Pregnancy journal (final entry): Birth

[post edited 10/12/17 to remove some identifying details]

Pudding is two weeks old today. Yes, she’s here! and such a source of joy. Strangely enough, I went into labor less than three hours after I posted my previous entry. (Erik actually read the post between my contractions, at my request.)

I was never sure I would be writing my birth experience here, but I figure I’ve been so open about the rest of the pregnancy that it would be unfairly obscuring a very significant part of it if I left it out. In fact, during the earliest stages of labor, I felt compelled to record what I was feeling, so in between contractions I jotted some observations into my phone. The rest I’ve filled in, in bits and pieces, in the days after birth. It’s a long account, but I’m okay with that. There is already more silence and mystery around labor and birth than there needs to be. No pressure to read it, I won’t be offended.

Early labor (at home)

Written at 7 PM on March 8, Erik’s birthday; edited March 21

This was the first hour of timeable contractions, sensations that had that bell curve they told us about (initial mild sensation building to a crest and then decreasing in intensity). It’s been an odd, hunkered-down day and then I had diarrhea and the contractions started not long after that, though I didn’t realize immediately what they were, as they were coming far apart and didn’t feel anything like I expected — more a strong feeling of downward pressure than encircling pain. It wasn’t until I had to stop mid-activity to lean over a chair and wait out the feeling that it occurred to me what was happening. Erik put on fresh sheets and turned on the heater and closed the curtains and I got into bed with the phone and iPad for what I expected to be a lazy quasi-nap… but then the feelings returned and we decided to try timing them just in case, and pretty soon it became clear there was actually something to time.

Each contraction felt like its own thing so I was surprised when Erik reported that a pattern was already emerging. The doctor had said not to call until they were five minutes apart, lasting 45-60 seconds apiece, and had been going on for at least an hour. I figured we had a long way to go, but then Erik told me they’d been coming 12 minutes apart and were lasting anywhere from 39 to 88 seconds; I was surprised that both the 12 minute intervals, and the minute-plus duration, felt shorter than I would have expected them to. I’d been told labor would completely skew my sense of time but I didn’t expect that to happen so soon!

Meanwhile, between the contractions Pudding was extremely active, and weirdly enough I had to pee copiously after almost every contraction. 

I’m in good spirits, grateful for Erik, shockingly hungry and thirsty. Wondering when I should give people a heads-up that something is happening. 

8:16 PM

Pudding hasn’t moved in an hour or so, or if she has it’s been very subtle. I guess she’s hunkering down too.

9:39 PM

Another snack, another poop, and more of my mucus plug (it started to come out over the last two hours). Contractions now average 6 minutes apart and 40 seconds’ duration. I feel a lot of them in my lower back and I’m achier in between, but it’s still very manageable. Erik is washing the dishes and cleaning the kitchen in short bursts between them! He’s timing on his phone with the Full Term app (we downloaded it after reading this incredible birth story) and it’s extremely helpful.

This is where I stopped writing. I continued the account on March 14; obviously the details had gotten hazier in the interim. (edited March 22)

I kept on having contractions and eating and drinking and peeing until shortly after midnight when we phoned the office and reached the on-call doctor. We had hoped she would give us a definite answer on whether to go to the hospital — if you show up too early they’ll send you back home — but it seemed that she couldn’t say because my water hadn’t broken. She asked Erik, “Is Lisa very uncomfortable?” which has to be the most inane question ever in this context! But she said she would phone the hospital to let them know to expect us.

I still felt that the contractions were doable, and I enjoyed the cozy atmosphere we’d made at home, but we knew there was a balance to be struck between continuing to labor at home and leaving for the hospital before it became too uncomfortable to travel. We decided that Erik would finish packing our bags (they needed last-minute stuff like food, phone chargers, etc) and feed Lyapa, but take his time doing so, so we didn’t head out too soon. Erik had been helping me through the contractions but I had to do some on my own while he was loading the car; of course I got through them but I did think at the time how grateful I was he was there for the others.

It’s worth saying something here about the contractions in general. I had been told that although they would inevitably hurt, they are highly individual, so there is no way of knowing beforehand what yours will feel like. One account I read described them as feeling like the tightening of a barbed wire belt; meanwhile, my mother said hers never hurt until we were about to come out. Probably the best preparation I did for them was in prenatal yoga, when our teacher Rosy had us hold uncomfortable poses for one minute while breathing through the sensations. When it came time for the real thing, Erik helped by supporting me physically (I leaned on him or held his hand or arm), breathing or vocalizing along with me, and telling me (in the early stages) how many seconds had passed so that I was able to get a sense of when to expect the apex of intensity.

Because I always experienced my contractions as pressure rather than pain, and was able to rest between them, I never felt that I needed pain medication; they got very intense, it’s true, but since the worst never lasted long, they seemed just a thing to get through rather than something so bad I needed escape or relief. Hard work, rather than torture. This is not a judgment on anyone else’s experience, merely an explanation of mine. I had always said I wasn’t going to martyr myself — if my contractions had felt like the barbed wire belt, I certainly would have accepted medication!!

This is where my brain was by the time we stepped out our door: I had enough foresight and presence of mind to think about the weather, but not enough energy to look up the forecast or even ask Erik to do so. So I opted to wear my shoes instead of my easier-to-put-on sandals, in case it was raining when we left the hospital (the right choice, as it turned out!).

I wore my favorite lounging dress, over undies but no bra, and put a comfy sweatshirt on top. I felt calm and excited, though there was a dreamlike quality to everything. As Erik locked up I had to lean over the banister and have another contraction, but afterward I remarked that it was a beautiful night, and it was: cool and clear, with that illusion of perfect stillness when the rest of the world seems to be in slumber. After I got into the car I shook uncontrollably, which is very common in labor; it would happen again when I got to the hospital. I had another contraction as we turned onto the main road; we both said, now that we’re in the car I can make more noise, and indeed, by the time we arrived at the hospital it seemed that the only way to get through the contractions was to moan through them: they were getting stronger. As we drove down the nearly deserted streets I said this whole journey has been surreal and now this is the most surreal part of it all, something I’ve always wondered about: the “I’m in labor” drive to the hospital. I hadn’t thought I would be so lucid during this drive but in spite of that time-standing-still quality of the late hour and the momentous occasion, I felt quite clear-headed.

Also to my surprise, I didn’t notice any bumps on the road. I told Erik anyway as we left our driveway that bumps weren’t going to matter because when I was fine it was all fine, and when I was not there was nothing that would make it better. Very true. It was a very short drive with no traffic, but even so, I felt then and feel now that I passed through some kind of transition between home and the hospital. By the time we arrived a lot of my clear-headedness had transformed into something much more akin to sleepwalking; it wasn’t that I wasn’t clear anymore, but that the immediacy of my physical sensations was taking over.

Active labor (in hospital)

We found parking not too terribly far from the entrance and I said I could manage the walk. At the ticket booth I had to stop entirely and turn to Erik and hold on to him when another contraction hit. A security guard, or maybe the ticket booth attendant, was walking by — a Latino man, middle-aged — and I utterly didn’t care that he saw; there was no hiding anything at that point and anyway I figured (still lucid enough to think of this) he’d seen it many many times before. I stopped again just before the main doors for another contraction. We got inside and the Black woman at the main desk simply said, benevolently, “Third floor,” and off we went. There was a young East Asian couple sitting in the waiting area and I wondered vaguely why they weren’t having a baby and what they thought of us. I had another contraction before we got to the elevators. I also pondered using the restroom near the elevators but decided I’d rather not go alone. We went upstairs and security pointed us to check-in, and I had another contraction while waiting to be registered. The desk staff seemed utterly unconcerned with me; in fact we had to wait while they did something else, and though I was past much critical thinking I was simultaneously vaguely annoyed they weren’t doing everything to help me and reassured because it meant I was nothing they hadn’t seen before.

The triage nurse was very nice but the triage process seemed to take forever. I peed (another contraction in the restroom), got into a gown and onto the exam table, and while she asked me questions (seemingly many and irrelevant) I had contractions; she told me to relax during them and not clutch at Erik, and I did so as best I could. I remember thinking her coaching was very soothing and I managed to tell her so. Finally she got around to examining my cervix and established that I was 4-5 cm dilated, about halfway to full dilation. Our admittance papers say it was 3:30 AM by this point.

in triage, between contractions

While the triage nurse was attempting to reach my doctor a young Asian nurse named Janelle came and fetched us and we walked to room 11 (actually 3211 or something like that). I had another two or three contractions along the way. I got into the bed and she put an IV and fetal heartbeat monitors on me, checked if I needed drinks, and then mostly left us alone. I remember feeling a bit miffed at that — what was the point of being in the hospital if they were just going to abandon us?! — but also I remembered that when we were making our birth plan I had wanted it to be just Erik and me, with minimal hospital staff around! And I didn’t need her, in truth; I just felt somehow that it would be better to have a professional around.

The rest of this phase is mostly a blur. The room was dim, I held onto Erik’s hand a lot, I moaned as loudly as I pleased. At one point, after a particularly intense contraction, I remarked to Erik that if my pre-labor self could have heard my moans she would have been alarmed, but she shouldn’t be; I’d read somewhere that mothers’ labor moans are “work noises” and I think that’s actually a very good description. They were not — at least for me — the groans of agony that I had always assumed, they were just the necessary sounds of this particular kind of work. Like tennis players’ grunts! Janelle came in sometime to report that she’d spoken to our doctor who was half an hour away and wanted to be called again when I was “complete” (meaning fully dilated). Before three hours had passed, I was so glad to hear Janelle say sprightly after checking my cervix, “Good news!” Soon after that our doctor called again to say she was 15 minutes away and hoped I wouldn’t have the baby before she arrived!

between contractions, looking quite a bit more tired at this point

Pushing

When our doctor finally turned up I was very glad to see her and thought, now we will soon be done. It felt like surely things would be speeding up. Our doctor examined me and noted that my bag of waters (the amniotic sac) hadn’t broken but said I could push if I wanted to. Janelle mentioned that her shift was ending and she hoped she’d get to see the baby! Also, my second dose of antibiotics (precautionary, because I tested GBS positive) would need to be at 7:15 AM and it was now 6 — the doctor said confidently that she didn’t think I would be in labor long enough to get to that.

Unfortunately, though her instincts had been solid throughout my pregnancy, she was very wrong on that point. I started pushing, with the doctor and nurse and Erik helping, in a spirit of hopeful anticipation of a quick job. Pushing, though, felt counterintuitive as they instructed me to hold my breath while bearing down, and that goes so strongly against my training in yoga and Pilates and every other kind of physical work I’ve ever done. It was also a weird position to be in, with my legs up and me grabbing them, but I didn’t feel I could do any squats or anything else at that point. I was feeling a lot of pressure in my rear end and the doctor said to push into that, which I tried to do, but it was hard to get the hang of. She put her fingers in there to help me know where to push, which helped but was also incredibly uncomfortable — I think my cervix was involved and if you have ever had a pap smear it was like that times a hundred plus the general pressure and the contractions.

At first I welcomed the pushing as it was a change from the contractions; those could only be endured but pushing was something I could do, and while I was focused on the pushing I didn’t have the bandwidth to notice how much they hurt. But before long these same features made the pushing more unpleasant than the contractions, because I felt unable to do it and yet I still had to apply full focus to each one and push as if I had not already been pushing for a long time.

While the earlier stages of labor had felt manageable, I can only say that the pushing stage became more and more miserable. It wasn’t necessarily that the pushes hurt — I would still describe them as intense pressure rather than acute pain — but that as time went on with little progress I began to feel as if it were futile and I was just pushing the same push over and over again. And the doctor and nurses encouraged me — sometimes gently, sometimes more actively — to push harder and longer, and this was such a strain each time, to be feeling so much pressure and exert myself to the utmost to make that pressure greater. The doctor said to curl my tailbone up and my head, neck, and core too — like a cooked shrimp, really. “Curl around your baby,” she said, but I simply hadn’t the core strength anymore, even with Erik helping me hold my neck up. With each contraction they could see Pudding’s head — and I could see Erik was very excited about this — but it never seemed to descend enough in spite of the new nurses’ (Ashley and Griselda, Janelle having finally gone off shift) encouragement that I was so close.

I continued to have no sense of time. Every time a contraction came, I pushed. Erik held my right leg and Griselda my left, and she massaged it in between, which was deeply soothing. The doctor was in and out. People (sometimes the doctor, sometimes a nurse) kept putting a cold compress on my forehead and then wiping my face and chest with it, which I appreciated. New nurses appeared periodically; every time someone new came in I found it simultaneously annoying and a welcome infusion of fresh energy.

Continued on March 17 (edited March 23)

I don’t know how long I’d been pushing before they started to do more than just coach me through pushes, and I don’t remember in what order most of this happened. They had me try to pee, and when I couldn’t, they put in a catheter just long enough to empty things out. The doctor (or Ashley?) said she thought once my bladder was empty Pudding would come right out. Nope. They gave me Pitocin, which I had not wanted to take because I’ve heard it can make contractions much more intense, but at this point it hardly seemed to matter; Erik says it made my pushes a little stronger, but it didn’t feel like it to me. They put a scalp electrode on Pudding to better monitor her, since the monitor on my abdomen wouldn’t stay put; I hadn’t wanted that either but again, it no longer seemed to matter. They had me try different positions — squatting on the floor next to the bed, hands and knees on the bed — and I had wanted to do all those in theory, because gravity could only help, but in the moment I hated them all because they meant I had to support so much more of my own weight and I couldn’t simply let go in between pushes to rest. They put an oxygen mask on me and I hated it (I hate having anything on my face). (Funny thing, I completely forgot about the oxygen until I saw this more than a week later!) If I had been more present for all of this I might have felt more concerned by the monitoring and the various interventions but I just couldn’t. Unlike my sister during her labor, I never went to a deep-down internal place where I no longer registered my surroundings, but I was very out of it, the way one is when one is very very tired; nothing felt real even as it all felt inescapably awful. I think I mostly kept my composure through all of this but I definitely whimpered at the end of some of the contractions. I was just so worn out and it felt as if I would be there pushing until the end of time.

Eventually the doctor explained to me that as I was getting so tired and Pudding’s heart rate was getting high enough to indicate she might be getting stressed, they were going to go further with the interventions. (I had been pushing for nearly four hours at this point.) There was a surgeon who was expert at vacuum extraction and she was going to watch me push and evaluate whether I was a good candidate. I had really not wanted the vacuum but I remembered my mom said my cousin had it (and he’s fine), and also I couldn’t care anymore. The surgeon was considerably more businesslike than everyone else and did not waste time telling me how great I was doing; instead she offered critical feedback as I pushed. Her plan was to do the vacuum procedure in the OR, and if it didn’t take, we would go directly to c-section. Part of me was appalled that it had come to this but the majority of my thoughts were just FINE; GET HER OUT! Another contraction came and they told me this was my chance to avoid the OR so give it all I had — which wasn’t so much by that point, but I tried, and there was much excitement because apparently (I only learned this from Erik afterward) I managed to get a bit more of her head out that time and that prompted the surgeon to change gears abruptly and declare she would do the procedure in this room instead of the OR. (Shortly after that, rather anticlimactically, a man came in and introduced himself as the anesthesiologist, and was told he was no longer needed.) The doctors did various things at the foot of the bed — what, I can’t tell you; I was more and more out of it with each minute — but there was a spot lamp set up and lots of people in the room. The crowd was another thing I had thought I didn’t want, but now cared nothing about. It occurs to me now that the whole experience was a perfect illustration that there is a time and place to consider optimal outcomes and then a time and place to just fucking get the thing done no matter how.

And the thing did get done. I can’t tell you whether it took an hour or five minutes. They set me up with the vacuum, I don’t know how. I don’t know who was doing what or what position my limbs were in. All I remember is my doctor doing something to my cervix/vagina/where all the pressure was and me pushing through another contraction, and the doctor (and probably everyone else) yelling at me to push hard, and something feeling absolutely horrible, and what felt like the doctor reaching into me and moving something around, and if I didn’t entirely black out at this point I at any rate don’t remember any details. And then I realized the dreadful feeling was Pudding coming out, and the doctor was telling me to lift my head and open my eyes and look, but I couldn’t do it and I didn’t care.

Pudding emerges!

Next thing I knew someone was putting a slimy, bloody, very small, very warm something — someone — on my chest and I came out of whatever stupor I was in to realize this was my baby… AND I didn’t have to push anymore. Much as I was pleased to know she was fine, and feel her slippery tiny limbs under my hands, I was tremendously exhausted and honestly couldn’t really handle anything. She yelled and everyone made happy noises in response, and I asked if Erik wanted to hold her skin-to-skin because I didn’t think I was getting the most out of this important moment and I felt that someone should. The doctor said maybe a little dryly, “Well, she’s still attached,” and I was surprised and then dimly registered that I could indeed feel the cord still connecting us.

The afterward is still hazy, but I remember some of it. A nurse cleaned up the baby, and the doctor helped Erik cut the umbilical cord (instructing him to use more pressure than he might think; he later said it was like cutting through an electrical cord), and he took off his shirt and they handed him the baby in a blanket and he held her next to him. For the next somewhile they were cleaning me up and doing various rather unpleasant things like massaging my uterus and getting out the placenta and stitching up what turned out to be a third-degree perineal tear (fourth-degree is worst; I’m glad I didn’t know this at the time). I talked a little bit to the doctor or nurses and from time to time looked over at Erik on the couch murmuring to the baby and I felt so full-hearted.

At some point I realized I was incredibly hungry and a nurse brought trays for Erik and me: mediocre cafeteria food that I could barely manage to eat since I could hardly hold my head up, but I ate the weird parfait dessert thing and then the weird turkey sandwich (with squeezes of light mayo) and much later the packet of saltines and weird tomato veg soup, and I felt better. I had thought we would not be in the room for very long and that we would be mostly left alone there but we weren’t alone and it seemed hours until we were taken to the recovery room. I didn’t care. I had a vague idea that I might prefer just to sleep but I was past having any real opinions. After they patched me up they still needed to examine the baby and I don’t recall what else. At some point they helped me to the bathroom and I was relieved that I could not only pee but that it didn’t hurt to do so. Then there were thick pads and weird mesh disposable underwear (I came to quite like these) — these, along with numbing spray and witch hazel pads, became part of my bathroom routine for days afterwards. Someone footprinted the baby. I signed papers. We finally had a moment to send photos to our families; we also asked them not to visit until the next day (a very good choice). Various nurses congratulated us and then we never saw them again; much later our doctor came back, hugged us both, and said she’d come visit the next day.

And finally I got awkwardly into a wheelchair and held the baby as the two nurses wheeled us down hallways and into the elevator and up a floor to a recovery room which was perfectly spacious and had a simply lovely view beyond the parking structure to the familiar streets of Berkeley and the port of Oakland and even San Francisco Bay. It was my first glimpse of the outside since the day before and it was raining and somehow I was so glad to see the rest of the world still there!

It’s hard to tell from this pic, but you really can see the bay and it is a lovely view.

Recovery

The nurse for the room was very nice and knowledgeable. Erik had a cot next to my bed and the baby had her clear plastic bassinet on my other side.

For the next two days we lived in this room as they monitored me and the baby, ran tests on her, and taught us how to breastfeed. I was brought more forgettable food — which I ate very hungrily — and snacks which I requested seemingly every time they came to check on me, while Erik made do with my leftovers and the Clif bars he’d packed. I tried to send him out for a proper meal, or at the very least to the downstairs cafeteria, but he insisted he was fine and truth be told I was glad not to be separated.

We were supposed to rest, and there was nothing I wanted to do more, but I couldn’t, somehow. It had been such a momentous time and my body was so worn out that I actually couldn’t really relax enough to sleep. The next morning I realized everything above the thighs was sore, from the obvious parts to my throat (from vocalizing) to even the muscles of my forehead. I was glad for the ibuprofen they were giving me every six hours. It wasn’t awful pain, at all, but it was just so everywhere. 

Naming

Continued, March 20 (edited March 23)

We had until leaving the hospital to decide on a name (actually we had longer but everyone said it was a pain to deal with naming after leaving the hospital), but we knew family would be coming and we wanted to name her before everyone else could weigh in. We had always had three primary names in mind (with a slightly longer list of backup options): Amara, Wilde, and the name we ultimately chose — which I will not be using online. Wilde started as a joke but it grew on us. After the baby was born and her birth was so different than we expected, I said to Erik, “We might really have to call her Wilde.” The trouble was that she just really didn’t look (or act) like a Wilde. She has a sweet, dainty face and a very calm demeanor. So we weren’t sure what to name her and we were much too tired to discuss it properly.

As it turned out, by the next morning Erik and I had both decided independently that she looked most like the third name, so that was settled. Her middle name took a little more deliberation, but we eventually decided to go with our original choice for a middle name; I’m also not revealing the exact name here, but it’s a more Asian as well as American play on the French name Mireille and the Spanish name Mireya. We were almost 100% decided when the birth certificate person showed up at our room so we said, all right, let’s do it! And so our baby was named officially.

I have to say that during my pregnancy I thought of our baby as all those names, so the fact that she can’t take all of them makes me a little sad, as if Amara and Wilde were also my babies and I’ve had to let them go so that our baby can exist. Of course I would rather have our real baby than any number of hypothetical other babies, but there is still a feeling of loss.

Recovery con’t

The rest of the hospital stay (just under 48 hours) was quite pleasant; I had thought, beforehand, that I might want to leave early but this was very much not the case. All the nurses were very caring and responsive, and knew so much about everything, and their breastfeeding instruction was an invaluable help — especially since there were enough of them (and a separate lactation consultant) that we benefited from many different perspectives. (Not that there are so many ways to do it, but you know how teaching is — a lot can depend on how someone presents something.) We were very fortunate in that we encountered only the normal learning curve with no significant issues, but even so, I don’t think we would have picked it up so quickly without all their advice.

I was also very grateful the nurses were a diverse bunch (ethnically, nationally, age); that made us feel that they were accepting of a variety of approaches and cultural attitudes, and not just passing on some standard protocol.

Both sets of families came to visit, bearing gifts and food, and our doctor returned and checked us out and told us firmly that we must nap.

Baby meeting her grandparents (my parents) and her cousin Teddy

We rested a bit better the second night, and then the next day were discharged into a drizzly morning and a brand new life. It was a strange experience leaving the hospital because everyone congratulated us, from the staff (which we expected) to total strangers entering and exiting the building. I suppose new parents, and especially a new mother, are unmistakable, but it was strange and touching to be pushed through the corridors being congratulated seemingly every minute. I realize now that this is a phenomenon that occurs in our society only during major milestones, because those are the only times (generally speaking) when our personal achievements are instantly communicated to everyone who sees us — graduations, weddings — and are, moreover, assumed to be unequivocally joyous enough that perfect strangers feel free to comment with sincere goodwill. I felt a little like crying; it was overwhelming.

Going home

The drive home was short and my mom and youngest sister had come to help us get settled. My poor sister was immediately put to work cleaning up the surprisingly copious amount of poop Lyapa had left for us all over the apartment. Lyapa herself, strangely enough, was far less wary of our baby than we expected, and mostly just seemed really happy we were back. She has continued this way in the days since… she doesn’t seem particularly interested in the baby but she is not avoiding her either, often spending nights next to the bassinet and purring at random times. This behavior is so far from what we expected that I am honestly at a loss for how to interpret it. My nephew (now eight months old) has visited several times and when Lyapa sees him she skulks into the farthest corner and faceplants. So whatever she is thinking, she clearly places our baby and her cousin in different categories and acts accordingly!

And now we are home with our baby; a nurse came two days after we got home and the doctor came two days after that, and we’ve had family (in which category I include my best friend Jackie, in town just for the occasion) visiting every 1-4 days, keeping us fed and doing helpful things like the dishes and picking up groceries. Some days after our arrival home I took my first shower and since my family was here to babysit, Erik came into the bathroom with me, in case I needed help, and we realized it was our first private time together. That was nice; we just chatted about how we were feeling about everything that had happened; it was our first post-baby date!

Although her birth was not what we expected, we’re very happy for how it went, and grateful to our doctor, the doctor who did the vacuuming, all the nurses, and the teachers of our birth, lactation, and prenatal yoga classes, for making such a milestone experience also a really positive one. I hope to write another post soonish about the adjustment to life with a newborn, but for now, I’ll just say that everything is going as smoothly as can be and we are all, though very tired (and often emotional in my case), doing well. 

[full name and birth date, weight, etc, were originally here, but have been removed for privacy.]

four days old

two weeks old