I was admitted to the hospital for 24 hours on April 4th due to high blood pressure (159/100), borderline-high levels of protein in urine, and high uric acid blood levels. Afterward, I was prescribed bedrest. I was beginning to get very nervous because my pre-ecclampsia with Veronica started out exactly the same way. Pre-ecclampsia is a potentially life-threatening condition which necessitates an emergency induction, guaranteeing a host of medical intervention. Having experienced it first-hand with Veronica's birth seven years ago, I knew this was a scenario I wanted to avoid.
At my 38 week appointment on Wednesday, April 20th, I told Michelle, the midwife seeing me that day, that although ideally I wanted to wait for labor to begin as nature intended, the symptoms I had developed were starting to concern me. Given that baby girl was measuring well and I was already "a good two centimeters" dilated and 50% effaced, it seemed smarter to at least try a simple induction now, while my health was relatively stable, than to risk developing pre-ecclampsia. She said really wanted me to wait another week before inducing, but did note my non-stress tests were perfect, the baby seemed healthy, and my body was favorable for inducing labor quickly. So she called the day's on-call doctor, Dr. Long, for a second opinion. He said to go ahead and schedule me for an induction 7:30am Friday, April 22nd.
I was pretty relieved to hear that. I asked Michelle what procedures would be involved. Since this wouldn't be an emergency induction, she said it was really up to me, and asked what my plans were for pain management. I told her I didn't want to use any meds, and she said that was great, it meant we could just do a gel induction and let things progress naturally from there. Theoretically, I could have as "normal" a birth as I had with Alexa and Penny, the only difference being I would already be at the hospital when labor started. Okay! She then stripped my membranes to try to get labor started on its own - which would have been great, but it only made me feel crampy for the rest of the day. Oh well.
Michelle also relieved me from my prescribed bedrest, since it obviously wasn't working. My blood pressure was still high, even after all that rest, and I was being induced in two days anyway. I went home, told Andy the plan, and spent the last two days of this pregnancy NOT on the couch! I happily spent all day Thursday nesting in the form of sewing the girls some matching Easter dresses.
Since I had no idea how long the induction would take, I told Andy he could just drop me off at the hospital Friday morning and I'd call him when I needed him. I don't mind being alone, in fact, I kind of like it. And I know boredom and anxiety is not the best combination for anyone, especially expecting dads, so I thought I would spare him. I arranged for my great friend Stephanie (who happens to be a school librarian whose school system had Good Friday off!) to come over to the house and watch the girls whenever I was ready for Andy to join me at the hospital.
Friday morning, I woke up spontaneously at 5:30am full of energy and excitement. I did some laundry and tidied the house a bit - it was pretty gross from being neglected while I was on bedrest. I woke the kids up, got them dressed and ready to go, and we all headed out the door to drop me off at the hospital. I had considered just walking the mile on my own to avoid having to get everyone up and ready. However, seeing that I was being induced for hypertension, walking even a mile would probably be frowned upon, eh? So we all loaded in the car for what would be the last time the whole family could legally fit in the little red Hyundai, and drove the mile down the road.
I asked to stop at Dunkin' Donuts on the way because I was hungry (egg white flatbread sandwich and small coffee, please), and because while packing my hospital bag the night before, I'd run across an online "what to bring" list that mentioned bringing a treat for the nurses' station. I thought that was a pretty nice idea. Although I inwardly debated whether donuts were the best choice. The recipients of these donuts would be taking care of me and needed to perform at their peak, not be drug down with lard and sugar, right? But then again, I wasn't going to win any cool points if I brought in a veggie tray. In the end, I chose to risk the stamina of my caretakers in favor of popularity, and ordered an assorted dozen.
Andy let me out in the hospital parking lot, we said a prayer, and I kissed everyone goodbye. With my red polka-dot overnight bag and fresh donuts in tow, I headed off to registration. It was odd to wait in line to register to do something so natural as have a baby, and I had to suppress a laugh as I told the lady at the front desk, "I'm Amy Gaskin; they're expecting me for an induction." The formal, corporate tidiness of the process was just really funny to me - quite a different experience from the earthy hoopla of arriving in triage in full labor. I handed over my photo ID and insurance card, signed a few forms, got my hospital bracelet, and was escorted to The Birthplace on the third floor.
Since my arrival was scheduled, no triage visit was necessary and I didn't have to wait for a room; there was already one waiting for me. With a meek little, "These are for you guys," I subtly left the box of donuts at the desk, and as I walked down the hall, I heard a faint, "Aww, did she bring us donuts?" Good. I was hoping the gift would come across as an attempt at sweet appreciation, not creepy bribery. Mission accomplished.
I was shown to room 319, asked to get into a hospital gown, and told someone would be by to get things started soon. Around 8:30a, a kind nurse named Mary (who I'd met during my overnight stay a couple of weeks earlier) came by to administer my paperwork, take a gazillion vials of blood and give me a standard IV solution. Although I'd successfully avoided getting an IV for Alexa and Penny's births, and I doubted the absoluteness of her statement that "all pregnant women are dehydrated," I really didn't have any reason NOT to get the IV solution. So I cooperated. She put in the needle, hooked me up to the external fetal monitor, and we chatted about her four boys and my four girls while I became a hydrated pregnant woman. I admit, I did feel pretty well after the fluids did their thing - and my sinus headache had disappeared. However, afterwards, she had to leave the heparin lock in place. And I hate hate hate the feeling of a heplock. I don't mind having blood drawn, I don't mind having an IV for a while- but the feeling of a needle left in my hand for hours and hours, while not unbearably uncomfortable, just disturbs me. And I'm always conscious of it because I can't help bumping it. Oh well.
Mary then asked if there was anything in particular I wanted during labor, which was a new question for me. I've never written a birth plan before. I have my ideals, stick to them, and just go with the flow - and the flow usually goes very well. I said all I could think of was what I DIDN'T want; I preferred to have as little medical intervention as possible. She asked what my plans for pain management were - I said I didn't have any - then I corrected myself and said, "I mean, my plan is to not use any medication." She gave me an encouraging, "Good for you!" and asked one more time if I was sure I didn't have any preferences for the birth. So I said, "I want to hold and nurse her as soon as she's born," and she said "of course, that's a given!" She asked, "You want Daddy to cut the cord?" and I had to inform her that Andy doesn't "do" cord cuttings (he thinks it's weird). But I told her, "I'll cut it!" She jotted down my "preference" with a laugh and said, "Oh, okay...MOMMY cuts the cord! That's a new one!"
I was then told it would take a while for Dr. Manning to come see me, since the birthplace had been super busy that week. 9 babies had born the day before, there were twins waiting to be born next door, a lady with no prenatal care had just walked in 8cm dilated, and three other women had been admitted for inductions before I had arrived. Since I was a low-risk induction and all my vitals were fine (even my blood pressure was pretty good that morning: 128/70), I was a low-priority patient and it was quite a while before anyone came by to check on me again. Which was fine with me - I was in no hurry, and I had my Kindle to keep me company. I finished up the paperwork she'd left with me, then sat in the rocking chair and got started on the latest Newberry winner, Moon Over Manifest (which I'd bought with the gift card Whitney Almarez sent while I was on bedrest - thank you, Whit!).
At around 10am, Dr. Manning (who has 8 kids and is my favorite doctor, by the way), came by to report my bloodwork came back great and we were good to go on the prostaglandin gel. A long syringe administered the gel to my cervix and I had to lay in bed hooked up to the fetal monitor for an hour while the gel absorbed. She said I was still measuring at "2, almost 3" centimeters and was 50% effaced, and she'd be back in four hours to check if the gel was working. I asked if I was allowed to order lunch during that time and she said absolutely! So after Mary came in to let me up after my requisite hour of absorption, I ordered myself some chicken tenders and salad. I figured I was going to need some energy.
After about two hours, I felt a little crampy and had a few very mild contractions, but nothing timeable. I definitely was NOT in labor or anything, and I just continued to rock and read my book. But I did notice whenever I went to the bathroom, the crampy feeling intensified. I figured that was a helpful position and spent most of the time reading my book while sitting on the toilet, hoping gravity would help things along. Everyone knows I'm a bathroom reader anyway.
Around 2:30p, Dr. Manning came back to check on me. I figured since nothing was really happening, she would resort to administering another 4-hour dose of prostaglandin. She checked me and said I was "a good 3 centimeters" and 60% effaced. This didn't sound very promising to me. However, she said if she broke my amniotic sac, she was pretty certain I'd go into labor right away - no more gel needed. I wasn't so optimistic, but I said to go ahead. So she and Mary performed the quick amniotomy and my bed was instantly soaked. I figured it was time to call Stephanie to watch the girls so Andy could come over to the hospital - just in case Dr. Manning was right and things progressed quickly.
Well, Dr. Manning was right. While I was calling Andy I had a bona fide, wow-I-have-to-breathe-through-this, contraction! And they kept coming. Andy arrived a little after 3:00p and by then I definitely was in labor, with contractions coming about every five minutes! I had been laying in bed on my left side ever since Dr. Manning broke my water. I wasn't planning on getting up anytime soon - I was comfortable where I was, and managing the contractions nicely. They were starting to get pretty painful, so I wasn't able to talk much; I just asked Andy to rub my back and distract me with talk about every day stuff - work contracts, invoices, youtube videos, whatever. I noticed when he'd say something funny and I laughed a little bit, the laughter relieved the pain of the contractions somewhat. I've heard of "laughter therapy" but always found it, uh...laughable. But what do you know, I think there's something to it.
Eventually, though, I got to the point where I didn't want to hear any more conversation; the contractions were becoming so intense, difficult to manage while laying still, and I needed to pay attention to my body. A nurse named Cheryl, who had just begun her shift, came over to introduce herself and hook me up to the fetal monitor. I wasn't exactly cordial with her. Rather than exchange pleasantries, all I could manage to vocalize was "NO MONITOR PLEASE!" Having something strapped to me and laying still was not something I needed. I needed to move. Soon! She said, "How about I get the doppler?" and I said sure. She did a quick baby heartbeat check with the portable doppler - and baby sounded fine. She asked if I would like a birthing ball (inflatable exercise ball) and I said thanks, that would be great. I'd used one for a while when I was in labor with Alexa, and it definitely had helped me manage my labor better. She brought the huge ball in and set it aside for me to use if I needed it (turns out I didn't end up using it, but I appreciated the gesture all the same).
I asked Cheryl if Dr. Manning could go ahead and check me now because I was planning on getting up and didn't want to have to lay back down again any time soon. She asked, "is it okay if it's Molly? Dr. Manning is really busy and it might be a while before she can get to you." Molly is a relatively new Certified Nurse-Midwife who I'd met in the office before. She is very nice, a little spunky, and very passionate about her work. She'd made a good impression on me. And while I really like Dr. Manning, I knew there were other women on the floor who needed her more than I did, so I said Molly was fine. At 3:50p, Molly came in and checked me - I was 80% effaced and 5cm dilated, but she noted "the baby is still really high up, at negative 2 station." I wasn't really concerned about that; I figured she would move down once I spent more time in a vertical position. I was wanting to get up out of bed anyway. At this point the contractions were coming about every minute, and Molly noticed I'd been "sounding" (coping with pain by humming a comforting resonance) a little through them. She said, "I think it's time for the tub," and I agreed.
As I made my way toward the the jacuzzi tub in the bathroom, Cheryl asked if I needed to "empty my bladder." I always inwardly giggle at the various phrases heard from medical professionals referencing going to the bathroom; you never know what you're going to get. Some are the very formal "void in toilet" types, others just say "go pee." I guess it's a personal preference you must make when you go into medicine. Yes, these were the thoughts going through my head at that moment.
Andy started to follow me into the bathroom and I snapped at him, "You don't have to help me go to the bathroom!" Poor Andy, he was just trying to be helpful! However, birthing babies is one thing, but I just don't like my husband around while I'm going to the bathroom. I don't care if I am in the middle of labor, I'm just weird like that. I know one day I'm going to be old and frail and he's going to have to change my old lady diapers or something - but we'll cross that bridge when we come to it. For now, I void in toilet alone.
So anyway, I did my business and then quickly changed into my tankini top. Molly and Cheryl later noted that they'd never seen a mom wear a swimsuit (or, half a swimsuit, rather) in the tub, and I mentioned this was my third time doing it. They said it must be my lucky suit. I guess so! I'm just much more comfortable laboring if I have SOMETHING on. I'm a modest girl if I can help it.
I plugged up the tub, turned on the water as hot as it would go, and blasted the water jets. Molly warned Andy, "things can progress really quickly once they're in the tub, so I'm going to go ahead and get everything ready!" I thought this sounded a little too optimistic for someone who had just been checked at 5cm, but whatever. I sat in the tub and...WOAH! The contractions went nuts and began what I can honestly call the most painful, intense experience I've ever had. Maybe it had something to do with having my water broken before transitioning - with both Alexa and Penny, the amniotic sac remained intact until right before birth and possibly provided some extra cushioning through the transitioning process. Or maybe now my cervix was just dilating at supersonic speed. Whatever was happening: WOW.
It was getting extremely difficult to manage the pain. I tried getting in a different position with each contraction, swinging my hips to counter the pressure, sounding a little more loudly through the contractions (I'm convinced I sounded like a drunk yoga instructor - Andy says this isn't true), and I just could not find anything that helped me stay on top of the pain and relax. I knew once I found a groove, I'd be fine - I was just having quite a time finding it. Andy did whatever he could to help me, even though there wasn't much he could do except offer me sips of water. But I loved having him there just the same. His presence is a calming influence; He's just that kind of guy. At one point he was bent over the tub, holding my forehead and for some dumb reason I was concerned he was going to get his sleeves wet. I tried to help him roll them up. I'm telling you, I really wasn't doing a good job focusing on my own body, which is probably another reason why I was in so much pain.
Contractions were practically on top of each other with hardly any relief in between. Right after whimpering through a horrendous one, I murmured, "This is ridiculous!!!" Andy didn't know what I was talking about at the time, but I was really starting to get mad. Mad at God that women had to go through this - no other natural process requires so much endurance and suffering. I couldn't wrap my mind around why I was doing what I was doing, what the point of these contractions even were - and why did I even want to have babies again? I was starting to let negative thoughts overcome me and it was greatly affecting my ability to cope with the crazy hard labor.
It only took a few seconds to realize my thoughts were completely counterproductive. I wanted to quickly change mental gears - and when the going gets tough, the tough quotes James. "The testing of your faith produces ENDURANCE" ran through my mind. All I really needed was to believe in my ability to endure this well. There were no other options; I had to get through it, and I could do it with a good attitude or a bad attitude. While no, I didn't have control over God's design of the birth process, I did have control over my attitude toward it. So I thought of all my babies at home and how of course I would have gone through whatever it took to get THEM here, so why was I being such a jerk now? I felt ashamed, but renewed, and prayed for peace and wisdom and strength and told myself to just focus on the AWESOME fact that very soon I would be holding a brand new baby girl!
Andy, oblivious of my inner dialogue, informed me he was going to turn off the water out of concern the bathtub would overflow. I was pretty sure there was an overflow valve or something that would prevent that. But just in case, I said okay, but to let ME turn off the water. I really don't know why I was so adamant about being the one to do it - perhaps subconsciously I saw this as an opportunity to feel in control of my environment. It took all my energy and focus to do it. I just stared that faucet dial down, practically hypnotized by it. And I turned that water off.
I then became acutely aware of the pulsating sound of the water jets all around me. I found it very soothing. I settled with my back against the the jets, listened to the water, put my chin down on chest, held on to the handles conveniently located on the sides of the tub, closed my eyes, and quietly and deeply breathed in and out while the contractions came on faster and with more intensity. Mustering up strength to perform the simple task of turning a faucet handle was what it took for me to get serious about focusing on what my body was doing. I'd found my groove and was able to stay on top of the pain. I felt very, very thankful.
Then Cheryl came in and wanted to do another doppler check. I ignored her. She asked if I felt any pressure? I ignored her. She kept asking questions and I kept ignoring her. Andy asked if I was okay (he was afraid I'd passed out or something) and I calmly whispered that I was fine. I simply could not afford to be interrupted. I had to make a decision to comply with my nurse or look out for myself. And I chose myself. Andy was confused about why I was acting the way I was, but when I later explained why I had been so "mean" to Cheryl, he understood. At that point, I couldn't worry if others assumed I was being rude. I'd found a way to cope, it was working beautifully, and I was determined not to be disturbed. I was aware of Cheryl's presence standing near the tub for a while, but I didn't say anything to her. I just kept doing my thing and made a mental note to apologize for ignoring her later. She left the bathroom and said she and Molly would be waiting for me when I was ready.
After a few more minutes, I suddenly felt the proverbial extreme pelvic pressure. While I have never felt the "overwhelming urge to push" that some women describe, I knew what this pressure meant: there was a baby ready to be born very, very soon. I also knew since my contractions were so close together, I was going to have to make the transition from tub to bed in one mad dash. So as soon as a contraction was over, I stood up, declared I was ready for the nurse, and shakily bolted out of the tub and up on to the bed before another contraction began.
Molly was at the ready to check me. She announced that the baby had moved down and I was "complete." I then smiled the BIGGEST SMILE, looked at Andy and said, "Yay! I'm complete!" My mood totally changed because I'd finally gotten to the part of childbirth that I'm completely at peace with. And the part I'm really, really good at. I'm a very efficient pusher! The pain of pushing a baby out, while very intense, doesn't bother me so much because I can wrap my mind around it - it makes sense to me. I understand why it hurts. I can visualize what's going on. I can control what I'm doing and why. The contractions were still coming on full strength but I could finally DO something with them. I got into my favorite birthing position: mostly upright, laying on my side, and used the side of the hospital bed for leverage. Molly or Cheryl (I couldn't tell who) applied a warm towel compress before I began to push, to help lessen my chances of tearing. They both kept encouraging me, repeating "listen to your body!" And although they didn't really NEED to tell me that (I was listening to my body very very well) I was so glad they offered a stark contrast to the team of people you see on TV shows, arbitrarily yelling, "PUSH! PUSH! PUUUUUUUUUUUSH!"
I waited for a contraction and carefully focused my abdominal muscles on pushing the baby down. I could feel everything so clearly, and I had a great mental picture of what was going on inside me. In that one push she'd made it all the way down to the birth canal and was crowning. I quietly waited for another contraction to come and let the baby stretch things out so I wouldn't tear when her head came out. Yeah, the "ring of fire" hurts - but it's a productive hurt; it has a purpose if you allow yourself to take it slow. Cheryl did a quick doppler check - baby's heartrate had dropped to 80bpm, but Molly said that was normal for a baby hanging out in the middle of the birth canal. And her heart-rate went right back up after a few moments. Another contraction came soon enough anyway - I pushed again and her head was out. And then a third push delivered the rest of her! Evangeline Emily Gaskin was officially born!
The feeling immediately after a baby is born is indescribable- all the pain suddenly disappears and is replaced by a wave of overwhelming elation. I leaned over and reached for my Evangeline who was completely purple and covered with vernix. She was making little noises, so I knew she was breathing and would be fine, and Molly suctioned out her nose and mouth while Cheryl tried to wipe her a little cleaner. I held her close and exclaimed over how absolutely tiny she was! I tried to nurse her, but she wasn't interested just yet. Andy was very concerned by her color and all the vernix, but Molly, Cheryl, and I reassured him that she was fine. And we were right, of course - she pinked up pretty quickly. I reminded Andy that she was born a little early, so it was normal for her vernix coating to still be pretty thick. Molly and I then started talking about how amazing vernix is, how it protects a baby skin in water for nine whole months, and how we'd both read somewhere that in some cultures, it's saved and used for medicinal purposes. Molly is someone I could easily be friends with in "real" life.
Molly handed me the scissors and told me where to cut the umbilical cord- and then snip! Evangeline was physically not connected to me anymore. I delivered the placenta a little bit later, which I described to Andy as being "probably the grossest feeling ever." But I did take a quick peek at it, out of respect that it supported my child's life for all those months.
I was so glad to be feeling like myself again, and remembered to apologize to Cheryl and Molly for giving them the silent treatment earlier. They laughed it off and said they understood. Molly said when she heard me sounding loudly in the tub (a.k.a. doing my best impression of a drunk yoga instructor) she figured I was beginning to transition, and when I got quiet I had found the will to refocus. I said that's exactly what had happened. I told her I guess every laboring woman should allow herself one good freak out moment, if only to let herself feel just how unproductive it is and to help motivate her to find something that works. She told me she was very proud of me and was impressed with how controlled I was during the whole process, especially while pushing. Which reminded me to ask her - did I tear at all? She checked and said, "Wow, nothing! Not even a brush burn! You should teach childbirth classes!" What an awesome compliment! One of these days I just might.
Molly said she had to run off to attend to some other laboring moms, but asked if there was anything I needed before she left. I asked if I could get the heplock removed and she said, no, they really like to keep it in at least an hour after birth, just in case something happens. Ooooooh well. Cheryl took baby Evangeline across the room to be weighed and measured: 6 lbs, 3.6 oz. and 18 inches long!
while I ordered some food: cheeseburger!
Since I hadn't been paying attention to the clock for quite some time, I finally remembered to ask what time she was born. Cheryl said 4:33p. Wow! No wonder those contractions were so nuts. I went from 5cm to birth in about 40 minutes. My entire labor from start (right after Dr. Manning broke my water) to finish was only about two hours.
Andy got in some cuddle time with Evangeline and then headed home to get the other girls so they could meet their new baby sister.
The girls came in and ooed and ahhhed over baby Evie. They were instantly in love and fell right into their big sister roles.
Penny even snuck in a requisite eye-poking.
I tried nursing Evangeline again, and this time she took to it immediately. Then I kissed all my big girls goodbye and told them I hoped to bring their sister home the next afternoon!
And...finally came my favorite part: the calm after the storm. The part where all is quiet, no one is hovering to take my vitals, no heplock is sticking me in the arm - it's just me and my Evangeline alone in our own little world for a little while, completely at peace, content to just stare at each other in awe of the experience we'd just gone through together.
