We are so excited to kick off the week with the first in a blog series of Birth Stories. Thanks so much for sharing, mama!
Midway though my pregnancy with our second child, I saw a story on the news about the Minnesota Birth Center’s use of nitrous oxide for pain relief. I delivered our oldest at our first choice hospital with a doula and a midwife on the earlier side of “normal” at just a little more than 38 weeks. My labor with him was intense and fast, but I was able to deliver him without pain medication. Due to being a first-time mom and a nuchal arm, he was delivered after a long pushing phase as U2’s “Beautiful Day” started on my birth mix. We all listened to Pink Floyd as the midwife stitched me, and I bonded skin-to-skin with our son. Our wishes were met at the hospital and by the midwives, and I don’t think I would have researched other locations had I not learned of the nitrous oxide option at Minnesota Birth Center. I did deliver our oldest without pain medication, but it would be misleading to imply that I felt I didn’t need anything. Transition was intense, and when thinking about his labor after the fact, I wished there was a safe, non-narcotic pain relief option that was a step below an epidural. The nitrous oxide seemed like a great option for me, and we decided to tour the Minneapolis location of the Minnesota Birth Center. We were very impressed with the midwife we met and the comfort of the birthing rooms, but given how quickly our oldest arrived, I was a bit worried about making it to the Minneapolis location from our home. Thankfully we learned a St. Paul location would be open before my due date, so I initiated the process of transferring care to the Minnesota Birth Center midwives where we were now planning for a July birth.
I loved my pre-natal visits with the midwives, and everything was progressing as medically unremarkably as it had with my first pregnancy. Baby two was transverse for a long time, but he did eventually turn head-down on his own. On the morning of my 36-week visit I giddily signed the nitrous oxide waiver while we chatted about how far along I needed to be to deliver at the Birth Center. Since you hear so many stories about women going into labor on the later end of “normal” with their first baby, I wasn’t exactly prepared when my water broke with our oldest. That wasn’t going to happen this time. I would have everything ready by 37 weeks. And I was well on track to meet that goal, but as I was resting with my son the evening of that 36-week visit, I thought I felt my water break. I had a sinking feeling in my stomach, as it was earlier than even I was prepared for this time. After texts to my husband, our doula, and my parents (our son’s sitters) that read “Not joking. My water just broke,” I called the midwives to discuss with them. What complicated matters is that it was a Thursday evening, and I wasn’t technically 36 weeks until Saturday. After discussion of a few options, I felt the option that made me the most comfortable was meeting the midwives at United, the hospital back-up for the St. Paul location of the birth center. Something I was told over the phone stuck with me all through labor. “You’ll have a birth center birth, but it will just be in a different location. We’ll make it our environment there.”
From the minute we walked into the triage area of Labor and Delivery and met our doula, some of my fear subsided. While it was not the environment I imagined for my labor, I knew it was the best place to be for my baby. We chatted with Martha, and my doula and I set out to walk the halls to encourage contractions. We walked and walked, ordered dinner, and walked some more. Did hospital regulations mean I was in a gown? Not at all! I walked the halls in my shirt, Hawaiian themed towel worn as a skirt, and flip-flops because I left the house without a lot of things on my list including my labor dress. I commented to our doula that it felt kind of like I was on vacation. When it was clear rest was the best plan for the night, our doula went home to sleep, and I rested as much as I could, though sleep was hard to come by as my husband snored and women around me were giving birth. In the morning Martha transferred care to Mary-Signe, and our doula arrived again. I was having sporadic contractions, but I wasn’t dilating. We agreed to let my body keep trying to progress on its own. Another shift change meant another amazing nurse, and the nurse at that time asked if I would like the massage therapist to visit. How could I say no? She massaged my feet and back while I relaxed and tried to mentally convince my child to emerge.
If active labor with my first was a sprint, it was clear at this point baby two’s labor was going to be much more like a marathon. With my oldest my water broke, and I kept on doing things at home. I needed to finish packing for the hospital, wash the sheets, make the bed, and I did all of that with only the most minor of cramping. I had only a few hours of measurable contractions before things were serious enough to head to the hospital, and then it was only three hours until I was pushing. So I was optimistic when things started to get a little bit more active after lunch, but the labor pains were still very tolerable. I started sitting on the yoga ball and swaying as much as possible, but after a night of no sleep, I was starting to get tired. My oldest visited and was quite upset to see for himself that his little brother wasn’t here yet. I comforted him in between contractions that were increasing in strength but still tolerable. Mary-Signe talked to us about considering drugs to encourage dilation as Pitocin wasn’t even an option at that point. As anyone who has met me can tell you, I’m pretty stubborn. I think my cells are stubborn, and after this conversation things started to pick up in intensity. But the numbers indicated that I wasn’t near active labor, and I certainly didn’t feel near it. This worried me because I knew we were closing in on the 24-hour mark of my water being broken but also because I was really losing energy. I knew I would need energy for what was to come, and I was getting nervous I wouldn’t have it.
Here’s where I need to insert a disclaimer. My memory isn’t as clear about this point in labor due to the lack of sleep. But with my memories, what I’ve been told by my husband and doula, and my medical chart, I know what happened. Contractions progressed that were unlike what I experienced with my oldest’s labor. I felt calm pauses between contractions that I had read about in Ina May’s books but never myself experienced. The tone of the room was that of absolute collaboration. It was beautiful, and my husband acted as a coach through contractions in a way that wasn’t possible due to the intense nature of our oldest’s birth since I had already entered “Laborland.” I knew we were making progress, and I suspected a more active labor pattern was starting, but more than anything I felt tired. We discussed Pitocin with Mary-Signe, and I believe I agreed to start the process as long as we also ordered an epidural. I was absolutely afraid of the intensity of transition due to my previous labor and my current level of exhaustion. I wholeheartedly wish I was able to choose nitrous oxide instead, but under the circumstances I made what I felt to be the best choice for my health and my baby’s. As I got into bed to start the Pitocin, Mary-Signe asked if she could tell me how far I was dilated based on some external indicators. I remember going back and forth about if I wanted to know, but in the end I wanted her to tell me, and I was approximately a 6-7. I did feel an enormous sense of accomplishment, but I also felt committed to some pain management because I suspected it would help me get over the final hurdle. We decided not to do the Pitocin since things were moving quickly, and I was next in line for the anesthesiologist.
When the nurse from the IV team arrived to start the process, he added to the light-hearted atmosphere of the room. I remember talking to him in between contractions, and though they were enough to make me focus on my breath, I was still able to stay on top of them. This is a source of pride for me, as I really wanted to use my breath this labor and stay in the range of productive sounds. After one contraction ended he told me, “This is why women have the babies. There’s no way men could do this.” And it was said in a very empowering way that just increased my confidence. Once the epidural was in, Mary-Signe told me to get some rest and they would check on me. I was a bit confused, as I didn’t have any intention of resting. My husband stepped out of the room, and Mary-Signe did as well. I told my doula I thought I felt an increase in pressure and felt ready to push. Due to my oldest’s nuchal arm, I never felt the urge to push. I just followed my doula’s instructions and my oldest emerged. I wondered if I would recognize that sensation. I did; it was pretty unmistakable. My doula left the room to get my husband and Mary-Signe. According to my chart I had the epidural for one hour before I started to push. During that phase I recall my husband’s encouraging words, Mary Signe’s acupressure, and a stubborn game of tug-of-war with our doula.
Our youngest child entered the world nearly 27 hours after my water broke and just shy of five hours from when I started regular, measurable contractions. Since he was early, there were additional people in the room to make sure he was stable. His Apgar score was the same as my oldest’s, and immediately after I delivered him he was placed skin-to-skin with me. We were surprised that he was a month early, but we were floored that he had a full head of hair. I wish every laboring mother could feel the support I did during labor. While I absolutely wish I could have experienced the beautiful environment of the birth center, I am so overwhelmed when I think about the serene environment we created at United. In many ways, it felt more like a birth center birth than my labor with our oldest who was born intervention-free at a hospital more well-known for natural birth. We learned a bit later that our son was the first baby caught by a midwife at that hospital in 25 years. I’m so grateful for everyone at the Minnesota Birth Center and United who made our experience as peaceful as possible. Not much went according to plan, but everything about it was even more beautiful and empowering than I could have imagined.
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