My four hour birth
Part 1: Was it time yet?
My first sign that something was happening was my mood. Around 8:30 p.m. on Monday August 15th, my daughter River, had a potty training accident and I reacted to her much more angrily than usual, “Damn it!” I mopped up pee resentfully with paper towels using my feet because I couldn’t bend over. I felt annoyed and at-capacity.
So I asked my husband James to put River to bed without me this time. I just wanted to be left alone and to lie on the couch. Then, as they read stories together in the background, I started to feel some cramps. It was around 9:15 p.m.
During my pregnancy, I’d gotten myself worked up a couple times because I felt cramps and I overreacted. Each time, I’d tell James, “Maybe it’s coming tonight?” And then we both felt anxious. After that, I learned to not take my cramps too seriously. But this time, they felt a bit more regular than normal, so I silently downloaded a contraction app and timed them. I didn’t want to alarm anyone.
I was closing my eyes and meditating with each cramp. Then a cramp came where the sensation traveled down my belly in a strange way. I followed the feeling with my attention. Woah, I thought, as the sensation felt narrow and pointed. And then I felt a pop. The couch and my skirt were suddenly soaked. I called over to James, “My water broke.”
He stopped reading and came over to the couch. “I’ve been counting my contractions with this app.” I showed him. He looked at the numbers and saw they were coming about every 3 minutes. We had been told to consider going to the hospital when they came every 5 minutes. He was surprised and a little concerned.
We called the midwife, and James started timing my contractions himself. James said my contractions started about 15 minutes ago and were coming every 3 to 5 minutes. He asked if we should go to the hospital. The midwife said it was early still. She summarized what we’d told her by repeating back that I was having contractions every 5 minutes.
Urgh. This irritated me because in my first labor, I’d also felt like my team was not taking the data seriously when I told them how quickly my contractions were coming on. And if we couldn’t align on the data, then I couldn’t trust that everyone was on the same page. So I clarified again with a firm voice that all of the contractions I’d personally measured — the first three — had come every 3.5 minutes, to be clear. She encouraged us to wait and get back in touch if things felt like they were progressing very quickly.
We got off the phone with the midwife and then called my mom to come take River. Once they left, we did a small ritual that my midwife recommended, which could help clear emotions that she’s seen get in the way of labor. We did a ritual to say goodbye to the state of River being our only child. I expressed gratitude and sadness that it was ending. It was a really special time we’d had. We both cried, and tried to let go.
My contractions felt much stronger now. I started to moan in a low, guttural way, which I hadn’t done at all during my first birth. I got on the ground to squat and for a moment and felt a sudden desire to bear down and push. Again, I didn’t want to be alarmist, but I said, “I think we should go to the hospital. Let’s call the midwife again.” It was only around 40 minutes after my first contraction.
We called the midwife again, and she was inclined for us to wait to go to the hospital, but offered to meet us at her office so we could do a check-up and see how I was doing. I didn’t want to go to the office but I also didn’t want to embarrass myself by asking to go to the hospital too soon.
I decided to do a meditation audio track, and I put on one called “fear clearing” that you were supposed to do in early labor to feel less anxious and more confident. It directed me to bring to mind my biggest fear related to birth and ask myself if there was anything I could do about it. I sensed that my biggest fear in that moment was that I might give birth at home accidentally without medical support. This would be a bad idea for me because I have a medical condition that would make that complicated.
During my first birth, the connective tissue that holds up my bladder got damaged, which means that my bladder no longer stays in place inside my body, essentially. I find it embarrassing and sad, but it’s true.
I knew that when the second baby came, I would need to have extra help. My team was going to need to actively push my bladder in to keep it out of the way of the birth canal, or else the baby could potentially cause permanent damage to my bladder as the baby descended during pushing.
So, realizing this was my biggest fear, I decided that feeling embarrassed for going to the hospital too soon was far less concerning than the medical risks I would face if I went too late. I told James confidently that I wanted to go to the hospital now. He asked the midwife to meet us at the hospital and we quickly headed in. I felt some relief.
My midwife met us in the parking lot of the hospital and looked skeptical when she saw me walking toward her. I was coherent, upright, and asked her how she was doing. She said, “Let’s talk about this for a minute.” It was clear she was unsure whether or not I should be at the hospital. Then seconds later, another contraction started, and I grabbed James for support. We walked through the hospital door and a minute or so later I had another one. I went down to the ground, moaning in the entryway. By the time we got to the waiting room, I was vomiting and moaning loudly, but still unsure if everyone was on the same page. I thought I should be at the hospital, but did everyone else?
Then, 10 minutes later, my midwife said something like, “We’ve got to get you into a [delivery] room” and this finally reassured me that we were on the same page about how far along I was and that I belonged there at the hospital. This was focusing and a relief.
They measured me at this point, and I was 6.5 centimeters dilated about an hour after my first contraction. For context, it took me around 20 hours to be at this point in my first birth. An hour later, I was at 8 centimeters. I was coping — barely — using a few techniques that I will share with you shortly.
Part 2: Using love to guide me through
I had a goal during my second pregnancy to avoid an epidural, though I felt open to seeing how the birth would unfold. My first birth was with an epidural, and I felt like I was operating a robot. Having no sensation in my lower half, I pushed with all my might, without having any idea how much force was needed. I think this is part of what caused damage to my bladder.
By contrast, reading about births without an epidural, it seemed like the body “was in charge.” The body “made” you push when you needed to, and I trusted that this natural system might use force in a more elegant way and prevent further damage to my prolapsed bladder.
So for months, I’d studied a course called hypnobabies to be as prepared as I could, and I had an iPod in my pocket with audio tracks that I’d been practicing nightly for a few months. These were meditations that were meant to guide me through the birth. But in reality, I did not want to mess around with anything.
In spite of having hope for a natural birth, I wondered in the moment if it was going to be too much. So after we got set up in the delivery room, I asked if there were any medication options, and they said they didn’t recommend medication if someone might give birth in the next hour. I might? I asked. Yes, this was coming fast.
I had the feeling of being on a roller coaster, and I was just going to try to hold on tight for the ride. The next hour was a blur of intensity. I managed to stay grounded about half the time, and half the time I felt like I was losing my shit. There were three things that worked to help me stay grounded.
One was that I was trying to honor what the contractions “wanted”. With a theory that a lot of pain comes from resistance.
I tried to let myself go and let the contractions do what they wanted. I (or they) wanted to be on my knees, wanted to push against something, and wanted to make sounds to express the intensity.
“Ahhhhhhhhhhhhrrrrrrr.” The contractions coursed down, down with a strong pressure, stronger than anything I’d ever experienced. I said to James, “These contractions are very opinionated.”
I also didn’t want them to happen at all. “I hate this…” I said, shaking between contractions. Sweating, shaking, hot, and on my hands and knees. Sometimes I would wince and try to get away. With those wincing contractions, I felt like I was drowning, and I knew what my mission was, to try to cultivate the “allowing” type. Each contraction felt like a challenge to channel this mindset.
Besides allowing, the second thing that worked for me to stay grounded was feeling supported and loved. I noticed that holding on to James seemed to help so I kept going back to that. James started saying phrases from the course I had been taking, and I told him to please be quiet. “Just love me.” A contraction would come on, and I would literally grab James. “Love me, love me!”
I told myself over and over, James loves me, and River loves me. I tried to really feel it. And when I did, I think it melted my fear.
James loves me, River loves me! I screamed in my head as I screamed out loud, “Rrraaaaaaaa!” I wasn’t focused on the pain then. And then the contraction would subside and I’d rest my head on my arms. This was working, barely.
The third and final thing that helped was pressure. At some point, my midwife pushed against my hips, and I said, “Yes, that! Please do that.” She also added a TENS unit, and that felt helpful. Then my midwife told our nurse that he could push on one side and she could push on the other side, and that felt helpful, too. We got into a rhythm where a contraction would come and I would cry to my team, “Come, come help!”
I was on my hands and knees. I would moan very deeply, I would rock and sweat, and then the contraction would leave and I would rest my head and breathe. Over time, they got longer, and I would tell my team, “Please don’t stop, please keep pushing on me. It still hurts!”
“Push on me, push on me,” I told the midwife and nurse. “Love me, love me,” I told James. I tried to imagine I was surrounded by love on all sides from my team.
James holding my arms, and the nurse and midwife pushing me from behind. I was surrounded by support. And with that support, I was not afraid. I could lean into my experience. I could do it.
I became more like an animal. “RRAAAAAAAA.” Occasionally still hating it. “I hate this so muchhhhhh” I said. But then trying again and again to feel love.
Eventually, the contractions had very little break between them. I started to throw up again, and then I started to feel a very strong desire to push.
Part 3: A finale that was more intense than I expected
Those contractions had been the hardest things I’d ever experienced in my life up to that point. But pushing felt like a relief in some ways because I could actively push all my energy down instead of just surrendering to the feeling.
I was on my hands and knees and in a rhythm. But the midwife couldn’t hold in my bladder prolapse from the position I was in. I had to move onto my back. Moving to my back felt like drowning. “I really don’t want to, no.” I resisted, I begged. For 10 or 20 minutes, I stalled.
The midwife became increasingly insistent and encouraging. I could do this.
I finally got on my back and found a new rhythm. It was the home stretch now. The baby was moving. I was roaring. It was going to be over soon.
Then the baby’s head pushed partway through my cervix and stayed. I was shocked. I didn’t know this would happen. I felt an unbelievably sharp pain. And unlike a contraction that came and went, this was relentless. This was the most intense moment of the night, and of my life.
I was in so much pain now that I couldn’t sense the contractions above the noise of this new sensation. And I was totally resistant now. I winced from it, screaming, “I can’t, I can’t, I can’t.” I tried to get away from the feeling. I was afraid. What if it got stuck here? What if I couldn’t push the baby out? I couldn’t stand this. I was screaming like an animal in a trap.
“Right now you’re tensing, Joanna, which is preventing the baby from coming out. You need to exhale slowly. Relax,” my midwife said.
This was fucking absurd. How could I relax? “I can’t, I can’t, I can’t.”
At this point, James looked at me. “You know how to open, baby, you can do this.” I tried and somehow, I let go enough. On the next contraction, the baby moved down. One more contraction now, and the head was fully out.
I felt some relief now. I was doing it. One more screaming push, and suddenly a large, sloppy baby with a long umbilical cord was plopped on my chest. Gasp.
“Oh my God, oh my God, oh my God,” I said, shaking. I couldn’t believe it. What is this? What is happening?
He was crying, understandably. “It’s ok,” I told him. I channeled love to him to help him feel safe, and he started to calm down. At the same time, I just shook and shook and shook from what had just happened to me. It was 1:15am, and it had been just four hours after my first contraction.
I wanted everyone to leave me alone, now. I was raw, and it had been too much. I was shaking and I felt like I wasn’t calm enough to even love the baby well. And I needed to love the baby well.
But a lot of stuff still needed to happen. I birthed the placenta. They cut the cord. They gave me stitches. I winced and waited for these things to be done. I needed to feel safe and free of pain. And be with this baby. Beautiful, so fresh, and now calm on my chest.
And then a final thing happened that really disturbed me. A strong woman nurse came in who I’d never seen before and said she needed to clear blood from my uterus. She started pressing on my belly, hard. It was really painful. “I don’t want this. No,” I said. She told me it needed to happen. I grabbed her hands and pleaded, “Please stop!” I tried to get away.
Then she asked James to help hold my hands down so I couldn’t resist. “No,” I said and struggled.
“Hey! Stop,” James intervened firmly and loudly. She stopped.
She had completely stripped me of control at a time when I was tender and raw.
Once she stopped and left, I learned more about the procedure. I was able to do it later on my own terms with someone else, and it went fine.
Although these after-birth procedures weren’t nearly the most painful things I’d experienced, they were the only ones that left me with some lasting unease. In an intensely raw state, being prodded without a feeling of control felt super shitty.
I don’t know how to explain or make sense of it, except as a learning that I’d spent a lot of time preparing for the birth without an understanding or preparation for the after-birth. I’d expected it to be all bonding and roses, but it wasn’t. I expected to be able to let go and be done, but I wasn’t done. It was still going to be hard, and I needed to be in charge of my experience until it was actually over. I’m still angry about this.
In summation, giving birth this time was the most difficult thing I’ve ever done in my life, but I managed to stay reasonably centered, and I’m proud of myself.
My husband said it felt like we were rushing down a very strong river, but that I had my hand firmly on the rudder the whole time. My midwife said I seemed so strong. And I had the birth I wanted.
In the days after the birth, I felt the glow of self-confidence. If I could do something like this, nothing else could phase me. Everything else felt trivial. I still feel this glow in a subtle way today.
