August 13, 2019

A Birth Center, Hospital, and 15 Hours of Pushing

From the beginning of my pregnancy, I was candid about my journey and enjoyed sharing what I learned and experienced. I was also open about my choice to pursue midwifery care and deliver in a birth center instead of hospital. Not surprisingly, in the 6 weeks since Malaya’s birth I’ve been asked many times, “How did the birth go?”
Not going to lie, I’ve struggled with how to answer that question! Do I keep it positive and say it was great and leave it at that? Do I tell them that it was more like 15 hours of pushing during labor (13 of those unmedicated) and didn’t get to experience my dream birth? To share or not to share…

Well here on my little online journal, I decided to do as I always do and share “the real” about my story. Not to puff myself up or look for an applause – certainly not for sympathy – but in the hopes of encouraging other young women who are facing the fears of birth. Women asking themselves all the same questions I did: “Can I do this? What should I expect?”
Secondly, I hope that this can be educational and informative. Possibly even helpful for someone who had a similar experience as I did. I personally have learned so much from moms who have taken the time to get a little raw with their stories. So now I return the favor.

Disclaimer: If you’re a male, get queasy, or are totally uninterested in birth-related details, feel free to click away at this point. ;)

Preparing in the Last Days of Pregnancy

I worked full time at my job for as long as I could, but at 38 weeks I knew it was time to go home and rest. Those last days of pregnancy were sweet (albeit a little uncomfortable) and I didn’t take them for granted. Everyone had warned me to not have any expectations for an early delivery since I’m a first time mom. Except my prenatal chiropractor, that is, who had predicted that I would go early. But I knew that anything could happen and everyone’s story is different.

I also knew the role that fear and anxiety can play in tightening up your body and slowing the onset of labor. So as much as this may sound funny, I literally “spoke” to my baby in the womb, telling her (and myself) that mama was ready for her.

“You can come whenever you’re ready, baby girl.”

I don’t know if this had anything to do with me actually going into labor before my due date. If anything, it was a verbal affirmation, giving myself permission to be at peace as I headed into the most intense challenge of my life.

Early Labor

On Monday morning, June 10th, I woke up around 7am, exactly 39 weeks pregnant. As I laid in bed enjoying the rest, I started feeling some light cramping. Chalking it up to your average third trimester pains, or maybe even Braxton Hicks, I went about my day.
By mid-morning I realized there was a pattern about every 10 minutes. In the afternoon I started timing it on an app to see if there really was something going on. When I finally texted my doula (click here to read what a doula is if you don’t know!) in the late afternoon to tell her what I was feeling, she told me that it definitely sounded like I could be in early labor. (Ah!) I’ll admit I wasn’t prepared for that. I knew not to panic or stress about it because it could very well just be “practice” labor. But I’d be lying if I didn’t say I felt some little butterflies kick in.

Dinnertime came, and I started preparing the food. As I cooked in the kitchen, I occasionally had to pause and brace myself on the counter to breathe through the contractions.
At one point, I was on all fours on the kitchen floor with my eyes closed.
Breathe in, breathe out. A few seconds later, I stood up.
“Well, that was a good one!”
Back to frying the chicken on the stove.

And so the night continued, with them getting closer together and stronger.
One of my midwives just happened to be in the area at the time, so she kindly stopped by and did a cervical check for me. I was 3cm dilated.
Michelle said, “Honey, I’m sure I’ll see you guys in a few hours at the birth center. You’re having a baby tomorrow!”
Ah, was this seriously happening? Right now?!

Laboring at Home

This WAS happening, because the contractions started to get a little more intense to where I couldn’t really talk through them. I had to focus on breathing. And then I lost my dinner.
My doula Karen and I had been keeping in touch, and at that point (around 11pm) we agreed it was time for her to come over and help support me.

And so began my first hours of active labor at home. Karen helped me breathe and stay calm during the increasingly intense contractions (or surges as they’re also called), and I tried different positions around my bed, couch, and finally, my bathtub. The warm water was soothing.
I again lost whatever else was left in my stomach.
I tried to get comfortable in the tub, and Karen kept in touch with my midwife team that was on standby at the birth center.
Finally, everyone agreed that I was progressing enough to merit going to the center. At 3:30am, I got into the back seat of our car with a bucket in hand, and closed my eyes to bear down for the next 25 minute drive.

Laboring at the Birth Center

I will never be able to fully express the sweet experience I had at Acorn Birth Center in Fallbrook, CA. From my first appointment to the last, the team became like family. I knew stepping into “the Butterfly Room” – with curtains drawn, lights dimmed, and the tub gently filling with water – that I was in the best of hands. With 2 licensed midwives, 2 student midwives, and my doula, I felt a crazy peace and excitement to have them all supporting me.

Acorn Birth Center in Fallbrook, California
the interior of Acorn Birth Center in Fallbrook, California

Of course, I was in a lot of pain. I had started to have intense back labor, and was needing help with counter pressure. Things progressed quickly as I labored around the room on the birth stool and in the warm tub. When I was checked again at around 5am (now June 11th) I was 9 1/2 centimeters.

Then my progression started slowing down, and it took another 3 hours to get to 9 3/4cm. Baby girl was down so low they could see her body bulging through my lower back/tailbone area (ouch) and could feel her head. By 11am I was finally fully dilated. We sent texts out to my family to let them know that I was starting to push and she would be here very soon.

What followed next was certainly the most intense and bizarre day of my life. It felt like an out of body experience almost, where I was so focused and in the moment that everything around me seemed dim, distant. Yet I heard and felt them and was fully aware. It’s hard to explain. I just tried to put into practice the things I’d learned from the Hypnobirthing book (that I had attempted to finish reading before going into labor) and listen to the direction of my team. I felt excitement, nervousness, peace, and determination.

a natural water birth at Acorn Birth Center in Fallbrook, California, woman pushing for 15 hours during labor

Thus began my journey of 15 hours of pushing. I started pushing with nearly every contraction from that point on – on the birth stool, on the bed, leaning over, on the toilet backwards and forwards, in the water, outside in the private patio. The midwives pulled out every idea and trick in the book they could think of. At one point they even put me on a massage table and did stretches and gentle massages to help me progress and to offer some relief. We did that twice throughout the day.
They gave me water, fed me fruit and crackers, and put homeopathic arnica underneath my tongue. Everyone took turns putting counter pressure on my lower back during every contraction, as the back labor had gotten more intense.

WHY wasn’t I able to push her out yet?

Half the day had passed, and the only answer we had so far was that I had a very tight “athletic” pelvis, which could be making it difficult for her to get through the birth canal.
The second possible answer came in the afternoon, when they did another check and realized that my water still had not broken. They broke it for me at that point, and I got back in the tub. Surely this would strengthen the surges and get her out!

Wrong. Hours and hours passed. I pushed and pushed. Drank more water. Tried new positions. I could see the exhaustion setting in on everyone’s face, and I felt a sense of guilt and failure.
What was I doing wrong?
My amazing doula Karen had been with me since the night before and hadn’t slept, so she called in her backup to replace her.

Our saving grace was knowing that both mine and Malaya’s vitals were strong and we weren’t in distress. But I started to lose some hope.
I kept going, though. Something in me just beared down and allowed me to have the strength to keep it up. I knew what I wanted — a birth center water birth — and I didn’t want fear, stress, pain, or anything else to get in the way of it.

Finally Receiving an Answer

Unfortunately, I wasn’t able to see that dream come to pass.
Around 9:30pm, after over 10 hours of continuous unmedicated pushing at full dilation, we finally got an answer when the midwives did another cervical exam, this time even more thoroughly.

I was told that I had a vaginal septum, basically a thick vertical band of tissue, that was blocking Malaya’s pathway out of the birth canal.

“A what?!”

I know, it confused me, too. How had that never been caught before until now? How had none of my doctors, OB, or even the midwives been able to identify it earlier on? I’ve had multiple pap smears and pelvic exams throughout the years and was never told that anything seemed “off.”
In the moment, though, all I was hearing was that I wasn’t going to be able to give birth to my baby girl in that room. They told me that they unfortunately did not have the resources to handle the septum in the event that it needed to be cut, caused bleeding, or –worse case scenario — that I needed a c-section.

My heart sank and I wanted to cry, but I was too tired to exert any more emotional energy. They left the room to contact EMS and the hospital that I would be transferred to, leaving us to discuss this new change of events. I was devastated and exhausted, but at the same time I almost felt a sense of relief that at least there was finally a real ending in sight so I could meet my baby girl.

Transferred to the Hospital

Paramedics showed up and we headed to the hospital with the team close behind. The drive in the ambulance was difficult because I didn’t have the counter-pressure support on my back from everyone. I had to stop pushing and yet my body was bearing down on its own to try to get her out. Squeezing the paramedic’s hand, I tried to answer his questions in between the contractions. It embarrassed me a little bit that I wasn’t able to maintain the low, focused moaning I had been working on all day. I wasn’t super loud, but the pressure was a little more intense now and I was strapped flat on my back where it was hard to get comfortable.

Funny enough, I guess I quickly became the story of the hospital that night — “that girl” who rolled in on a gurney about to have a baby. Apparently that doesn’t happen too often there!

Once in the room, I had to wait another 30 minutes for the anesthesiologist to arrive to administer the epidural. It wasn’t in my original birth plan to have any pain meds, but it became necessary due to my situation and the need for some rest.
Not going to lie, it DID feel great to finally have some relief after such a long day. But the 10-minute process of sitting on the edge of the bed, having to stay completely still and unassisted while multiple contractions came? Phew. That was by far my biggest challenge of the process.
“Breathe in, breathe out,” I heard over and over.

Giving Birth

I was incredibly blessed yet again to have an amazing hospital team waiting for me. There just so happened to be a nurse midwife on call that night, who sweetly accommodated the team with me and listened to all my requests. She did all in her power to prevent a c-section, telling me all of the options and going over the risks of each.

In the final few hours, I was numb from the epidural but still had a lot of work to do. We decided against cutting the septum due to the risks involved, and instead opted for trying to just move it out of the way so I could push the baby through.
It was tedious still. They put me on oxygen to help with Malaya’s recovery and keep her heart rate up. Then out of the blue, I started having intense heartburn. It limited my ability to push because I needed to curl forward and squeeze, which aggravated my chest and throat. I was burping and having a hard time holding all the way through the 10-second counts. The nurses gave me some tums and I tried to push through yet another frustrating obstacle.

By now it had been an additional two hours of hard work. The baby’s heart rate had been strong and healthy, but suddenly it started dropping and she had a harder time recovering after contractions. It was the scariest thing to hear on the monitor.

The midwife decided we needed to expedite things. Baby had been in the birth canal too long and it was time to get her out. She performed an episiotomy then (another ouch and sadly unavoidable).

Finally, at 2:43am on Wednesday, June 12th, my baby girl was able to make her way into this world and take her first breaths. She was perfect. After all of that time, she didn’t have one bruise, discoloration, or deformation. She had a head full of pretty dark hair and was 6lbs 14oz, 18 3/4 inches.

The septum had torn on its own on her way out, leaving no need for any intervention with it.

I had endured 15 hours of pushing actively during labor, most of it unmedicated. It was a feat my birth team called “record-breaking.” (In fact, my sweet doula Karen even recommended I try to get into the Guiness Book of Records! And she was serious, ha!) I had labored at home, at the birth center, and at the hospital. I’d experienced all the beauty of naturally allowing my body to do what it was made to do; and I’d received the blessings of modern medicine to help where needed.

Malaya Rae | 6lbs 14oz | 18 3/4 in

No, it wasn’t exactly what I wanted. But I’d been warned to not have too high of expectations, and I had done everything in my power to be open minded. I could also say without a doubt that I fought my hardest and put to practice all I had learned:

Stay calm, trust your body, breathe intentionally, don’t focus on the pain, verbally affirm yourself, welcome the contractions, have faith, and be patient.

I also received answers for something that could very well change the rest of my life. The presence of the septum explains so much that I’ve experienced since my teen years that I thought was “normal.” Turns out there was a very good reason for those things. Now I can follow up with a pelvic floor therapist and work on recovering my new body.

I’m grateful that I had such an incredible team who cheered for me to do this as naturally as possible. If I had gone with a hospital birth, there is no guarantee they would have found the septum. They would never have let me labor that long fully dilated, and they most likely would have told me I needed an emergency c-section.
My team at the birth center believed in me from the start, set me up for success, and supported me every moment.

Praise God, that even when we can’t see the big picture, HE CAN!

If you have any questions, leave them below and I’m happy to answer. I’m no expert, I just speak from my experience and hope to help a soul or two along the way.

XO, Charity

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