For me, the story of Harry's birth has always been tinged with regret. Although the outcome (Harry, my most beloved son) was perfect, I can't shake the feeling that something could or should have been different, that I could or should have done something different, that he needn't have come into the world the way he did, purple-faced through a surgical incision. Could I have done a better job in early labor of changing positions, spending more time on hands and knees or leaned over a birthing ball or over a bed in order to rotate him from the posterior position he was in? Should I have walked more in early labor? Spent more time in the tub? Gone home when an early exam showed I wasn't making much progress? Waited longer before consenting to a cesarean to give my body and my son more time to prepare? I have always wondered whether the story was really Harry's birth story or whether in fact it was my story, the story of how I birthed my son.
Josie's story, on the other hand, was and remains quite clearly her own. And this is the story of how she was born.
Monday was the holiday. We took Harry to the farm to see the animals in the morning, figuring that walking around might get things going. I had been at 1cm and 75% effaced at my appointment a week earlier and hoped it wouldn't be too much longer, as my hospital will not induce a woman who has had a prior cesarean, so I had to go into labor naturally or would be required to have another. After the farm, we went to the local pan-Asian restaurant we went to the day before Harry was born. Because it was a holiday, I couldn't get the same bento box lunch special, but I did my best to replicate it. I had started having intermittent but very irregular contractions after we left the farm, but they never really organized. I would have 6 or 7 in an hour, then none, then a few more. By night, they seemed to have stopped. They started up again in the morning, probably around 7 or 7:30, but they were still weak and disorganized. But I had been having a ton of discharge overnight and that morning and had the feeling Tuesday would be the day, or at least the start. When P left for work, I told him to try to get as much done as he could in the morning, as I might need him by afternoon.
I got Harry to daycare around 8:30 and stopped at Dunkin Donuts on my way home. By the time I got home at 8:50, I realized the contractions were more painful, coming every five minutes and lasting close to a minute. That phase of labor with Harry had lasted so long, though, that I figured things would stay like that for a while, so I went to go lie down for a bit to listen to a Hypnobabies track and drink some water and decide what to do next. I never did eat that donut.
The contractions kept getting stronger, so at 9:10, I decided to get into the tub on my hands and knees and let the water flow over my back for a bit. By 9:21, they were 3-4 minutes apart and quite strong and I started to get a little nervous about being alone for the day. Or even just the next hour or two. I got out of the tub but couldn't even manage to get dressed. I lay on my bed, wet and naked, listening to more Hypnobabies. By 9:38, the contractions were 3 minutes apart and I called P to tell him that I needed him to come home, that I couldn't do it on my own. He said he was on his way. I wrestled my way into underwear and a shirt, hanging over the side of the hamper moaning as yet another contraction came, and gave up on getting any more clothing on.
When 10 rolled around and P wasn't home yet but the contractions were 2-3 minutes apart, I knew it was time to call the doctor's office. I was told I should come in to the office first to be checked. This seemed like a bad plan, but I wasn't in a position to argue so I didn't. As I was hanging up, P got home.
P then scrambled to grab the things that hadn't made their way into the bag yet. I guess I thought we'd have more time. From the time we had that "today is the day" feeling until we left for the hospital, eight hours passed with Harry. This time, it was less than 2 hours, and I couldn't put on pants in that period, much less pack a bag. We were at the hospital before we realized we had forgotten the camera. At some point, it was pretty obvious that going to the doctor's office first was a terrible plan. P called and told them we were going straight to the hospital.
Easier said than done. Even though it was after morning rush hour and there was no Red Sox game, something had traffic all stopped up. P tried to find an alternate route but there was traffic everywhere. I felt every bump and every pothole in the road and found it very tough to release and relax during or even between contractions. I couldn't lean my seat back because of the carseat behind it. I clung to the handle above the door as though doing so could slow everything down or somehow speed the car up. Eventually, my hand grew numb but I still held on.
When we finally arrived at the hospital, we had to decide whether P would drop me off then park the car or park and go in together. Neither was acceptable to me -- I knew I couldn't walk in from the garage but also refused to go in alone. The guard said we could leave the car if P moved it within five minutes. I barely made it through the door before another contraction hit. Someone brought a much appreciated wheelchair and I became one of those women who had to be wheeled to L&D. After what felt like a long wait at the admissions desk in L&D (four contractions, I think), we were able to bypass triage and go straight to a room. I was checked and was only at 4cm, which seemed shocking, given how strong the contractions were. But it was still only a little past 11am.
The doctor came when P was moving the car and remarked that the monitor seemed to be picking up my heart-rate periodically and that they'd need to adjust it and keep it on a little longer. She then checked my pulse and realized it wasn't mine, that the baby's was dropping with each contraction. Because I had just gotten there and it was a bit soon to call it a pattern, she said we had a few options: (1) wait and see; (2) wait and see but also order an ultrasound to see if we could tell what was causing the decels; or (3) break my waters and attach an internal monitor to the baby's scalp to permit closer monitoring. She noted that waiting now could reduce available options later, but I wasn't comfortable with (3), so I opted to wait. She said they'd check my progress again in an hour.
The decels continued but were getting worse. The baby's heart-rate was dropping from the 150s to the 50s with each contraction, but the contractions were so close together it couldn't rebound. It had only been forty-five minutes, but the doctor made clear that breaking my waters to permit more consistent monitoring was the least invasive option that she could recommend at that time, and I didn't question that at all. Some time before noon, my waters were broken. I had dilated to a 7.
Within fifteen minutes, the nurse could feel the baby's feet on the top of my uterus trying to push down and out. And I couldn't keep myself from pushing involuntarily even though I wasn't fully dilated (nor did the nurses or doctors, of whom there were many in the room by this point, encourage me to stop). But the baby was posterior and dilation was slowing from its extremely rapid pace and the heart-rate continued to drop with each contraction. There were concerns regarding uterine rupture and that the cord might be wrapped around the baby's neck. Regardless of the reason for the decels, everyone in the room felt the baby needed to come out immediately, myself included. There was just no way to know how much longer it would be before I was at 10cm and ready to get the baby out or how much more the little heart could handle.
The anesthesiologist was called in, and they did verbal consents for a spinal and for the c-section as they wheeled me to an OR, lacking time for written. It was a little scary, but, unlike with Harry, it felt like the right choice -- the only safe choice. It took three or four tries to get the spinal in (and I was still having contractions every two minutes, which made it really tough for me to arch my back for insertion). But once it was in and the pain let up, I realized I was far more okay with the outcome than I'd been the last time. I wasn't shaking or crying. I didn't need anti-anxiety meds. I just wanted to get it over with. The time from deciding to have the c-section until the surgery began (honestly, probably close to 45 minutes) felt like the longest part of labor.
The surgery began just before 1, and at 1:16 P got to stand and announce that we had a girl. They let me give her a kiss before wiping her down and let P participate in a lot more of the post-delivery process than he had previously. And I got to carry her with me when we went to recovery. On the whole, not the birth story I had wanted, but it was the story of how Josie was born.