An end to the waiting

Normandie Mae Melli finally put our waiting to an end at 8:12 pm on Friday, January 17th. As to be expected, every second of the 32 hours of labor, every minute of the 12 days past her due date and every day of the last 10 or so months was well worth the wait to meet this beauty.

While it's still fresh, I wanted to jot down some thoughts on the experience. Some details are too personal or precious to publish on the Internet, but I know a lot of pregnant women right now so if anything from my experience could be helpful, I'll try to include it.

This post is looooooong. But frankly, so was labor. I tried dividing it up into sections to make it more readable, and threw in some photos.

Background
The day I found out I was pregnant, I called The Birth Center (from here on out referred to as TBC) in hopes of getting a slot to deliver there. I had heard wonderful things about it from professors and my primary care NP. Fortunately they were able to take me and that's where I got all of my prenatal care and where I ultimately delivered.

It is an out-of-hospital facility run completely by midwives and nurses. It is located across the street from Bryn Mawr hospital so in the event of an emergency, mom and baby can be transferred and admitted immediately. Even in the event of a non-emergency requiring hospital care, TBC maintains a working relationship with Delaware Co. Hospital (which is where my induction would have been) and the midwife follows you to the hospital and directs your care until delivery. A pediatrician is on call so if one is indicated at delivery, the baby can be evaluated at TBC.

The bed where Normandie was born

When someone signs up to deliver at TBC, the expectation is there will be very minimal intervention during the birth. Pain medication is not an option with the exception of morphine in certain cases (I happened to be one of those cases…will explain). No electronic fetal monitors are used during labor (but they have them to do non-stress tests, for example). There are 3 birthing suites, each with a jacuzzi tub. During labor a woman is free to move and assume any position she pleases. She can and is encouraged to eat and drink. She can wear whatever is most comfortable. She is attended by a nurse and a midwife the entire time.

Ben and I are extremely grateful for the care we received at TBC and if we are blessed with another one and happen to still be in Philadelphia at the time, will most definitely try to deliver there again.


The Plan
On Thursday, January 16th (11 days post due date), the plan was to have an ultrasound in the morning to make sure I still had enough amniotic fluid. Next would be a non-stress test to make sure the baby was still healthy enough for labor. If the results of those two tests looked good, the next step was to take castor oil to try to induce labor. If it didn't work, I would take Friday to recover (without going into too much detail, it can be very dehydrating) and then try castor oil again on Saturday morning. If still no labor, an induction was scheduled at the hospital for Sunday night (which happened to be the same day as the NFC/AFC championships so daddy was hoping it wouldn't come to that either. Watching those games with Normandie in our arms was way better than watching them from a hospital bed).

Taking the castor oil sounded awful but I was happy to do it if it meant getting labor going and avoiding a hospital induction. Based on a recommendation from TBC, I scheduled a pedicure/reflexology massage at La Beaute for noon on Thursday-after the tests and before the castor oil…just in case. I figured it would relax me either way, but it has been known to start labor too.

The tests went well. The non-stress test was at TBC. At the appointments the week before, I was 1 cm dilated. On Monday I was at 2 cm. Thursday morning I was at 3 cm. Each time I was checked, the midwife "stripped my membranes". It was nice to know my body was slowly preparing, although there were still no signs of labor. We were handed the castor oil and headed over to the pedicure. My mom and I both thoroughly enjoyed our foot massages….even if you are not trying to induce labor, I highly recommend the reflexology massage at La Beaute (ask for Jasmine)! Best massage either of us has ever had.

After that, we headed to the grocery store to pick up food for the next several days (just in case). We selected items for chocolate milkshakes, my drink of choice to chase the castor oil. While in the grocery store, I felt the first contraction.

Labor
At first I thought it might have been another Braxton Hicks contraction (of which I had many), but this was different. This one definitely came with some cramping and discomfort. I didn't want to get my hopes up. But then another one came probably 6 or 7 minutes later. And then another. Literally within an hour of the reflexology massage, labor started. Just saying.

We got home and I decided to hold off on the castor oil because I didn't want to get dehydrated if I really was in labor. I immediately started doing everything I could to keep things going. I bounced on the exercise ball, did squats, went for a long walk, etc. Here I am at Clark Park on the long walk. A friend had told me swings can help.

 Every now and then I tracked how close together the contractions were. They started about 5 minutes apart. After several hours they were 4 minutes apart. I was supposed to call TBC when they were 4 minutes apart, lasting one minute, for an hour. As I was bouncing or squatting or breathing through a contraction, my mom and Ben cleaned the whole apartment.

I called the midwife on call when I got to the 4-1-1 stage and I still felt ok. She suggested remaining at home until I felt like I couldn't cope well there anymore. So more bouncing, more squatting.

The evening news came on. Then Jeopardy. More bouncing, more squatting. I called again and the new midwife on call suggested I wait longer even though I was getting pretty uncomfortable and anxious at home. So we waited until 11 pm (the end of Parenthood) and then packed our things and left.

The 30 minute car ride wasn't as bad as I had expected it would be (driving through West Philadelphia in the winter can be bumpy). I think I had 8 or 9 contractions, but all were easy to breath through.

When I arrived at TBC, there was already someone else in labor. I got checked and was at 4-5 cm. The midwife told me I was neck and neck with the other woman in labor. Within an hour, she was pushing and I heard every yell through the wall. That was daunting…not only because she progressed so quickly, but because her cries of pain reminded me of what was ahead. Somewhat disappointing, when I was first checked, the midwife suggested I go back home. I knew I wouldn't be able to sleep at home. I had tried taking a shower but our hot water ran out at home, so I didn't think that would help either. She let me stay as long as I promised to be active.

This is when we first arrived at TBC; breathing through a contraction in The Yellow Room and getting vital signs checked 

After several hours of climbing up and down the stairs and more bouncing and squatting, I was still at a 4-5. It was hard to believe since the contractions had gotten closer and far more uncomfortable. I felt like I was coping reasonably well, but after she told me that, I felt like the contractions started to get ahead of me. It was difficult to breath through them and to relax in between.

She suggested a dose of morphine because I had already been in labor for over 12 hours and for some people, it helps them to sleep for a few hours and wake up in more active labor (so this is when morphine is used…when someone has been in labor for a long time and not progressing and the body needs a break…the morphine wears off in about 4 hours and you are back to drugless labor).

I was more than willing to go with that suggestion. She gave me the first dose that normally knocks people out. Thirty minutes later she came to check on me…I did feel more relaxed between contractions but I was still feeling every one intensely. So she gave me another dose, saying this one would surely knock me out. I started dozing in between contractions, but each one would jolt me awake, making it more difficult to cope with them. Even still, they did seem to slow down and I was able to get in a few hours of relative relaxation.

At around 8 am, a new midwife came on. I knew I was going to like her. She checked me and I was at 6 cm. She said I could go home if I wanted, but technically I had progressed, and she was willing to work with me to try and deliver that baby. I was more than willing to do whatever she suggested.

I threw up a couple of times

So here was our new plan. For about two hours I would climb stairs, do squats and lunges, and bounce on the ball. After that she would check me again and could rupture the membranes ("break my water") if it seemed like nothing was happening. This usually kick starts labor even more, but it also comes with risks. So off to the stairs we went. My mom did a lot of stairs with me. Ben was there too. Labor was hard for me, but I imagine a lot of it was boring for them. Regardless, they were so faithful to me.

About an hour in, the midwife came to check on me and listen to the baby (never once was I attached to a fetal heart monitor, freeing me up to move around as I pleased. The nurse and midwife took turns listening to the baby's heart with a Doppler every 30 minutes or so at this point).

As she was checking me she noticed something was dripping. My water broke on its own! We went back to the room to double check. Sure enough, no need to rupture them. But at this point she didn't want to check me as frequently because of the risk for infection.

Active labor
Fast forward a little bit, I continued using the stairs, the bouncy ball and the shower. In fact I used the exercise ball IN the shower-that was the BEST. By the time she checked me next, she was able to rupture the membranes even more. Sometimes what happens is that the bag breaks up high, so fluid just leaks out slowly but there's still a lot of fluid down by the baby's head. With a contraction, the midwife was able to burst the whole thing. Gushing, gushing fluid. Ben couldn't believe how much fluid I had been carrying around. This was great because it's the pressure of the baby's head pressing down on the cervix that helps labor progress and without the fluid in the way, the pressure increases significantly. And oh, did labor progress.

This is the point that I wanted to believe that I had entered transition. From what I knew, transition was the hardest but the shortest part of labor. It's when the cervix dilates from 8 to 10 cm and at 10 cm it's time to push. I still felt as though I was able to handle the contractions with focused breathing and I threw in some moaning that seemed to help too.

I asked the midwife if she thought this was transition. She smiled and said, "not sure." One thing I truly appreciate about her is that she rarely confirmed my suspicions. She usually answered with a smile and a "not sure." At the time it frustrated me, but now I can understand that she didn't want me to rely on something that might have defeated me in the end. Turns out, that was not transition. Things were about to get a whole lot harder. If she had answered yes to my question, the next stage would have been harder to deal with than it already was. If she had answered no, although this was probably the case, it would have defeated me before I even attempted the next stage.

Transition
After I asked my transition question, the midwife suggested I get in the tub. I was more than willing to try it. I had heard from so many people that sitting in warm water was relaxing and so helpful for getting through transition. Well, it didn't work well for me. Maybe I naively thought the contractions would disappear in the tub. They did not. Maybe I thought sitting or lying would be a more comfortable position. It was not. My tub time did not last long and I got out to try something different.

Around this time, I noticed that my midwife had not checked on me in a while. The nurse kept coming in to listen to the baby. I was sitting backwards on the toilet. Again, some people rave about this position. I was not a huge fan. With each contraction, I began feeling a strong urge to push. I asked to be checked because I figured this must be it, I've reached 10 cm. A different midwife came in to check me. The thought crossed my mind that my midwife had left me, and that scared me, but I was in too much discomfort to ask why. Turns out she had to run to the hospital to do rounds and she was back within an hour. When I saw her for the first time after she came back, it was like a very dear friend that I've known for a long time came back. I had known her for less than 12 hours at this point. Labor does that I guess.

Anyway, the new midwife checked me and I was still at an 8. How could this possibly be. The urge to push was getting stronger and stronger. She said that with the next contraction, I could try to push and simultaneously she would try to push the remaining bit of cervix over the baby's head. Sometimes this works. Again, willing to try anything. So we did and I screamed and I am so ashamed to say I think I kicked the midwife. It hurt more than anything. And it didn't work.

Back to the shower I went. My midwife came back. I cried a little to see her. She told me to picture the cervix melting away with each contraction. The nurse told me to try not to push if possible. I asked why I wasn't allowed to start pushing. They told me it didn't sound like I was ready yet. I didn't understand what they meant. When they left the room, Ben whispered to me that he overheard them say my moaning didn't sound guttural enough yet to indicate I was at the point where it was time to push. But I wouldn't be able to fake it. Well, I was willing to try that too.

Now, when I had heard that woman yelling when I first got to TBC, I questioned if I would really need to yell like that. I thought maybe I would be more of a silent laborer. But if they wanted guttural sounds, I was more than willing to oblige if it meant pushing the baby out. Even if they hadn't needed to hear me do it, I would have eventually succumbed to the pain and hollered anyway. I started yelling with each contraction, as guttural as I could. I felt like the sounds were coming from the deepest part of me, originating in the place of pain and filling my head.

This is the part I had wondered about since the day I found out I was pregnant. Would I be able to do it. It was long and it was hard. Nothing could have prepared me for it. Some things helped me get through it. My mother and my husband's presence helped the most.

My midwife suggested I get back on the bed, this time on my side and she could try pushing the cervix away. So we did. And again, I think I kicked my new best friend. I screamed, I cried, I cursed. I think I tried slapping the wall but it was too far away. That was the very worst part.

Next we tried hands and knees, with my arms and head hanging over the exercise ball. She did let me push as long as she could try pushing the cervix away. My mom had brought lavender massage oil and was massaging the bottoms of my feet during this part. Ben was softly stroking my back with his fingertips. They stopped during the contraction and then resumed once my hollering stopped. It was a beautiful way they served me at a time when I was too beastly to acknowledge it or ask for it.

Then we tried semi-sitting. Then we tried the birthing stool with Ben sitting on the bed behind me so I could relax in his arms in between contractions. I believe this is the point where she was able to push the last of the cervix away and I started pushing on my own.

Push
You only push during the contractions. One of the beautiful parts of labor is that contractions actually slow down during pushing, giving a woman time to rest in between. My problem was that I was feeling so much pressure, I couldn't always tell the difference between the end of a contraction and the pressure from her head. So sometimes I would give 5 good pushes but the contraction would last for a minute after my last push, and I'd be too tired to keep pushing. I could tell the contraction was still occurring because my stomach would still feel so hard.

So I was instructed to take a few more deep breaths at the start of the contraction and to wait to push until I really felt the urge. This did seem to help.

Ben said my entire back turned beet red with each push and he didn't realize I had such defined muscles in my back. I don't, but I think that every muscle fiber in my being joined the fight. There were handles on either side of the birthing stool which I was supposed to grip and pull on each time I pushed. The next day, my arms were more sore than they've been in a very long time. Well, everything was for that matter. Even my throat was sore from the yelling.

The midwife suggested lying on my back, which is counter intuitive, but after trying all the different positions, that seemed to be the one where I made the most progress. We had already started to see the head, but it rocked back beneath my pelivc bone in between pushes. The goal was to push her head out far enough so that it would stay put in between pushes, then I could really start making progress.

After what felt like a very, very long time, her head stayed put in between pushes. My mom would hold up a mirror for me in between contractions so I could gauge my progress. I found this to be so helpful and encouraging.

I'm not sure how long this part lasted. I know I was pushing for 2 1/2 hours, but how long I was on my back, I'm not sure. I would feel a contraction coming on, I'd breathe an "ok", my mom would hold my right foot and the nurse would hold my left. I'd take a few deep "cleansing" breaths and then would push with everything I had while curling my chin towards my chest and attempting to make a "C" with my body around my baby. Quick breath, push again. Quick breath, push some more. I'd try to get in 5 good pushes. All the while I could hear the midwife coaching, "good, good, more, more, that's it Kristin, that's it." I could hear my mom and Ben getting excited, letting me know I was getting closer. The last push would end and I'd lie back on my pillow. Ben would cool me off with a fan, my mom would get me a drink of Vitamin water or juice box, hold up the mirror for me to see my progress, and we'd wait for the next contraction.

I felt very hot and was sweating a lot. I knew I was so close to holding my baby but I felt like every ounce of energy had been spent. If I had to compare the experience to a marathon, I would liken this part to the last mile, or maybe the last quarter mile, shoot, the last 0.2 miles when you've seen the 26 mile marker and it should be over but there's just one last push to finish...when it's no longer your legs that are carrying you but the will of your mind deciding to take each step.

Deliverance
From deep in my abdomen the contraction began. I took a few breaths until I couldn't not push. I whispered, "ok". This time Ben held my right foot, the nurse my left. I bared down with everything I had left. A brief burning sensation and then unbelievable relief. Shrieks of joy from all around me. I didn't know exactly what had happened, but I knew it wasn't over yet. But there was so much rejoicing, I couldn't hear the midwife or her instructions. Finally I locked eyes with her and saw her say, "one more push". I obeyed but this time it felt different. I could feel lots of little pieces moving around inside and then they were out. And I felt so different. I could see her at last.

"Kristin, reach down and pull out your baby." I took the slippery babe from the midwife's hands and lifted her onto my stomach. Her hips and legs were still inside me when I first held her. Pulling her onto my stomach delivered the rest of her body. I don't know how to describe how it felt to have the rest of her come out….just that waves of relief began washing over my body and I could barely speak. Ben cried, "touchdown!", I could see my mom tearing up with joy. The nurse wiped Normandie down while she was still on my tummy and we heard her cry for the first time. Hues of blue faded into pink as she began to breath. I cried a little too…from thankfulness, relief, and a joy so deep.

Rest
At some point in the last hour of labor, the midwife had asked me if I would be ok with getting a shot of pitocin as the baby was born. Because I had been in labor for so long and my uterus had been contracting for over 30 hours, she thought pitocin would help the uterus contract better after the baby was born. More than happy to get that pitocin and hopefully prevent a hemorrhage. The nurse gave me the shot while Normandie was being delivered, I didn't even feel it.

A few minutes after she came out, the midwife asked me for one final push. I felt something squishy come out and then the relief was complete. I had just delivered the placenta. The midwife showed it to Ben and I, explaining which part had belonged to me and which had belonged to Normandie. I had seen placentas before but it was bizarre to see my own…to see the organ my body had manufactured just for Normandie. Don't worry, we didn't take it home with us. I was glad to marvel at it for a few moments and then be rid of it.

They waited until the cord stopped pulsing, and then Ben cut it. The baby I had been carrying since April was finally detached from my body.

Normandie stayed skin to skin with me for over an hour. I'll never forget what it felt like for her to look in my eyes for the first time. She was so awake, so alert. The nurse attached her to my breast and she nursed for the first time. Everything about her was so pure, so perfect.

I tore during the pushing and needed stitches which the midwife and nurse took care of right away. They gave me some local anesthetic. And then they let us bond as a family for a few hours. During the latter part of labor Ben had the genius idea to order Thai take out. My mom ran out while I was pushing to pick up the food, afraid she might miss the baby being born. Fortunately I was still pushing for another hour and she didn't miss much! None of us had eaten much that day and that Thai food tasted divine, at least it did to me.

Later the midwife came in and did Normandie's newborn exam. When she was finished she handed her back to me and said, "she's perfect". The nurse was monitoring our vitals. Eventually she gave Normandie a quick bath and washed her hair, then gave her a shot of Vitamin K and applied the erythromycin ointment to her eyes. After the bath I realized what beautiful blonde hair she has.



My mom and Ben got to hold her while I got cleaned up. And then we all slept for a little bit, including Normandie.

My beautiful mama with her newest grand baby

12 hours old, getting ready to leave TBC and go home for the first time!

Early the next morning we packed up and drove home. It was amazing to have my mom here for a few days. She watched over Normandie so Ben and I could sleep. She continued to clean and cook for us. She delighted over her grand baby. Seeing her go a few days later was tough but we knew she needed to get home. We are deeply thankful for everything she did for us during the month she was here. It was the most time I've spent with my mom…probably in ten years or so…and I cherished every moment.

First family outing

Our precious newborn

Meaning
My mom delivered my sisters and I in a hospital, without any form of medication. I've grown up hearing her tell the stories of our births, always in awe that she was able to deliver each of us without any form of pain medication. She always described the experiences as the most pain she's ever experienced, but that she would do each of them all over again because we were at the end of the pain. I knew that I wanted to be able to tell Normandie the same thing.

I've run several marathons and have completed 3 half-Ironmans. Labor was by far the hardest thing I've done. It exhausted me physically and emotionally and mentally. I had a verse that I planned on praying through the hardest contractions…but I couldn't remember it in the moments of pain. The beautiful thing about the experience when I look back on it is that the pain was never without purpose. I was never alone. Never abandoned. Each wave of pain brought her closer and closer. From the moment I pulled her onto my chest, I could say it was all worth it. But I couldn't say I would do it again. The first few days afterwards I needed to heal emotionally as much as I did physically. I wasn't even sure I could say I would want to birth another child.

Then we had a follow-up appointment at the Birth Center. Ironically, we were seen in the same room where we delivered Normandie. I thought I would never want to go back into that room, at least not for a long time. But one week later, when they led us down the hall and told us we'd be seen in the Yellow Room, I felt enormous peace walking into the room. In a way the room was beautiful to me.

And as I rocked her while waiting for the nurse, I knew I could do it again. I will be able to truthfully tell her that her birth was the most beautiful experience of my life, and that I would do it a thousand times over again if it meant being her mother.