The Gory Details

It’s Baby Week, ya’ll.

Elysia was born on March 20. This week, I’ll be sharing different pieces of that experience, a day at a time. All of the posts about Ely’s birth are here.

If you’re confused about all of this, check out the posts under the surrogacy category, you’ll catch up.

This post is for Ely’s birth story.

It is…well, you know, a birth story. With details.

After it was all over, when Misty was about to check to see how compromised my ladybits were, I realized that I was on the floor in the most exposed part of my house (more on that later). So I asked JC to take Logan into the man cave for a bit and talk about…manly things.

If you feel like this is a post you want to sit out in the man cave, go right ahead. The PS4 is in there, and the D&D books and all the good snacks, and even the Coca Cola with real sugar that they smuggle over from Mexico (why do we build the wall, my children? The wall keeps out the good Coke…). Despite its name, the man cave is gender-inclusive. So… Feel free to escort yourself out.

And here we go.

My least favorite question about labor is, “How long was it?” because, at least with Petra’s and Ely’s births, there is literally no answer. A few hours or a few weeks, in both cases, although by both measures, Ely’s was longer.

Anyway, that means this “birth story” starts about four weeks before the actual birth.

February 21, the point I moved from people saying I looked so cute to saying I looked so tired. And I was only going to get tired-er.

I had pretty intense prodromal labor beginning several weeks before Ely was born. Prodromal labor (also called “false labor,” although there’s nothing false about it) is kind of like Braxton Hicks contractions, only more labor-ish. Braxton Hicks contractions aren’t regular, and they usually will stop if you change positions, put your feet up, drink some water, etc. Prodromal labor features contractions that are patterned, just like real labor. They usually aren’t painful, but they are noticeable, and sometimes uncomfortable. They’re exhausting, kind of like doing a lot of sit-ups. And they can go on for a really, really long time.

Beginning about four weeks before Ely was born, I had prodromal labor more days than not, and usually for several hours at a time. The contractions were every 3-5 minutes and lasted around 45 seconds. They often kicked in at night, and made it hard to sleep. A number of nights, I thought, “Maybe this is it?” but they didn’t ever get closer together, longer, or more intense, which would be the signal that I was in active labor. I was nervous that I’d have the baby before Natalie got here (she came at 38 weeks). I was excited, thinking, “Could it be tonight?” And of course, I was uncomfortable enough that sleep was nearly impossible.

Generally, you want the baby facing the spine of the person they are trying to get out of. The other way is trickier.

I was also confused, because the baby’s position was generally anterior (which is supposed to be a good thing), and she was already pretty low down. I thought that both of these factors meant she might come early. One theory about prodromal labor is that it’s the body trying to turn the baby around into a good position for birth…but if she was already in a good position, what was my body doing messing with that?

The periods of prodromal labor kept getting longer until, the week before she was born, I had it from 5 pm to 5 am every night. On Friday, March 16 (the official due date), it started up at 2 o’clock in the afternoon, as I pulled into the arboretum to go for a little walk with Natalie, JC, the kids, and Jacob. The contractions were enough that the walk was pretty challenging for me, but I didn’t say anything to anybody. I didn’t want to get them excited.

And it’s a good thing, too, because I had consistent prodromal labor all the way through until 4 am on Sunday morning (the 18th), and it was not the big event.

Natalie kept suggesting All The Things to kick it into gear (“Have you tried going for a walk? Can I bring you some spicy food?”) and I was pretty snippy with her because I was already doing all the things, including several things she didn’t even know to suggest (breast pump, all the weird yoga from SpinningBabies, evening primrose oil), and it was not helping. And I was tired and grouchy.

The midwives kept telling me to chill out, because I was barely at my due date and the baby would come when she was ready. I was pretty snippy with them because I could tell I was getting more and more exhausted and if I didn’t have the baby soon, I doubted I would have the energy for labor at all.

Are you bored and exhausted by all this yet? Because I sure was.

Oh, and a few people have asked me how dilated I was at this point. The answer is I don’t know, but I think not much. Misty doesn’t check dilation unless there is a good reason; it doesn’t do much for predicting the onset of labor, particularly in someone who has had a few babies. I checked it myself a couple times out of curiosity, and it wasn’t ever over a centimeter by my estimation, before active labor kicked in.

Time, marching on.

On Sunday after church, I texted Misty and told her I was starting to lose it and I hadn’t slept in days. She suggested that I call my chiropractor and get in for an adjustment and maybe some acupuncture.

The next morning, I called, and they got me in right away. I drove over there (still contracting), and sat in their parking lot for ten minutes before I could make myself go in. I was so tired, I was sobbing, just sitting there in the car. I thought, What if this works, and I go into labor without getting any sleep first? I don’t know if I can do this. But another contraction hit me, and I clearly wasn’t going to get any rest regardless, so I finally cleaned my face up and went in.

I hadn’t ever had acupuncture before. The needles didn’t feel like much of anything. I just sat in the chair for half an hour, trying not to look at the needles, and stared at the artwork on the wall. I think maybe I fell asleep for a minute or two then, but mostly I was awake and just not thinking about anything. I’m rarely so tired that I can’t even think, but that’s how it was.

And then I drove home (probably I shouldn’t have been driving, as sleepy as I was. Don’t be as dumb as I am…).

That afternoon, Natalie, Logan, and I took Petra and Silas to the park and then the library. The contractions had quieted down for a bit when I was at the chiropractor, but they picked up again at the park. I thought they were maybe a bit more intense than they had been before, but I also was tired, and I figured the placebo effect might be relevant, as I had just spent half an hour with magical labor-starting needles in my feet and hands, so I was skeptical.

What, you don’t take your dinosaur to the library?

I took the kids home, did all our evening stuff, and the contractions kept slowly edging toward being a bit more intense. I timed them for a little while, and they were getting longer than the earlier ones had been–a bit more like a full minute, and still three minutes apart. But I still didn’t believe in it. I also didn’t want to say anything until I was really sure, because so many people had to come over for the birth. I didn’t want to drag everyone out of bed for a false alarm.

I put myself to bed around 9. Even though I knew I wouldn’t sleep, being horizontal in the dark felt like a step in the right direction. The contractions kept going, getting very slightly longer and very slightly more intense, for hours. At about 3:30, I got up to use the bathroom, and lost my mucus plug, with a fair amount of blood. I didn’t see my mucus plugs with either of my other pregnancies, so this was sort of interesting, and 100% as gross as it sounds. I figured that meant that labor was really happening. I tried to wake JC up, unsuccessfully, and instead called Misty. I told her that it seemed like the whole thing was ramping up more slowly than my other births. She should come, but definitely take her time.

“Contractions three minutes apart are pretty close,” she said.

“Yes, but they don’t really hurt that much. I’m having one right now, and I’m able to talk to you. And also, I’ve been having contractions three minutes apart for weeks. I think that’s the only interval my body knows how to do.”

Then I finally woke JC up, and called Natalie and Logan.

JC and I started filling the birth pool. For Petra’s birth, I had been in our bath tub. We had thought about renting the birth pool for that one, but we had concerns (which we later learned were 100% valid) about the stability of the living room floor. We’ve since fixed the floor, and I thought a birth pool would be better than our tub–for one thing, the tub is in an alcove, which made it hard for people to help me–they could only be on one side of me. So, for this birth, we had a birth pool and ran a hose from the kitchen sink to it. We just recently got an on-demand water heater, which I am overall pretty happy with, but it has a low flow rate (around 2 gallons per minute). We also discovered, when the pool had about 10 inches of water in it, that the water heater has some kind of safety feature that makes it turn itself off if it runs for over an hour. So there was some Ma Ingalls-style boiling pots of water on the stove action going on. It worked out fine, but was not something we had expected.

Logan helping the birth pool fill up.

I still was convinced that things were ramping up slowly–I was, after all, making phone calls and trying to help with the birth pool situation, moving the birth kit stuff into the living room, changing my clothes (for the curious: I wore a tank top and a swim skirt, which I think was a pretty good choice for a water birth with a crowd of people here), etc, none of which I could have done at a similar point in either of my other labors. So I asked JC to wait a bit before calling Tiffany (the photographer) and Laura (who was going to watch the kids). I think he ended up calling them around five.

While we were waiting for Misty, Logan, and Natalie to come, I was completely fine between contractions. When they hit, I sat on a yoga ball and put my head down on a stack of pillows on the couch. Even at this point, when the baby was definitely on her way, the contractions weren’t especially painful. I’ve had menstrual cramps that felt worse. Breathing through them was easy.

Even as they got a little more intense, I was able to talk and joke between them. When I was waiting for them to pass, I found that my breathing was accompanied, in my head, by the chorus of the Lenten hymn some members of our church had composed.

The Lord, our protector declares,
We’ll walk under trees in the shade.
Our swords will be made into ploughs,
And no one will make us afraid.

It’s pius to the point of being out of character for me to be humming a hymn during labor–I even thought so at the time–but singing it every Sunday for six weeks, I’d learned the long breathing phrase of it, and that’s what my body reached for when I needed to be slow and steady and fearless.

Time is blurry during labor. I know that Natalie and Logan showed up, buzzing with excitement and nerves. Misty and Christina, her student, came in around the same time. From around this point on, my perceptions got blurry and inward-focused. I’m sure I’m remembering things differently from how everyone else who was there would describe it. In particular, I know there were times when I felt like people were not being helpful, when really I just wasn’t in a place to receive their help.

Eventually, breathing through the contractions got a little harder, and I decided I wanted to get into the pool, even though it was still pretty shallow. I remember how the water helped me during Petra’s birth, and I felt like I needed that. And it did help, for a bit. I was still able to breathe through the contractions. I was still mostly leaning forward, now onto a cooler that we filled with water and stuck in the pool, rather than couch cushions.

At some point, Tiffany arrived, although I don’t really remember her coming in. A bit later, and much to my surprise, Myers walked in–Laura had to teach that morning, and couldn’t get a sub on that kind of notice, so she sent him. I would have thought it would be uncomfortable to have him there, but I honestly didn’t care. He just said hi and then went upstairs with the kids. I don’t think I saw him again until he was leaving, but that could just be laborvision talking. I was grateful he was there, because my kids trust and adore him. I knew they would feel safe with him, no matter what else happened.

Some time after everyone showed up–a little after 6 am, I think–the contractions got a bit more intense. They still didn’t hurt, but they were definitely uncomfortable and required a lot of focus to just deal with them. Natalie got in the pool with me around this time, and she was rubbing my back and pouring water over me. I remember that between contractions, I still was lucid enough to ask for what I needed–for a towel to put over my shoulders because I was a little cold, for one of the kids’ plastic cups so Natalie could pour the water more easily.

And then, for no reason I can identify, I felt like it was time to push. And that’s when things started to hurt. It felt like pushing against a wall. Like nothing was happening. I felt like the energy that should have been moving the baby down and out didn’t have any way to escape and the only thing to do with it was to make a lot of very intense noise. And so I did. Misty said, “You’re using a lot of energy vocally, try not to waste it,” and I couldn’t figure out how to tell her that I didn’t have an option, that there was nowhere else for that intense energy to go.

I remember joking, between contractions, that I had hoped maybe this time, I’d have one of those nice, polite Scientology births. It was only half a joke–I don’t think Petra’s birth was especially noisy; not silent, but I knew I was capable of a relatively calm birth, and with all of these people here, I did somewhat hope for that.

I also, at this point, suddenly felt all the tiredness of a month with no sleep. Each of my other labors started in the middle of the night, but with each of them, I felt a kick of adrenaline that powered me through them. I did not have that kick this time. I just was deeply tired, down into my bones. And that’s when I got really scared, because I thought, I can’t do this. I’m too tired to do this.

In my other births, I didn’t ever have a feeling like that. I remember feeling like, I don’t want to do this anymore, but not I can’t. In fact, I rarely think I can’t in any situation. I have whole months of I don’t want to, but I can’t isn’t very me at all.

And I was suddenly terrified because, well, in the middle of labor, at the point where you’re pushing, especially at a home birth, it’s not like I can’t is much of an option. I didn’t even know what could or would happen if I really couldn’t do it, and I do remember wondering about this right in the moment. I was crying then, every contraction beginning with a moan, cresting with a howl, and ending in sobs.

The really hard part.

Looking at the record afterward, I discover that this went on for about 20 minutes. That isn’t so long, I guess. Lots of women push for an hour or more. But it felt longer because I hadn’t ever pushed quite that long, and because it didn’t feel effective.

I said, “I don’t know if I can do this. I don’t know how much more I have in me.”

Everyone kept trying to reassure me, “You’re doing great, it’s fine.”

I asked, “Is anything happening? I don’t feel like anything is happening.”

Misty said, “It looks…like, yes, I can see your labia parting at least when you’re pushing.” But she didn’t sound particularly convinced, so neither was I.

But it wasn’t fine, and I didn’t know how to begin to tell anybody. I felt like no one really understood what it meant that I was trying to push out a baby when I hadn’t slept for more than three consecutive hours in a month. I kept trying to tell them that I was too tired, that I just wanted to sleep, and their responses felt kind of patronizing: “Just a little more and then you’ll be able to go to bed.” I felt totally alone, even though we had seven other adults in the house.

I remember JC holding my hand, the feel of his fingers wrapping around mine. “You have enough,” he said. “You might not have much, but you have enough.” And I believed him, because he was the only person who seemed to understand how little I had left.

Misty was listening to the baby’s heart, and she said, “I don’t love the baby’s heart rate. Can we try a different position? Could you turn over and have JC support you from the back?”

One thing I appreciate about Misty is that when she’s concerned, she says, “I don’t love ____.” Not, “I’m worried about _____” or “______ is a problem.” Just, “I don’t love this.” It’s so calm and not panicky. Even knowing Misty and having heard her say she doesn’t love all manner of things my body is doing, even knowing that another midwife might express the same concern with a lot of urgency, I still don’t feel any panic when she says it. I just want to do whatever she suggests because I sure would like for her to love what’s going on.

She later told me that another thing she didn’t love was how long I was pushing for. She’d seen me give birth two other times, and she knew this was not normal for me.

The part where it got better.

So I turned over, and braced myself against JC. Suddenly, it stopped hurting. Another solid push and the baby’s head was out. I keep meaning to ask JC about this, but I think I said something completely bonkers at this point like, asking Misty, “What are you doing?” and she was helping Natalie catch the baby, because what else would she possibly be doing. I’m pretty sure I said something nutty and distant from reality following the delivery of each baby head that I ever birthed, now that I think about it.

“Oh, she’s posterior,” I heard Misty say. “And she’s got her hand by her face. Why does your body like to do that?” I knew what she meant–Petra was posterior as well (and Silas kept turning that way, but ended up being born anterior), and I didn’t have any of the labor challenges typical of a posterior presentation. Her active labor was only around two hours, and I didn’t have any back labor, either. Maybe all that prodromal labor was trying to make Ely posterior, rather than helping her into the position that would be good for most people. I also realized later that once I turned over, I was in the exact position I was in when Petra was born. Maybe my body is just weird.

Catching her baby!

And then one push more and her body was out. Natalie caught her and immediately scooped her to her chest. I felt a little tug and grabbed Natalie’s shoulders. “We’re still attached, you have to stay close!” I said. Flustered, she handed the baby back to me. We were both crying at this point. All, I should say, as that baby had a good set of lungs on her.

One-minute APGAR = 10! A record for babies that I birthed.

“No, you can hold her,” I said, “Just stay close to me.”

“Don’t pull!”

We held the baby between us and just stared at her as she screamed. She was a nice, pink chunk of a baby. I thought she must be bigger than my babies were, but after we measured her, it turned out her weight was about the same as they were; she was just shorter, so plumper. Natalie asked me a couple times if she was okay, and I kept saying, “Yes, she’s perfect. Look at her, she’s perfect.”

(Photo by Tiffany Showalter)

I had expected that I would feel like I wanted to hold the baby, but all I really wanted was for Natalie to be able to hold her without being nervous about hurting me.

I think none of us could really believe that this had just happened.

Finally, I noticed that the cord had stopped pulsing, and I asked if they could cut it so Natalie could take her baby and stop worrying about that.

Cutting the cord.

Misty helped Logan cut the cord, and then Natalie and the baby got out of the pool.

Logan takes his baby for the first time.

This is the point where things get really super gross. If you didn’t excuse yourself to the man cave earlier, you might want to consider it now.

One of the things that has been deeply frustrating to me about this entire process is that, way back, over a year ago, when I went to Phoenix for my medical screening, I asked the reproductive endocrinologist if IVF pregnancies are any riskier or otherwise different than normal pregnancies. She very confidently said, “No. It’s exactly like a normal pregnancy.” I asked her a few times, a few different ways, and I think she was irritated with me.

Over the course of the past year, I’ve learned, from looking up studies on things that I see people talk about in online surrogacy groups, that this is not remotely true. Identical twins are much more likely in IVF (the number usually cited is 3%, but I think it might be as high as 7%), and they are much riskier than fraternal twins, which are riskier than singletons. Pre-eclampsia (especially postpartum) is more common. Antenatal and postpartum depression are, according to one study, five times more common.

One thing I was especially concerned about going into this was placenta problems, where either it doesn’t detach correctly or it fragments and some pieces of it don’t come out. Misty and I had a conversation about how to handle the third stage of labor, including the possibility of pitocin to help make sure it all got out of there.

So when I felt something big and squishy–but not as big as a placenta–come out, I panicked a little. I asked Misty what it was, and she said, “It’s a clot.”

“It’s definitely not a piece of placenta?”

“No, definitely a clot.”

Then I looked around the pool and saw that there were several other clots in the water already, some as big as my fist. About the moment when I noticed this, the placenta itself decided to make an appearance. Christina said, “We’ll check that in a bit,” and I said, “Could you check it now, please?” They did, and reported that it was all there.

At this point, I relaxed. I felt like the things I was concerned about had all not happened. I was relieved. I thought, I’ll just sit here and breathe for a moment.

The moment was a short one.

Misty said, “How do you feel about getting out of the pool?”

“I don’t feel quite ready to stand up yet. I’m okay here for now,” I told her.

She said, “I don’t love that it’s trickier to estimate your blood loss when you’re in the water. Can JC and I help you get out?”

I was surprised that she said this; after Petra’s birth, I stayed in the pool for a pretty long time and no one seemed concerned. Later, when I looked at the pictures and saw just how much blood was in the water, I understood, but right in that moment, I didn’t get it.

Apparently, I lost a lot of blood…

To make any sense of what happened next, I need to digress for a moment and tell what happened the last time I gave blood, which, was when I was in college. I felt fine, passed the iron screening and all the questions about HIV and tattoos, filled up my bag of blood, and then, when the phlebotomist pulled the needle out of my arm, I threw up on him and passed out. When I resurfaced, he said, “Are you a registered organ donor?” When I confirmed that I was, he said, “Good. You’ve done your work for society. Never give blood again.”

As JC and Misty were helping me out of the pool, I fainted. Of course, I don’t remember much of it at all. I remember feeling very confused, and asking what had happened. Someone told me I had fainted, and then I think I fainted a second time. The next thing I knew, I was lying on the living room floor. I was awake, and I remember them taking my blood pressure (60/40) and feeling for my pulse. Misty was trying to slide some absorbent pads underneath of me, and I couldn’t lift my bottom up to help her. She pressed on my belly to squish my uterus down a bit more and try to stop it from bleeding. She gave me a shot of pitocin and pushed my uterus some more. I heard her ask Christina to double check that all of the placenta was definitely there, and Christina reported that it was intact, and she was sure. Misty told me that the bleeding had stopped and my uterus felt like it was contracting as it should. When she said that, I felt completely confident that I would be fine. I was light-headed, yes, but I knew if I just stayed flat on the floor, my body would make some more blood cells, and I’d be alright. Natalie was very concerned, and I kept saying, “I’m fine, go look at your baby, I’m fine.” I tried joking around to make her feel better. She asked if they should take me to the hospital, but I knew I’d have to get out of the house somehow to do that, and I wasn’t about to unless Misty told me to.

In my chart, Christine wrote down that I said I felt “sweaty and overwhelmed.” I don’t remember saying that, but it sounds about right.

Apparently, this part was when everyone else was the most scared, but I really wasn’t. I felt very calm, especially because Misty kept telling me what she was doing and what was going on. We’ve been through birth together before; I trusted her. JC trusts her too, so even though he was more concerned than he let on at the time, he believed her when she said I’d be fine.

They kept giving me gatorade, coconut water, and chlorophyll to drink. I felt alright as long as I stayed flat on the floor. I heard Ely crying and she sounded hungry. Our plan had been for me to nurse her for the first couple of days, until my milk came in, for both my health and hers. I told Logan he could bring her to me and I’d nurse her lying down. I had to ask for help rolling onto my side, which surprised me. I was weaker than I thought. But I managed to nurse Ely and snuggle her a bit, without getting dizzy again.

First meal.

After a while, I tried to sit up, and I was talking to Tiffany. I said, “Is there water running?” She said she thought that someone had started the washing machine, and I said, “No, it’s a higher sound than the washing machine…” and then I felt like I was going to faint again, and then I lay down and threw up all that chlorophyll, which threw everyone into a panic again. I again insisted that I didn’t need to go to the hospital, I just would not sit up for a while.

I ended up spending, in total, about five hours on the hardwood floor of my living room. JC took the kids to Marcella’s for Terrific Tuesday, and they were a little confused about why I couldn’t get up to hug them goodbye. Natalie said, “Isn’t there someone else who could take them? What if we need to take you to the hospital?” I said that I didn’t need to go to the hospital, I just needed to wait for my body to catch up with itself. JC didn’t say so at the time, but he told me later that he was thinking the same thing as Natalie.

I felt alright when I saw Natalie and Logan holding the baby and focusing on her, and becoming parents. I didn’t like it when everyone was fussing over me, because I was not the point, and I was sure I would be fine, I just needed time.

I was uncomfortable, because the floor isn’t a cozy spot to spend several hours, but I was also chatting with everyone, surprisingly lucid despite everything. Tiffany and I had a conversation about my new photo wall, which images showed things I had learned from working with Rosetta Stone photographers, which images were by people she knows. I asked questions during the newborn exam, even though I could barely see what was happening. I even told people where to find all kinds of things, from clean diapers to a baby hat to the kids’ coats.

Checking her out.

Misty kept saying, “I’ve seen women lose twice as much blood as this and be fine.” So I told her about how I’m not supposed to give blood. “Some people don’t handle blood loss well, and I guess you’re one of them,” she said.

7 lbs, 6 oz.

Later, I asked Dr Google and found several studies showing that postpartum hemorrhage is more common with IVF pregnancies, too. I’m not sure I technically had a hemorrhage–that’s a blood loss of 800 mL or more, and Misty estimated mine as “a little over a pint,” so 500 mL or around there. But if I had known that this was a risk, particularly knowing my own history of not being great at tolerating blood loss, I might have made some different choices. Maybe I would have elected to give birth at the birth center, which is right next to the hospital, instead of at home. Everything was fine, and Misty handled it all perfectly well, but it could have been much worse. I feel deeply frustrated that I asked, specifically, about potential complications well before I was even pregnant, and got such a dismissive, and ultimately dangerous, answer.

Eventually, I was able to crawl to the guest room and climb into bed. I had planned to get a shower after the birth, as I did with Petra’s, but even though I was covered in many truly disgusting bodily fluids, I didn’t trust myself to stand in the shower. I did, finally, to my great relief, get to sleep. Although I know I woke up to feed Ely another couple of times, the next twenty-four hours were a blur. I don’t remember much at all until I finally got that shower the next afternoon.

Snuggling Ely after feeding her, about 12 hours after the birth. I made that blanket! And also the baby.

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