At ten o’clock the doctor (whom I’ll call Dr. Bubbles because that’s what her voice reminds me of) comes in to meet me and find out how we’re doing. Since it’s been four hours since my last cervical check, I’m hoping that I’ve gained at least a centimeter or two (secretly I’m hoping that this new increasing frequency and painfulness of contractions is transition). I nearly cry – and actually do cry, after Dr. Bubbles leaves – when she tells me that I’m still at 4.5cm. Pitocin is now non-negotiable, especially since I’m still bleeding. I understand this, but I feel like my own desires for my birth are in danger of getting swamped by the ideas of this strange doctor, and I try to communicate to her how important it is to me to keep the interventions as few as possible. In my hyper-emotional state I’m not sure how well I succeed at communicating, but Dr. Bubbles does agree to begin with a very low dose of Pitocin in order to give me a chance to keep progressing on my own. I’m glad, because I know my chances of making it without the epidural will decrease the more Pitocin they give me.
Speaking of the epidural, the next hour-and-a-half is the period of labor during which I seriously consider it. The previous four hours were hard but manageable because I assumed I was making progress. Now I’m in serious pain, and not even sure it’s accomplishing anything. I rock through each contraction, breathing in rhythm, eyes closed, concentrating on the fact that it can’t last forever. “It will end. It will end.” That’s my mantra, and with it I can just cope. But we’re nowhere near the end now, and the thought of hours and hours more of this is very discouraging. I’m not sure how long I can keep doing this.
That’s what I tell Mom and Bryan, my voice frantic, as these minutes pass. I feel overwhelmed, especially when I forget to anticipate a contraction, when I’m off-guard and the pain hits me before I’m breathing to deal with it. The thought of much more of this makes me really want the epidural; I refrain from insisting on it because I am finding the pain just barely manageable. It must be clear to Bryan and my mom that my resolve is wavering, though, because they are giving me constant reassurance and support, telling me how great I am doing, staying close to me, one on each side, so that I can lean on them for whatever I need.
By this time it’s been an hour since the doctor checked me, and I’ve been on Pitocin for forty-five minutes. The nurse said it would take an hour to kick in but I can’t imagine how that’s possible, since the contractions are hard, strong, and coming faster. I grow more panicked, and Mom tells me just to take it one contraction at a time, asks me if I can just manage to get through another half an hour. Can I make it to 11:30? It feels impossible but I promise to try, and somehow I do make it, one contraction at a time, just like she said.
Deb the nurse comes in at 11:30 to let us know that Dr. Bubbles will be back soon to check me, and it gives me a new milestone: I just have to make it until the doctor gets there. (Not true, of course, since the doctor’s arrival will hardly make the pain stop, but it helps to have something to focus on.) Deb also realizes that she’s forgotten to increase the Pitocin dose, which has been going up in two-unit increments every half hour. She reaches for the IV bag and I beg her not to up it again until the doctor gets here, in case the dose I’m getting is already doing enough. She hesitates, torn between her obvious sympathy for me and the need to follow doctor’s orders, and finally agrees to increase it by only one unit.
(In retrospect, and from talking with my mom, I now know that the total amount of Pitocin I got was tiny; it almost certainly made no difference at all whether the dosage went up by one unit or two. The benefits of the compromise were almost certainly only psychological. Which doesn’t necessarily make them less important, as encouragement was exactly what I needed at that point.)
Deb is back with Dr. Bubbles at 11:40, and I hold my breath while she checks me. Big choices hang on this moment: if I’m still at 4.5cm after an excruciating hour-and-a-half, I am going to be seriously reconsidering my commitment to my ideal birth plan (which has of course been shot to pieces already, but I’m trying to retain as much of it as I can). But Dr. Bubbles, stripping off her gloves, smiles at me. “Apparently a little bit of Pitocin was all you needed. You’re at seven centimeters.”
I exhale in relief and ask shakily if this means we don’t have to increase the Pitocin anymore, and she nods. I’m glad about that, and glad also because I know 7cm means I’ll soon be in transition, so the end is in sight. I’m still in enormous pain during my contractions, more pain than I’ve ever experienced before, but it is easier to handle because I’m encouraged to be progressing and my mental and emotional state is much more positive. Rather than worrying about whether I can make it, I start simply concentrating on getting through.
Very soon this is absolutely necessary. I thought the contractions of active labor were bad, but they were nothing compared to the transition contractions. There is no question of doing Sudoku now, no question of doing anything except making it through the blinding pain. The contractions, which come barely a minute apart, are long and unrelenting (my mom looks at the monitor and says “they look like circus tents,” which is exactly the image I remember from the chart we studied in Lamaze class). Between them it is all I can do to recover and prepare to breathe through the next one.
Sometime in here I’ve moved from the bed to a large soft recliner chair that’s in the room. I have a feeling this is slightly unorthodox, but Deb is sympathetic to our cause. She seems to have shed her earlier skepticism about my birth plan, and has joined Bryan and my mom in cheering me on. I need the encouragement, especially the several times that a contraction hits before I’m properly prepared for it. These have me near panicking, and until I catch my breath again I feel like there’s no way I can handle this. I’m helpless, the pain simply overwhelms me.
But mostly I do remember to breathe, and mostly I do handle it, which amazes me. This is so much bigger than anything I’ve ever been through. It’s huge, all-engulfing, far beyond the abilities I thought I had, but somewhere deep inside me I find the strength. I find it because I have no choice, but I find it also because I realize, instinctively if not consciously, how huge, how life-changing, this whole thing is. And I find it because, in a very real way, I was born to do this.
So I bear through the pain, feeling often as though I am outside myself. During contractions I rock the chair violently and slap my feet on the floor, concentrating on the feeling of the cold hardness against their soles. Usually I keep my eyes closed; when I open them I stare at a picture on the opposite wall which shows a path winding through a garden. For me the path comes to symbolize making it through labor, and later when it’s all over I will look at the picture and experience a profound sense of relief.
It feels like ages but is really only about half an hour before I start feeling the urge to push. At first I don’t identify it as such, and insist that I’ve got to go to the bathroom. I’m allowed to go, with the understanding that I’m not to push while I’m in there, but I accomplish very little because, of course, it’s the baby’s head that’s causing all that pressure. When I’m back in the chair, the sensation continues to increase with each contraction. Finally I cry frantically that I have to push, I just have to.
Deb agrees to check me, and I’m at nine-and-a-half centimeters, so we start preparing to transfer me back to the bed. By the time I’m there, with the super-bright delivery lights shining in my eyes, Deb checks me again and announces me ready to push.
I’ve heard from some people that finally being allowed to push is a relief, but my mom has warned me that it’s not that way for everyone; for her, pushing was just a different kind of awful, and not necessarily better. So I’m prepared for that. But for me, it is better. It’s hard work, unbelievably hard, but it’s not as bad as transition. The transition contractions were horrible pain that I just had to wait through; these contractions are sharply painful when they begin, but I stop feeling the hurt as soon as I start pushing. This means that as soon as I can feel a contraction coming on I’m frantic to begin, and often I yell out when this happens.
I don’t have to be in stirrups, thank heavens, but am instead sitting up, with Bryan holding one of my legs and Mom holding the other. I have trouble getting the hang of pushing at first – I exhale loudly instead of holding my breath to push; I throw my head back instead of putting my chin down to make sure all the energy goes in the right direction. (Mom actually finds a way to hold my leg up with one hand and my head forward with the other; this will make her very sore the next day but I am very thankful to her for doing it. Later I will see that during the few pushes I did with my head back, I burst all the blood vessels under my jaw line.) At first I also make noise while pushing, but Deb warns me that if I keep doing this I will make my throat raw, so I stop. It will hurt quite a bit the next day, anyway.
Deb is right there, monitoring the baby’s progress down the birth canal, changing the pads occasionally as heaven-knows-what comes out of me as I push. I’m working as hard as I’ve ever worked before; this takes huge amounts of physical energy. I’m covered with sweat, and for a moment I think longingly of a shower, but there’s no time to focus on that, no time to focus on anything except getting this baby out. It’s encouraging that I seem to be making real progress; they keep telling me how awesome I’m doing and I know they’re not lying because I can feel the baby’s head moving down the birth canal.
I feel an enormous amount of pressure, more than I’ve ever imagined I could feel and still remain intact. I find it astonishing that my colon is apparently still inside my body – with this much pressure I would expect it to have made its way outside me by now. Between contractions I flop over, exhausted, trying to gather strength for the next round of pushing. It feels best to lean forward, but I’m warned that once the baby gets far enough down, I won’t be able to do that any more. Sure enough, pretty soon I’ve got no choice except to lean back, which is not nearly as comfortable and makes it harder to breathe.
Time is suspended, but I will later learn that I pushed for only forty-five minutes total. After what must be about half an hour of pushing, Deb calls Dr. Bubbles because “we’re getting close.” I don’t notice her arrival but soon she’s there, gloves on, doing her thing as I continue to push. I’m fairly oblivious to her; my mom will tell me later that she was doing quite a bit of perineal massage, and also gave me a shot of local anesthetic at one point, but I miss all that. The job of pushing is my whole world.
They tell me that the baby is crowning. It burns, but it crosses my mind that “ring of fire” would definitely be an overstatement. (That was the local anesthetic doing its job, of course.) They tell me I can feel her head, and I reach down to feel something wet and hard. It’s my first conscious physical contact with my baby, but I’m too diverted to appreciate the wonder of it. I’ve still got the job of getting her out.
That is not going so well. The crown of the baby’s head is right there, but she’s not moving any more because the perineum is too tight. Dr. Bubbles tells me that she can “take a little snip” to speed things up, but she’s fine with just letting me tear if that’s what I’d prefer. She’s not pressuring me, just making the options available and leaving the decision to me. I really want to avoid an episiotomy – I’ve read about how tears heal more easily – so I tell her that I’d rather just tear. We keep going, with the pushing.
But I am drained now, ready to collapse after eleven hours of labor on two hours of sleep, and while I push through several more contractions, the option to speed things up is tempting. Hoping fleetingly that I won’t regret it later, I tell Dr. Bubbles between gasps to go ahead and do the episiotomy on the next contraction.
The following seconds flash by. I begin to push, barely register the doctor doing her thing, and suddenly my baby is on my chest. She’s purple and covered with a lot of vernix, but she’s beautiful. Dr. Bubbles clamps the cord and hands the scissors to Bryan, who is wide-eyed but remarkably steady-handed, especially considering that he was worried that the birth process would make him queasy.
(This was not an unfounded worry. At one point during our NFP class oh-so-many years ago, the discussion got slightly technical and Bryan became so nauseated he had to leave the room. Considering that, it’s quite significant that he made it through our daughter’s birth without wavering even a little.)
He cuts the cord, and the baby is handed off to the nurses around the warmer, which is on the other side of Bryan. They bustle around her as we watch. It occurs to us that we should name her, and we confer silently with our eyes before announcing that her name is Camilla Claire. I look at my mom and she smiles at me – she likes the name, or at least is doing a very good job of pretending to like it.
Lots of things are going on now. The nurses continue to work with Camilla while Dr. Bubbles delivers my placenta. I delivered the baby, but it really does seem like she delivers the placenta – they told us in birth class that we’d have to push the placenta out but I don’t; the doctor gives my stomach a tiny bit of pressure and it slides right out. Apparently it is also followed by a blood clot, because Dr. Bubbles says, “Oh, you did have a little abruption.”
I probably would have asked questions but I’m too distracted now – it has occurred to me that I haven’t heard a big cry from my baby, the way I’d expected. Sure enough, the nurses are still bustling, and there’s a noticeable tension around her. One of the nurses smiles reassuringly at me, tells me that the baby is fine, just not crying quite the way she should. They’re going to take her to the special care nursery (this hospital doesn’t have an NICU) to work on her some more.
First, though, they swaddle her up and place her on my chest again so that I can hold her. I appreciate this, and it makes me feel better about her condition, since I imagine they wouldn’t stop to let me hold her if things were horribly urgent. She’s even more beautiful now that she’s clean, but she’s breathing funnily – hacking and wheezing – and I want her to be better even more than I want the chance to hold her. I hand her back to the nurse, and tell them to “Fix her, please.” Bryan goes with her off to the nursery.
It’s not an ideal state of affairs, but I’m too euphoric to be worried. This is good, since Dr. Bubbles is doing uncomfortable things to make sure that none of the placenta is left in me. (I tell Bryan later that she was using what looked like a small shovel and a pair of barbecue tongs, which makes him laugh, but that is how I remember it.) She then stitches me up, asking me if I can feel the stitching and giving me another small shot of anesthetic when I tell her I can.
These things – the excavation, the stitching – would be decidedly unpleasant under normal circumstances, but in comparison to what I’ve just been through they seem inconsequential. And I am on cloud nine, awash in post-birth hormones, utterly relieved to have made it through labor. I can’t stop talking, and I’m sure everything I say is nonsense, but I want to share my happiness with everyone around me, want them all to feel as good as I do.
I am suddenly both very cold and very hungry. Deb, bless her, brings me warm blankets and a menu for the hospital’s room service. (I know! Swanky!) Fortunately it is not too late to get lunch, and I call down to order a hamburger and soup and juice. By the time they arrive, Bryan is back.
He brings a vase of purple alstromeria. The card says “Love you both!” which makes me tear up happily for the hundredth time that hour. He also brings the assurance that Camilla is doing very well. They want to keep her in the special care nursery for a while longer to monitor her oxygen levels, but we should have her back in a couple of hours. I’m too happy to even be sorry that we don’t get to have her right away. And anyway, the time passes very quickly as we call various friends and relatives to tell them the news.
Before we know it, it’s time to go get our daughter.