Then today, I read the story of the birth of a friend's fifth child – an emergency C-section at 34 weeks. I was so moved by the story. The strength and confidence of the doctors and nurses. The love between my friend and her husband. The lump rose in my throat. And suddenly, I was ready to tell my own stories.
Avery Evelyn Pepple came into this world nine days late, at 8:55PM on Sunday, June 22nd, nine days after her due date, after being served with the biological equivalent of an eviction notice. At seven days past my June 13th due date, I'd been looking forward to the membrane sweep that would hopefully induce labor and bring forth my daughter into the world. My body had other plans. My cervix, far from "ripe" was shut up tight. Not effaced or dilated – at all. So closed that a membrane sweep was not possible. Nothing indicated that I was anywhere near labor. That baby was perfectly comfortable where she was.
I, however, was not so comfortable. After nine months of morning sickness, I was sick of being sick. I was still throwing up all day, every day. I was tired. I was more than ready to meet this baby. And so when the OB-GYN who check my fluid levels said "I'd induce," I decided to ignore the cautions of the midwives who were my primary caretakers and serve my stubborn little daughter with her eviction notice.
The warnings about induce in my "unripe" state were ominous.
"It could take 48 hours, maybe 72."
"It might well result in a C-section."
"Your body might not go into labor at all."
I didn't care. I was done. I was willing to try anything.
Induction was not what I'd planned for. I'd told one of the midwives a few weeks earlier that I wanted to labor for as long as possible at home, where I felt safe and comfortable. I knew that the longer I labored at home, the better my chances for the natural birth I so badly wanted, and I was determined to make it so. I'd also written in my birth plan that I didn't want a Hep-Lock (the IV port), or other medical interventions.
With an induction in my "unripe" condition, that was all lost. I checked into the hospital at 7AM on Sunday morning. I was immediately outfitted with several monitors and a Hep-Lock in my left hand. At just after 8AM, the midwife, just starting her shift, administered the first dose of misoprostol to cue my cervix to dilate.
And then we waited. And waited.
At 12:30PM, all was still quiet on the uterine front. The monitors to which I was attached still blipped with agonizing calm. The midwife came in. She checked my cervix. Zero dilation. Zero effacement. As she administered the second dose of misoprostol, she began the quiet expectation setting conversation. "This is your second dose. If things don't start to move along, we are going to have to start discussing alternatives. Some women just have a very hard time going into labor. Sometimes a C-section is best." Not the words I wanted to hear.
Two long hours passed in agonizing peace.The 2014 World Cup was on, and we fretfully watched soccer as the minutes ticked by and nothing happened. at 2:30PM, the nurses administered the dreaded pitocin in the hope that it would nudge things along.
Just after 3PM, I was wracked by a contraction. It came on with force, and lasted. My first reaction was that I needed to sit on the toilet, so I did. When it passed, I came back and resumed watching soccer.
Ten minutes later, I shot out of bed with another contraction. Another trip to sit on the toilet. When it passed, I stood at the sink basin to wash my hands and was calmed by the cool water running over them. So I stood before the sink, hands in the cold water. Another contraction came, and then another. Mark sat watching the World Cup game, periodically asking me if anything was happening. I kept telling him "No, it's still early. Nothing to get excited about." Meanwhile, the contractions were coming faster and faster. With each one I let the cold water flow over my hands and pressed my forehead to the cool formica of the sink basin, my body angled at 90 degrees, legs splayed.
I heard the game end. The US lost, knocking them out of the World Cup. And then it really began.
But I didn't know that.
I'd never been in labor before. What did I know? And everyone – all the classes, all the books, the midwives and my doula who'd cautioned so strenuously that inductions like mine take days to produce a baby – told me that what I was experiencing was "early labor." It was pain that women vacuumed their carpets through. Pain that women showered through. Pain that women held young children through. Early labor lasted for hours, sometimes days. And damned if I was going to be weak.
So I stood at the sink basin. And I swayed. And I let the water run. And I reassured my husband that I was fine. I was fine! My water hadn't broken. I hadn't lost the mucus plug. It was early. No reason to call the doula.
At 4:45PM, I agreed to call the doula. She'd told me that she'd know it was urgent if I couldn't talk through a contraction. Convinced that I was in early labor, I forced myself to talk through multiple contractions. I gritted my teeth. I kept talking. "Yes, I'm fine. Yes, It's early. No, you don't need to rush. Give your kids dinner."
My nurse kept urging the labor tub. "No, too early. I'll need it later. Too early for that."
Finally, a little after 6PM, the midwife came in and decided it was time to check dilation. I was at 4cm. I'd come a long way, but not that far. No one said I was in active labor.
I agreed to get in the labor tub. And I hated it. The heat was unbearable during contractions, so I asked that the water be cooled. I sat in a bath of cold water until my doula arrived around 7PM and immediately demanded that we turn up the water temperature. And as soon as we did, it was unbearable again. I was burning up. I had to get out.
I made it back to my room on my own two feet. I profusely apologized to the nurses at the central nursing station for loudly groaning through two contractions. They were coming so fast! So fast! Contractions in early labor weren't supposed to come this fast.
The doula asked if I wanted to have my cervix checked. It was 7:35PM. I did. Seven and a half centimeters! But bad news, I was putting too much pressure on my cervix. Far from standing at the longed-for sink basin, they wanted me to lie down on my side. Keep the cervix from swelling. I remember nothing but the contractions coming wave on wave, focusing all of my energy on one canister light on the ceiling, breathing in the unnatural way the nurses and doula instructed me to breath.
I was permitted to get up to use the bathroom. Finally, the mucus plug came! For me, it felt like progress, a sign that maybe things were actually happening.
Not five minutes later, I had an overwhelming urge to push. This was not optional. Not at all. It was primal. It was happening.
I remember screaming, "I'm want to push!" as I pushed. I think nurses rushed in.
I remember a flurry.
I remember shouting at someone, "Why hasn't my water broken? I can't have a baby if my water hasn't broken!!!"
I remember the midwife suddenly appearing between my knees.
And then my water broke, like the force of a levee breaking. A massive release of pressure, liquid shot across the delivery room and people diving out of its path.
And then I pushed. For 45 minutes. I kneeled. I stood. I squatted. Compared to the contractions, pushing wasn't painful, just profoundly uncomfortable. Imagine taking the biggest, stubbornest shit of your life... that's pushing. Except that you don't have a choice. You push when your body tells you to push.
At some point, it became necessary to push while lying down. The placement of the placenta had made it hard to get the baby's heart rate all day, and according to the monitor, her heart rate was dropping with each contraction. They needed to attach a monitor to the crown of her head. I barely remember this, but I'm told by the other people in the room that it was so.
Finally, the midwife could see the head. A little fuzzy crown began to emerge. Unmedicated, I felt the ring of fire as my body stretched to its limit to birth this baby. I felt the contraction wain, but I was done. I held the push, and finally... release. Avery's head emerged. With the next contraction, her body slithered out and into the waiting hands of the midwife.
I'd later learn that the midwife delivered six babies during her 24 shift, Avery being one. When she'd checked me at seven and a half centimeters, she had rationally assumed that I still had some time to go. She got the call that I was 10 centimeters and pushing 30 minutes later as she scrubbed in to assist in a C-section. She told the doctor, "gotta get this one out, I've got another on the way!"
Avery's birth was not the birth I imagined. It was not the one I planned. It was assisted by some intensive labor-inducing drugs and a great deal of naivety on my part. It was fast and intense, and gives me immense admiration for the women who endure long labors. But it was the birth I gave, and an experience for which I'm immensely grateful.