Wilder Eugene Freeman Smith Falls’s Birth Story
After a relatively easy, pleasant pregnancy, I expected labor and delivery to be straightforward, not easy—I never thought it would be easy—but straightforward.
I began prelabor over the weekend of May ninth. I came home from school Friday after getting everything in order at school (journals graded, School Loop updated, sub plans solidified) and felt uncomfortable and different. Melissa was in town, which was exciting and fun; I thought for sure she’d be assisting in the baby’s delivery. We went out to eat at Picante, and the whole time I felt baby pushing in my pelvic bone. My lower back ached, and it felt uncomfortable to walk because baby was so low. I woke in the night having contractions, not just the Braxton-Hicks that I’d been having but menstrual cramp-like lower back contractions. I thought for sure I was in labor.
When I woke in the morning, we called Julia, our midwife, to give her the heads-up, and we called Stacey, who said she was going to try to get as much done as possible before coming up. After waking and getting up and around, the contractions seemed to stop or at least taper way off.
It was a beautiful Oakland Saturday. We made eggs from our chickens and then went to the Lake Merrit Farmers Market where we stocked up on greens and other goodies. We decided to walk around the Grand Avenue area. On our way to the bookstore, we noticed a new artisenal liquor store and went in since Melissa was excited about having good quality liquor around her house. We went to the bookstore and then ran into someone I played high school softball with who happened to have five month-old twin boys. Then we went back to the liquor store to do a sherry tasting. I figured, “I’m in prelabor! What the heck! I’ll try some sherry.” It was delicious and fun. And then we went to lunch at Mariposa.
That night, same thing: I awoke having contractions again. We called Stacey in the morning; this time it seemed for real. We walked to brunch at the new vegan cafe in the neighborhood and then joined Jeff, Michele, Veva, and family for a lovely mothers day brunch. I put in for my sub and alerted everyone that I was going on maternity leave officially. Stacey showed up in the late evening, and, again, by this time, the contractions had lessened. We all went to dinner at Burma Superstar and enjoyed ourselves, though, again, it seemed I was not in labor.
Melissa left in the morning, but Stacey stayed Monday and Tuesday. By Monday I was having almost no contractions, and it was super hot. We entertained ourselves playing Scrabble and Lost Cities. We went swimming at Mills College, and Tuesday night Jeff and Jeff came over and we played One Night Werewolf, and Stacey decided to go back to school Wednesday. She left early in the morning to drive back to Santa Cruz.
Wednesday came and went. This was our official due date and also happened to be a full moon. We stayed up kind of late watching Game of Thrones. So, by the time I went to bed it was 11:30. When my contractions started at 1:30, I knew it was the real deal. They were intense and painful and coming very close together. This time I called Stacey and told her it was for real. I’m not sure how I knew it was different, but I did: I guess the pain was more intense; I felt the contractions more in my cervix. I couldn’t get back to sleep. The contractions kept coming, not the customary fifteen to twenty minutes apart, but, again, every four or five minutes. Clay texted Julia early in the morning to let her know that my contractions were two to four minutes apart, lasting for thirty to ninety seconds for the last hour, and she showed up around nine in the morning to check me and then left again. Stacey showed up around ten.
At one o’clock pm, I was averaging two to four minutes apart, and the contractions lasted forty-five to ninety seconds. Clay reported to Julia that I was sad that I wasn’t getting more of a rest but that I was still cogent and responsive to encouragement. I was happier to walk around because lying down felt too painful, and I vaguely remember pacing about the house.
The rest of the early day is a bit of a blur. I was in pain and not getting much of a chance to rest. I spent some of the early afternoon in the birth tub, which perhaps slowed the contractions down, or at least allowed me to relax enough between them to “sleep” a bit.
During our birth team meeting, Julia asked me what my ideal labor would look like, and I jokingly said that I would want our kitties curled up next to me, purring away as I labored. We all laughed about the cats hanging out while I moaned in pain, but, in fact, both kitties hung out during a lot of my labor. Emmet stretched out on the couch and fell asleep. He was unfazed by my moans of pain, and I was able to pet him and kiss him a bit between contractions. Mama hung out too. At one point when I was in the birth tub in our bedroom, she came and sat in the doorway and sort of watched everything happen. It was very sweet; we called them my “kitty doulas.”
Julia did little checking of my progress, so I’m not sure at what point I officially hit active labor; I just remember being vaguely aware that the daylight was waning, and suddenly it was dark. I must have had little rests between contractions. It never felt like full-on sleep but rather the kind of waking dreams one has right before falling asleep.
I moved a lot around the house. I labored a lot on the toilet, in part because I was pooping profusely for a while until I cleared my bowels fully. We put the futon on the floor in the living room, and I labored a bit on that, a bit on our bed, a bit in the birth tub. Julia kept encouraging me to lie down on my side. She said this often helped things progress, but I found this a very hard position to be in. It made the contractions even more intense, and I kept having cramps in my hips and upper thighs. Stacey and Clay did a good job keeping me hydrated and even trying to feed me a bit. I ate some watered down yogurt and had some miso broth. But mostly I just wanted water and my laborade that Clay had made me with water, coconut water, salt, lime, and honey.
At some point in the night, as I was nearer to being fully dilated, the contractions started coming on really strong. They were one right on top of the other, often for long stretches at a time, and I started to feel how exhausting and hard it was to not have any respite or break from the pain. This intensity went on for some time, and, when Julia checked me, she said I was almost fully dilated but still had a lip of cervix remaining. I remained in this state for what felt to me like hours. I couldn’t fully dilate, and I found myself during contractions moaning, “Open! Open!” to no avail. I threw up a bit during this portion of labor.
Finally Julia gave me the option: She could break my bag of waters, hoping that, at that point, the baby’s head would no longer have that little bit of cushion and would finally push the cervix the rest of the way open, or she could manually try to stretch the remaining cervix around the baby’s head. I think we’d decided she’d break the waters, and she’d even gotten her tool out for that, but she changed her mind. She said, “This baby knows what it needs to do, and I feel wrong about breaking the waters if that’s not what the baby wants.” I think she was particularly concerned about doing this given my state as group B strep positive: She wanted to keep the baby protected by the amniotic fluid for as long as possible.
She did finally decide to manually open the cervix. This was enormously painful but at least felt like a change, something that could be done to help me fully open. At the point at which she stretched the last little bit of cervix over the baby’s head, we heard a pop, and my waters did break.
At this point, I was finally fully dilated, but I felt dismayed by the fact that I didn’t seem to be getting a break as many of the birth stories I had read suggested, and also, it didn’t feel “so good to push” as many of the birth stories I read said. My contractions still hurt, but I wasn’t getting any relief from pushing.
This all happened around midnight. I had been in active labor for eleven hours, which was what Clay and I had agreed on with Julia would be the cut-off point at which point I would take antibiotics for the GBS, as an eleven-plus hour active labor is one of the risk factors that could lead to group B strep infection in the baby. I discussed this with Julia, and she said that it would be sort of pointless to take the antibiotics since it would take at least an hour to take effect, and pushing usually only lasts an hour (two at the most), so any benefits from the antibiotics wouldn’t affect the baby anyway. We decided to not do antibiotics, and I reassured myself that very soon I’d be holding my baby; the end was in sight after such a hard and difficult active labor.
From time to time throughout my labor, Julia put her doppler on my belly during contractions to ensure the baby’s health. The baby’s heart rate was so strong and consistent, and I came to think of the quick little trot of the heart as the galloping of a horse. I continually talked to baby, calling him my little horse and encouraging us to work together to bring him out.
At this point, Julia called Kirsten, the second midwife, who, in my fuzzy awareness sort of just materialized soon thereafter.
I pushed in various positions and various locations. The pressure in my rectum was very uncomfortable, and I couldn’t really find a way to push that would relieve that pressure. Progress was slow, and the midwives decided to put a catheter in since I wasn’t able to pee because of baby’s position against my bladder. They hoped that clearing my bladder would make more space for the baby to descend farther.
I finally returned to the birth tub, where I felt some sense of relief from the pressure on my rectum. I could be on my knees or squatting without tiring out my thighs, and it finally felt good to push. Julia had a flashlight and was able to look inside me and see the baby’s head. She encouraged me to reach up and feel baby’s head. It was so close, right there, a mere inch or so away. I continued to push, and at one point, Clay came into the tub with me and held me in a sitting position so I could push. But to no avail. The baby didn’t progress; I could still feel the head an inch away.
Julia said that the baby was maybe having a hard time moving around the pelvic bone and encouraged a change of position. I got out of the tub and lay down on the bed. This was the position I had been laboring in early that I hated, but pushing wasn’t so bad. I pulled my knees back and pushed by curling my head up and pushing into my bottom, as Julia and Kirsten kept exhorting me. Still no progress. Julia began putting her fingers inside me trying to show me where to push and trying to maneuver the baby’s head around the pelvic bone. This was very painful but was also very helpful: the pain made me push harder—I wanted to push her fingers out of me, and I could feel very clearly where to put my energy.
Finally, at one point in the midst of all this pushing, Julia looked at Kirsten and held up three fingers and mouthed something. I asked her what that meant, and Julia said I’d been pushing for three hours. I asked what that meant. She told me that I’d been pushing for much longer than was typical, and we were going to have to start thinking about next steps. I didn’t know what she meant, at which point she became straight with me: If I didn’t begin to make more progress, we’d have to go the hospital. She let Kirsten have a go at putting her fingers inside while I pushed to get a different perspective on whether or not baby was moving down at all, to try to maneuver the baby in her way.
I continued to push for one more hour in this manner, and Julia finally said we’d have to do something different. The idea of going to the hospital seemed terrible to me, primarily because I couldn’t fathom being in the car. But I was tired and demoralized; I didn’t understand why I’d been working so hard and making so little progress. So we decided to go to the hospital. Julia said they’d be able to give me pitocin to try to strengthen my contractions, which might be all we needed to move the baby down farther.
She called ahead while Clay, Stacey, and I tried to pack. I’d packed a bag, but we still had some things to gather. This process seemed long and terrible. I had to put on clothes, including mesh panties and a pad because every time I pushed, I was pushing out amniotic fluid and blood. Finally we loaded into the car. Stacey sat with me in the back. I tried different positions, kneeling while leaning over the back of the seat, squatting on the seat, half standing/half crouching. It was four in the morning, so there was very little traffic, and Clay ran every red light, driving in a steady but controlled manner since I couldn’t deal with too much abrupt movement and didn’t have a seat belt on.
We arrived at Kaiser and parked in the “women in labor” parking lot. We had to phone to be let in, and meanwhile I continued having contractions. I squatted outside on the sidewalk holding onto the beam of the walkway and pushed, all the while exhorting the doctors to let me in. Finally someone appeared: maybe he’d been on a smoke break or something, I don’t know, but he let us in and ushered us to the elevator (I refused a wheelchair since I couldn’t really sit down). We got up to triage, and had to wait for them to prepare a room for me. We were fairly lucky in that they’d had a number of women go into labor in the night and had no rooms, save one, left. (It was after all a full moon!).
It seemed like it took forever to get into the room, and, once I was finally in, Julia said I could take off my clothes if I wanted to, which I did. I continued to push, but she urged me to save some of my strength, to not push as hard, until they could get me on pitocin and get a doctor in to see what was going on.
I don’t know how long it took for them to finally get me on the pitocin drip, but it seemed like forever. At this point, everything seemed like it was taking a long time—getting the IV in, getting the continuous monitoring on, getting someone to assess the baby’s progress—and I was ready for something different, for some very clear attention, for something to be done that would change the stasis that I’d found myself in for the past several hours.
Julia discussed my GBS positive status with the doctors and let them know I hadn’t had any antibiotics. The doctors and Julia decided that, once again, I didn’t have much longer to go, and so any antibiotics would be pointless.
They put a continuous monitor on me that meant I couldn’t move around the room, but we were able to hear the regular horse gallop of my baby. They coaxed me into the same position I’d been in at home, on my back with my knees pulled back, Stacey and Clay helping to support my thighs so that they wouldn’t become too exhausted, and, again, the doctor put her hands inside me to help guide the baby out. Her manual manipulation of the baby while pushing really hurt, much more than Julia’s hands had, and I came to think of her as my arch nemesis. She kept telling me to get mad at her hands, to try to push them out, to use my anger at her to push this baby out.
I continued to push like this for another two hours. At this point, the baby was making progress. Everyone could see the head coming down the birth canal as I pushed. I suppose I could have seen this too (They’d set up a big mirror), but it was too hard for me to look when I pushed; I had to close my eyes and put all my energy into my butt.
Finally, the doctor said, “We have to talk seriously about next steps.” She was concerned that I’d been pushing so long—six hours—and, though I’d made progress, the baby still was not born. She gave me another half hour of pushing before we had to move on to other options. The doctor was very clear that she wanted to do a caesarean. She was worried that baby’s shoulders were stuck, and this is why minimal progress was being made. She worried that I’d birth the head, and the baby would still be stuck and require even more pushing but make a caesarean impossible. I asked that, now that I had more pitocin, I could keep trying for fifteen more minutes before deciding on a different course of action. The doctor agreed, and I continued to push in this way.
Finally, the doctor reaffirmed her desire for a c-section. Julia asked why we couldn’t try the vacuum, and the doctor started to list all the possible negative side effects with the vacuum: Aside from possible damage to the baby, she was worried that it only added about ten percent; that the other ninety percent of what was required to birth the baby would have to come from me, but I’d already been pushing six and a half hours. Again, she reiterated her concerns about why the baby hadn’t already descended farther.
I felt tired and scared. I knew I wanted to have the baby vaginally, but I didn’t know if that was possible at this point. She left the room, and when she returned, she said that it was only fair that she tell us the possible dangers of a c-section as well. Of course neither option sounded good, but I still felt committed to a vaginal birth. I looked to Julia for her advice, and she said she really thought we should try the vacuum. So that’s what we did.
The doctor left to get the specialist who does the vacuum deliveries, and of course I kept having contractions and pushing, and again Julia counseled me to save my strength as much as possible for the vacuum. A whole team assembled in our room. There were tons of people there. This is, I think, in part because there was a shift change, and all kinds of interns and such were there as well.
The doctor told me I had one try to get the baby out with the vacuum. I felt pretty scared by this ultimatum, and everyone encouraged me to push like I’d never pushed before. Clay and Julia held my legs, and I waited for a contraction. It didn’t come for quite a while. I don’t know how long it was; Clay said maybe seven minutes, when all my other contractions had been only a couple minutes apart. I sort of just lay and rested, waiting to feel the strong urge to push. When I finally did, I pushed as hard as I could. I had four big pushes in this one contraction. I didn’t look at what was happening; I just knew that suddenly it was enormously painful. I remember yelling out, “That fucking hurts,” and then I opened my eyes and a whole baby was emerging.
Afterward, Clay and Stacey told me that when he crowned, they continued pulling with the vacuum to birth his head, and then kind of grabbed him and yanked and twisted. He was born all in one fell swoop, no crowning and then birthing the head and then birthing the shoulders, just one full baby all in one push. I could see that the baby had a funny knob on its head from the vacuum, but then baby was on me, right on my chest, wailing away, all bright red and strong. Stacey was standing over me crying and congratulating me on doing it, and Clay was taking pictures. After nearly thirty-one hours of labor and seven hours of pushing, my baby was born.
I could feel something pressing hard on my urethra, which really hurt. I asked what it was and was told it was the cord, which was apparently somewhat short, so it was pulled tight over my urethra as it stretched between the baby and the placenta. The doctors began pressing my abdomen, which also really hurt, and I asked what was happening, and they told me I still had to birth the placenta, which I’d forgotten about. This also hurt but much less so than birthing the baby, and it was over very quickly.
Clay cut the cord when it was ready, and I just held the baby. Finally, an hour or so had passed, and everyone but Clay, Stacey, and Julia had left, so we finally looked to see his sex: a little boy. He was eight pounds, four ounces and twenty-one inches long. He scored an eight and a nine on the Apgar, once again, demonstrating how strong and healthy he was.
The doctor returned to tell me that I’d had a third-degree tear, that the birth tore the muscle of my rectum (though it didn’t tear all the way through, thankfully), and I’d need to go to the operating room to be stitched up. We discussed my anesthesia options.
About two hours after the baby was born, I was taken to the OR to be stitched up. I was so tired at this point, that I think I mostly slept through it, though I only had a spinal anesthesia. I felt tingly all over and, of course, numb from the waist down. I also felt shivery and shaky.
We stayed in the hospital for two days. Everyone was really wonderful; I hadn’t anticipated how nice this aspect of being in the hospital could be: Folks were there to wait on me, to change my dressing and bring me my medication. We also got different breast feeding advice from all the different nurses, which I think accounts for the ease with which Wilder and I learned to breast feed.
Everyone was also really nice about our breaking of the rules. Policy stated that all guests had to leave by nine o’clock pm, but Stacey stayed over both nights; she slept in the fold out chair, and Clay and I shared my hospital bed. Also, Wilder was supposed to sleep in this little plastic box, but Clay and I co-slept with him both nights, and no one said a word about either of these policy breaches.
Shana came shortly after I got out of the OR and brought us lunch, which, given that I hadn’t eaten in nearly two days, was well appreciated. I mowed down on her seaweed snacks and grapes. Michele, Jeff, and Veva also came to visit the second day. They brought the kikoi soup and other nourishing foods for me to heal and help my milk come in.
Finally on Sunday, we were discharged and brought Wilder home.