XP: Luke Patrick Med Free Hospital Birth w/ Midwife

Luke Patrick was born at 40 wks, 2 days on Friday, May 20 at 1:16 PM after almost 36 hours of labor, including 16 hours of hard labor and 20 min of pushing. It was a long road but avoiding the epidural was completely worth it to me, espeically because of the freedom it gave me for pushing positions, and I would hands-do it again. Here's the crazy long story:

I started having regular painful contractions about 1:30 AM on Thursday, May 19. They were consistently about 5 min apart, but only 30-45 seconds long, and accompanied by bloody show. Every time, they started as a pain my rectum that spread around to my lower abdomen ? not what I was expecting since I thought they would be in my back more. These continued until 9:30 AM but then spaced out for the rest of the day. During the day, I took a couple walks, napped for about an hour, and tried to take it easy watching TV. When I tried going to bed around 9:30 PM, they really started growing in intensity and getting closer together. I woke up Sean around 11:20 PM and called the midwife on call (Angel) to tell her we would meet her at the hospital. We got to L&D around 12:20 AM on Friday, May 20 and were taken to triage. I was at 4 cm and 50% effaced and had a bunch of bloody show and regular 4-5 min contractions so was admitted. I was GBS positive so they put in a hep lock and started me on antibiotics. Once the first dose was in, they unhooked me and I labored walking the halls, sitting on the birthing ball, and sitting in bed and the contractions were getting to be longer and much more painful. I began to moan ?O? through them over and over as low-pitched as I could and to need to move rhythmically, either rocking my whole body or one of both of my legs. Sean would help with some of them by swaying with me, strongly stroking down on my shoulders, or rubbing my back.

When Angel checked me at 4 AM, I was 5 cm and 80% effaced. I was a bit disheartened that I?d only progressed 1 cm in 3.5 hours, and even more so that I still had to wait to get into the Jacuzzi tub until I was at least 6 cm dilated. I continued to labor, this time trying to do lunges with one leg up on a bench in addition to the other positions. I also labored on my side in bed, trying to sleep in the 4-5 min between contractions and then popping up to a sitting position during contractions because it was too painful to lay down while one was happening. At 6:30 AM, I was checked again and was now 6-7 cm and 100% effaced with the baby at 0 station. I got in the tub around 6:50 AM. The water felt great and really helped with the pain of the contractions and I was able to doze off for a while, which was much needed given that I?d been awake except for a few brief naps for almost 30 hours.

I?d been having some nausea throughout labor, but it got really intense after I?d been in the tub for a while and I ended up throwing up the entire contents of my stomach (just water and bile at that point). I felt so much better after vomiting, as unpleasant and violent as it was, and was optimistic that I had made good progress. I got out of the tub at 9:30 AM and the contractions started coming one on top of another. Angel checked me to discover that I?d only progressed to 8 cm in 2.5 hours in the tub. This was pretty discouraging since I thought I?d be at least 9 or maybe even complete, especially after the vomiting which can be a sign of transition. My water had still not broken so Angel offered that as one option to try to get progress to pick up and I agreed. I was feeling really overwhelmed at this point and started crying to let off some of the emotion and frustration. After I?d finished a round of monitoring, I got back in the tub at 10:10 to deal with the pain. It got to be so intense that I could no longer cope by moaning and I started to lose control and scream at a couple of the contractions. Angel had me get out at 11:15 to check my progress and I was still only at 8 cm (a loose 8). I decided to labor out of the tub to try to make that last bit of progress but the contractions were coming very close together and were really painful, so I didn?t much feel like moving around and preferred to sit in the bed. I did manage to sit and rock on the ball for a while. When Angel checked me at 12:15 PM, I had progressed to 9 cm ? some progress but still not complete. We briefly discussed some pain options and the only one I could potentially have would be an epidural since it was too late for IV meds since they wouldn?t be out of my system in time. I really didn?t want to make it that far and get an epidural but was starting to despair being in such intense pain for any longer. Angel asked me if I thought I could wait another hour and I didn?t, but we agreed that I would wait 30 min to see if I could dilate to 10 cm. Sean helped me do lunges between contractions since that seemed to help me dilate earlier, and also to stand and sway during contractions, and to rock on the ball. That 30 min is a bit of a blur because of the pain, but I remember contractions coming on top of one another without any breaks and feeling like I was falling asleep almost instantly (like while sitting on the ball) when there were breaks. Angel came in right at 12:45 PM to check me and I had progressed some and was complete except for a lip on my cervix. My heart absolutely sank at the thought of needing to labor even a minute more. I think Angel sensed this and suggesting that I try a practice push at the next contractions to see if she could push on the lip of my cervix to make it go away. I did this and it worked! I was ready to push!

Angel asked me to try pushing in the standard on-the-back position with me holding my legs back. I didn?t like this at all and didn?t want to try pushing like this beyond 2 contractions. We then tried pushing with me on my side. I thought this was a bit better, but still didn?t like it, even though I could feel the baby moving down a bit. I asked to try squatting and Angel told me to go for it. I did a full squat on the floor near the end of the bed with Sean standing behind me so my back was supported a bit by him and me holding onto the leg of the bed in front of me. I stayed like this for a while and could really feel the baby moving down. Throughout all of this, I couldn?t really tell exactly when I was having contractions (they still felt more-or-less constant) and I never really felt the natural urge to push that I had been looking forward to. Having been in labor for about 36 hours, about 16 of those being hard labor, I just want to push and have him out so I kept pushing. While I was pushing in the squat position, Angel was behind me trying to see and having a bit of a hard time since my bottom was almost on the ground and I was basically all of the way under the bed. She asked if I could move to the hands and knees position on the bed and squat back in that since it was basically the same position except a bit flipped. I agreed and moved up onto the bed with everyone?s help. I could really feel the baby?s head between my legs at that point and started bearing down backwards pushing madly as soon as I was in position. I could hear myself yelling with each push, which felt back-to-back to each other, but was it a bit surreal that those noises were coming out of me. I could feel Angel and the nurses wiping and rubbing around my perineum through a lot of the pushing and could feel a lot of liquid coming out. I was worried about pushing too hard but Angel assured me to keep going and was really helpful in telling me when to push hard and when to back off a bit and let myself stretch. I felt the ring of fire but it wasn?t as bad as I thought and she had me push through it as she and the nurses kept up whatever they were doing to support me. I could feel the baby?s head push through and then his shoulders on the next push, and then his body, which was really squirmy feeling. He was born at 1:16 PM. Angel immediately passed him through my legs onto the bed underneath me. It was the most amazing moment and I was shocked that he was out after only about 20 minutes of pushing. I had a bit of hard time figuring out how to grab him and flip onto my back but was able to do that and bring him immediately to my chest while we waited for his cord to stop pulsing for Sean to cut it. The nurses wiped him down a bit on my chest and tried to stimulate him to cry. He was clearly breathing, but not as vigorously as they liked so once Sean had cut the cord a few minutes later, they took him over to the monitoring area a few feet away for deep suctioning. They weighed and measured him on his way back to me ? 7 lb 9 oz and 19 ? in long. During this, I delivered the placenta and Angel pushed on my abdomen to make sure my uterus was clamping down properly to make sure I didn?t need a shot of Pitocin since I requested to avoid it if I didn?t need it. The nurses got the baby back to me pretty quickly so we could continue our skin-to-skin time. I didn?t have any perineal tearing, but did have a minor tear on each of my labia. Angel numbed me and sewed each of these with a stitch and I was happy to be focusing on my son to distract from the sewing since the entire area felt so sensitive even with being numb. While on my chest, he was able to find my nipple with some gentle guiding and tried to latch a few times, which he was eventually successful with for one side. He had a good wide-mouthed latched and sucked for a little while. During this time, Sean and I were able to talk a bit and agree on a name ? Luke Patrick. We are both completely in awe and so thrilled that he is here, safe, and healthy.

Breastfeeding is going really well so far. My milk came in yesterday and is getting on everything, which is pretty amusing.