My due date had come and
gone without incident. And after a week had past, I became
serious about trying every trick I had heard of to bring on
labor. A little castor oil in my eggs (gross, but not
unbearably so), sex (which seemed like the worst idea in the
world to me when I was super pregnant), climbing the many
stairs in my apartment to do laundry, scrubbing the floors,
walking around the park, more sex, primrose oil capsules, blue
cohosh, black cohosh, pineapple, hot as hell thai food,
gnawing on basil leaves, eggplant Parmesan sandwiches, and
acupuncture…I would try just about anything because I really
did not want to be induced. I had an appointment for a foly
catheter induction scheduled (followed by a pitocin induction
if that didn’t throw me into labor) and I was intent on
MISSING this appointment.
I was scheduled to get induced initially two days before my due
date, but thankfully, I rescheduled. I made this induction
appointment after a midwife (one of many at my OB practice) told me
that going beyond my due date might put my baby at higher risk of
stillbirth. The literature does point to pregnancies that go beyond
the 42 week mark as being at higher risk, but I wasn’t even at 41
weeks yet. Of course if a medical professional says, "if you don’t
do what I am saying, you may hurt your baby", you listen. She
explained my options: I could have a mechanically induced labor to
ripen the cervix (“but who wants to have a catheter inside them?”
she added) or I could have a “Miso” induction—which she presented
as if it were as harmless as having a cup of Miso soup -- “you come
into the hospital, we give you a small dose of medicine to ripen
the cervix overnight, and you’ll probably sleep through it and go
into labor the next morning”.
Thank god for the internet. This “Miso” induction she spoke of is
Misopropil— also known as Cytotec, is a cheap and widely used
induction agent—not formulated or intended for the use in labor (it
is an ulcer medication!!!). Cytotec’s manufacturer, Searle, has
repudiated its use for induction and cervical ripening because of
Cytotec’s potential risks. The FDA states that Cytotec’s major
adverse effects include uterine hyperstimulation, which can be
severe and result in serious fetal distress; amniotic fluid
embolism (carrying a high maternal and infant mortality rate);
uterine rupture; severe genital bleeding; fetal death; and maternal
death. Other adverse effects include retained placenta and passage
of meconium (the baby’s first stool) into the amniotic fluid. Aside
from these risks, first-time mothers have approximately twice the
likelihood of cesarean section with induction compared with natural
onset of labor. This risk is due to the drug induction itself, not
any reason that might have led to inducing the labor in the first
place.
So how could she justify scheduling me for an induction that posed
so many risks for myself and my baby? This midwife clearly did not
believe in my body's ability to birth. She probably assumed I would
have a failed induction and need a cesarean. After some research, I
called my midwife to say that I did not want a Miso induction, and
that I wanted to wait and go into labor spontaneously. She said,
“Well, in my experience, women with BMIs higher that 26 tend to
have cervixes that won’t dilate without chemical induction.”
Okay—first I was being pressured into induction because of the
increased risks of a long gestation to m y baby and NOW she’s
saying that because I am a curvier gal, my body is somehow clueless
about giving birth (by the way, I had NO other risk factors in this
pregnancy—no gestational diabetes, no elevated blood pressure, etc)
I have since searched high and low for ANY medical study that
supports her belief and have come up with nothing. I argued with
her that I’d like to give my body the chance to go into labor on
its own—at least through the weekend (agreeing to the postponed
induction with the foly catheter instead). She was condescending
and doubtful, but ultimately said it was up to me.
I wrote an email to Henci Goer, author of wonderful book The
Thinking Woman’s Guide to a Better Birth in hopes for some
insight. Henci was so encouraging about my body knowing exactly how
to birth. She also sent me links to research about
induction—particularly the dangers of Cytotec. Luckily, I also had
the support of my wonderful doula, Rachel, who encouraged me to
wait it out--reminding me that most first time moms average a
gestation of 41 weeks and a day. The day I went into labor
naturally marked that average--I was pregnant 41 weeks and a day
when I had my baby!
I went into spontaneous labor in the wee morning hours during a
rainstorm. My contractions started waking me up at 2am, so I got
out of bed and started cleaning. I had a feeling that my labor was
starting, so I cleaned the cat box because I knew It might not get
done for a couple days (my kitties don’t have toxoplasmosis—though
finding this out cost 300$ and it only cleared my partner Brian
from having cat box duty as his sole responsibility). I did some
organization around the apartment for a bit and then took a
wonderful bath in our Jacuzzi tub. I deep conditioned my hair and
carefully shaved my legs, knowing that I might not have the luxury
to do these things in the busy weeks to come.
I told Brian at around 4am that I was starting labor. We snuggled
in bed and he put on "Kill Bill 2" for me (a movie I love and find
oddly soothing). I held on to him tightly through my contractions,
which were not that close together yet. I called Melissa, my
nearest and dearest who lives north of Boston. She was one of my
labor support team. She would head down right away, driving too
fast in the rain to help me through this.
The sensations of labor are difficult for me to describe. I liken
it to the feeling of riding an amusement park ride—like you are
calmly being pulled up a steep incline and you suddenly
drop—stomach in your throat, feeling20out of control (for a full
minute!). And as suddenly as it comes on, the free-fall is over.
You regain control. And you try not to be too freaked out that that
same feeling is going to happen again in a few short minutes. At
first the contractions were not all that painful—just intense. At
times they felt primal and out of this world--but not painful at
all. They built up slowly and at times I found myself wanting to
escape the waves of pressure. Surrendering to the feeling was the
only way for me to get through. I found myself saying “release,
relax, and surrender” to myself during the contractions. It
helped.
Melissa arrived shortly after "Kill Bill" ended. We timed
contractions on her iphone using the “Contraction Master”
application (highly recommended and fun!). A couple hours later I
called Rachel and she came over to help me as I labored at home
through the morning. Her calming presence really helped me through
hours of contractions. I intended on staying home to labor as long
as I could.
We kept the mood light and peaceful. Rachel baked some brownies for
the nurses with me (although I contracted through most of the
process, and blamed the brownies). At one point I wanted to be
alone, so I went to my bedroom and quietly labored with my eyes
closed , listening to my hypnobabies tracks on my earphones (also
recommended—although my birth was not pain-free, the relaxation
techniques were very helpful) . I had no concept of how much time
was passing…We watched episodes of Desperate Housewives when I
joined everyone again. I felt like I would have a contraction every
time I moved, so I tried to remain still.
We went to the hospital only when I felt it was absolutely time to
have my baby (thanks to my doula's gentle distractions and
encouragement). At the hospital I was chastised for forgetting to
call my practice to notify them I was in labor (oops!). When I
arrived, I was 8cm dilated, and a wonderful midwife was on call to
deliver me. She and the team of nurses were kind, encouraging, and
simply perfect. I was not offered any drugs at any point during the
birth. I thought I would have wanted to move around more during
labor. I did labor on the birth ball for a while, but I found the
hospital bed most comfortable—whenever I moved, I felt terrible
pressure.
I had read so many horror stories about hospital births, and had
fully expected to come into my hospital birthing process kicking
and screaming for a natural experience. I had imagined a candy cart
of painkillers being pushed on me by the hour. I thought the person
delivering me20might break my bag of waters or give me an
episiotomy without asking. I thought I would have to make a fuss to
hold my baby immediately after birth. But I am happy to report that
none of these things happened. And I attribute this experience to
the fact that I stayed home laboring as long as I could. I had been
warned by one midwive at my practice to "stay home as long as you
can while you're laboring--because if you hang around the hospital
to long, we'll want to play with you". I knew I didn't want anyone
"playing" with my birth pocess.
I regret that before the birth I had made Brian promise to stay
near my head during my labor—above my waist—so he wouldn’t be
traumatized by seeing the whole messy process. Sure it’s messy, but
it’s also beautiful, and next time I plan on inviting him to
witness the entire event. He was a very calming and encouraging
presence for me during the birth, even though he felt that he
didn’t do much at the time. I also know that if I have another
child, I will choose to have a homebirth. But this choice is not
because my hospital birth was unpleasant--I just think it would be
a much more beautiful experience (and besides, the most unpleasant
part of my labor byfar was the 3 block car ride to the hospital)
.
One hospital procedure that wasn’t planned on was an episiotomy.
The midwife later told me that the baby’s umbilical cord was quite
short—and that probably was what made the procedure necessary. When
she told me I needed one, I asked if I could try two more pushes
without it. She said, “Absolutely,” and I gave it my best shot (to
no avail). Luckily, it caused me very little discomfort and healed
quickly.
I went to the hospital at 2:00 pm and my 7lb 9oz son, Nathaniel
Hayden Lima, was placed in my arms just two and a half hours later.
This birth was the most incredible experience of my life so far. I
was truly blessed with a beautiful and merciful
birth.