First, let’s start at the end.
I gave birth to a little baby boy at 8:41 am on December 8th 2014. After a long, rainy night, he was born not long after the Scandinavian sunrise and into a beautiful, bright blue day. I was surrounded by seven women and Paul, all who watched as I reached down and pulled my son up onto my chest as he yelled his way into the world while the others murmured their congratulations in Danish and English.
I suppose that’s the most important part of the story. But I know that I’ve always been interested in the entire story of other births, and now I have a chance to talk about my own. I also know that I’ve appreciated other stories that have details — technical details and a lot of them — so I want to include those here. It’s going to be long. Just is.
Finally, I have what I think is a little bit of a unique opportunity since I have access to all the midwives’ notes during my labor. I wrote what I remembered before ever seeing them (they were uploaded to me two weeks afterward), but I’ve interspersed their notes here in grey (and translated into English) just to see if I remembered things the same and for the general interest of it – though, admittedly, I didn’t include every blood pressure reading. Additionally, Paul wrote his own version before reading mine and his is also interspersed here in blue. It’s been a really fun exercise to compare all three accounts.
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I had been feeling a bit of pressure on my cervix for quite a few days (weeks?) beforehand. I remember thinking that I wouldn’t have been surprised if I was dilated at least 3 cm, but I couldn’t actually know since I never had an internal exam. On Friday, even though I was a bit “waddley”, we walked for about an hour and a half that evening in the city center, finding a nice place to eat dinner. Saturday afternoon, we went on another two and a half hour walk to the old city to see the Christmas Market and go to a Christmas concert at the cathedral. As we walked to the cathedral, I remember feeling a new, sharp kind of punch downward. As we sat through the concert, that happened a few more times, but I wouldn’t have called them contractions. Just random sharp punches that disappeared once we made it home.
Heidi had been feeling some twinges of pain and/or pressure for a couple of days leading up to the 7th. But while some of them were rather sharp, we just thought it was our little guy moving around on her pelvic bones. Whether these really were warning shots over the starboard bow or not, I guess it’s impossible to know, but it’s interesting to note.
On Sunday, we slept in and then Paul made the first batch of official Danish Christmas aebleskiver with strawberries and cream. Otherwise, we just took it easy. Around 4pm, Paul went over to our neighbor’s, who is also Paul’s co-worker, to go over a conference talk and I settled into a skype chat with my Mom to go over her plans to fly out to Denmark the next week.
I remember moving out of our nice glider chair and onto the floor to sit cross-legged (I’d been preferring the floor to the couches for a couple weeks). Good thing. Because about ten minutes into the call, I heard a bloop and was immediately drenched in what felt like a huge gush of water. Absolutely no warning on that one.
My mom could only see my shocked face, though, and heard me gasp/squeak followed immediately with, “I need to call Paul right now.” I just remember her saying, “What happened?! What happened?! Did you see something? What?!” And me, still shocked, saying, “My water just broke! I can’t move! I need a towel! How do I get to a towel?! I need to call Paul. The carpet! I need to get a pad to see what color it is. But…but…but…” By this point, I’d gotten such a huge rush of adrenaline, my hands and legs were shaking and I hadn’t moved an inch.
Luckily, the phone was within reach and after connecting first with our neighbor (“Okay! He’s coming! I’ll call you a taxi!” – Helpful Neighbor.), Paul was home in what felt like two seconds and helped get me off the floor and mobile again. He called the midwives, who advised we eat a good dinner and come in for a check at 7:30pm. Paul made me pasta with broccoli and grapes, got the last of our things together in case we stayed at the hospital, called a taxi, and put everything in order while my mom stayed connected and kept excitedly clapping her hands and calling all my sisters and dad to tell them the story.
This entire time, I still felt nothing (except for gushes of water whenever I moved) and was mostly happy to keep skyping and talking with my excited family until I suddenly started to feel like the only thing I wanted was quiet and to be alone with Paul in the dark. So I waved goodbye and spent the last half hour getting ready to go.
Heidi’s water broke, to begin with. Broke on our living room floor. While she was on Skype with her mom. It was around 4:30pm on December 7th. I was, of course, not there for the excitement, being at the next door neighbor’s house for a bit of Sunday afternoon job-related business.
After her water broke, Heidi gave me a call, and I hurried back over to the flat. I helped her dry off a bit and made an appointment with the hospital to have her and the baby checked after we had a chance to eat some dinner. I made a quick pot of spaghetti, and while Heidi ate it and talked with her family on Skype, I made sure that our bag was packed with all of the labor & delivery essentials. I was remarkably calm during this time, by my standards. I think Heidi was a bit more freaked out. But that can be forgiven seeing as she knew that the hardest part was now fast approaching.
Phone Consultation Notes: 40 weeks and 3 days gestation. Called because water has broken. Fluid is clear. No contractions. Appointment made for 19:30.
We took a quick taxi ride to the hospital (five minutes, maybe a little more) and had a little check-up in the night clinic. Everything looked fine and I was having contractions every five to ten minutes, though they didn’t feel very painful. I finally had an internal exam and was told I was already at 4cm (!! Yay!).
The midwife offered us a labor and delivery room at that point, but we decided to go home to see how things would shape up. I wanted to be in the quiet and in a place I knew for as long as I could, just alone with Paul.
Our first trip to the hospital (7:30pm) was rather anti-climactic. A kind midwife checked the baby’s heartbeat, asked us some questions, and informed Heidi following an examination that she had reached 4cm. Heidi seemed happy about that. I was, too, but I had no way of knowing how long she may have already been dilating prior to this. Hours? Days? Also, there was the fact that Heidi hadn’t had regular contractions yet. The midwife gave us a choice of going to a labor room and hoping that the contractions would start soon, or going home and returning when active labor (1 minute contractions every 5 minutes) began. This sounded like the more comfortable choice, so we returned to our flat via taxi.
Clinic Appointment Notes: Check-up for water breaking around 16:45. On arrival, scattered contractions approx. 5-10 minute intervals.
Physical Examination Fetus presenting with head, engaged. Fetal weight estimated at 3400 g. Fetal heartbeat 11-12-13-11-12. Cervix effaced. Dilated to 4 cm. Water broken, pink coloration with some blood.
Recommendation Return home. Call Labor and Delivery when in active labor.
We got home around 8pm and immediately the contractions were becoming more regular, though really not bad at all. I remember I would just walk around in circles through our tiny apartment, back and forth from the bathroom to the bedroom. It seemed like a good idea to sit on the toilet through some of them and on others I’d just kind of lean against the table or walls. They came about five minutes apart for two and a half hours (though, if you’d have just asked me, I’d say this lasted maybe ten minutes) and Paul would occasionally ask if I wanted to go to the hospital since we were in “the zone” of contraction timing, but I really didn’t feel any urgency.
Around 10:30 I had two much more painful contractions in a row and finally said okay. By the time the taxi showed up ten minutes later, I was still feeling myself between contractions, but definitely feeling serious pain when they came. I remember putting on my boots upstairs while Paul went down to load the taxi and hearing the taxi driver start applauding loudly when Paul told him where we needed to go and Paul laughing. In the taxi, I didn’t sit down, but rather knelt on the backseat and leaned against the back. Speedbumps were slightly unpleasant and we were almost to the hospital when I could feel a contraction coming and I said, ‘I’m sorry Ken! (the driver) But I’m going to be a little loud.” and he said, “It’s okay! You’re having a baby!” Then doing a bit of loudish, low, uh, wailing (?) until we got to the door. Somehow a wheelchair appeared and Ken took the helm while Paul buzzed us in and pulled our bag.
It wasn’t long after returning home that the contractions began for real-zies. They weren’t 100% consistent, but if we got home around 8:30 or so, I think Heidi was in active labor by 9:00pm. She walked around the apartment looking for blankets, beds, toilets, pillows; anything that might help her during the next contraction. I timed her contractions faithfully on her smartphone, provided back massages when able, and tried to guess what she might want before she had to ask for it. This continued for about another hour before the contraction rate increased to one every 3-4 minutes. The increased frequency was coupled with increased pain, so Heidi asked that I call the hospital and let them know we were coming. This taxi ride was much less fun than the first, with Heidi having painful contractions in the back seat while I tried to comfort her. Ken the taxi driver was a kind man and helped us get Heidi into a wheelchair and up to the labor & deliver ward while I carried the bag, Heidi’s favorite pillow, a random blanket, and I don’t-remember-what-else.
Finally (it felt) we made it to the delivery ward at 11pm and were checked into Room 1 and introduced to our midwives, Mette and her student-midwife Pia. This is where things started getting real fuzzy for me.
I remember getting to the room and immediately throwing off all of my clothes to put on the soft terry cloth robe they gave me. I remember laying down, but needing to be on my side since it was very uncomfortable to be on my back while Mette and then Pia checked me. I remember their gloved hands covered in what looked like a lot of blood (to me) and saying that I was still at 4cm.
This was disheartening to say the least since I’d essentially gotten to 4cm completely unaware and painlessly and in the last three hours of regular contractions, I hadn’t progressed at all. Plus, by this point, they were coming every 3-5 minutes (or shorter?) and I could not get myself to relax or breathe through them at all. I remember being coherent enough to try to keep my voice deep when I roared/yelled through them, but that was the only control I had. I rarely opened my eyes for anything at this point and remember feeling like my world had just become pain+yelling/roaring/saying “No no no no no no no” followed by only slightly less painful stretches of tense whimpering.
I got into a warm bath at some point soon after arriving, but I wanted it deeper and bigger. I wanted to kneel and not have my back exposed to the cold air. But still, it did seem to help for the however long I was in there (20 minutes? 2 hours? no idea). Then, I suddenly needed to throw up and was so grateful Paul was right there with a bag (or three) for me to fill up in quick succession. This development was discouraging because I felt like I had essentially purged any chance I had for future energy stores and was now just empty and tired.
Upon our arrival (10:40pm), we met our midwife and her student assistant Pia. They got us situated in our labor room (#1!) and helped Heidi get out of her clothes. I got them up to speed on the labor’s history so far while poor Heidi continued to deal with one contraction after another. They checked to see how much Heidi had dilated, but she was still at 4cm. This was quite disheartening given the amount of pain Heidi had dealt with already. We were in for a long night for sure. I massaged her back with some tennis balls in a sock (sounds weird, but it totally works. Try it.), got her some ice water to hold on her forehead, water & juice to drink, and helped her switch positions on the hospital bed when she wanted to. The first pain relief we tried was bathtub full of warm water. Heidi kneeled in it with a warm towel on her back. It seemed to work better than nothing, but after Heidi vomited a couple of times, she understandably wanted a change of scenery.
Notes
Due date: Dec 4, 2014. Gestation at 40 weeks and 3 days. Spontaneous water breaking around 16:45 today, fluid clear. Contractions started around 19:30 and now regular with 4 minute intervals, lasting 35 seconds at strength 2 (out of 3).
Heidi is handling the contractions well, is well supported, and calmly breathing.
Clear amniotic fluid with signs of bleeding. Fetal movement shows life.
Physical Examination
Uterus is relaxed and soft between contractions.
Fetal heartbeat is good. 12-14-13-12-12-11-11-12-11
Cervix dilated to 4cm. Fetal position at -3 and engaged
Patient rejected offer for enema.
Heidi requests to use the bathtub, it is being filled.
Notes Contractions are increasing. Coming at 3-4 minute intervals, lasting 40 seconds. Strength at 2-3 (out of 3).
Good fetal heartbeat (12-10-11-11-11). Going into the bathtub.
Notes Heidi vomits, but tackling the contractions nicely.
I got out of the tub to try having some nitrous oxide and oxygen to hopefully help me breathe more deeply, but the mask required me to suck in the gas and felt too claustrophobic. I didn’t make it through one contraction with that mask on but Paul was rolling some tennis balls on my lower back and that helped a lot. The midwives checked me and I remember hearing them say the number in Danish to each other and wanting to cry. When Mette turned to me I was already wishing I could just sob before she even had a chance to say in English, “You are still at a four…but maybe during contractions we could call it almost a four and a half!” By this point I’d been in active labor (since beginning of serious contractions, not water breaking) for six hours, at the screaming/incoherent level for three, hadn’t progressed at all, knew I still had to more than double the progress I’d made before I could even begin the final pushing stage, and knew that cm 8-10 were supposed to be exponentially worse than cm 4-7.
Notes Heidi has increasing pain and vomits again. Decides to come out of the bathtub and would like to try Nitrous oxide.
Notes Heidi is in knee-elbow position, struggling nicely through contractions. Contractions at 2-3 minute intervals, duration 35 seconds, strength 2-3 (out of 3).
Good fetal heartbeat. Heidi did not seem well with the Nitrous oxide. Offered a heating pad for the lower back. Heidi informed about pain relief options, including the effects of an epidural. Heidi will consider this as it seems contractions are difficult.
I remember hearing Mette and Pia telling me things I logically knew – that things don’t progress in a linear way, that it could suddenly go quickly very soon, that we could try acupuncture or some sub-dermal injections – but I also kept thinking that I was already feeling exhausted, had thrown up all my food, was on the edge of losing my mind and didn’t know how to get control of myself during contractions….and that I still needed to go more than the distance I had already gone. I could not imagine how I could have any energy left, even if things went quickly from that point on, to do any kind of pushing. I literally thought I would die and if I didn’t die, I would rather die. I remember actually looking at the wall during one contraction and thinking that if I had to go through one more, I’d rather get to the wall and smash my head against it hard enough to go unconscious.
After talking with Paul (and screaming through two or three more contractions), I asked for an epidural around 2:30 am. The hardest part was just waiting for the doctor to come and then having to sit still through a contraction while he worked (I yelled so loud that I probably terrified the entire ward). It took another twenty minutes after the medication started before the contractions could come and me not absolutely lose my mind over them. But, then I remember, for the first time in so many hours, finally being able to relax in between, breathe through the pain, and get through one and then another, and soon I was able to sleep in between.
We moved her back to the bed and tried some laughing gas, but the mask made Heidi a bit claustrophobic, and the added resistance required to breathe it in made it too much for Heidi to want to deal with during a contraction. I should mention now that while at the beginning of labor Heidi was able to talk okay in between contractions, by this point in the game she was becoming increasingly incoherent even when the contraction had stopped. She would moan and repeat the words “no” and “can’t”, which didn’t give me the impression that she was keeping a positive attitude about how things were going. We had now been at the hospital around 2 hours, so the midwives checked Heidi again. She had dilated a bit more, but only to 5 MAYBE 6 (Heidi’s interjection: False!). Mette offered a few more pain relief options like acupuncture and hypodermic water injections, but at this point I was pretty sure Heidi wanted (and probably needed) to get an epidural. She needed to relax or her dilation was never going to get to 10. Plus now she had thrown up all her food. Where was she going to get the energy to finish this? Mette told us the risks about the epidural, but not in way to try to scare us. I got the impression that she actually thought it was the right decision. We called for the doctor and waited.
Notes Heidi goes to side-lying position and then half-sitting position.
Physical Examination
Cervix dilated to 4-5cm
Fetal position at -3
Heidi is in a lot of pain and would like an epidural. Is informed of effects and side effects, consents.
Notes Anesthesiologist in the room. Heidi finds the contractions very difficult but is good at relaxing in between. Contractions at about 3 minute intervals, lasting 40 seconds, strength 3 (out of 3).
Around 1:30am on December 8 the doctor came to put in the epidural. I tried to watch as little as possible. Instead, I tried to distract Heidi from the IV and epidural needles by talking to her about our upcoming trip to the US and the possibility of visiting Iceland or England on the way. The first IV try failed, requiring both her hands to be needled, but the doctor did excellent work with the epidural itself. Within 20 minutes of its placement, Heidi was feeling much less pain and was finally able to relax a bit, especially between contractions. By 2am, she was completely coherent again, but very tired. We were able to shuffle her to the toilet (her legs were a bit numb, but she could still walk), but mostly she just laid on her side and relaxed. She even dozed off at one point, giving the midwives (and me) a scare when her diastolic blood pressure dropped to 41. But it rebounded just fine in the next 5 minutes. The epidural was working.
Over the next two hours I intermittently dozed and low-moaned through the stronger contractions that I could still feel as not-painless pressure around my tailbone. The midwives didn’t come and check on progress until near the end of that period and then very happily told me I was fully dilated and effaced and we would start pushing soon.
The midwives pulled up the delivery bed next to Heidi’s labor bed and told me I could lie down there for a nap if I wanted to. It was at this point that I realized that I hadn’t really sat down, drank anything, or used the toilet the whole time we had been there. I decided I would do all three (not necessarily in that order), and then lay down for a rest. The midwives checked Heidi one more time (she was around a 7 already), and then left us for a well-deserved break. The bed was hard as all get out, but I didn’t care. It was just nice not to be standing. Plus Heidi was clearly not in pain anymore. We drifted off to a 2-hour nap.
Notes Beginning the effects of the epidural block. Heidi feels increasing pressure at the rear, but no urge to push yet.
Physical Examination
Cervix dilated to 6 cm, perhaps 7 cm during contractions.
Fetal position at -2/-1
Heidi moving to a side-lying position.
Notes Heidi rests.
Notes Heidi is well and rests. Approx 3 contractions every 10 minutes, a little irregular.
Notes Pressure at the rear is growing, but no feeling to push yet.
Physical Examination
Cervix dilated to 9 cm
Increasing contraction strength, approx 3-4 every ten minutes.
Walked to the toilet and urinated. Heidi will rest a bit longer waiting for full dilation.
Notes Heidi sleeps between a few contractions.
Notes Urge to push increases gradually, however it is unconvincing.
Physical Exam
Fully dilated. Heidi is ready for delivery.
4 cm to 10 cm in two hours! And those were hours where I slept and only had to moan a little now and then! My body was being super awesome! I was so happy and thought that surely everything would go fast now. I was able to get up and walk/shuffle around, empty my bladder a little bit even, and snuggle back in bed as the midwives put on their plastic coats and set up the delivery bed. It was only 4:30am and I figured I’d be done with the whole thing within the hour, mostly because they told me they put a one-hour limit on pushing. I thought, “No problem! Let’s do this! Easy peasy.” I was in such a good mood I even asked the midwives if they’d like to have a couple pumpkin chocolate chip cookies I’d brought to share. And when they said, “Okay, we’re going to lower your epidural level a little bit so you can better feel the pushes.” I was like, “Sure thing, buddies! No problem! Have another cookie!”
Please take note that in the last paragraph I said it was 4:30am and I didn’t actually birth this child until four hours later…
This is where things get even more hazy for me.
When I was examined again, Mette told me that the baby’s station was at a -2 (essentially, 2 cm higher than they wanted before I began to push). Since my body seemed to really be responding well with the epidural, they very nonchalantly said that we’d just wait another half hour to let my medium-strong and consistent contractions work the fetus down.
That half and hour wasn’t super fun, but it wasn’t unbearable either. I’d been through what I thought was unbearable a few hours before, after all, but I had to admit that yes, even with the epidural, the lowered dosage was enough that I was in some serious agony. What really helped though was a difference in my mental state. Whereas before I hadn’t progressed a single centimeter and faced six more centimeters of unknown horrors, this time I could think, “Just seven more…just four more…just two more contractions and I can push!”
Notes Ready for assisting in delivery. Heidi in knee-elbow position to help descent. Epidural block reduced to 6 ml/t.
Mette and Pia returned and checked me again, and again I could understand the Danish numbers they were saying and see their attempts to stay very, very positive when they turned and told me he had not descended at all. I think they could see the fear in my face because after a bit of conferencing (while I writhed around on the bed behind them), they came back and told me that we would try pushing for half an hour to see if that could get him down.
Spoiler alert! It didn’t. At all.
At around 4am the midwives checked Heidi again and informed us that she was fully dilated to 10cm. Huzzah! However, the little guy’s head hadn’t descended all the way yet. So even though Heidi was now feeling pressure and the urge to push (not to mention some pain again because the epidural dosage needed to be lowered for the pushing stage), she was not allowed to push until the contractions had helped the little guy’s head come down. We waited 30 minutes. No change. 60 minutes. No change. Heidi was starting to feel more pressure in her back and tailbone now. Finally, Mette decided that maybe Heidi could help the baby descend by starting her pushing. She pushed with each contraction for about 20-30 minutes, but to no avail (but much travail). So Mette said no more pushing, and we had to wait again.
Notes Heidi moves from knee-elbow position to half-sitting. 4 contractions in 10 minutes. Attempted to push over three contractions, but head has not descended.
Encouraged to pant through contractions, waiting to push actively. Recommended to stand up, but Heidi cannot cope with this right now.
Again, I fell into this world of yelling-pain and darkness (never opening my eyes). I don’t know how long I was there while we tried to get the contractions to just help his head descend and the midwives lowered the epidural dose again. I remember feeling like a freaking superhero for being able to turn over onto my hands and knees for one contraction, just because I knew that moving around or changing positions could help – I immediately flipped back over. I even tried walking a bit and was encouraged to go to the bathroom to try and pee since a full bladder could have possibly been the problem (I couldn’t pee that time. It was super frustrating.)
When I got back into the bed, Mette very gently told me that she and Pia really thought my bladder was very full and they would like to use a catheter to drain it. My first reaction was, “NO! Interventions! Incontinence from botched catheters! Slippery Slope! Pitocin horror! Nooooo!” (I’m not going to claim I made total coherent sense, but you get the picture. I had been doing so well, I didn’t want my choice to have an epidural spiral me into all sorts of pathologies.) But finally, I gave in because I honestly knew it had to be done and I wasn’t able to drain it on my own.
Pia was awesome. The catheter was just fine, didn’t hurt at all. And I got rid of a whole heck of a lot of urine.
Notes Heidi pants through contractions. Heidi helped to toilet, but cannot urinate. At 6:30, inserted catheter and drained 400 ml urine. Having 4-5 contractions every 10 minutes.
Some vague amount of time later, after writhing around through more contractions that were incredibly painful at this point and being required to pant through them all instead of being able to push (pushing hurt waaaay less), I was checked again and was only at a -1. Some progress yes, but not enough.
In general, the fetal monitor I had strapped around my waist (put on at the start of the epidural) was showing a “happy” fetus with no signs of distress, but all my writhing would make it cut out every now and then. Looking back, I believe the midwives were beginning to get just a little concerned about how long this was taking and wanting to watch the baby’s vitals more consistently. But I have to give them credit for always being very positive whenever they talked to me (again, I never saw their faces because my eyes were always closed).
They finally told me that even though the contractions were strong and regular, because the descent was taking longer than normal, they needed to give me an IV drip to make them even stronger (repeat “NO! Slippery slope! Pitocin horror! etc. etc.”). Oh and P.S. we’re going to lower the epidural even more. Third fun surprise, we need to insert an internal fetal monitor.
Notes Heidi has now been fully dilated for two hours and it is difficult not to push during contractions. Epidural block has been reduced again. Strength of contractions are declining but remaining at 4 contractions every 10 minutes.
The couple has been informed about the need for the s-drop (medicine to strengthen contractions). This also discussed with the coordinating midwife, Sanne Engel.
6:50 am – begins to push actively
6:55 am – begin s-drop. Heidi has a hard time not to push during contractions, so allowed to do so even though contractions not optimal. Observe a little pressure from fetus’ head during contractions.
You may be wondering at this point – well hey, wasn’t Paul there? Short answer is: yes. Longer answer: At this point I don’t think I’d actually seen him for about two hours though I could hear him now and then asking me if I’d like some juice or water and then feeling a straw against my lips. I remember one contraction where in a haze of pain-confusion I slapped his hands away from caressing my arms and then immediately lunged forward, grabbed his shirt to drag him practically on top of me, and squeezed him around the waist in a bear hug while yelling through the rest of it. I remember him laying next to me and holding my hand while I tried to sleep between contractions when I had the earlier epidural. I remember him bringing me a cookie. I remember hearing his voice say, “You’re doing so well. You’re so strong.” I remember asking for a kiss and then shoving him away because a contraction started before he could get to me. I remember opening my eyes once and seeing him near the corner of the room looking tired and helpless and wishing I could just run over and hug him. I remember him putting chapstick on my lips and a cool cloth on my head and brushing my sweaty hair out of my face. He was there. Never sitting the entire time, through the whole night. Always right by my side.
I continued to stand by Heidi’s side through all of this, getting her juice and water whenever she would agree to drink some. The massaging had to stop when the epidural went in, but I kept running my fingers over her skin, especially her face, and cheering for her whenever it seemed appropriate. The little guy’s heartbeat had been remarkably stable throughout the whole process, but now seemed to be increasing a bit. This prompted the midwives to put a little probe inside Heidi and onto his head. The heartbeat measurements were now more accurate, and thankfully, more reasonable as well.
Finally (FINALLY) I was told I could push. The repeated refrain was, “We need to have a birthday here. Soon. We need to give this baby a birthday, okay, Heidi? We need to do this soon.” Finally (FINALLY) I didn’t have to pant through the really, incredibly painful contractions and could push, but wasn’t sure exactly what that meant. How do you push something out of your uterus? I mean really, how? It’s not like it’s something you do all the time (ever). But I tried and tried and tried. For an hour I tried. And the midwives could only say, “It is like three steps forward, three steps back.” I had hoped they’d just mistranslated themselves, but no, it was true, the fetus was not making progress.
Notes Heidi is tired but with a good mood. S-drop dosage increased.
Then came the dreaded words: “We are going to call the doctor in now. Your baby is doing okay, but this is taking a long time and the doctor will just come here to assess things.” (again, “NO! Slippery Slope! Pitocin horrors! Episiotomies! Forceps! No!”) I pushed and pushed. I remember feeling sweat dripping from strands of my hair and onto my stomach as I lurched forward each time.
I pushed through an entire midwife shift change without opening my eyes or saying goodbye. Suddenly there were two new midwife voices in the room, Lene and Lykke, who were much louder cheerleaders and much more instructive. A huge “ah ha!” moment for me was Lene telling me to hold the pushing pressure even as I took a new breath, not release it.
Again I heard them say, “We need to have a birthday here. You are going to do it now, Heidi, okay?” as I gasped for air in between contractions. I pushed (there has to be a better word for this) for another 45 minutes and remember at one point opening my eyes a slit to see seven women in the room I’d never seen before. There were carts rolled into corners and certain newcomers were busying themselves arranging things on top or washing their hands. I was mildly shocked since I had not heard them at all – only Lene and Lykke cheering me on with occasional “You’re being so strong, Heidi!”s from Paul.
Around 6:30am another check confirmed that the head was finally in position and pushing could begin in earnest. Heidi pushed and pushed her hardest, two, three, sometimes four times during a single contraction. But the little guy just wasn’t moving very quickly. Mette thought it must be because the contractions weren’t strong enough (not sure if that may have been influenced by the epidural, but it’s possible), which led her and Pia to give Heidi an IV of a drug to increase contraction strength. This did seem to make the contractions more consistent and (maybe) stronger, but progress continued to be painfully slow. I did get a glimpse of the top of a little head with some hair, but it just seemed stuck.
Notes Heidi fighting well and supported to push effectively. 4-5 contractions every 10 minutes. S-drop dosage increased. The couple informed of the midwives shift change and agrees.
Notes Fetus’ head coming very slowly. S-drop dosage increased.
I could feel Lene stretching my perineum at every contraction with her fingers while she yelled, “Push now! More, more! Even more! Keep going! Deep breath! Now again! And longer and more! And more!” At some point, Lykke said that they could see his head and a little bit of dark hair. I think this was meant to encourage me, but all I could think was that they only saw “a little bit” of the head. There were mumbling conferences about using a vacuum extractor and from where I was, I just could not understand why they weren’t using it to help me. In between contractions at one point, I felt so trapped in a kind of painful exhaustion that never ended that I sobbed out, “Please, why don’t you help me? Please help me! Please!” and “Give me back my epidural!” (to which a confused Lykke replied, “We didn’t take it away! I promise!”).
At 7:15 we said goodbye to our nighttime midwife friends and welcomed the day shift of Lene and her student assistant Lykke. Not sure if it was because we were all so tired and they were fresh or if it was a personality thing, but there was an infusion of energy into the pushing process at this point. Lene in particular was very vocal about giving Heidi instructions of when and how to push, the whole time helping to stretch Heidi so that she wouldn’t tear when the head did come out. Around 7:40, Heidi had been officially pushing for longer than an hour, which was the time limit allowed before I doctor needed to be called to assess the situation. The doctor was called, but in the meantime, Heidi finally seemed to be making some progress. Here pushes were still strong even though I have NO IDEA from where she still had the energy at this point. I would help pull her legs wide, keep her hair out of her face, and push her head towards her chest during each pushing session (always holding my breath, clenching my jaw, and making “pushing” noises with her…this was subconscious). After the pushing, I would put a cool cloth on her forehead, lightly massage her jaws, and tell how amazing she was doing and how much of the head I could see now.
Notes Actively pushing for over one hour. Coordinating midwife and Dr. Lise Lotte Andersen informed.
Notes Now actively pushing for over 1.5 hours. Dr. Anne Gotfredsen in the room.
Once, I realized I hadn’t been feeling Lene’s stretches or her voice (for how long, I have no idea) and opened my eyes to see a random older woman with a tray of tools sitting in between my legs and kind of prodding around. I screamed, “Please don’t cut me! Please don’t cut me!” No one cut me. And I saw for the first time that the sun had risen and the sky outside was a bright blue.
At another point, I heard Paul say that he could see hair, a lock of hair, that he was right there, Heidi. And I heard Lene say, “Okay Heidi, you are going to do this yourself. You are going to birth this baby all by yourself and you are going to do it right now. Because you’re strong and you don’t need help.”
By the time the doctor arrived, she had pushed his little head out far enough that it didn’t go back in between pushes. The midwives would place a warm cloth on the top of his head to keep the little guy warm and help Heidi to stretch so she wouldn’t tear as easily. The doctor took a look at our progress and decided to let us continue while she consulted with another doctor. Heidi was running out of energy, but she was so very, very close to being done now. We all could feel it. We could see it. Lene was absolutely determined that Heidi should do this on her own and told her as much. The doctors weren’t so sure, though. They were quietly preparing their tools for an episiotomy and possible vacuum extraction.
Notes Now making good progress. Will soon have a spontaneous birth.
I really thought it would never end, this cycle of curling forward into a tense C, holding my breath or yelling through a push (I could generally fit three within a contraction), yelling “My hair!” as I lurched forward and hoping Paul could get the sweaty strands out of my face faster than I could notice them. In between contractions I’d gasp for air and cry out that my back hurt.
Notes Doctors called in to assess the long pushing time – approx 2 hours. S-drop was begun due to weakness before fetal head reached pelvic floor. Now pushing fine with head making progress. CTG shows possible complications. Dr. Dorte Kolster determines CTG changes from fetus’ progress through birth canal during contractions. Head is progressing quickly during contractions. Noted meconium in amniotic fluid.
Then I started to feel the burning and nothing could have motivated me more than that because I knew that meant crowning. One or two contractions of burning that almost felt like a relief and then one final push and my only high-pitched scream and finally I could look down and see a face and head, all purple and elongated. One easy push (comparatively) after that and I could feel the body begin to come out. I could hear Paul crying and the midwives telling me to “take my son.” So I leaned forward, put my hands under his arms, and pulled his little long skinny body up to my chest as he started to cry loudly and long.
But then she did it. With another great push, she got the head through and I saw his little face for the first time. And I sobbed. I couldn’t help it. I didn’t plan on it. I just did. I started crying like a baby before the BABY was even crying like a baby. The only thing going through my mind was: “That’s him. That’s your son.”
At 8:41am, the midwives had Heidi reach down and take our new son and bring him up to her chest, skin-on-skin. He was bluish and a bit covered in blood, but it only took him a couple of seconds to begin crying. I watched in amazement as he cried for several minutes and changed color from bluish to pinkish. He was the cutest little guy I had ever seen.
It was 8:41 am.
Notes A living boy born. Nose aspirated. Highest Apgar score.
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It took me a while to come back into my own head there. I could see this baby on my chest, a stripe of blood across the bridge of his nose, looking up at me with these bottomless dark eyes. And I could see Paul at my side, tears in his eyes. But I didn’t feel relief or joy or anything – I think my brain was just happy to take a moment to actually not have to feel anything. Feeling nothing was the best present I could have gotten at that moment. Feeling everything (all the exhausted feelings!) came after about ten minutes.
I remember delivering the placenta what felt like almost immediately after the birth. I remember asking Paul, “How bad is it…down there? Really. Tell me.” and him saying, “Nothing is bad. It looks really good!” I asked Lene how much I tore and she looked up, surprised, and said, “Tore? You didn’t tear at all!” Later, I did find out I needed a total of six stitches, but it was only one for a superficial tear in one labia, two for a small “abrasion” inside my vagina, and three to repair a small vaginal ring muscle that had stretched enough to be injured underneath the skin. This was fantastic news as tearing or getting an episiotomy was one of my biggest fears. I am so grateful that doctor backed off when I yelled I didn’t want to be cut and for Lene’s patience to stretch my skin during each contraction and Lykke for putting a warm towel over my perineum in between every contraction. Seriously. I can’t thank them enough for being, you know, decent human beings to me!
Notes 8:47, placenta delivered weighing 650 g. When examining, observed perhaps a 1st (?) degree tear on labia. Total bleeding estimated to be 300 ml.
We stayed in the delivery room for a few hours that day. Lykke brought us both some breakfast absolutely festooned in little Danish flags (birthday decorations in Denmark are all about the flag here) and wished the baby a happy, happy birthday.
We had a nice long nap together as a family there and tried to decide on a name (we didn’t until the next day). After a visit from the pediatrician, proving that I could walk and pee on my own, and a surprise visit from my pregnancy midwife who was on duty in the acupuncture clinic, we bundled all our things together, I got in a wheelchair with the baby, and we set off for the Hospital Hotel where we happily spent the next two nights together, eating really good food, getting advice and help from the midwives on call there, contacting our families, and finishing up any check-ups and tests the baby, now officially named Hadrian, needed before we went home.
Before we left, the midwives gave me a binder of information and stats from the birth. And I read there in Lene’s handwriting at the very bottom of the summary page, “Godt kæmpet!”
Well fought!
That will be the birth motto I’ll remember for the rest of my life.
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