Emilia's Birth

My Birth Story

Around 2:00 or 3:00 a.m. on the night of February 28^th I wake up to some pretty noticeable cramping. The cramps come every 15-20 minutes and last for just a few seconds (10-20 seconds). I had been feeling some braxton-hicks contractions for several weeks now and these cramps remind me a lot of the cramping I would feel right before getting a period, so I don't think much of it and just assume it's my body's way of getting ready for labor. The next morning, Jorge informs me that he had woken up periodically during the night to me groaning in my sleep.

It's the morning of my mother's departure. We drive her to the BART station so that she can board the train to SFO to catch her plane back to China (where she has been living and working as a teacher for the past two years). She's been staying with us in Oakland for 3 weeks and has helped me a lot in the these last few weeks of pregnancy by keeping me company, cooking for us, and helping to keep me distracted as we waited and waited... and waited. I'm exactly 41 weeks and anxious to meet my little baby. Both of my parents had come to town and we were all waiting around for the big day, but by this time, my dad had already returned to Idaho. Saying goodbye to my mother as she was getting ready to travel to the other side of the world was an emotional moment for me; I knew my baby was coming soon and I had really hoped she would be here for the birth. But, childbirth is unpredictable and life works in strange ways sometimes, so after my due date had come and gone and my mother's date of departure approached, I began to make peace with the idea that she would probably not be here to greet her first grand-baby. After saying goodbye, I notice on the drive home that my cramping is becoming increasingly more frequent, and I can't help but laugh at the irony of it all; of course my mother would have to leave the day I'd be giving birth! (Little did I know at this point that my labor would continue for another two days.)

I spent the rest of the day hanging around the house, cleaning, and relaxing with Jorge. The cramping was definitely regular but very manageable. Again, it was very similar to the pain I dealt with on a monthly basis with my period, so I was pretty used to handling it by now. I don't remember too much else about this day, other than the fact that I definitely did not feel like cooking, so I asked Jorge to go out and buy us some burgers and fries. For some reason, I was really craving red meat, which I now realize was probably my body's way of gearing up for the enormous physical task ahead.

Around 9 p.m. I call my doula to let her know things were happening and I was definitely in early labor. She suggests a warm shower, a glass of wine, and just relaxing at home for a while longer because it could still be a while before baby came. She also tells us we should try to get some sleep. I follow her suggestions but am not able to fall asleep, so around 10:00 p.m., while Jorge is in bed, I decide to get into the shower. The warm water feels so good during the contractions. I spend about an hour in the shower, feeling excited and anxious about what's to come.

At 11:30 p.m. I feel the contractions getting a little more intense and I'm anxious to have somebody check my cervix so I can find out how dilated I am. I wake Jorge up and we decide to head to the hospital, which is only 5 minutes away. (In retrospect, I wish I had stayed home longer because I was definitely still in early labor at this point.) The midwife on call checks me and I am only 3 cm dilated. My contractions are now 3-4 minutes apart and lasting about 40-50 seconds. In order to be admitted, I need to be at least 4 cm, so the midwife says that we can either go home for a while or stay and walk the halls. I decide I want to stay because I don't want to have to go through filling out all of the paperwork again and would rather avoid another uncomfortable car trip while in labor! We walk the halls for three hours and, when she checks me again, I'm 4 cm and almost fully effaced. At 3:00 a.m. the morning of March 1^st, we are admitted to the hospital. I hand the midwife and nurse my birth plan. They seem accommodating and, for the most part, very respectful of my desire for a natural birth.

It's morning time and I am still walking around, pacing the halls, and dealing with each contraction one at a time. At some point, I start to feel nauseous and throw up, which I recall reading somewhere was a normal reaction in labor. I go to the bathroom and notice my mucous plug is coming out. Being up and moving around is what feels the best. Lying down is painful and uncomfortable and I find myself not enjoying the 20 minutes each hour when they ask me to be in the bed so they can check the fetal heart rate, but I know it's hospital protocol. The baby's heart rate is nice and strong. The contractions are getting stronger but are still very manageable as long as I'm able to stand and use good breathing techniques. At 9:00 a.m., the new midwife on duty checks me and I am 6 cm! I'm very excited and it feels like things are truly progressing.

My doula ends up being caught up at another birth so we meet her back-up doula, Lucy. She's wonderful and I find myself immediately comforted by her presence. She reminds me to breathe and keep my jaw loose during contractions, rather than tensing up. At 1:00 p.m., I'm checked again and still only at 6 cm. The midwife and I discuss breaking the bag of waters to accelerate labor and we agree to do it in a few hours if things haven't progressed. First, though, Lucy and I try acupressure to see if it helps. I also ask Jorge to do nipple stimulation, which is known to be helpful in speeding up labor. The contractions are getting stronger and Jorge and Lucy help me breathe through them. In between the contractions, we talk, laugh, and hang out.

At 4:00 p.m., I am dilated to 8 cm and fully effaced! I am so ready to have this baby. I'm excited and feeling hopeful. I haven't needed a single intervention yet, including an I.V., and I'm feeling good about how well this birth is going. I'm drinking plenty of water, snacking on some nuts and jello, and trying to stay calm and in the moment. Little do I know that the hardest part is still ahead.

Around 6:30 p.m., the midwife (who is now at the end of her shift) checks me again and I am still at 8 cm. She breaks my bag of waters, hoping this will speed things up a bit. I spend some time in the shower and on the birth ball. Both help lessen the discomfort from the contractions.

At 10 p.m., Sonia (the new midwife on duty), informs me that I am still at 8 cm. We're all disappointed and I'm starting to feel discouraged because I feel like I have been working hard and yet I haven't progressed. The midwife uses an internal fetal monitor to asses how strong my contractions are. She suggests using Pitocin (artificial oxytocin) to speed up and intensify the contractions, explaining that, at this point, they are not strong enough to further dilate my cervix. I'm disappointed and worried because I know that Pitocin leads to intense contractions and, in most cases, women on Pitocin end up asking for an epidural because the pain is way too intense. But I'm also exhausted and feeling pretty down about how long this is taking. After discussing our options, at 11:25 p.m., I agree to the Pitocin (it is started at level 1). I'm also given Fentanyl to take the edge off of the contractions, knowing well from my research and from talking with other moms, that the Pitocin is going to be really difficult to endure. (Unfortunately, the Fentanyl did not seem to make a difference in the pain. However, it did allow me to fall asleep very briefly in between contractions--some much-needed rest at this point.)

At 1:00 a.m., things are extremely intense and I'm feeling pretty out of control. The Pitocin is at level 3 now and the contractions are very difficult to get through. I'm having a hard time breathing through them. I start to hyperventilate during the contractions and feel like I am having trouble breathing, so I ask for an oxygen mask, which helps a little. At this point, I am much less mobile; I'm hooked up to the I.V. and there is an internal fetal monitor attached to me, which makes it hard to move and get into position that help me handle the contractions better. I'm starting to feel frustrated that I'm basically stuck to the bed, but I can at least move to the bathroom, so I do that and try sitting on the toilet for a while. I feel myself really opening up in this position and much prefer being on the toilet to laying in bed.

I'm feeling pretty miserable and start considering an epidural. I realize at this point that I am kind of losing it and that, instead of relaxing through the contractions, I am tensing up, which makes them infinitely more painful. At 1:10 a.m., I decide on an epidural. The pain is too much to handle and I am too tired to make it through the contractions. The anesthesiologist says it'll take about an hour to get it (because they have to wait for the results from my blood work). At this point, Jorge and I have both been up for over 36 hours. (I still don't know how Jorge managed to stay awake that long. I, at least, had the labor hormones!). For a while, we sit back-to-back on the bed, leaning against each other during my contractions, and falling asleep a little in between them.

At 2:30 a.m. (with still no epidural) I suddenly recognize within myself a strong urge to push. I keep thinking I need to go to the bathroom and I start to let out deep moans. Lucy goes to get Sonia, who checks me again. I am now 10 cm! It's hard to adequately describe the amount of relief I am feeling at this point. Finally, this baby was going to come out! At one point soon afterwards I ask the nurse for a catheter because I really need to pee but can't due to the pain of the contractions. The nurse had been pumping me full of fluids through the I.V. and we are all shocked at just how much pee comes out. Getting all of that fluid out really helps lessen the intensity of the contractions. Why didn't I ask for the catheter sooner?!

At 3:00 a.m., I start to push. First, I push standing up. Sonia checks me while I'm standing and announces that she can see the baby's dark hair! I feel a rush of adrenaline and start to mentally prepare myself for the task ahead. It's too late for the epidural now and I am ready--and excited--to birth my baby the way I wanted to all along, naturally and in whatever position feels the most comfortable. I decide to get onto the bed on my hands and knees. I'm making good progress in this position and moving the baby down well with each contraction. After a while, I decide to use the squat bar that attaches to the hospital bed. I had read all about how squatting is a great position for birthing and knew it was really something I wanted to try. Unfortunately, after about 30 minutes of pushing while squatting, I am so exhausted that my knees start to give out, so my midwife suggests a side-lying position instead.

The room is dark and quiet. Jorge's iPad is playing some beautiful calming music that I had picked out ahead of time (the album is called “Relax: A Liquid Mind Experience”). The baby nurse helps by holding my right leg up while I push. Another nurse holds a mirror at the foot of the bed and I can see the baby's head. It's a bit discouraging because I realize at this point that there's still so much left to push out and I am so tired! But, I also realize that I don't have much of a choice other than to keep going, so I give it my all. Jorge is at the foot of the bed next to the midwife, ready to help catch the baby. I can feel everything as the baby is slowly making its way down the birth canal and remember thinking to myself that pushing was a relief but also a lot of work. The midwife did not direct my pushing at all; she simply allowed my body to push the baby out on its own while providing gentle support to my perineum. 

Finally, after pushing for about 1.5 hours, at 4:39 a.m. on the morning of March 2nd, our baby is born! Jorge hands her to me and announces that she is a girl. Emilia Solymar Banuelos is vigorous, healthy, and has already opened her eyes. She is placed on my chest immediately. Ten minutes later, Jorge cuts the cord. A short while later, my placenta comes out with one last big push. While all of this is happening, I am overcome with a huge rush of endorphins and in a state of complete post-birth euphoria. I'm amazed at how wise my body is for flooding me with these incredible pain-relieving hormones and I am grateful for having just barely missed the epidural.

My midwife informs me that I have a partial third degree tear, likely caused by the shoulders, and she calls in the doctor to stitch me up. Since I had no anesthesia, this part is definitely uncomfortable, but at least now I have my baby to distract me. I stare at her in awe as she lays on my chest and we are all shocked at how big she is: 8 pounds 11 ounces and 19.5 inches long! She cries a lot and I am amazed at how loud this tiny newborn can be. About two hours after the birth, Emilia latches on for the first time. She is definitely hungry, as am I. Our baby is finally here, 9 days late and one LONG labor later. We are exhausted but extremely excited and relieved.

Reflection

I was in active labor for a total of 30 hours. Despite how long it took, I feel quite positive about my birthing experience and I am glad I was able to (almost) have the natural birth I wanted, even while being in a more medicalized setting. That being said, I do think a few factors might have contributed to the slowing of my labor. I strongly believe that all of shift changes I experienced (I saw a total of three different midwives and three different nurses during the course of my labor, all of whom I was meeting for the first time) made it hard for me to truly relax and let go. Also, I have always had an innate dislike and distrust of medical settings, so it is hard for me to relax and feel comfortable in a place that normally just makes me anxious and uptight (this might also explain why, prenatally, I had high blood pressure readings whenever my care provider checked me at the hospital but normal blood pressure whenever I checked it for myself at Walgreens!). I think I was also worried that I was “on the clock” which created this time pressure for me and might have inadvertently slowed my labor.

Would my labor have been quicker and less stressful in a more home-like environment rather than surrounded by medical gadgets beeping at me all of the time, reminding me that I was on the clock and making me feel more like a sick patient than just a normal woman having a baby? Would I have been able to relax more towards the end if I had been with just my closest loved ones and attended by just one midwife whom I would have gotten the chance to know and trust throughout my entire pregnancy rather than meeting for the very first time during one of my most vulnerable moments? I'll never know. But these are questions I ask myself sometimes.

Overall, I'm grateful to the wonderful team of hospital-based midwives that assisted me through my long labor and birth. They allowed me to labor for a long time (which most hospitals don't do), they encouraged me to use more natural and less invasive techniques to accelerate my labor before suggesting Pitocin, and they never once made me feel silly for wanting to give birth naturally (natural birth, at this hospital and most U.S. hospitals, is not very common). They listened to me and respected my choices. They allowed my body do the work it needed to do and gently suggested the use of synthetic oxytocin when I was exhausted and needed a little help to get my baby out. 

I'm proud to have given birth at Highland Hospital, a public hospital serving mostly low-income uninsured people in Oakland, California. They are one of just a few hospitals nationwide to be designated a “Baby-Friendly Hospital” from the World Health Organization, meaning they support breastfeeding and newborn care practices that encourage breastfeeding (such as skin-to-skin). Their Labor & Delivery department is truly exemplary and I hope that the hospital midwifery care they provide will serve as a model for all other hospitals in the country who haven't already adopted this model of care.