“I don’t want to play anymore.” Jess quietly whined with a pretty little pout. She looked at me then up at the midwife, the nurse came into the room to adjust the Pitocin drip. Jess’s eyes were wide, scanning her surroundings the way little kids do when they encounter an environment for the very first time. There was also a deep set heaviness in those eyes from the combination of the enormous work of labor and lack of sleep. There was an innocence that radiated from Jess, wrapped up in a flannel cotton blanket, she was completely surrendered and yet completely in control. Labor and birth are mostly a balancing of these two qualities. Labor becomes a dance, learning how to flow with the requirements of each moment. She was on the toilet, pillows propped behind her back…every opportunity for comfort and rest were extremely valuable.
We helped Jess back to the bed. Curled up on her side she quietly breathed through another contraction. The contractions were gripping, sharp and steep. Jess would throw her head back pull up and away from the sensation then she would courageously sink low into her body, meet the rush with her determination, catch the wave and ride it out where she would be safely deposited on the shore, allowed to rest for maybe a literal minute or two before the next sharp wave from the relentless sea smacked into and through her again.
After disappointing results from an internal exam the midwife motioned for me to step outside. “Do you think Jess will ask for an epidural if she wants one?” She asked me, her hands on her hips and biting her lip, looking like she was trying to solve a puzzle in her head while staring at the floor for answers. “I mean she’s been doing this for so long. She’s gonna need to have the energy to push the baby out.”
It had in fact been a very long labor. It was Sunday morning, November 24th. Jess was only at 7 centimeters after laboring for more than 30 hours.
Just the day before I woke up to a text at 5:40 am. We r in labor give a call Tom’s message read. I rolled out of bed and stretched happy to surrender my day to the rhythm of birth. I decided to call knowing I couldn’t make an accurate assessment through texting. “What’s happening?” I asked
“She’s been having contractions regularly since nine o’ clock last night, they are five seven and ten minutes apart.” Tom reported as I yawned into the phone.
“Okay, can she sleep?” I asked knowing that labor often slows down when the sun comes up for some reason. I think there might be little labor fairies that come out at night, they cast their spells guided by the moon to coax babies out of their aquatic home when its time, then when then at sunrise the spell is broken, paused until the magical moment when evening again arrives.
Jess was quite certain that she could not sleep. A good sign that labor was well established. “Give her some strong black hot tea with lots of honey” I instructed. “…and then she should get in a hot shower for a while. Call me when the contractions are more regular.”
I thought about going back to bed but since Jess had been in labor all night I figured she’d have the baby by late afternoon. I packed some items to take to the hospital and also my gym bag, my plan was to squeeze in a workout after the delivery that day.
I left my house around 8:00 am. It was a gorgeous fall day. Crisp and bright, the wind picking up causing the amber and burgundy piles of leaves on the ground to lift themselves up into the swirling winds. Spirals of leaves floated across the winding road on my drive, reminding me of Salvador Dali’s paintings.
At Tom and Jess’s house I was greeted, of course, first by Apollo and Daphne, Tom, holding onto each of their collars as they barked and tried to lunge toward me. They are medium sized dogs with a monster sized dogs attitude. I’m a little afraid of them. I peered over the chaotic canine scene to where Jess was reclined on the sofa under the vaulted a-frame celling beside a window lined wall of the log house in the woods. I said hi or something and she managed a weak smile. She looked so tired and pale. I knew immediately that labor had not progressed very far after all just by her position on the sofa.
“Can I feel your belly?” I asked wanting to get a sense of how strong the contractions were.
“Sure.” Jess agreed and moved a blanket away. I noticed very little tightening as Jess contracted and wondered about the back pain she was feeling with the contractions.
“How about doing some exercises to get the baby to turn around in case she’s posterior.” I suggested and Jess got up quickly (another sign that she was not very far along) and did various exercises interspersed with rest to persuade baby to turn. A baby who is posterior, especially a first baby can make for an incredibly long and arduous labor.
The house was comfortably quiet and warm. Tom built a fire in the woodstove and sleeping purring cats were permanent couch fixtures that day. Jess’s contractions started to become slightly more intense and she would sit on the birthing ball while leaning into a pile of pillows on the couch. Apollo kept watch from his position on the floor and Daphne obnoxiously although adorably climbed in figure eights around Jess; from the floor to the ball to the couch then to the floor again, squeezing herself under Jess, between the ball and the couch and back again. Daphne’s oversized alternating pointy and floppy ears and perpetual smile made me laugh. Tom eventually grabbed her by the collar and commanded her to sit on the recliner with him. She looked up at him with one ear up, one ear down, her mouth closed into a sort of pout and her eyes grew large and looked sad as she raised one eye brow then another. Who could ever stay mad at this dog? I wondered.
With Daphne settled down and sleeping on the chair with Tom the house quieted down again and I could pay attention to the labor. “I think the contractions should last longer than this.” Jess said, reading my mind perhaps. “I mean, they are coming about every five minutes but they only last about thirty seconds. They need to be longer. Right?” She asked me. I agreed and we decided to give some natural augmentation remedies a try. I left to make a run to the store to pick up some castor oil.
When I returned with my bag of tricks Tom whipped up an oily concoction as per my instructions and Jess bravely drank the whole thing. The contractions had slowed in my absence. Jess suggested I go to see my son’s football game. He was in the super bowl, their team undefeated. Even though I don’t understand or enjoy the game, I’m not really sure what a first down is, I love being in the stands cheering my kid on…whatever it is he and his team are doing out there on that field.
I showed up at the game which was about fifty minutes away from Tom and Jess’s house and found my family. “Hey mom!” My son Jamie looked at me sort of puzzled. “Should you be here? Aren’t you kinda far from the baby?” He asked concerned which I thought was really sweet coming from a 19 year old boy.
“Unfortunately for Jess,” I explained “I think I have plenty of time.”
“Okay then, did you bring me some food? Or do you want to go get me some.” Jamie’s mind back on the bottomless pit of his stomach. I watched the annoying preppy little cheerleaders’ preform their halftime routine. Shaking their not yet developed butts and breasts, rotating their hips in suggestive moves. These girls are only 12 and 13! I hate this aspect of football most of all. Halftime thankfully over the teams got onto the field in their positions. I was about to ask what position Josh was playing so I could report back to Jess who was curious…but my phone rang.
“I’m not saying that you have to rush back…” Tom omitted the usual phone pleasantries and got right down to the vital information “…but the contractions have picked up. They’re much stronger and closer together.”
“I’m on my way.” I said and dug my keys out of my bag.
“Where ya going?” Jamie asked
“Baby.” I said with a smile. He smiled back understanding there is really no predicting the timing of a birth.
Back at the house I realized that Jess still hadn’t progressed very far. I began to worry about her becoming exhausted. She took a bath and rested a bit. Jess reminded me very much of the Mennonite women I used to attend in labor, they were quiet and strong. They never complained, almost to a fault because sometimes they wouldn’t call until they were almost at the pushing stage. Often we (the homebirth midwife team) would show up to find mom in the tub holding her baby, birthing all alone.
Jess was totally serene, completely composed doing that dance between surrender and control, balancing it perfectly. Except for the purring cats and crackling fire the house was completely quiet. I was enjoying the peace and stillness of this early labor. Somehow during labor time ceases to exist, I watched the sky beyond the dense bare trees in the woods begin to take on the colors of dusk; a deep slate color washed into a lighter blue, then into an organy-pink glow. Eventually the cold heavy slate color of evening descended on the horizon enveloping everything; the sky, the trees the light inside the house also got sucked up into the vacuum of night. I knew it was night, but my internal clock had been stopped. It no longer mattered, sleep would come when it came, and I would eat when I could. The outside world no longer existed. This mom and baby were the center of the universe and we would all obey their laws.
The midwife on call encouraged us to come to the hospital. In the triage unite of the birth center the nurse gave Jess a rather aggressive exam. “You’re only a centimeter and a half.” I was hoping for three but was not surprised by this information.
A peppy little middle aged blond with a 20-something personality showed up at Jess’s bedside in scrubs. “Hi I’m April” She said and extended her hand. “I’m Kerri.” I said and explained that I was Tom and Jess’s friend/doula. April suggested exactly the same plan I had which was for Jess to go home take a sleeping pill and hopefully get a couple of hours of much needed sleep. I grabbed my bags, told Jess a story about my own experience with a pokey birth.
“I was induced with Elizabeth and progressing very slowly…” I said to Jess looking down at her on the triage bed. “I took a sleeping pill and slept for about three hours, then woke up in more active labor.”
“Three hours of sleep would be great for her” Tom said and I regretted giving them so much hope for a much needed nap that would probably not happen…but it could.
“Well hopefully you’ll get some good rest.” I said and patted Jess on the shoulder before grabbing my bags. “I’m gonna go get a little nap myself. Call me when labor picks up. Okay?” and I walked outside into the night air, memories of past births I’ve attended resurfacing in my mind. Most first time births that were long and slow like this usually ending up with epidurals, many of them C-sections. I knew Jess didn’t want this…she was optimistic and determined, I absorbed this energy from her and held onto it so I could give it back to her when she needed it later.
Again, I surprised my family by showing up at home around 8:00pm, funny it was 12 hours since I had first gone out. “What are you doing here?” They all asked. “Did she have the baby already?” My daughter excitedly hoped.
“No.” I said. “I’m not really here…” My kids all nodded their heads, familiar with my role in the birth process. Eric looked a bit confused, not having lived with me when I was always on call years ago. But Eric often looks confused so I just didn’t bother explaining. I went to bed for about an hour when I got another text from Tom waking me from a pleasant dream. We are going back to the hospital. It was 10:44 when I got this text. I somehow dozed back off then woke with a start about thirty minutes later. How could I let myself fall back asleep? I wondered.
Through a couple of texts Tom let me know Jess was only 3 centimeters dilated. He described her as being dopey tired and said the same of himself not sure I can be the best coach right now. His last text read. I rolled out of bed, grabbed my things and headed back to the hospital. When I arrived Jess was unable to be comfortable in the bed. A good sign of labor progressing I thought. Jess and I moved slowly from the ball to the toilet, she took a long candlelit bath in the tub, contracting quietly and peacefully the whole time. Tom had wrapped himself up in my big blue soft heavy yoga blanket and got some much needed and deserved sleep. At some point just before dawn April checked Jess’s cervix again. Jess’s eyes were closed as I held her hand through the painful exam. April bit her lip, looked at me and shook her head while her fingers were still examining the cervix. She reached around inside a little further to determine the baby’s position.
“Jess, you’re still the same.” She paused put her hands on her hips and leaned in a little closer to Jess’s face. “There’s been no progress.” April said slowly as if trying to convey complicated information to a child. Jess remained calm and serene, twirling a lock of her hair as she digested the information. April rubbed her chin for a moment then said “The baby’s head is well applied though!” I suppose she had been thoughtfully searching for a hopeful bit of information, it was just a small bit but it was something. Tom sleepily ambled over to the bed.
“What? There’s been no progress?” He asked and rubbed both hands across his head as if to try to get this news to sink in.
“Let’s talk about augmentation.” April pulled up the stool on wheels and sat by Jess’s bed. “You could get up and walk the halls, I mean really walk, fast and hard. That could get things going, you could also do some nipple stimulation. These are two natural forms of augmentation.” I looked at Jess. How long had it been since she’d slept? I knew these augmentation methods would totally exhaust her and probably not work. My sleepy mind showed me a visual scenario-like a flip book cartoon where the characters become animated stick figures as the pages quickly flip under the guidance of a thumb; Jess walks for hours, the pages turn and show a stick figure pregnant Jess exhausted, slumping over, asleep on her feet. I see a replay of stick figure April doing an exam and shaking her head in disappointment again, then the scene goes to the operating room and a C-section. I’m not sure if my thoughts were a dream or thoughts, perhaps both I was so sleepy. While I’m all for natural methods to enhance or augment labor sometimes medicine is a sweet blessing. “There is also Pitocin augmentation”, April offered and pulled my sleepy dreaming mind back into the room with her voice, I made some approving comments of this method and related a short story of my personal experience with the drug.
“It’s simply going to get you where you were headed anyway.” Lena, the nurse on duty chimed in. “It will just get you there more quickly.” She smiled confidently at Jess. I liked that perspective and so did Jess. The team wheeled in the IV machine and within ten minutes Jess’s contractions picked up.
It was extraordinarily uncomfortable for Jess to be in the bed, as much as she longed to rest so she moved from the ball to the toilet, to hands and knees, to the shower for a couple of dozen contractions. When April rechecked her she was five centimeters. “Only five?” Jess asked. This was the first time Jess had outwardly appeared a little desperate.
“Five is good Jess.” I offered and the midwife and nurse chimed in with approval and praise.
Several dozen contractions later the hospital room was filled with sunlight. I had no idea what time it was and didn’t look at the clock on the wall although I had become very aware of the incessant and annoying ticking sound it made. I thought about taking it down from the wall and putting it in a closet but restrained myself. The days were now blending into one another like the cool subtle colors that washed the sky at dusk the day before, or was it two days ago?
“I don’t want to play anymore.” Jess whined a little sitting on the toilet with pillows propped behind her back. I would push on her knees each time she had a contraction to help open her hips and relieve some of the pressure in her back.
“Let’s do another exam.” April suggested and crossed her gloved fingers while making eye contact with me as Jess slowly lifted herself from the toilet.
“You’re six to seven.” April said after the exam. I knew what they meant when they said “6-7” they meant six but we’ll throw in the seven for encouragement.
“I can’t keep doing this!” Jess quietly said in frustration, putting the heels of her hands over her eyes and grabbing onto clumps of her hair with her fingers.
In the hallway April and I discussed an epidural. “I know she is six centimeters and that’s sort of late for narcotics but are they also still an option?” I asked remembering the birth of my first baby 26 years ago as if it were just last week. My Pitocin induced labor was natural and by 6-7 centimeters and being awake for a couple of days I couldn’t bear the pain any longer and asked for medication. I remember my body relaxing between contractions after getting pleasantly messed-up up on Demerol, I even slept. It wore off just as I was ready to push.
“Yes, that’s still an option.”
April described medication options to Jess. “I don’t want to, but…” Jess apologized it seemed for even considering medicine and we all swarmed in with loving affirmations of her hard diligent work. That taking medication at this point wasn’t “giving-in” It was smart!
“This isn’t just a regular old marathon you’re running here Jess you’re doing some sort of crazy ultra-run and using available support is very wise.” I said
Jess and Tom decided to choose the narcotic option. I was literally falling asleep on my feet and when I watched Lena give Jess the dose through the IV I told Tom I was going to crash for a bit. I curled up under my blanket and began dreaming before I even closed my eyes.
When I got up Jess was on her side, looking very far away, her eyes were opened but I couldn’t tell if she was asleep or awake. The combination of exhaustion and drugs had Jess looking very much like a suffering patient rather than a woman experiencing a normal birth. This labor was one of the most intense I ever remember, and every other birth I attended with 30 plus hour labors had received epidurals by now. I think Jess’s complete acceptance, laid back attitude and wise decisions conserved her energy as well as her mental and emotional state. I suspect I would have fallen apart hours ago if it were my own labor. She must have dug very deep to find that level of trust to manage the awesome force taking its time possessing her body.
I stepped out of the room leaving Jess with Lena for about a half an hour. I had heard April say she would do another exam at noon. I looked at the clock for the first time in many, many hours. It was noon. I made my way back to Jess’s room, my fingers crossed. The door to room 339 flung open and Lena popped out all smiles. “She’s complete!” She told me as she rushed past me down the hall to go get whatever it is nurses need to get when birth is imminent.
Jess was on her back the bed set up like a big throne. I looked at April and raised my eyebrows. “I’m just waiting for her to get the urge to push.” April answered the question she had read on my face.
“What if we were to get her onto her side?” I suggested. April agreed that that would be a good idea. She’s such a great midwife, humble, down to earth, her energy was like a warm golden light. All mothers in labor should be so lucky to have this kind of support.
“Okay Jess, I want you to bear down with this next contraction.” One of us said, it might have been me, maybe it was the three of us, midwife, doula, nurse, blending our voices and energies creating a single unit of support. Sort of like all those individual leaves that were lifted off the ground by the strong swirling winds, transformed into one collaborative moving piece of art, the beautiful and awesome force of natural birth swirled around the room, collecting each of our best qualities and mingling them together to form the huge net, or launching pad or whatever it was that Jess needed in that moment.
“I can’t…” Jess panted, her eyes closed her head thrown back and shoulders drawn up to her ears. “It hurts.”
“I know the pain is intense, but you need to push right through the pain, trust your body, you are perfectly safe.” Our trio sung out to Jess as she bared down a little, testing her own limits.
Tom was quietly emotional and snuggled up next to Jess, kissing her head, stroking her hair, I couldn’t hear what he was whispering to her but I could feel his energy spilling out from a deep abundant well, coming right from the center of his heart.
“I see the head!” April said and we all encouraged Jess to push harder, longer, get your breath, curl your body around your baby and PUSH!
April massaged the perineum trying to avoid a tear but we both knew there was already internal tearing from the bright red blood that was collected in the folds of the baby’s head. “Push a little more gently now.” April instructed then slowly the head emerged. Again, for me time stopped and there was nothing but quiet in the room from my perspective. Every time I witness a birth it’s like a force casts me out of my body and I become an ethereal figure hovering above the room watching the awesome scene from a different plane. I watched everyone move in slow motion, Jess holding onto the rail of the bed, breathing shallow breaths, I saw Dad glance over at his daughters head then his focus was back to Jess, I saw Lena and the other nurses cheer and I saw April articulating direction to her team but I couldn’t hear anything. My only working senses were coming from my eyes and a sixth sense in my heart. I watched the baby slowly turn her head as her body rotated inside just the way they are supposed to. She was so pretty. “She’s already pretty!” I heard myself say out loud then the reality of time and space reappeared, I reentered my body it seemed. I heard the baby cry. “Oh my God! She’s crying already!” One of us, or maybe all of us said.
“Open your eyes Jess.” Lena instructed, grab your baby. Jess opened her eyes and groped the air as one of the baby’s shoulder popped out, April held onto the baby’s head as the other shoulder emerged Jess’s fingers were almost reaching the baby’s shoulders when the rest of her little body slid out with a swoosh. April and Lena guided the little pink newborn into Jess’s arms and she settled back into the pillows expertly holding her little girl.
“Did anyone check to make sure it’s a girl?” Someone behind the curtain called. Lena lifted the blanket, gently pried open the baby’s legs to confirm that it was a girl.
“Does she have a name?” Someone asked. Jess and Tom looked at each other then said “Yes.”
We waited then I asked “Well, do you plan to share it with the rest of us?”
“Its Riley. Riley Jane Shields.
There is nothing as beautiful as the look of complete relief and love on a new mothers face. Jess leaned back into the pillows. The naïve childlike look during labor was replaced with a look of total confidence and peace.
I got the privilege of holding Riley when she was only minutes old. Her eyes were shut tight. As I spoke to her eyes flew open, big blue/black innocent eyes looking right at mine. I could have held her for hours, but it was dads turn. Tom snuggled in with Riley on the couch while the medical team expertly repaired the internal tears that occurred from Riley’s compound presentation; her left hand was on the side of her head as she was born instead of being tucked into her chest. I watched as the messy puzzle of torn tissues were matched up and sewn together. When the repair was finished Jess looked as healthy “down there” as an eighteen year old. There are often benefits to having a hospital birth, had this type of tear occurred at home, it most likely would be patched up “okay” but the descriptive word is patched-up. Jess was as good as new.
Riley took to breast feeding like a pro, natural birth babies usually do.
It was time to leave the new family to themselves. The nurses filed out of the room and I said goodbye as well. I looked back before I left the room, capturing and safely storing away in the memory banks of my mind the most precious moments of new life.
Welcome to the world Riley Jane. You entered this planet surrounded by so much love. You will carry that love with you forever. And you will always have a very special place in my heart.