birth story (long, sorry!) - epi-free hospital birth after (slight) cervidil induction

elinorc1 · September 2012

Hi, thought I'd share my birth story since it helped me so much to read other stories on here, although I'm mostly a lurker rather than a poster.... (skip to the 5th paragraph if you just want to read the labor part and not my long preamble)

We live in Mexico City where hospitals have high CS rates and midwives are thought of as witch doctors who look after the Indians... But we got a good vibe initially from our doctor after talking with her about natural birth, in spite of my constant worrying over whether we'd be able to get a vaginal birth within a system that is so set up for cesareans (the insurance companies here won't pay direct for vaginal birth, for eg... And everyone at work kept asking me when I was going in for my cs.) Anyway, we stuck with the dr because of our initial gut feeling and I think that was important. I seriously did consider switching drs several times after I was diagnosed with a marginal placenta (1.3 cm away from cervix at 31 weeks) and she wanted to send us to the ultra-high-cesarean rate hospital here -- but, in fairness to her, she was great. She continued to check my placenta even though she was convinced it wouldn't move and lo and behold, it did. By 35 week it was 2.5 cm away and it actually continued to move after 35 weeks -- just telling this part for anyone being threatened with extra monitoring or something for marginal placenta. The dr agreed we could deliver in the more natural-birth friendly hospital after it moved past 2.5 cm.

Anyway, fast-forward to Monday August 27th. We had had an appointment with her the previous Monday and she had talked about wanting to start an induction because he was 'big'. She repeated that she wanted to induce again when we saw her on Aug 27. I was 0.5 cm dilated but I hadn't felt any contractions and had had no other signs of labor. We talked about how we weren't at all worried about him being big... He was measuring between 8 lbs and 9 lbs which is huge for Mexico City standards (average weights closer to 6-7, partly because of altitude) but didn't seem that daunting to me or my husband. The dr argued that by some calculations my due date was Aug 22 (based on LMP) although the dating ultrasound had given us Aug 31. We agreed that if I still wasn't presenting signs of labor by Friday Aug 31 we'd come back and she'd start the lowest dose she could of something to soften the cervix and see if that got things started.

I was convinced I would start labor before Friday Aug 31, but it didn't happen. We went to the appointment at 9am and she talked about wanting to use a cervix softener. We didn't really know how to argue with her more at that point, but she knew we weren't thrilled with the idea so she said she'd use as low a dose of prostaglandin (pretty sure it was cervidil) as possible. She said the only downside of the 'induction' would be that if my waters broke it would mean intense contractions... I was pretty confident that wouldn't happen since I'd read it's only 1 in 10 labors that start that way... anyway. She put in a quarter of a tablet of prostglandin and after a brief time hooked up to monitors to check all was working and the baby was ok (I was indeed having contractions, but still not noticing them) she sent me on my way with instructions to stay upright, keep moving around, and do everything I could to improve the baby's position (he still wasn't engaged even at 40 weeks...) If nothing had happened by 4pm, she said she'd add another 1/4 of a dose.

We went and ate a big breakfast and I had far too much cheese on my molletes. It was delicious at the time though. We headed home where I sat on my birth ball and wandered around the house doing bits of housework. I still wasn't feeling any contractions. At 1pm, we sat down to Skype with my in-laws to update them on what was -- or wasn't -- going on and I felt like I wet my pants. I went to the bathroom and as I sat down on the toilet more fluid came out. For some reason, I still wasn't sure it was my waters breaking. I put on a pad and went back to the other room. When I got up again, I noticed more fluid. I went to the bathroom and noticed the fluid in the pad was clear which made me happy and decided it really must be my waters breaking. I called the dr and she said to keep her posted and call in every hour or so. I still wasn't feeling any contractions around 1.30pm so I decided to start making brownies and cookies to take to the hospital to bribe nurses with...

By 2pm I was feeling contractions. By 2.30 I was sat on the birth ball in the kitchen, rolling my hips around and watching the oven, and thinking that the contractions were more frequent than I expected. My dad and DH started timing them for me. They were 2 mins 40 to 3 mins apart and lasting for about 45 seconds. When I heard that, I decided I didn't want contractions to be timed any more. I was still able to distract myself but it was getting harder. I stayed on the ball or I did squats and we watched TV and then listened to music. By about 3.30pm I was having a bit of back labor and my husband helped applying counter pressure on my hips. We had the Birth Partner book out as a reference (I loved that book) to find different positions for me to be in. I got in the shower around 4pm and that felt good. Then I got out of the shower and sat on a chair backwards, leaning over the back of the chair. That also felt good. I was having to breathe through contractions and I was counting breaths. I knew if I could make it to 10 I would get past the peak and I could make it to a rest period. One of the worst parts of the water breaking was that all the leaking fluid was just uncomfortable. I was in no way prepared for the sheer amount of fluid coming out and pads were not good at absorbing it.

The dr suggested we meet at the hospital at 6pm and although my plan had been to labor as long as possible at home, I was ok with this suggestion since contractions were pretty intense and I was optimistic I was making fast progress... We got there, I was hooked up to monitors for about 15 minutes and checked. I was at 4cm which crushed me briefly, since I'd hoped to be at least 6cm... I got over it and she sent me down to the hospital room to continue laboring there. I went outside briefly to walk around and threw up all that cheese I'd eaten for breakfast... A nurse came and told me the dr said I couldn't eat or drink anything now, after being sick. My husband argued on my behalf but she was adamant. Fortunately, 15 minutes later the dr came in to check on us and said that was ridiculous, I could eat and drink whatever I wanted. I had a cereal bar and I labored in the shower in the dark and on the toilet (also in the dark, wrapped up in a big blanket). I got out of the bathroom and labored on the ball again in total silence and still in dim lighting. I was still working on counting breaths through contractions and getting to number 10 was still working for me. The doctor was checking in on us every now and then but mostly we were left alone. Around 8-9pm she checked me again and I was 5-6cm. She used a remote/hand-held monitor thing to check the baby and said he was fine. I was briefly depressed again by not making more progress but I continued to be able to breathe through contractions so I knew I could keep going for a while. At 10pm she checked me andand I was almost 7cm. She used a hand-held monitor to check on the baby, who was doing fine, and she said I could go up to the labor/delivery/recovery room and have a bath. We hadn't planned on doing this because it wasn't covered in our insurance but the idea of a bath suddenly seemed so good and I was so happy I could use the one-purpose room rather than the more medicalized delivery and separate recovery rooms that we went for it.

The time it took to run the bath (30 minutes!) was agonizing. I did the 'slow dance' with my husband and gripped his hand hard when I had a contraction. Once in the bath, I tailor sat and continued to just breathe through the contractions. They left the lighting dim and continued to leave us pretty much alone, apparently opening the door only to check with my husband how I was doing. I was barely noticing anything, even time at this point. The contractions were intense and sometimes I felt like I had two or even three on top of each other with no breaks. Somehow I was still able to breathe through them although I was having to count to more than 10 to get past the peak. Around 12.30 I swore at one contraction -- probably the first word i'd said in hours. And after the next I told DH I wasn't sure I could take much more. He went and got the doctor who asked if I was feeling pushy. I wasn't really sure but with the next contraction I did feel pressure and the doctor encouraged me to try pushing and gave me some instructions on how to push (basically, wait for the contraction to become strong, take two big breaths and then push while holding my breath in). I tried that and it made the contraction feel like it wasn't painful, which was nice...The doctor used the remote monitor to check the baby's heart rate, and he was still fine. They set up this upright bed/chair thing for me to push in but they decided it was too small for me, so they moved me to the bed in the room and adjusted it so I was more or less sitting upright with my knees up -- kind of like a squat position, but supported. I was grateful they kept the lighting dim and just had a floodlight thing down by the dr so she could see what she was doing.

I'd read in birth stories that pushing is a relief. I found that it made the contractions much less painful but I found pushing pretty frustrating. I couldn't feel it as much as I expected too -- and I couldn't tell if I was being effective. The doctor got the nurses to hold a mirror for me to see the head moving down but I couldn't see it very well and it didn't really help me. I also knew the dr was setting up to do an episiotomy and for some reason that didn't bother me as much as I expected. I really reached a point very quickly (I only pushed for 40 minutes) where I just wanted the baby out and I was fed up with people telling me how to push when I was trying my hardest with every contraction. I also found that at this point the time between contractions was really really long and I felt compelled to try to make jokes during it to cheer myself up and distract the drs, for some reason I was worried they were getting tired of waiting for me. It was a bit weird. My husband told me afterwards it wasn't that long between pushes, it must have just felt like that to me.

Anyway, at some point they did the episiotomy and the baby came absolutely flying out all in one go, while screaming. They very quickly cut the cord which was around his neck although they somehow let my husband cut part of it too -- I'm still not quite sure what happened there. DH thinks they panicked because the baby came out quicker than they had expected. Anyway -- the baby (a boy - Tom) was given more or less straight to me and we did skin to skin and they helped me get him to latch. It was amazing. I didn't notice the placenta being delivered, although I remember the dr saying, "Now I'm delivering the placenta" and they gave me some pitocin in my thigh to help the uterus contract -- I was too obsessed with staring at my baby to object to that too. He arrived at 1.19am, about 12 hours after my waters broke and he weighed 8lb 5. He is gorgeous and DH and I are besotted.

I expected recovery to be a breeze, since that's what so many people write in these stories. I felt a bit let down that it wasn't easier, since that was one of the reasons why I'd wanted to avoid pain meds or an epidural. I went to sleep for a few hours that night and woke up around 5am in agony because I needed to pee and couldn't. When I eventually did pee, around 8am, it was the most amazing relief. I don't know if it's because of the episiotomy or what, but I felt pretty crappy for two days and I was really not prepared for that. I wasn't prepared for how painful it would be and that I'd have to take painkillers afterward. I don't know why, I think I just had a lot of confidence that if I could get through labor without interventions I'd feel on top of the world.

A week later though, I'm feeling pretty good. I barely remember how terrible I felt last weekend. I have a beautiful baby and breastfeeding is going pretty well. And, apart from the episiotomy, I got the amazing hospital birth I dreamed of.

The things that most helped me were being able to labor in the dark or with dim lighting, minimal monitoring and checks, using the tub during transition and being able to move around and do what I wanted while at the hospital. I loved 'The Birth Partner' and also 'Ina May's Guide to Childbirth'. DH and I took birth classes but they were more just to get us familiar with Spanish vocabulary for birth. They helped a bit, but I learned more from the Ina May book and the Birth Partner and definitely a lot more from lurking on this board.

Thanks to you all for being such a wonderful community - and loads of luck to you with your own births.

robyn2201 · September 2012

Congratulations!

julyjennifer · September 2012

Congrats on your son! Way to go on birthing your way even against the mainstream in your area. Your story is really inspirational.

KelliLynee · September 2012

Congratulations! My first birth was medicated and I had an episiotomy, and I think your pain is probably related to the episiotomy. My pain lasted a week or less... hang in there!

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birth story (long, sorry!) - epi-free hospital birth after (slight) cervidil induction

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