[Deb]

My first birth was very traumatic for me and this, my second birth, was a healing experience! Here are my reflections:

"You're not here." That was how my appointment was characterized by an OB in the practice who was about to do an off-the-books membrane strip and (successfully) trigger my labor. Why rush nature? My deadline for the Birthing Center at St. Luke's Roosevelt was down to 36 hours and I was still just one cm and "long." The baby's movements had become slower and less frequent. I was feeling really good - well slept, well hydrated, pain-free. I thought the odds it would trigger were low, but perhaps in combo with some good jostling/hiking... Dr. H explained that they were not even going to pull my file, she was just going to do it on the sly. On her lunch break (about noon). Awesome. It was an energetic membrane strip! And it was my fourth (one for the first pregnancy and three for this pregnancy), so I know my membrane strips.. this one had zest!

I left the office with a big thanks and a 'hopefully see you later.' I walked home via Central Park. My braxton-hicks contractions were accompanied by some cramps now, but I didn't dare get my hopes up. I kept thinking that they would settle back down but did some lunge-steps here and there to put pressure on the cervix and encourage them.

I thanked my nanny for taking care of my 18-month-old son all morning and let her go home. My son and I strolled from our house to the fancy Apthorp Pharmacy on W 78ths St. and I bought a scented candle. At this point I had to sit down though a contraction. OK. Game on. It's about 3pm by now.

We turned west and headed to Riverside Park where I knew I could hit bench after bench on the way back home, which I did. I called my Dad and let him know things *might* be happening tonight and let my husband know he had to come home right after work. I was still worried things would peter out. My son played in the park as the contractions became more serious. At 4:30pm I sent my husband (L) this email: "Can't make it home from the park. Come now." When contraction hit, I looked to make sure my son was not near anything dangerous, and I worked through it. The kid was having the time of his life, mucking with trashcans and doing all sorts of usually off-limits stuff while I labored.

The next few hours are fuzzy. I called my doula and she suggested walking, keeping upright, and should she come? I wanted to wait off just a bit longer to be super-duper sure... I ate a solid dinner. Finally around 8pm I called my doula (K) and asked her to come over, knowing she had a long trek from Brooklyn.

K arrived at 11pm and from her notes I looked "calm." We decided to go for a walk outside in the cool night air. I remember the moon was almost full. We walked up and down sleep hill in Riverside Park three times. This is when she and I started to feel out our rhythm while I was contracting. She also looked deeply into my eyes and showered me with a warm peaceful gaze and smile which said to me "I know. I know what's going in. I'm with you." It was great. I remember she told me to "give it to me" at the crest of the contractions. She had me hold on to her arms and squeeze to reflect the intensity of the contractions. This - plus my vocalizing - turned out to be a great way for me to communicate to her how intense things got later on. I'd say a big lesson I learned from laboring with K, looking back, is how key it was to have this "code of intensity" that allowed her to get inside the labor in real time. Later on, when I had to get in/out of the cab or was being examined for dilation, I wanted K (e.g. not my husband) to be there because I knew I could signal to her what I was going through and that she would get it.

We walked up a big hill near my apartment and at one point a big Labrador retriever came up to me and snifffed me all over. The owner was very apologetic but I thought it was funny. If only he knew...

We got back to the house. At this point, K started timing the contractions. 5-10 minutes apart lasting 30 seconds. I wanted the jacuzzi (we have one in our apartment, lucky us). We filled it up and I got inside. Very nice, though nowhere near as awesome as the Birthing Center jacuzzi later on.. The contractions slowed way down. After about an hour, I got out of the jacuzzi, things got much more intense. Contractions every 3-4 minutes lasting a minute.

We start walking back and fourth in my living room through the long contractions. In retrospect, I was in transition! I remember thinking "mental note: some of these contractions feel like my cervix is being YANKED open!" It felt like something deep inside me was being stretched but with the big, transition contractions, the stretching would feel like a yank.

At 2:45am I tell K to wake my husband. He mainly focuses on getting everything ready, At about 3am we call the practice and the OB on call (Dr. H) said to make tracks to the hospital. L goes to get a cab. I remember waking past my Dad (who was going to take care of my 18-month-old) on the way out and he was so respectful of the space I was in. He said something very tender as I left. "Good luck, girl." Or "God bless, dear."

In the hallway I look at K and say, weepily, "Can I have a hug?" and say, "I bet I'm only 3cm!" We get me into the cab and I braced myself for pain. I have 2 contractions in the cab and two more while trying to get out of the car. A guard suggests a wheelchair and I refuse it at first, then take it. We make our way to maternity triage. I strip, gown up and get wrapped in all the machines - heart rate, contractions, pulse, etc. The nurses are pretty gruff.. it's all "We need a good trace! Sit up more!" and so on.

At this point I'm in agony and snap at everyone using three word sentences. Dr. H asks me what took me so long to call in, and examines me. I'm.... NINE CENTIMETERS. K shouts with delight and there are some high-fives all around. For a good long moment, I feel like birth rock star. Then Dr. H explains that there is another mom pushing at the moment and she has to call back up or something. If she was trying to make me feel bad it was not working! I'm released from the horrible triage unit and wheeled up the the Birthing Center.

Once in the Birthing Center, I mention wanting to use the birthing chair and they set it up and have me sit on it. I do and it's horribly uncomfortable. Dr. S (the back-up OB) asks me if she wants me to break my water. I say "Tell me about what that means so I can psychologically prepare myself..." and before I can finish the sentence GUSH! my water breaks all over the birthing stool. I instinctively look down at my Thanksgiving-turkey-is-done-belly-button watch it shrivel.. and turn brown!

I get right into the jaccuzzi the contractions IMMEDIATELY slow to a crawl and the intensity goes way down. K puts glorious cold rags on my forehead and I can honestly say that right there, nine centimeters dilated, 15 hours or so of labor, the cab ride, triage... I didn't even feel pregnant. I remember thinking to myself... "If I close my eyes, I could be on vacation in a hotel hot tub or something, reading a magazine, tra-la-la..lala..." Amazing.

Then I had to get out to get examined. Ugh. With a lot of work, I get out of the jacuzzi and start to shake uncontrollably. I manage to get onto the bed and endured the most horrible three minutes of the entire birth.

I lay on the bed, legs splayed and I remember grunting and blowing raspberries like a horse to try to manage the pain. I was NOT expecting that and it completely threw me off my game. The exam felt rough, unyeilding and I felt like a trapped animal. Dr. S said I was still nine cm and the baby was high. I needed to get the baby down and to do so would need to stay out of the jacuzzi. At this point, I'm shaking with pain and the exhaustion starts kicking in.. she says she will be back in an hour to check me. I say AN HOUR??? I can't take an hour of no jacuzzi. I ask Dr. S if I can get a epidural, expecting her to say it's too late. She says "Of course!" But am I SURE? Yes I say. NOW.

I'm wheeled out of the Birthing Center and into Labor and Delivery. The anesthesiologist was dry and funny as he went through his well-rehearsed shtick. The epi took some time to do it's thing, but once I was numb, I fell immediately asleep to the sound of the baby's heartbeat monitor. It was full-on morning by now.

At around nine am, Dr. S examined me and I was fully dilated (NO PITOCIN!) and it was time to start pushing with the contractions. A nurse got one leg, and my husband got the other and I pushed. I remember thinking that this was going to take a few hours but Dr. S acted like the baby was going to be out in a few pushes.

The baby's hear decels with each push so we're back to the game of resting for a contraction between pushes to let the heart recover (we did this with my firstborn). Dr. S suspects a "nuchal cord" (cord around the neck) which my firstborn had, and is fairly common.

I push/rest/push for 20 minutes or so and everyone starts to get excited as the baby's head becomes visible. I remember pushing and Dr. S says, very calmly, "Stop pushing." Then before I can think, she pulls out my son and says "Here you are, Mommy." It's 9:47am. 18 hours of labor.

I'm stunned. I'm stunned that the baby is born and I actually GET TO HOLD HIM. I'm completely prepared for someone to take him away to do this and that procedure, but no. He is in my arms and stays there.

I sing to him a special song that I made up and stroke his skin and just marvel at him. After a few minutes I try breastfeeding him and to my amazement, he latches on and starts nursing like a complete pro. It took days (and lots of help) for my firstborn and I to get the hang of nursing, but here we were, in perfect synchrony, nursing away. I can't believe it.

Dr. S waits until the cord stops pulsing and L cuts it. I have only one very superficial tear and I get one little stitch. I deliver the placenta and Dr. S lets out a gasp... the cord insertion to the placenta is 90% detached... this explains the decels!! The placenta is sent immediately to pathology for analysis and Dr. S tells me that we were extremely lucky to have avoided maternal-fetal hemorrhage (the nurse says in her 11 years of births, had never seen such a near miss). I later learn that this is called a "velamentous insertion of the umbilical cord" (the umbilical cord inserts on the chorioamniotic membranes rather than on the placental mass) and occurs in 1% of pregnancies.

I attached a pic for the hard-core birth geeks. You can see the strands of umbilical vessels - unprotected by Wharton's jelly - connecting the cord to the placenta. That was all that connected us. Amazing!

[Hershel]

Thank you for sharing the useful information about the Birth from first stage to the end.

[jcsites]

This story is so inspiring..