Theo did not want to come easily. Our boy was camera shy during ultrasounds and apparently apprehensive about making his appearance outside of my belly. On Monday, April 7, I started having Braxton Hicks contractions which are basically the sensation of tightening of your uterus without the pain of a true contraction. I didn’t think much of it until later in the evening when I started to feel crampy and the BH contractions continued to persist. All night and into the early morning hours, I was texting Shelby, my go-to friend-doctor, trying to figure out if this was true labor or not. Around maybe 2 AM, the cramping pain increased slightly. I decided to wake Eric and head to the hospital. In triage, they told me my cervix was only 1 cm dilated and that I was experiencing what they call “latent labor”. This meant that I could either transition into labor or continue to have these on-again-off-again contractions indefinitely. We returned home to a Trazadoned dog and a warm bed to rest in before our weekly OB appointment that Tuesday morning.
At 10 AM on Tuesday, April 8, I visited with my NP, Holly, and explained to her the events that unfolded that evening. Because I continued to have sporadic contractions of minimal pain, she offered a cervical exam to assess any changes. With her fingers in my cervix, she estimated 1 cm and asked me if I wanted a membrane sweep. I looked to Eric with a bit of panic and said yes. After what felt like 2 minutes but was realistically only 30 seconds, the sweep was complete. Holly said I had dilated to 4 cm just during the sweep. More cramps came quickly after followed by a deluge of bloody mucus. The next couple of days started to blur together. Between bloody pads and irregular contractions, I kept looking for signs of active labor.
At some point Wednesday night rolled around. I hadn’t slept at all. My contractions were becoming painful enough for me to find sleep impossible. Around midnight, of Thursday, April 10, I started tracking these painful contractions. These were just painful enough that I had to groan through the pain but could still hypothetically multitask such as pay attention to someone talking to me. These contractions mostly radiated through my lower back - like a small bucket of ashes had been dumped there for a minute at a time. Simultaneously, my entire stomach hardened around my baby.
At 2:11 AM on Thursday, April 10, I texted my mom and Eric, “I think it’s time”. We rallied in the living room adding the final touches to our go-bags which had been packed all week. I added last minute oranges, phone chargers, and coconut water, and we packed in the car to drive to the hospital.
At the hospital, they put us in triage and offered a cervical exam. Three centimeters. I was massively disappointed, but based on the regularity and higher pain threshold of my contractions, the physicians advised that I stay at the hospital. Having 0 hours of sleep under my belt, I opted into intravenous pain medication to get some rest before labor escalated. They moved us into the larger L&D room, hooked me up to the meds, and I slept for over 3 hours. The decision to take these meds is one that still haunts me. On the one hand, I did feel like I needed rest, but the hangover and delirium that persisted after I woke up was sickening - cue 10 hours at Berghain type of hangover. I could barely speak or open my eyes. My brain was moving slowly, and I had an even more difficult time processing new crossroads such as whether or not to have my water broken. I told my team that I wanted to be more alert and energized before taking such a big action so that I could handle my contractions better. I was completely unaware of the time - probably sometime late Thursday morning now - but the team said they’d come back in a few hours to check in.
During the next check-in, I was still drowsy but slowing coming back to life. The team decided to give me IV fluids to help flush some of the drugs from my system. Contractions were slowly becoming more painful again. I tried walking around, bouncing on the birthing ball, and taking a shower. Eric was there by my side to rub and put pressure on my back during every contraction. I still hadn’t made up my mind about having my water broken, but it was Holly who helped put the decision in perspective. To paraphrase, she said that the goal when coming to the hospital is to get the baby out, and that how you get there isn’t that important. I metaphorically ripped up my already equivocal birth plan and heeded her advice. I decided it was time to have my water broken. After all, I wasn’t going to gain any more energy as the clock ticked on.
The process of having my water broken was about on par with the mucus sweep - extremely uncomfortable but without unbearable pain. I felt the gush of warm fluid fall out of me. Very quickly after this procedure, the contractions started to ramp up in pain and frequency. Everything from this point on started to become a blur for me as I couldn’t live outside of the pain in my body. I don’t know if I was having contractions for 20 minutes or 5 hours. Now, I was loudly groaning through contractions and gripping onto whatever was within arms reach. Gripping would soon turn into thrashing and groaning turned into repetitive chants of “No no no no no”. At one point, I was leaned over the hospital bed, vomiting into a bag and dropping amniotic fluid (and probably urine) all over the floor and onto my slippers. I wanted to die. Our incredible nurse, Krystle, started to take over for Eric with back rubs and reassurances that I could do this in spite of my cries of “I can’t do this”. She kept telling me, “You’re doing this” which provided me with momentary comfort while engulfed in a vacuum of pain. This was the point where I would ask for an epidural.
I was still in my black hole of pain while the anesthesiologist came into the room, suited everyone up in hairnets and masks, and started asking me questions about my identity and what procedure I was getting. I could barely speak between contractions. My hands were gripping the soft gel pads that lined the stand meant for me to lean on while they placed the catheter in my back. I remember someone giving me a sheet to cover my chest for modesty which felt ridiculous to me at the time given my writhing and groaning without hindrance. Apparently the epidural placement is a two-person job. This was the first time I actually felt like screaming as we waited for the more senior doctor to enter the room to kick off the placement. At some point she arrived, and I used every last shred of willpower I had to stay still as the needle went into my spine. They warned me about stinging - I felt absolutely nothing. In agony, pain becomes small.
This became the turning point of Theo and my birth story. The epidural started doing its job. I could relinquish some of the physical and emotional grip that had pulsed through my body as sensation started to fade. I began speaking again, even cracking some jokes as I am known to do. My mom felt comfortable enough to head back to our house for some time as she could see that I was safe, if only temporarily.
Me sitting in “throne” after the epidural kicked in.
I slept in between check-ins from doctors, nurses, and the anesthesiologist. I saw his face for the first time and realized how kind and friendly he was. I was periodically poked with a dull tack to check my numbness and repositioned to distribute the drugs more evenly. Hours began to pass with little disruption. At the first hint of the pain coming back, I pushed my dose-up button to gain additional relief. I felt safe.
Early in the night, my nurses came in in a calm hurry. They told me “we are going to move you” as they rolled my body, shook me from behind, and hurriedly moved around the wireless fetal heart monitor that was strapped to my belly. Their absolutely cool demeanor kept me calm and without panic. They told me that sometimes baby just settles into a new position and needs to be moved around to get his heart rate back up. This course of events - a rush of nurses into our room, body shaking, position adjustment - happened maybe 3-4 more times throughout the night. The position that seemed to resonate most with Theo is called “throne” which virtually had me sitting up right with a peanut ball between my legs. The epidural kept me calm enough to rest while using my fuzzy robe as a makeshift neck pillow.
It was just before midnight when an alarm was ringing that caused me to call a nurse in. The alarm was just a nuisance - nothing related to Theo or my vitals. While our nurse was in, she happened to check Theo’s vitals and noticed another plunge in his heart rate. She started the same routine of moving around the monitor on my belly, except this time, there did not seem to be a resurrection of a stable heart beat. The monitor moved once, no heart beat. Twice, no heart beat. Three times, no heart beat. The nurse called in for backup. Immediately someone told me, “You’re baby is under stress. It’s time to start pushing”.
A flurry of doctors and nurses set me up to start pushing. They told me that they had notified NICU to be available as soon as Theo arrived. The epidural dulled my senses as we waited for a contraction to come on and I was instructed to pull my legs towards me from behind my thighs and push my bottom for 10 seconds at a time as if having a bowel movement. I quickly realized the type of pushing required to get this baby out was a skill that I would develop over the next 2.5 hours. Periodically, the doctors would also try to turn Theo to get him in a better position for delivery. In between contractions, I chatted with the doctors and nurses and made some jokes about the color of Theo’s hair. At times, I would even say we had fun. I even had Eric turn on the birth playlist I had made to keep the energy going in the room. Doctors took turns assisting me in pushing as even they needed breaks during this saga. The pain started to build again as the pressure of his head descending in my pelvis became more noticeable. I continued to dose out more of the epidural drugs to help get me through it. Some of the groans that I thought I had left in the past started to creep back in.
Me pushing with the assistance of doctors and nurses.
Clearly there was some sort of hierarchy of doctors who came in to assist my birth. The top ranking doctor seemed to only come in when something went wrong. Just before 2:30 AM, he came in and let me know that the baby needed to come out now or they would need to intervene with forceps or a vacuum. Eric describes the next event as my motherly instinct kicking in for the first time. I gave my baby one final huge push and out he came. I could hear voices saying “Miriam he’s out” and “That’s your baby”, but I was struck with absolute horror when I opened my eyes to see a blue, silent baby with a cord wrapped around his neck. I thought he was dead. I sobbed and pinned my eyes shut as the team removed the cord and transferred him to the NICU team in our room. The same high ranking doctor came over to me with kind reassurance, “Look at your baby. He’s crying. He’s ok.” I opened my eyes only briefly to see my healthy boy, and moments later, he was placed on my chest where I could formally meet him for the first time.
Theo being handled by NICU immediately after birth.
I still continued to sob as the skin-to-skin moment did not feel real. I was still stuck in the trauma of thinking that my baby was dead. I wasn’t ready to jump into love so quickly. When I tried to open my eyes, I was having double vision, so I mostly kept my eyes closed while I embraced Theo.
Me sobbing as I held Theo for the first time.
My mind went back to a moment earlier in the day where we heard a loud cry followed my a round of applause coming from down the hall. Some lucky family had a textbook birth that was worthy of an immediate celebration. Theo did not get a round of applause. Nothing that I read, watched, or learned prior to his birth prepared me for the trauma I felt in that moment. Four days of latent labor followed by about 24 hours of active labor had drained me. I wanted this to be the happiest moment of my life, but instead, I was numb.
As hours quickly passed, we began to transition into postpartum care. My head became a bit less clouded and my sense of humor slowly returned. I don’t know when the switch flipped, but the oxytocin began to outweigh the trauma. I looked at Theo. He was perfect. He still is perfect. He had puffy little cheeks and gorgeous plump, pink lips. His dark hair definitely resembled his dad. I had never seen something so adorable. That’s my baby. That’s love.
Eric consoling me as I held Theo.
Me transitioning into joy.
