After 40 weeks, the big day is here! Or is it? I hit my 40 week mark and there I was still pregnant! I tried everything including spicy thai food, garlic, pineapple, raspberry leaf tea, and eggplant parmesan, but nothing worked. I walked 10,000 steps a day… yes I really did walk that much and still nothing happened. I had a very healthy pregnancy and was used to running and walking every day which is why I was so mobile at the end. Whether you are early, on time or late that big day will eventually be here.
I chose to divulge my birthing experience since I had so many questions prior to giving birth as a first time mom. Between friends, google and other moms sharing their experiences it helped calm my nerves, so I wanted to do the same for other soon to be mommys!
As everyone does, I had a birth plan that I was hoping to follow. I thought with my active and healthy pregnancy I would be able to go into labor myself without any intervention from my doctor. Unfortunately, that did not happen and I was just along for the ride!
To say the least my birthing plan was modified quite a bit when I went into the 40 week doctor appointment. The doctor told me I was dilated about 1-2 centimeters and effaced at 50%. They had me schedule an appointment for one week later, at 41 weeks on the nose. If I did not go into labor by then they would schedule an induction for that day. Alternatively, I could just schedule an induction for the day before I turned 41 weeks. After reading about inductions, it seemed there could be a greater chance of a c-section if I was induced. In addition there would need to be another night spent at the hospital while receiving both Pitocin and Cervidil. I was interested in doing an all natural birth, including no epidural, so this did not interest me unless absolutely necessary.
I considered the options over the next few days and made a few more calls to my doctor before making a decision. The practice I was using did not want me to go past 41 weeks as they said nothing good comes from waiting beyond that gestation. I decided I’d rather not come in for an additional appointment just to hear that I would have an induction later that day. I called the doctor back and scheduled the induction the last day they would let me go, which was the day before I turned 41 weeks.
I did not give up hope on a natural birth and every day I tried something new that I had either read online or heard from friends. No luck with any of them. This baby girl was coming on her own time or she was going to be forced out it seemed…
Hospital Bound!
That fateful Sunday rolled around and there I was still pregnant! The way my hospital began the induction process was to give me a call sometime after 12 PM that day to tell me to come in. I was essentially on call since they did not know when a bed would be free. At about 2 PM I received the call saying it was time to come into the hospital for the induction.
Taking a step back, induction was not what I planned for, nor what I wanted, but the experience wasn’t all that bad. My husband and I had extra time to pack anything we would need. We had an additional week to get prepared for the baby, spend time together and anticipate the birth. We were prepared and relatively calm heading to the hospital, as there were no contractions and nothing unexpected occurring.
Decision between Doctor and Midwife delivery
While you are pregnant part of your labor plan will include whether a doctor or midwife will be delivering your baby. I was set that I wanted a doctor to deliver me from the beginning, so I tried to set up every prenatal appointment with a new doctor in the practice. It was extremely unlikely I would actually get my doctor for delivery unless I delivered during office hours, as they all rotated night and weekend call.
When making the decision on whether to go the doctor or midwife route be sure to find out what the chances are you will actually get the individuals you want to deliver you and how often they are on call. This is very important because you will want to feel comfortable with whoever is delivering your baby. It is a good idea to meet all the doctors and midwifes in your practice or as many as you can.
After attending a Childbirth Essentials class, the knowledge, experience (15+ years) and personality of the teacher, who was also a midwife caused me to alter my labor plan. If she was on call I wanted her to deliver my baby. During this class we also learned the main differences between a doctor and midwife delivery. Typically midwifes are much more hands on prior to active labor. I liked the fact I knew she would be by my side throughout the entire labor process. While doctors will be with you during the active labor, midwifes are typically by your side long before that and helping you in any way you need.
Midwifes are also typically more flexible throughout the whole labor process and do offer more options for pain management and delivery. If you choose a doctor the nurses typically play a larger role prior to the active labor.
However, doctors do offer an extremely high level of education, knowledge and will be able to handle any complications that arise. Even if you choose to go the midwife route you may need to have a doctor intervene should any complications arise. Check with your doctors office to see how a doctor delivery can differ from a midwife.
Another factor in deciding if you would like to have a physician or midwife deliver you may be the rate of c-sections. It was about 40% for physicians and 20% for midwifes in my practice. While both are high, 40% seemed alarming. It is a good idea to ask for these rates when making your decision.
My midwife was absolutely amazing throughout the whole delivery process and worked to ensure I had a vaginal delivery. When we have our next baby (if we are so lucky) I can only hope I can have her by my side again. However, I did not feel the same way with other midwifes in the practice. I would still highly consider having a physician deliver me if I could not have this midwife as they offer an extremely high level of experience and education.
The week prior to my due date I asked for the on-call schedule for doctors and midwifes. I was allowed to switch paths through the day I went into labor. When I went past my due date I asked for the next weeks schedule. Ultimately my decision to go the midwife route was made that last week looking at who would be on call for my delivery.
Process for Induction
We got to the hospital, checked in and were taken to our room. Shortly after our arrival the first nurse came in to take vitals and set up the IV in my arm to be ready to give fluids. They then checked to see if I was dilated any further. Unfortunately nothing had changed since the prior week so the Cervidil was inserted at around 7 PM. Cervidil can help to dilate your cervix. It is a small vaginal insert that will stay in place typically for 12 hours. It looks similar to a tampon but much smaller so be careful apparently they can fall out. Mine did not, but you don’t want to have to go through the insertion process twice.
This was a quick procedure, but now the nurses needed to monitor both myself and the baby until they removed the Cervidil the following morning (12 hours later). There was one heart rate monitor on me and one on the baby. Now it was just a waiting game. We ate, talked and tried to go to bed early as we knew the next day was going to be busy, exciting, stressful and we would soon be a family of three!
It was very difficult to sleep for many reasons. First of all, you are in a hospital bed, then you have to be careful how you lay down not only for the baby, but also because of the heart rate straps that are tracking the baby and you. If you move the wrong way and the tracker comes off, the alerts will sound and the nurse will rush in. Then when you get up to go to the bathroom you have to remove the cords for the tracker to the monitors and reattach them once you got back to your bed. In addition, the monitors and heart rate belts were pretty loud. We would have the nurses turn them down in our room, but inevitably the next nurse would come in and either turn them up or forget to turn off the monitors which are way to big and bright to be a night light. If you are scheduled for an induction, try to get some sleep before heading to the hospital!
Throughout the night several nurses came in to make sure everything was alright, along with the on call doctor who wanted to introduce themselves. Every time you think you are about to get to sleep another person seemingly comes in.
The most uncomfortable part for me was the IV. It was not inserted in the typical place where I get blood drawn from, but half way between my wrist and elbow.
After the relatively sleepless night it was time to await the check-in with the midwife (since I had chosen to go with a midwife delivery).
My midwife came in to check on me around 7:30 AM. The Cervidil had worked and I was 3-4 centimeters dilated. The next thing was to decide if I wanted an enema. Of course that was not something I would want in any circumstance. It sounded very uncomfortable, but I spoke to the midwife and nurses about the benefits of doing one. I was told this could jump start contractions, so I opted to do this as anything to avoid Pitocin was worth a shot. It did work and I started having contractions!
Pitocin and Epidural
At this point my midwife told me I could take some laps around the delivery wing to try to get the labor jump started. I took several laps and my contractions were coming almost every 2 minutes and lasting about a minute. Despite the frequency they opted to start the Pitocin to make sure contractions would continue and the baby would come.
The Pitocin was pretty awful. After trying to go without the epidural for a few hours, the contractions were coming so fast and hard I opted to have one. The epidural was a pretty painless process. I had a great Anesthesiologist who was very quick and did a good job. The worst part about an epidural is you can no longer stand up and move around, you have to remain in your hospital bed.
On second thought, the worst part may have been the catheter. That is very uncomfortable and pretty awkward. In addition, you are no longer allowed to drink water or eat food, only ice chips. Oh the joys of having a baby! Totally worth all of the splendors of pregnancy and labor to meet that little one, but oh so awkward at the time! Anyways, the epidural was amazing and perhaps too amazing! My midwife then allowed me to “labor down”. Basically, I took a nap for an hour or two and by the time I woke up it was time to start pushing and have a baby!
Throughout this whole process I was pumped full of fluids. In never having an IV I didn’t know what to expect. These made me very cold and I am typically a very hot person! At times I could not stop shivering, so I was layered in blankets.
Labor and Delivery!
It was finally time for the big event! It was definitely a new challenge to push with an epidural. One of the best parts of an epidural is reducing the pain, but an unintended consequence is not feeling the contractions or the act of pushing. In my circumstance I could not feel the act of pushing at the beginning of labor which made it hard to know if I was making any progress or actually pushing at all! It is hard to explain, but I could not feel anything, so when I was pushing I couldn’t tell if I was actually pushing and whether I was pushing in the right place! The nurse was supposed to dial back the epidural, but did not which caused my epidural to be too high. This can be a problem. Be sure to make sure your epidural is at the right level. The midwife caught this error and immediately fixed the issue decreasing the dose of my epidural.
Labor was a little scary . Our babies heart rate was dropping when I was pushing… My midwife called the doctor on call to be prepared to come in for a c-section or vacuum as I was having a hard time pushing and feeling the contractions from the epidural. Boy did that scare me! I pushed and pushed and pushed with my amazing coaches, my husband and Mom, along with my midwife who truly was the best and helped ensure I had a safe and vaginal delivery.
Within 30 minutes of active labor my precious baby girl was born vaginally and it was all worth the wait, pain and everything else endured in those 41 weeks. The small amount of time you will be in pain and discomfort are worth the lifetime of happiness you will receive.
My advice is accept that your birth plan can change. Make sure you stay informed throughout the whole process and question the medical staff if you think something isn’t right. Look into benefits of doctor delivery vs midwife to see what fits into your labor plan best. Most importantly no matter how awkward or painful something is it will all be over soon and you will have the best gift!