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In a nutshell, I was wildly unprepared for child birth.

But let’s start with the good stuff, shall we?

I had an amazing pregnancy. No morning sickness, no complications, stable blood pressures, weight gain was textbook healthy, continued rock climbing and practicing yoga, and went to work all the way up until my water broke. Everything was great and I assumed that my good health would provide me with a smooth and magical experience. You know, the kind of magical experience that women post on Facebook and Instagram…

Leading up to the big day, I did my best to prepare for what I regarded as the most difficult physical and mental endeavor a woman will ever experience. I read endless articles, watched tons of YouTube videos, and talked to several women about what to expect…

  • How to identify the the signs of labor
  • What contractions would feel like and how to manage them
  • What to bring to the hospital
  • How long I might stay in the hospital
  • How to communicate my birth plan with my midwife

etc. etc…

But as I sit here and write this, 7 weeks after delivery, I can’t help but think that there was really nothing I could have done or learned that would have made me feel 100% prepared for what was about to happen…

Are You Sure Your Water Broke?

On Saturday, February 22 at 7:00 am, I was lying in bed when all of a sudden I felt a gush of liquid pour out of me. This may have been my first pregnancy, but there was no mistaking that my water just broke. My squeal of delight woke up David and when I told him what had happened, he jumped out of bed and immediately started packing his “go-bag” (this part always makes me laugh because we had countless conversations about when he should pack his go-bag, and at the end of every conversation, it never got packed).

Oh, and he apparently took some photos too…

Kiki knew something was awry.

Leaking amniotic fluid all over the place (TMI?), I quickly ran to the bathroom to clean myself up. I changed my clothes but the fluid just kept coming! I remember feeling a surge of anxious energy; I was so excited to finally meet Olivia but I also felt like I wasn’t ready. I don’t know if it was the realization that pregnancy was over and I would no longer keep her this close to me, or the realization that shit was about to get real - the pain of contractions and birth, and the stress of being in the hospital.

I remember drying off after getting out of the shower and saying to David,

“I don’t know if I’m ready.”

“You’re ready,” he said, “you have to be. You can do this.”

According to my birth plan, I would stay home and labor as long as I could until my contractions got closer together. I wanted to be at home, relaxed in my own environment. I had plans to do some pottery, play in the kitchen, read a book, maybe take a bath. But none of this happened because my contractions didn’t even start…

Normally, contractions start before your water breaks, or shortly after. But for me, I had no contractions.

When I called my midwife to check in and let her know what was going on, she told me to take my time but to head to the hospital that morning; I ate some breakfast and took a nice neighborhood walk with David before heading in. Given the circumstances, I knew that once we went into the hospital, we weren’t leaving. Because my contractions didn’t start on their own within the midwifes desired time frame, I would be augmented, or in other words, I would need medication to help start my contractions.

There went item #1 on my birth plan - laboring at home…

10:00 AM

We arrived to the hospital around 10 am and were immediately taken to a labor and delivery room. Lucky for us, we were one of only a few patients admitted that morning so we skipped the tiny triage room and went straight for the big leagues.

I changed into a hospital gown and they started asking me questions and taking my vitals. I was 2 weeks early so they wanted to be sure it was amniotic fluid I was leaking.

I was a little surprised by this, as I was 100% confident that my water broke. What else could it have been?! I know what peeing feels like for Christ sake and it wasn’t that. We even flashed them a picture of the bed and bathroom to give them a better idea…

What was most frustrating was that we waited for about an hour to have someone come check me to be sure that’s what had happened. Finally, the midwife (or nurse, I can’t remember) came in to take a peek…

“Oh yeah, the sac has been ruptured,” she said.

David and I looked at each other and rolled our eyes.

You Need Pitocin to Get Those Contractions Started. And Some Blood Pressure Medication.

They noticed that my blood pressure was a little high so they kept monitoring it. There were times when it read normal, but it kept jumping all over the place. Naturally, I was a bit nervous. I have a history of hypertension while on birth control pills - it took me years to figure out that the pill was the culprit. I think back to those days I would obsessively monitor my BP at home; my numbers were often times in the 150’s/90’s and it caused so much anxiety for me.

Remembering that my BP was perfect throughout my whole pregnancy and watching it creep up like this now was extremely anxiety provoking.

Every 15 minutes or so the nurse would come in to check my pressures and ask if I felt any contractions. Pressures were still sporadically creeping and I had only minor intermittent cramping. As for the contractions, this was my first time giving birth so I wasn’t sure what I was supposed to be feeling.

11:00 AM

After an hour or so, contractions still hadn’t presented themselves the way the nurse and midwife had wanted, so my midwife informed me that I would have to be administered Pitocin, a synthetic form of oxytocin, to get contractions started. I didn’t really like the idea, considering I wanted to wait and see if contractions would start on their own so I could do this thing all natural. But I also worried about infection; what if my selfish desire to have a natural labor and delivery caused an infection and harmed Olivia? I agreed to the Pitocin.

They put in an IV and started the Pitocin. Contractions started almost immediately; not painful, but I could feel them.

Typically, Pitocin is started at a low amount, and is increased gradually to progress labor. What I had forgotten at the time was that pitocin intensifies contractions, making them more painful than they naturally are (so I’ve read).

At this point, my blood pressures still weren’t looking too hot so they also gave me an IV for Labetolol, a blood pressure medication.

If blood pressures kept climbing, I would need to be given an epidural because, according to my midwife, sometimes if pain is reduced, blood pressure comes down. I’m sure you already guessed it, but I had planned not to have an epidural (for various reasons). I told my midwife I didn’t want one, and she respected that, but also made it very clear that high blood pressure during labor and delivery can be dangerous. If push came to shove, I would absolutely need one (especially since the labetolol wasn’t working quite as well as they had expected it to).

I was also told not to walk around while laboring to further prevent my pressures from increasing…

Seriously?! I’m just supposed to sit in this bed for hours?? What about the downward dogs, cat-cows, and birthing ball exercises that were supposed to help me encourage dilation and deal with the pain of contractions?! I looked at the clock and noticed that it was 1:00 PM and I hadn’t dilated at all. I knew I would be sitting around for a while…

One thing I could do was breathe. And I swear these deep yoga breaths helped me get through those excruciating contractions.

9:00 pm

Over the next 10 hours, Pitocin was slowly increased and my contractions were monitored to see how close they were getting.

The contractions weren’t THAT painful for a while. And because I had no idea how much longer this was going to take or how much more intense the contractions would become, I continued to deny the epidural and any pain medication the midwife offered.

Hmm…You Need More Pitocin.

There came a point where my contractions were consistently close together but i wasn’t dilating quickly enough. The staff was going to have to increase my Pitcoin to encourage me to dilate more. We were roughly 15 hours into it since my water broke and with infection at risk, they wanted Olivia out sooner rather than later.

I wasn’t comfortable receiving more Pitocin. The MD on call wanted to give me an amount that would exceed the upper end of the hospital’s protocol. I was aware of the risks - fetal distress, uterine rupture, risk for C-section. Additionally, if more Pitocin was administered, they would put in an Intrauterine Pressure Catheter (IUPC) to get a more accurate reading of my contraction strength and to be sure the stronger contractions weren’t effecting Olivia’s heart rate.

It felt like there was intervention after intervention being pushed on me and I felt really uncomfortable about it all.

I asked if I could hold off on the extra pitocin and the IUPC to see if my body would respond on its own. The midwife allowed it. And my body responded within the hour.

12:00 AM

I remember David falling asleep just when my contractions starting getting painful. He had been amazing all day; getting me snacks, walking me to the bathroom, trying to entertain me to keep my mind off of everything. I knew he was exhausted so I’m glad he got some Z’s before things really got crazy…

I forgot to mention that I had a new nurse during the night shift. She was was seriously a godsend. She helped me do some stretching in bed that would open up my pelvis and encourage dilation. She massaged my back and hips during contractions to reduce pain (and showed David how to do it). She brought out a peanut ball and an exercise ball for me to sit on to also encourage dilation. She provided the kind of care I had written out in my birth plan and didn’t think I was going to get.

This part is a total blur but I think I dilated from a 7 to a 10 in under an hour. Contractions were excruciatingly painful and I remember begging for the epidural only to be told it was too late. There were countless times I pleaded David to take the pain away (poor David!) At this point, I completely disobeyed my “bed orders” and was up trying to find any position that would reduce the pain of these crazy contractions; getting on all fours on the ground, hanging my arms around David, laying on my side, kneeling, squatting. Nothing really helped.

One thing the nurse encouraged me to do which was really helpful was to visualize the contractions as waves rising and falling in the ocean, breathing in through my nose when they rise and breathing out when they fall. She even played the soothing sound of waves crashing on her phone for me. I do this breathing all the time during my yoga practice but I found the wave visualization especially calming and felt that it did help me manage the pain of my contractions.

I feel like I have to push…get the nurse!

3:00 AM

The urge to push was unmistakable. You don’t need to have given birth before to know when this is happening.

David and I were alone in the room when I felt this coming on. I asked him to get the nurse. He said something like”what do you want me to tell them?” and I replied yelled “just tell them I have to push!”

He quickly returned with both the nurse and the midwife, and when they entered, I heard someone gleefully say “we’re having a baby!”

THANK GOD. This is it. The pain is almost over.

The prospect of no more pain gave me a second wind. I kept repeating to myself: this pain is temporary; women give birth all the time; my body will do what its supposed to do.

I pushed for 1.5 hours. But it felt like 5.

I have never felt so exhausted in my life. Pushing was grueling, to say the least. And it felt like everything was moving so slowly. There were full-on give it everything you have pushes, and lots of half-assed exhausted pushes in between. And most of the pushes resulted in what felt like zero progress.

I remember feeling like I was going to pass out. And times that I felt I just couldn’t finish the job. I remember thinking just give me a C-section or please please please just give me some pain medication. My eyes were closed the entire time; I couldn’t even muster the energy to keep them open.

In a fit of heat and sweat, I rolled my hospital gown down off my shoulders and chest so my skin could breathe. David put a cold washcloth on my head and rewet it with cold water every so often. That felt really good. He also held a straw to my mouth and encouraged me to keep sipping on the apple juice to keep my blood sugar up and give me the energy I needed to keep pushing. I hadn’t eaten a real meal since breakfast the morning before, and they cut me off eating solid food about 12 hours ago. Although I couldn’t feel it, I was starving. I remember David saying hours after birth, “I don’t know how they expect women to expend this much energy without letting them eat.”

But amid all the pain of contractions and pushing, something strange occurred to me…

pushing felt kind of good if I timed it right. When I tuned into my body and pushed right when the contraction was peaking, it wasn’t as painful.

At some point during the pushing hour, my midwife left to deliver a baby at another nearby hospital. I remember her saying that it was this woman’s second baby so delivery should be quick and she’d be right back.

You’d think I would have freaked out with my midwife leaving and all but honestly, the only thing I cared about was getting this baby out and putting an end to all this pain. I didn’t really care. Olivia was coming whether or not the midwife was here.

My midwife did eventually make it back in time to deliver.

Finally, Olivia started to crown and boy could I feel it. She came out a little more with each push and I could feel things stretching and (probably) tearing but that pain was nothing compared to the contractions. I welcomed this pain because it meant I was getting closer.

I remember David saying I was doing an amazing job and that I was almost there. I remember my midwife saying “push push push!” during every contraction. I remember my nurse telling me how strong I was. All of this gave me more strength to keep going.

“what should I be doing?! Am I supposed to push or not?!”

Once Olivia’s head and shoulders were out, the team left my side and scrambled around prepping things. With everyone frantically moving about, I just lay there, Olivia halfway out, and still having those urges to push. I yelled,

“what should I be doing?! Am I supposed to push or not?!”

“No, don’t push! Give us one second…” someone said.

What in God’s name were they prepping?? Couldn’t they have gotten this shit ready before hand? I gave them 20 hours to prep things!

I resisted the urge to push but not for very long. I gave everyone a warning that I was going to keep pushing. Holding her halfway out of my body wasn’t in my birth plan :p The midwife came back over, I pushed a couple more times, and Olivia was out.

She was out. SHE WAS OUT. Oh my god I did it.

They immediately placed her on my chest and she stopped crying instantly. I looked over at David to see that he was crying. It made my heart melt. I wanted to cry too - and I thought I would, especially because I sobbed my way through countless YouTube videos of other women’s births - but I was too exhausted. I had nothing left in me. I began to feel guilty for not crying and for not feeling a sense of overwhelming joy that so many women talk about experiencing.

Little did I know that I would feel this overwhelming joy so many times in the weeks to come. A joy so overwhelming that it would shatter my world and rebuild it into something more beautiful all at the same time.

My midwife stitched me up (I experienced a second degree tear) as I lay there with Olivia. They performed a few assessments on her while she lay on me and David fed me snacks.

After some time, we were wheeled off to a postpartum room, which is where the real excitement ensued…

I’ll preface this last part of my story by saying it was all a blur. Not only was I sleep deprived and physically and mentally exhausted, my hormones had just taken the single largest dive in their life, leaving me feeling anxious, scared, and alone, despite the support that was all around me. I had always heard how magical this time was right after birth; for me, it was hard to feel that. And even now, I sit here wondering if women just leave all the hard, raw details out of their recovery story.

Stay at the hospital as long you can, they said. It will help you rest, they said.

As I was wheeled to the postpartum recovery room, I felt like a warrior of a woman. I just gave birth, without an epidural, and I’m still alive! And holding Olivia in my arms was proof. It felt like the worst was over and I couldn’t wait to eat, sleep, and ogle over Olivia’s cuteness with David while we stayed at the hospital for one more day.

Once in our room, the nurse took my blood pressure. It was normal, and I was thrilled. Phew, I thought, those high pressures are gone.

The nurse had about a million things to tell me before I could even look at the breakfast menu. Did she actually think I had the capacity to comprehend anything before replenishing my body and bringing my blood sugar back up? You know, that stuff that fuels your brain cells and allows you to think function? I kept thinking, I have no idea what you just instructed me to do. I need food. now. (I hope they take my patient survey remarks seriously and start having a meal ready and waiting for women the second they are wheeled into their postpartum recovery room. Better food would be a great addition, too.)

David wasted no time on room service and headed straight to the caf. In minutes, he returned with eggs, hashbrowns, bagels, fruit, milk, and THE most delicious chocolate glazed doughnut I think I’ve ever eaten. Maybe it was that good because I was starving. Or maybe it really was that good. We’ll never know.

You know how people always tell you to stay at the hospital as long as you can so you can rest while others help take care of your baby? Is that even a real thing? I never got any rest because someone came in every 20 minutes to check on me, educate me, or assess Olivia. I slept for maybe 2 hours at a time for the 5 days we ended up being there. It was more like a trial run of what being home would be like. And actually, being home was far more restful.

In came the nurses, housekeeping, lactation consultants, doctors. Every 20 minutes we heard a knock knock on the door. It was exciting at first, but it quickly wore on me because what my body really needed in those first several hours was food and sleep.

The fact that I was continually bombarded with staff visits immediately after birth demonstrated to me that postpartum rest was not a valued part of care as it should be.

I sometimes wonder if my blood pressures would have regulated better after birth had I been given the opportunity to simply rest.

Everyone was tip-toeing around the word Pre-eclampsia

Later that day my BP started getting higher and I started feeling more anxious. I bet my cortisol levels - a stress hormone which further increases blood pressure - were through the roof. The nurse continued to monitor my BP throughout the day and night, coming in every 15 minutes to check it.

Every 15 minutes it was high, and every 15 minutes I stressed a little bit more.

This frequent checking continued throughout day 2 which is when we were told we wouldn’t be going home that day. I needed to stay so they could monitor my BP. If it got too high, I would be at risk for seizure and stroke.

It was near impossible for me to focus on my lactation education with this potential stroke scenario weighing on my mind. Learning to breastfeed is difficult as it is; throw in sleep deprivation and stress and the task becomes even more challenging. I wasn’t pumping as much as I should have been either because I just didn’t feel good. And getting Olivia to latch was touch and go for a while.

As a result, she had a low blood sugar episode which required a donor milk supplement to quickly get her sugars back up.

This was the first time I cried.

I cried because her sugar was low and it felt like my fault. 
I cried because I was exhausted. 
I cried because my body hurt and had nothing left to give. 
I cried each time I heard her scream from the heel pricks needed to re-check her blood sugar.

Later that night, the nurse became increasingly concerned with my BP and received the doctors order to administer oral labetolol, the same BP med I was on during delivery. The 15-minute BP checks continued and I received more and more labetolol as my BP wasn’t responding how they had hoped. They then tried a different medication, Procardia. That didn’t help either. Then they tried a combination of Labetolol and Procardia, which helped a bit, but didn’t last. Finally, they stuck an IV in me and gave me Labetolol that way, which started to help a little.

During all of this, each nurse had a look of surprise on her face after every high reading, which made me stress even more. I questioned whether they knew what they were doing. I felt like they weren’t able to get my BP under control and I feared that I would have a stroke or a seizure.

This was the second time I cried.

Skin-to-skin with Olivia always helped calm me down.

I cried thinking what it would be like if something happened to me. That I would never see David’s face again. That Olivia would grow up without her mother. It felt like my whole world was crashing down around me and that there was nothing I could do about it. I feared that I would die.

This might all sound overly dramatic but with all that was going on, my sleep deprived, hormone-chaotic mind went straight for the worse case scenario. I couldn’t help it.

David, tired of all the 15-minute check-ins, politely demanded that I be given a couple hours of uninterrupted time to sleep. The nurse agreed and placed a cuff on my arm that would automatically measure my BP every 15-minutes so she wouldn’t have to keep coming in. There were a few times David ran to the door to prevent people from coming in. It was like the “do not disturb” sign didn’t apply to anyone.

The next day I received a visit from one of the midwives on call. She had a passion in her belly, upset that no one from the hospital thought to call and update them on my poorly controlled BP. She led with the fact that I wouldn’t be going home today and explained that she wanted to immediately start me on IV Magnesium Sulfate which would lower my seizure threshold. In fact, she said I should have been started on this days ago. She was also very upset with how frequently I was being checked on. She quickly put an end to that. It felt good to have someone familiar come in and take charge.

It didn’t feel good, however, to be told I needed another IV medication because my health was at risk. What was going on? This felt more serious than just high blood pressure.

I don’t have a controlling personality, but I felt very much out of control and very uncomfortable because of it. Still, at this point, no one outright said I had pre-eclampsia and that my blood work was trending towards HELLP syndrome. Had they explained this to me, I likely would have welcomed the Magnesium and not given them so much resistance.

I wanted to refuse the Magnesium; I was scared to be given yet another drug and I didn’t want to believe that things were going wrong. I was also just so tired of being at the hospital; I kept thinking I should be home right now, enjoying my new life. I thought that if I could just get some rest and some fresh air that I could bring my BP down on my own. When asked if I could step outside for some fresh air, the midwife said “absolutely not.” I was too at risk for seizure.

Being told that I couldn’t go outside to get some fresh air completely broke me.

Once she left the room, I cried. I cried to David and told him that I felt trapped. It felt like things continued to get worse instead of better, and now, I couldn’t even go outside?

The midwife came back in and said it was my right to deny the magnesium, but she highly recommended I take it given that my BP was so high. Acknowledging her expertise, and scared that I might experience a seizure, I agreed to it. But not without some fresh air first…

David had a long conversation with my midwife about why I couldn’t get some fresh air outside. Whether I have a seizure in my hospital bed or a seizure in a wheel chair outside, what’s the difference? I remember him telling her “this girl needs nature. I know you’re concerned about her physical health, as you should be, but what about her mental and emotional health? It’s all tied together and it doesn’t feel like we’re receiving the type of care that treats a person as a whole.”

(David also had this “treating the patient as a whole” conversation with the attending physician, who was receptive. There were so many times my treatment was dished out without explanation, leaving me to feel like I was just another patient taking up a bed.)

In the end, he won, and I was wheeled outside into cold snowy weather for a bit of brisk, fresh air. As I was wheeled past the nurses station, I’m sure they all thought I was crazy; do you REALLY want to sit outside in 30 degree weather right now? Yes. Yes, I do. Because any place is better than a hospital bed right now. It may have only been 10 minutes, but that 10 minutes of watching the snowfall in peace and quiet brought me back down to earth. Calmness washed over me and I was ready to move on with things.

The magnesium ran for 24 hours. I later found out that I should have been bed-ridden with a urinary catheter placed. Instead, I was able to walk to and from the bathroom when needed with assistance. No one ever told me why the catheter wasn’t placed but I think it’s because they knew I’d throw another fit.

Don’t mistake me for someone who doesn’t acknowledge the expertise of our health professionals. I absolutely do; they are trained and experienced to care for sick people. But I expect more from our health care system. To treat the person as a whole. We are the wealthiest country in the world with some of the smartest people. We can do better.

We played the waiting game during our last day there. If I could consistently show three (somewhat) normal blood pressure readings, I could go home. It wasn’t until day 5, the day i was discharged, that the attending physician explained I had pre-eclampsia and that my lab work was trending towards HELLP syndrome.

Thankfully, I passed my “BP test” and home we went. I would be on BP meds for the next 8 weeks, and would still freak out about high my BP’s got at home, but at least I got to be home.

Thank God Olivia was healthy through all of this. Besides the low blood sugar incident and a little bit of jaundice, she was golden. I’m not sure how I would have handled everything had she also been sick.

I would be remiss if I didn’t leave one final word crediting David for his stoic nature and stability throughout all of this. Had he fallen apart with me this all would have been exponentially more difficult. He was my patient advocate every time I needed one. He helped me make decisions when my brain was too frazzled to think. He encouraged me to dream about our future with Olivia instead of stressing about the difficulties at hand. And he held me every time I cried (which clearly, was often) at the hospital and recovering at home. He’s everything I could have hoped for in a husband and more. There’s no doubt in my mind that this experience has helped us grow closer together.

It took me a few weeks to acknowledge that my experience was traumatic. Recovery at home is a whole other story that I’m not going to share right now but I will say, that for the next month, I feared everyday that the pre-eclampsia would come back (because it can). I cried everyday thinking I was going to die. I cried feeling like I wasn’t meant to have children, thinking that if I gave birth during a time when we didn’t have advanced medical care, I would be one of those women who died from childbirth. Then, just 1 week later, the Coronoavirus pandemic hit and I cried thinking about losing Olivia to it.

Ok, this is really the end…

I didn’t know how hard labor, delivery and recovery would be. But, as all women say, it was worth it. Olivia brings me a joy I’ve never known before and a love I’m still trying to understand. N’tima Preusser’s essay “When Love Feels Heavy” is spot on. If you’re an expecting mother or a new mom who feels alone, give her essay a read. I wish I had read it before giving birth…

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