By Stephanie A., Mother ~ (with midwife commentary by Callie Clark, CNM)
This is the birth story of Alistair June, “Sunny”. He was born on a Thursday, May 11, at 11:43am. He was eight days early. I was fully prepared to be two weeks late, so when I woke up just after midnight Thursday morning with horrible stomach cramps and diarrhea it never crossed my mind that I might be in labor. But after an hour or so, Dave said that the cramps seemed to be coming in regular intervals and he started timing them. (He had been saying all along that the baby was going to come early.) They seemed to be coming every three minutes so he decided we should call the midwives.
Hayley was on call and advised Dave to give it an hour and call back if they hadn’t slowed down. During this hour Dave managed to pack some things to take with us (I hadn’t bothered to pack a bag yet since I was so sure the baby wouldn’t be coming for another three weeks). I spent the hour curled up in a fetal position on the floor of the shower, trying to relax and visualizing my cervix opening with each contraction. When Dave phoned Hayley back to say the contractions weren’t slowing down, she told us she’d meet us at the birth center. The 10 minute drive to the birth center was AWFUL. I was on my hands and knees in the back seat trying to ride through the contractions.
We got there around 3:30am. Hayley did a quick exam and I was already 8cm dilated. Both my mom and her mom h
ave a history of short labors so I thought maybe I was going to get lucky and this baby would pop right out. But, that’s not what happened.
Hayley prepared the tub. (We’d read that a water birth could potentially lower the risk of infecting the baby with GBS and I had tested positive, but didn’t want to take antibiotics.) I labored in the tub for a while until I felt like I wanted to push and called Hayley in. She said there was a little lip of my cervix left, but I could try and push over it. That didn’t work so she said we’d have to wait until it receded. I let myself float in the tub and meditated and moaned through the pain. I have no idea for how long. (It was another 2 hours and 45 mins until the cervix was completely dilated) Hayley came in to check on us at regular intervals and her presence was really calming.
At 7am Hayley came in to say her shift was over and Callie and Erin were going to take over. Erin did a check and said I could start pushing, but all that floating and meditating had gotten me pretty relaxed and my contractions had slowed down. After pushing in the tub for a while with no success, Erin and Callie moved me to the birthing stool. After a couple of ineffective pushes there, Erin asked when the last time I peed was. It was a while ago and Dave had been giving me lots of sips of water, so she said to try and pee. I did. I peed bucketfuls all over the floor. Every time they thought I was done I just peed a ton more. The nurse was wiping it up with pee pads, but I just kept peeing. Erin suggested we move to the toilet. When I finally got all that pee out, my pushes started being more effective and the baby started moving down. (If the bladder is full, it can take up a lot of space in the pelvis and impede the baby’s descent into and through the pelvis. Because of all of the sensations of labor and pressure from the baby’s head on the bladder and urethra, sometimes it becomes very difficult to empty the bladder. Sometimes we need to use a catheter to empty the bladder, but luckily this time that wasn’t necessary.)
I pushed on the toilet for a while. I have no idea how long. I had lost all track of time. I was exhausted and it seemed like the baby would never come. I was ready to give up, go to the hospital, and have him cut out of me, but Callie wasn’t going to let that happen. She kept reassuring me that I could do it. (At this point, it had been 2 ½ hours of active pushing. Stephanie was getting really tired from all of the hard work and the uterus was getting tired too. The contractions were spacing out from every 2 minutes to every 5 minutes. By this point we had tried many different positions for pushing to see what would help Stephanie best: laying on the bed on either side, squatting, birth stool, in the birth tub, and what seemed to work best was sitting on the toilet. This is often a very effective position since we are used to pushing effectively in this position.)
Later, Dave told me that around this time the baby’s heart rate started to drop and the mood in the room was that I had to get the baby out soon. Erin said she thought maybe the baby was sunny side up. At the time, however, I didn’t notice any of this. I wasn’t really an I at all. The pain was just rushing over me. My legs were weak from squatting for so long over the birth stool and the toilet. Callie said if I was going to have the baby on the toilet, I’d have to stand up when I did. (Standing up when the baby is born is important to make room to bring the baby up to the mother’s chest.) I didn’t think I could, so we moved to the bed. I tried a few positions, but after reading so much about not birthing on your back and being intent on not birthing that way, it was the only position that seemed to work.
After some pushing there, Callie started milking me to get the contractions to come closer together and stronger. If I had been in any state of mind to make judgments or narrate what was happening I would have thought she was milking me like one might milk a cow, but I wasn’t really thinking at all at the time. It’s true what they say about really losing yourself in the moment. (Nipple stimulation is an effective way to get the contractions stronger and closer together. A breast pump is one way to stimulate the breasts. Sometimes the mother stimulates her breasts herself but in this case, Stephanie was too tired. The partner is sometimes helpful with this as well, but in this case the midwife demonstrated how to effectively do manual nipple stimulation and it seemed to work well. Nipple stimulation is most effective when it mimics a baby nursing at the breast.In the hospital they surely would have started IV Pitocin by this point. Nipple stimulation encourages the mother’s body to increase its own internal Oxytocin levels, which does the same thing that synthetic Pitocin does.)
I still wasn’t managing to push very effectively so Callie was pressing somewhere inside of me where she wanted me to push and she had Dave start counting through the contraction so I would push for the whole count. Whatever Callie was pressing was really, really painful, way more painful than the contractions themselves, but Dave told me later that it seemed to be the only way to get me to push with enough power and in the right spot. (Usually we encourage the mother to follow her instincts and push according to her urge, but in this case that was not effective enough at getting the baby out so the midwife was assisting in showing Stephanie how to push effectively. At this point Stephanie had been pushing for over 3 hours.)
At one point, I remember the nurse saying that it was almost noon and I had to get the baby out before lunch. And, finally, he was crowning. There was a mirror for me to watch the birth, but I didn’t want to watch I just needed to focus on pushing. Pushing the baby out was a different kind of painful–a stinging, burning that really was nothing compared to the horrific pain of whatever Callie had been pressing on.
(I was so proud of Stephanie! By the time she birthed “Sunny” she had been pushing for just shy of 4 hours. What a strong mama! When the babys position is Occiput Posterior, or “sunny side up” it is sometimes more difficult to give birth. Many of those babies will turn their position during the labor, but others just come out that way, staring straight up with eyes wide open as soon as they are born.)
When they put the baby on my chest, I couldn’t believe I’d actually done it. I remember saying over and over that I couldn’t believe that I’d done it. I really couldn’t. It didn’t seem real. I was SO exhausted.
Sunny was born just before noon. And, Erin was right, he was sunny side up (hence his nickname). Despite his position, I somehow managed to avoid having back labor. Thank god because I had all the pain I could handle.
I tore a bit and needed a few stitches, but after like four hours of pushing, a few stitches were nothing. And we had a beautiful, healthy baby boy.