision with the midwife to begin the induction, so I was admitted. My doula (and mentor) Terry came to help me settle in at the hospital while my husband Bradley went home to gather our things and feed the cat. I insisted he download a bunch of movies and TV to the laptop because I had been to some very, very long inductions and wanted to be prepared.

My midwife administered cervidil, which is a little strip of fabric covered in a gooey prostaglandin gel that, when placed, sits behind the cervix. It sits there for 12 hours, and most people don’t feel more than crampiness. I was glad Terry had insisted on coming because the insertion was pretty uncomfortable, given that my cervix was still hard, closed, and posterior. Terry and I hung out for a while, chatting while I was monitored. I talked to my sister on the phone, who had some sweet reassurances for me. Monitors came off because it was clear the baby and I were both tolerating cervidil well. Then Bradley arrived with all of our stuff plus a late lunch for me, and Terry went home.

Bradley and I turned on some lame home design show, and then I laid down and tried to watch Parks and Rec while eating the sandwich Bradley brought me. He napped. Around 8pm, he ran out and picked us up some dinner, because we were really, really sure this was going to be a long experience. I was getting a teensy bit crampy while eating egg rolls (three, to be exact, because I didn’t feel like waiting for my wonton soup to cool). By 9pm, the crampiness started to feel like actual contractions. We started the series finale of “Veep” and I switched from sitting on the ball to standing and leaning forward. At the start of the episode, I noticed contractions; by the end, I was pausing hard and missing jokes.

Around 9:45 or 10pm, I was feeling a lot more intensity and told Bradley I might need Terry to come back soon. He tried to temper my expectations - again, we \*really\* thought we were in for a very long induction - and he said, “maybe let’s check in with her and tell her we’ll let her know in a half hour.” I agreed that sounded good, but then had a super intense contraction and said “tell Terry to come back NOW.”

By the time Terry arrived - maybe 45 minutes later? - I was switching between laboring on the toilet and rocking on my hands and knees while pushing my head into the back of the bed. Bradley says that Terry basically walked in, rolled up her sleeves, and got to work - jumping into my birth was no joke.

I had been really explicit with my midwives from the start about all of the things I wanted and all of the things I did not want. When a nurse came in to offer something, I’d say “unless clinically indicated, I do not want: a Hep Lock, continuous monitoring,” etcetera. My midwives were amazing and collaborative and really listened, so I was incredibly mobile and also astutely observed. I consented to having my blood pressure regularly checked, though I don’t remember when or how often that happened.

It’s a bit of a blur to me after Terry got there. I remember sitting on the bed and on the ball and on the toilet, pushing my head, absolutely burrowing into Bradley or Terry’s stomach. Contractions started coming really fast and intensely, and I’d get three in a row with no break. A peak and a dip, a peak and a dip, a peak and a dip, but no real relief until three were over. Terry kept asking me to try an asymmetrical position, like putting my foot on a stool. My doula brain knew that Terry was suggesting this because I had a weird contraction pattern and the indication was that my baby was malpositioned. My birthing brain thought this was absolute bullshit and I told her as much.

At some point, after being in the shower for a while, I thought my legs were going to give out. I said “it’s going to feel worse to be in the bed, but I want to lie down.” Terry really helped me jangle my foot and flutter my lips to help me stay in that left side-lying position, and in-between contractions, Bradley would give me water and then I would semi-doze before the next three contractions. Bradley also kept telling me, “you’re almost there” near the peak of a contraction, and “it’s settling down” on the other side, which I found really helpful.

I know that I changed positions and coping movements a few more times, and then at 3am, the next midwife on call, Betsy, came in to remove the cervidil and check me. Things were so, so intense by that point that I had no idea where I was in labor, but I hoped it was far. The exam was painful - I had to ball up my fists and put them under my hips so Betsy could access my cervix. She mentioned that she couldn’t feel my bag of waters and asked when they’d broken; I had absolutely no idea (this was also definitely an indication that my fluid was truly, clinically low).

Betsy noted that my cervix was 3-4cm and 50% effaced. Both Betsy and Terry seemed excited (or acted excited) and my doula brain thought how weird it was that I’d made that much change on cervidil (it’s not very common). My birthing brain, however, was livid. I might have started crying. I really thought I should be done.

Betsy took my monitors off and recommended I get in the shower for another hour. She thought that my contractions might space out now that the cervidil was out, and that she might ask to check me again in an hour and we could decide on next steps.

In trying to get out of the bed, I had overwhelming contractions and suddenly starting pushing, hard. Everyone - including me - was very surprised. Betsy said, “I’ve done this for 40 years, but I could be wrong. Can I check you again to see if I missed it and you’re fully open?” I said yes but couldn’t move my body; Betsy checked me from behind and confirmed that I was still 4cm. Repeated instruction to get in the shower.

It seemed like both a very long time and a very short time that I was in the shower. In reality, it was about 45 minutes of me absolutely losing my mind. I was still getting monster, three-in-a-row contractions, and growling, pushing during every one of them. I was kneeling on the floor of the shower, alternately yelling “I’m not getting a break, I’m not getting a break” and “I can’t stop, I’m sorry” regarding pushing.

I knew that if I kept pushing like that, I’d swell my cervix shut. My doula and my midwife were quietly standing in the doorway, discussing the need to encourage me to get an epidural if I’d made no change in an hour. This was also where I started to say “I’m gonna need to get the epidural, I couldn’t do it, I’m gonna need to get the epidural” in between growling and trying my hardest to not push, which was futile.

At 4am, Betsy asked that I crawl back onto the bed so she could check my cervix again and they could take some vitals. I got back onto the bed saying “nothing’s going to be different” and really meaning it. I was so, so mad at that point. Betsy checked me and said, “okay, so there’s a cervical lip.” And had I been in my right mind, I would’ve understood that to mean I was fully dilated. But I was on another planet, so when she asked me for a push, I was deeply confused. I was just trying not to push! For like 45 minutes! Somehow they all convinced me to start pushing again and while I did that, Betsy pushed the rest of the cervical lip over the baby’s head (which felt exactly like what it sounds like). I pushed once or twice more and then the baby’s heart rate dropped.

While I knew it was normal for the heart rate to drop during pushes, typically it comes back up. My baby’s heart rate was in the 70’s and wasn’t resolving. I changed positions, they gave me oxygen, I changed positions again, and nothing was helping.

Everyone in the room was extraordinarily calm. The nurse very quietly began to set up an IV for me, which I inferred was because they wanted to prepare in the event of a section. My midwife said “okay. So I need you to give me two really good pushes, and then I’m going to go get an OB down the hall and he’s going to help the baby out with the vacuum.”

I was really frustrated but anxious to get my baby out soon. I gave two very strong pushes and then the OB from down the hall came in (wearing a spectacular toupee, I am told, but I couldn’t pick him out of a lineup then or now). He pulled the light down from the ceiling, took a quick look and then said “hey Caprice! I’m going to rotate your baby with you.” I said okay and in the next two pushes, Dr. L literally rotated my son’s position from OP (sunnyside up) to a more optimal position. Immediately after the second push, his heart rate shot back up. Dr. L took off his gloves, waved goodbye, and turned things back over to Betsy.

I gave maybe one more push and then the head was visible. Betsy called my husband over - who had been very anxious to catch the baby - and asked him to get ready. Someone told me to reach down and feel my baby’s head as he was crowning. That was such an incredible moment, and a weird one, too, as I recall thinking “this ring of fire thing is not nearly as bad as I imagined.” One more solid push and his head was out. The whole room cheered so much that I truly thought I was done and I had pushed all of him out. I was so pleased with myself until Betsy said, “push one more time!”

One more mighty push and Betsy guided Bradley’s hands to catch our son. They handed him up to me and he gave some good mighty cries. Milo was finally here! He looked amazing and we all cried together. 4:31am. About 13 hours after the start of my induction. 6.5 hours of brutal, no break contractions. A little less than 30 minutes of pushing.

We snuggled together while waiting for my placenta, which arrived about ten minutes after Milo. I did have to ask that they not give me pitocin postpartum (unless there was a medical indication that I might hemorrhage). I got a local anesthetic and a couple stitches for a pretty minor 2nd degree tear. Milo spent close to two hours on me, getting some great skin to skin time and attempting to nurse.

As Betsy inspected my placenta, she found that I’d had a partial abruption. This was likely due to my high blood pressure, and Betsy believed it was why my birth went as quickly as it did. Although it wasn’t my first choice, I’m unbelievably grateful for my induction. More than that, I’m grateful that my team was so deeply respectful, collaborative, and observant. I felt so cared for, free, and safe. And this is all I want for any birthing person, anywhere: safety, collaboration, and deep respect.

When I think back on my birth now, almost two years later, I’m struck by how little I remember about the physical sensation. My visceral memories are of the hands-on, loving support of my husband and my doula, and of the absolute high I felt when pushing and receiving my son into this world. Falling in love with my little family has been the most tremendous privilege and honor of my life.

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