On Wednesday, June 30th, I woke up and did what I had been doing every Wednesday for most of my pregnancy. I took a photo of my bump to post to this blog. I wrote that it was hard to believe that I might be pregnant for another 4+ weeks. Being pregnant was fun for a while, but I was over bathroom breaks 3 times a night, not being able to bend over and put on my own shoes, and feeling constantly fatigued (even more so than the 1st trimester). On the weekend before, we had completed everything on our baby to-do list. We were ready to meet our baby! I had made a prediction several months before that our baby would come early. Everyone thought I was crazy because most first time moms are late. I can’t say why I thought early, it was just an intuition. I eventually narrowed down our baby’s arrival to a particular week: July 5-12. In the final weeks of my pregnancy, I stopped thinking of the baby as Tray and started thinking of Olive; intuition told me our baby would be a girl. I never really let on to anyone that I thought she would be a girl. On the elliptical at the gym, I would think of Olive and her birth and what it would be like and it would bring tears to my eyes and I could see my heart rate go up.
On the evening of Wednesday, June 30th, Matt and I decided to go for a walk/run around our neighborhood. We had been doing this for a couple of months. We would run a block or two, and then walk several blocks. We discovered many new streets and viewpoints during these routine outings. On this night, as we neared our house, we ran past a couple of young guys hanging out on the hood of a car. We were on the opposite side of the street when one of them yelled out, “Excuse me!” I answered him and his reply was: “You’re having a girl, aren’t you?” We laughed and said we didn’t know. He assured me the baby would be a girl; he could just tell. He laughed and said to Matt, “I bet you want a boy though.” Matt just smiled and said it there was a 50% chance of a girl and a 50% chance of a boy.
That night I got up to use the bathroom around midnight. Then, around 3:40am, I woke up and felt the urge to go again. Only this time, it felt different. I felt very wet. I navigated my way to the bathroom in the dark as I had done countless times before. When I sat down, there was an involuntary release of fluid. I thought it was amniotic fluid. I turned on the light and my heart skipped a beat when I saw bright red blood. I sat down again, another gush. I got up and immediately woke Matt and told him I was bleeding. We called our OBs office and left a message on the emergency line. But I knew we needed to get to the hospital, Swedish First Hill, only 10 blocks away. By 4am, we were in the car on our way to Labor&Delivery triage. The OB called back as I was entering the hospital through the back emergency entrance as we learned we should do if it was the middle of the night. At that point, I hadn’t felt our baby move and I was freaked out.
In triage, they were waiting for me (the OB on call had called them and told them to expect me in the matter of a few minutes since we had talked). Matt was right behind me. They immediately hooked me up to monitors to listen to the baby’s heart rate. At that point, I was still bleeding. Around 4:20am, I passed the test I will always think of as the most important test of my life: happy baby, healthy heartbeat. But we still didn’t know what was wrong. The OB on call came in and did an exam, they drew blood samples to send to the lab, and they tested the blood for amniotic fluid. They found no trace of amniotic fluid so my water had not broken. For the first time, the OB mentioned the possibility of a placental abruption.
What seemed like only minutes later but must have been at least 1.5-2 hours, a very sweet young nurse named Julien came to our triage room. She would be the first of many nurses we would encounter during our multi-day stay. Julie checked us into L&D and the constant monitoring of me and Olive began. They gave me fluids, drew more blood from both arms (I was bruised on both sides by the time I left), and told us we would be taken for an ultrasound within a couple of hours.
Around 10am, an orderly wheeled in a bed and said he would be taking us to Radiology. I asked if I could walk myself and he said no. At Radiology, the ultrasound tech introduced herself as an intern (not exactly what you want to hear under these circumstances). The ultrasound took 45+ minutes. In one of the shots, you could see our baby’s profile and it looked she was sticking out her tongue. The intern left and the tech came in to take an additional look. No one was saying much. During the exam by the tech, she swapped wands on the machine and soon we were looking at high-tech 3-D images of our baby. We could see her face perfectly. The tech said she would give us a CD of the photos and we thought that was so sweet – the first of many kind gestures we would experience at Swedish. When the Radiologist came in, she seemed perplexed. There was no evidence of an abruption or placenta previa. She could identify where my placenta was attached to the uterine wall (it was way up high under my left breast) and there was no sign of a tear or rupture. My bleeding had stopped by now. She explained that the test results could not rule out an abruption; it could only rule it in. The technology wasn’t sophisticated enough to make a distinction between blood and amniotic fluid; they look too much alike. I was wheeled back to my room in L&D.
A couple of hours later, a different OB from the same group came in. She had reviewed all of my test results and was ready to give a recommendation. She explained that our baby was term (past 37 weeks) and viable outside of the womb. I had lost a significant amount of blood. I was having painless contractions 2-3 minutes apart since they had started monitoring around 4:15am. She gave us 2 options: I could be induced (her recommendation) or I could go on bed rest with constant monitoring for 1 week to see what might happen. We asked her what induction would look like. She said pitocin and possibly a foley catheter (a small, 3cm balloon that’s inflated inside your cervix to encourage dilation). We said we wanted a second opinion, that of our regular OB who was out of the office that day but would return on Friday. She agreed we could wait until Friday with constant monitoring in the antepartum wing.
She sat really close to me on the bed and she said, “I know what you’re thinking. You’re thinking this is your first baby and this isn’t how you imagined it would be. I’m a mom too and I understand that. But we have to do what is best for you and your baby and induction is the safest solution. Why risk more bleeding?” I started crying. She was right. I needed time to process how different this was going to be. How it wasn’t going to go the way I had been daydreaming it would be when I was on the elliptical at the gym.
We were transferred to anterpartum where we would stay for the next 48 hours. The rest of that first day, I was monitored constantly which meant I was tethered to the bed with bands around my stomach to which fetal heart rate and contraction monitors were attached. My chart said “constant monitoring with bathroom privileges.” I couldn’t get up and go for a walk and I couldn’t take a shower and I couldn’t even stand up and walk around the room. We started making calls to family and friends. We called our doula, Cheryl, and explained the situation. She was with another mom in West Seattle who was 2 weeks past her due date. Her water had broken overnight. Cheryl hoped she would be able to stop by and see us in person sometime on Friday. All the while, my contractions continued 2-3 minutes apart.
That night, after the nursing shift change, we met our new nurse, Deb. Deb had recently transferred to Swedish First Hill after a long stay at Swedish Ballard as a nurse midwife. She looked the part and we immediately liked her. She liked that we had chosen to be monitored (instead of induced) while waiting for a second opinion. We asked about the uncomfortable vinyl chair in the room where Matt was supposed to sleep. It didn’t lay flat and he was too tall to fit in it. She said she had seen a rollaway bed in another room but it had a reserved sign on it. I was upset that Matt wasn’t going to get a good night’s sleep. A few minutes later, Deb wheeled in a bed. She said she just went ahead and took the reserved bed. We had an immediate need for it. Another kind gesture.
The next morning at around 8am, our OB, Dr. Kimelman, came to our room. We had really grown to trust her and her moderate views. Matt and his analytical mind and penchant for extensive research had tested her on many issues during our office visits and we found her answers to be very thoughtful and fair. The first thing she said was that she could not believe that it was me who was in this situation. Of all of her patients, I was the last one she was expecting to see under these circumstances. Then she gave her recommendation: induction. She said she had sought the opinion of a perinatologist (an OB for high risk pregnancies, which I was now being considered). They made the same recommendation.
Again we asked what induction would look like. She too mentioned pitocin and a foley catheter but said she wanted to check my cervix to see if all of the contractions I was having had resulted in any progress. The day before I was at 1 cm, 70% effaced. This time I was 2cm, 75% effaced. My body seemed to be ramping up on its own. As a result, the foley catheter was no longer an option (I was already too dilated). Pitocin it would be. We explained that our doula was still with another mom and we wanted to buy some time to see if she could make it to our birth. We asked who would be on call from our OB’s group. We were happy to learn that Dr. Kimelman would be on call for 24 hours, starting 8am Saturday morning, this meant she would probably be able to deliver our baby. At that point, I was ready to be done with bed rest, done with all of the monitoring and ready to meet our baby. I was still very emotional about how different it would be, but I was resigned to their recommendation. We set a time for induction: 6am Saturday morning. That night, Matt and I fell asleep in my bed together. We knew it would be the last time it would be just the two of us. We were excited to meet our baby but I was also mourning the loss of our relationship as we had known it. We were scared and restless.
The next morning, I was up at 5am to prepare for my 6am induction. I remember putting on some makeup (waterproof mascara), putting my hair up out of my face and changing hospital gowns. I looked in the full-length mirror at my reflection and knew it would be the last time I would see myself pregnant with this child. I had grown so accustomed to how I looked. In that moment, I was a little sad that my pregnancy was ending. Six came and went and soon it was 8:30am and still no word about when I would be induced. Dr. Kimelman stopped by and said L&D was extremely busy and there weren’t any rooms available. She would give us another report in a couple of hours. Then it was 11am and I was anxious and mad that we were still waiting. At around 12:30pm, Dr Kimelman came back. She apologized for the wait and said that she had personally written my name on the board, assigning me a room in L&D. Barring any other high-risk or complicated labor patients, an L&D nurse (who our OB had hand-picked for us based on our desire to keep things as non-invasive as possible – another kind gesture) would be picking us up within the hour. Then our OB said, “instead of putting you on pit [pitocin], I’m going to strip your membranes and break your water.” I liked that idea because it wasn’t pitocin, but, in the excitement of getting a room, we didn’t ask why she had changed her mind.
By 1pm, an L&D nurse named Angie came to our room in antepartum and we were then transferred to a room in L&D. Our doula was still with the West Seattle mom. She had now been in labor for 48+ hours and was at the hospital. A back-up doula named Katrina was with us instead. Again, not according to our plan but we were grateful for her presence and advice. Within 30 minutes, Dr. Kimelman announced that she would now be stripping my membranes and breaking my water. Katrina said to me, “if you have any questions about this, now is the time to ask.” So, I asked, “why did you change your mind about pitocin?” I was shocked at her reply. She explained that breaking my water was the only way she was going to be able to get me into L&D that day. If my membranes were ruptured, I was put higher on the triage list than someone being induced. I asked whether she thought this would start my labor and she said, “I’ll be disappointed if it doesn’t.” In that moment, I was very grateful and felt very lucky to have chosen her. She knew she had set an expectation that she would deliver our baby and she was doing everything she could to make that happen. She was confident that my body would do what it knows how to do and go into labor on its own, without the need for pitocin. She was right!
I walked the halls of the hospital for 15 minutes or so using a remote monitor for the baby. I was anxious for things to get started. At one point, I got trapped by a large tour of pregnant women and their partners; I felt like a monkey on display: “And here’s a real life woman in labor.” My nurse Angie joked that I should drop to all fours and start moaning. I didn’t have a chance to play that little joke because within about an hour (around 2:30pm or so) the contractions started. At first they were manageable and I was able to use my Ujjayi breath to cope. It was around this time that my contractions went from 2-3 minutes apart to 1-2 minutes apart. I continued to cope using a breathing rhythm that sounded like a long moan. I used the birthing ball, the bed, the rocking chair, and standing upright. Katrina said she thought I had entered active labor. I remember acknowledging what she said, but I didn’t open my eyes. In fact, I didn’t open my eyes and look at anyone for a good 5 hours at least.
Around 6 or so, I got into the birth tub. I had been looking forward to the moment they told me I could get into the tub. Water is supposed to be one of the best ways to cope with pain. But you can’t get in too soon or it can stall your labor. The contractions were still coming a minute apart and every 3rd or 4th one was a back-to-back contraction. I remember hearing Matt and Katrina saying “let go of this one, this one’s over” (they were watching the monitor and could tell when I was past the peak). But a lot of the time, I remember saying “no, it’s not going away” or “it’s back.” Despite my high hopes for the birthing tub, it did absolutely nothing for me. I felt trapped, like I couldn’t find the right position and the right rhythm. It was around this time I started thinking about the epidural. My eyes were still sealed shut.
After about an hour in the tub, thinking about the epidural the entire time, I said I wanted to be checked by Dr. Kimelman. I told myself that if I was 6 or 7cm dilated, I would forego the epidural. If I was anything less, I honestly felt as though I didn’t have the energy to continue. It wasn’t about the pain, it was about fatigue, which is what I always knew it would come down to. 2.5 days in the hospital leading up to this moment had left me exhausted, both mentally and physically. Dr. Kimelan came and checked my cervix and I was 4cm and 100% effaced. In reality, I had made great progress, but in my mind, I was thinking that I’d only dilated 2 more cm in 5 hours of pain and fatigue. I said I wanted the epidural. Matt and I had discussed that when I asked for the epidural, he should try to talk me out of it. I heard Matt say, “can we have 5 minutes.” I sharply replied that I didn’t need 5 minutes. Angie started an IV and called for anesthesia.
The anesthesiologist was in my room within 20 minutes. She asked me to sit on the edge of the bed and be as still as possible as she inserted the needle and catheter into my spine. Even if a contraction came, I needed to stay still. The contractions were coming fast and furious so there was no avoiding that I would experience at least 1 or 2 while she was performing this very delicate job. A strong one hit me and I squeezed Matt’s hands as hard as I could. Then, I vaguely remember Matt saying to Katrina “I’m going to faint.” The next thing I remember is the anesthesiologist giving orders to get Matt’s feet elevated, to give him juice and something to eat, etc. The energy and attention in the room shifted to my poor husband lying on the floor of our birthing suite. A new nurse, Maddie, came up close to my face and introduced herself. She was a beautiful young woman in her late 20s. We grew very fond of her during the duration of our stay in L&D. She was the nurse who would help deliver our Olive.
Within 15-20 minutes, the contractions started to fade. I opened my eyes for the first time in hours and Matt was standing next to me and I said, “I can see you.” Our doula, Cheryl, was there now too. She had finished her other job. The West Seattle mom had finally delivered her baby, a 12lb boy, by c-section. She had been in labor for nearly 72 hours. It was around 7:30pm.
I must have fallen asleep almost immediately. My body was so exhausted it was an effortless sleep. When I awoke, it was nearly 9:30pm. Matt was there, as was Katrina, Cheryl, and Maddie. The irony of this was not lost on me. I was surrounded by 4 wonderful support people and I was snuggled up in bed, comfortable as can be. The contractions were still coming but I couldn’t feel them. Later, Matt told me that Cheryl had been watching my contractions on the monitor and had told him that we would have a baby before 1am. She was amazed that the contractions were still only 1 minute apart. She commented that an epidural was probably the right decision for me because I had been fighting my body. Now that I was relaxed, my body could do what it knew how to do. I have very fond memories of the 5 of us sitting around the L&D room for the next couple of hours just talking. It was so peaceful and I felt so loved and cared for by these (mostly) strangers.
At 11:30pm, Maddie announced that she would be checking my cervix for progress. Once again, I closed my eyes (even though I couldn’t feel anything) and waited to hear the news. Cheryl said, “Big smile from Maddie. What does it mean?” Maddie announced that I was 9.5cm. Cheryl was right, in a matter of only 4 hours, I had gone from 4cm to 9.5 cm. It’s typical to gain 1 cm every 2 hours. My body had been ready all along. Maddie said I should take a nap because I would start pushing within 1 hour. I had hard work ahead of me. Katrina offered to massage my feet and I slept until about 12:15.
When I woke up, Dr. Kimelman was in the room. Cheryl and Katrina were on either side. Matt was near my head. Cheryl and Katrina explained how I needed to push. They were surprised that I had such great control of my lower body given the epidural. I could easily lift my hips off the bed and I could feel my feet completely. But there was no pain from the contractions. Perfect! I would pull my legs back, take in a deep breath, hold that breath inside of me, and bear down as hard as I could. I would do this in clusters of three simultaneously with a contraction. We did a test run. I heard Dr. Kimelman exclaim, “I already see hair!” Then she looked at me with a smile and said, “You’re making me rush around here!”
It was either Cheryl of Katrina who suggested that we take a poll in the room to guess the gender of our baby. Cheryl and Katrina who had been watching the fetal monitor for many hours, predicted boy based on the heart rate (boys usually have a slower heart rate). Maddie guessed boy. Matt guessed girl as did Dr. Kimelman and the second set of hands (nurse) they called in for the delivery. I could have been the tie-breaker, but no one asked me what I thought! I continued the pushing for a series of 5-6 clusters of breaths. Again, my eyes were closed the entire time. Dr. Kimelman announced that I needed to open my eyes to see my baby. As we had planned, Matt was the one who got to announce the sex. At 12:48am, he tentatively said, “A girl?” It was confirmed. Then he looked at me and said, “We have a girl.” They placed her on my chest and she was perfect. I couldn’t believe that she was the one who was inside of me all that time. I never thought she would be as perfect as she is. Dr. Kimelman said, “You’re the most amazing pusher I’ve ever seen.”
When my placenta was delivered, Dr. Kimelman and my doulas gathered around to inspect. There was clear evidence of an abruption. There was clotting in a couple of places. The OBs had made the right call all along. Dr. Kimelman then said to me that if I had been on pitocin my labor wouldn’t have been as intense as it was. On pit, they can control how fast your contractions come and they like to settle you into a pattern of every 2-3 minutes. My body made quick work with contractions only 1 minute apart. The irony! I was so against pitocin and now I was being told that my labor would have been less intense with it. I was still glad to have avoided it.
After everyone had left for the night, it was just me, Matt, and Olive. We admired our little girl, every detail, while we waited for a postpartum room. Around 5 or 6am, Maddie came in and helped me out of bed and into a wheel chair. She rolled us out of our L&D room and down the hall toward postpartum. I was sad that it was the middle of the night. There was no one in the halls to see us but I felt so proud holding my daughter in my arms.
In the end, I could not have been more satisfied with my labor experience and with Olive’s birth. I got to experience everything I wanted to experience. I went into labor naturally (except the rupturing of my membranes). I know what it feels like to have labor contractions. I know what it feels like to hit a wall of exhaustion and surrender to the moment. I got to push my baby out even if I didn’t feel the “ring of fire.” I was surrounded by people I trusted and, most importantly, I was handed a beautiful baby and we are both healthy.
Matt’s former boss sent an email congratulating us on the birth of our daughter. In it, he said he hoped that Olive would get to experience the very best life has to offer. It all comes down to that sentiment and it’s really all you can hope for!
