This was not the birth story we had written. The intervention-free, natural hospital birth surrounded only by a midwife, a doula, a supportive husband, and a birth photographer. This was instead an epic adventure, where in the end control was loosed, hard decisions were made, and our son's first experience in this world was not the embrace of his mother, but the sight of our incredible midwife and the kindest OB under the bright lights of an operating room.
Labor started slowly sometime Saturday evening, July 26th. We had made a trip to Coon Rock Farm earlier in the day to buy some lamb and eggplant for a Moroccan tagine. (It's an old wive's tale that eggplant induces labor, but why not?) Vance spent most of the afternoon preparing it, not knowing that this would be our last normal meal for a long time. During dinner I noticed that the Braxton Hicks contractions I'd been having for months were changing character: the tightening was stronger, distracting, and became more painful as the hours progressed. After a while I realized I was wincing through them, so I mentioned it casually to Vance and tried not to get too excited.
We did what we'd always planned to do if labor started in the early evening: let our doula, Andrea, know that things were getting started, and go to bed. I'd need my strength and wits for the next day, when our son would surely be born. I napped between contractions, but started timing them with the Full Term app when they became close enough together to prevent me from falling back asleep in between. Each contraction lasted longer than anything I'd prepared for (many exceeding two or even three minutes), which felt a little cruel but still manageable.
Vance called Andrea around 1:30 AM. I insisted that she didn't need to come over, so she didn't, but I think he felt some reassurance having talked to her. By 9:30 am I'd started to lose my mucous plug. I took a long shower, which was restorative but stalling: things really slowed down after that.
But Andrea came over to help me labor actively anyway, giving Vance an occasional break and managing Chester. We walked the halls and the stairs countless times, resting, rocking, and snacking in the nursery when I needed it. We went for a walk outside in the rain, breathing in the sweet smells of summer from under a yellow duck umbrella, never straying too far from home. The walks Vance and I took that day were some of the sweetest, most beautiful moments of our marriage. He never left my side, never got impatient, never asked for a break.
At the time, our backyard garden was bursting at the seams with technicolor tomatoes. Lunch was a bowl full of the day's harvest: sungolds, purple heirloom cherries, and juicy slicers with fresh mozzarella and a handful of basil.
Our photographer Becci joined us around 3 in the afternoon, and we called the midwives to update them on my progress. We wouldn't head to the hospital until my contractions were consistently four minutes apart for an hour, but it was good to get a feel for how busy they were in Labor and Delivery, and whether they'd like to see me sooner given how intense and long the contractions were becoming.
By 4 o'clock I was back in the shower. Vance's "car wash" shower, an over-the-top monstrosity with 27 shower heads, was finally proving itself useful. I sat on a low stool and used two of the handheld shower wands as a comfort measure during contractions. I must have been in there for 30 minutes or more; the water ran cold.
Labor had lasted nearly 24 hours at this point, so we scarfed down eggs and bacon for dinner for a boost of protein and retreated to the bedroom to do some restful movement on the birth ball while timing contractions. I knew labor couldn't last forever, but it was important to me to keep moving to be sure it didn't last any longer than it had to.
After a brief rest, we started walking again, within and without the house. The longest contractions seemed to happen near the garden, where I'd squat and use the rotting wooden beds for support.
Night crept up around us, cool and quiet for so late in July, and my body was crying out for rest. I sat and rocked in the glider, Vance never more than a few feet away, for what seemed like hours. By 1:30 AM contractions were finally 4 minutes apart, and with as long as they lasted there was little room for rest in between. We quietly packed up the car and left for the hospital, and Vance called my parents to let them know things were rolling.
By 2:30 AM we were checked into Labor & Delivery Room 5. The last room they had available on a very busy night. My contractions seem to halt the minute we crossed the threshold into the ER, but I tried not to let that discourage me. Vance and Andrea set out some candles, turned on some relaxing music, and dimmed the lights. It was late, but I had a renewed sense of energy. (I may have been the only one).
Annie, the nurse on duty, hooked me up to the monitors, which seemed to bob and weave around my cavernous belly every time I moved. I did my best to relax fully, especially through contractions, to keep the monitors happy. The baby seemed to take a cue from me to do the same, so the straps had to remain on longer until Annie observed the desired number of "accels."
I kept hearing "XLs" and didn't have any idea what she meant. Only that she was looking for more of them. When we prodded for more information, she explained that "accels" were heart rate accelerations, and that she was looking for a certain number of them 15 BPM above the baseline.
Mary Ellen, one of the midwives, came by to check me after a while and determined that I was dilated to 3 cm, fully effaced. The baby was still very high, though, and had his arm up over his head.
It suddenly made sense why labor was moving so slowly; he wasn't putting enough pressure on the cervix with that arm up. I felt like someone had let all of the air out of my balloon. There would be no baby tonight. With the midwife's blessing, we went home.
Andrea retreated to one of our Airbnb rooms for a rest, and we said goodbye to Becci. My parents had arrived sometime before then, and finally laid down for a nap after I convinced them the baby wasn't going to drop while they dreamed.
Since the moment I set foot in Duke Regional's Emergency Room, contractions slowed to a frequency of about 15-30 minutes apart. This continued throughout the next day and into my previously scheduled midwifery appointment in the afternoon. Andrea sweetly joined me and Vance there for the non-stress test, and the three of us crammed into a tiny room with a La-Z-Boy and a monitor, listening to the baby's heart beating while my contractions were plotted on the screen. The room quickly became engulfed in our collective body heat, a tiny fan moving the swampy air around with all the efficiency of a cat blowing out birthday candles.
Anne, another one of the midwives, poked her head in to look at the strip, reassuring me that my body was made for this, that the baby looked great, and that I was doing all the right things.
I mostly believed her.
Andrea stayed with us until about 4 PM, giving us homework (The Miles Circuit) and encouraging us to get some rest. We spent an hour or two moving through the stages of the circuit: open knee-chest, left side-lying, movement, repeat... The day faded quickly into night, one contraction at a time.
It was so hard to get any rest by now. Contractions were sporadic — anywhere from five to thirty minutes apart — and they were at their meanest when I was laying on my side. Which, for those of you playing along at home, is the only safe way for a very pregnant woman to sleep. When I couldn't take it any more, I'd move to the rocker in the nursery, and Vance would cuddle up with Chester on a blanket on the floor. A little while later, we'd go back to bed, and the whole cycle would begin again.
By the fourth day of my labor, the mild to moderate contractions had become routine. The strongest rushes were manageable and even welcome; they felt like progress more than pain. My voice was hoarse from hours of vocalization and I had finally figured out what all of the knobs did in Vance's shower. In other words, I was pretty much a pro at this labor thing.
It was on this day that we started into the more esoteric items on the "how to restart a stalled labor" list, exploring pressure points, massage, curb walking, pumping, and copious amounts of eggplant. In search of the latter, I sent an SOS text to Crawford at Piedmont. I'd never ordered take-out from a top-tier restaurant, but now seemed like as good a time as any. I ordered the Carolina flounder with extra eggplant, and a bowl of the legendary sweet corn and barbecued shrimp soup. (Corn has no known correlation to restarting a stalled labor, but I couldn't resist; it is the stuff dreams are made of.)
Vance left to pick up my dinner and returned a short while later, balancing a veritable feast on his Vespa. The amazing people at Piedmont had heard of my 60-odd hour marathon labor and sent along skirt steak, smoked trout dip with lavash, compressed watermelon salad, and a bucket of mocktail in addition to the pile of marinated eggplant with a side of fish that I'd ordered. (There may have been something else they sent for Vance, but I'm not at liberty to say...) I hadn't smiled that wide in days. Every time I think about it I swell with gratitude at their kindness.
We set up a picnic in the nursery on a couple of TV trays and went to town, saying goodbye to Andrea for the third day in a row.
At her suggestion, we had arranged for a massage therapist (who also happens to be a doula!) to come by for a last-minute prenatal massage. Camille gave me a wonderfully relaxing but firm massage, and showed Vance a few pressure points to try on me. I had totally lost track of what time or day it was by then, but it turns out she stayed with us for three hours, escaping quietly out the back door sometime after midnight.
After an indulgent evening of pampering, contractions had quieted and the baby rested for most of the morning. We had another midwifery appointment scheduled today, with an ultrasound to check fluid levels and lung function. I never dreamed we'd actually have to show up to this appointment; surely the baby would be born by now! But here we were.
Over the course of the morning I noticed in myself a creeping pessimism about my ability to deliver this baby. While the ultrasound showed a healthy, though tired, baby with plenty of fluid, I had labored for days with what felt like no progress. That feeling was quickly confirmed when I was checked for dilation.
His hand is still above his head. I've got to tell you, it's the cutest thing; I can feel all of his tiny fingers. (Awww.) But three centimeters is very generous. You're closer to two.
What every laboring woman wants to hear after days of hard work: You've gone backwards. Somehow I managed to keep it together in this moment, but it didn't last. By the time we were in Michele's office to talk about our "options," I was losing control.
It's time for a plan.
The funny thing about a birth plan is that a third of the parties who are supposed to follow it never even see it. Mom and practitioner can plan all they want, but the baby never receives a copy, never signs off on it, never agrees to comply with whatever is written on it.
My birth plan was fancy. It was printed on bright white card stock, with clear headers, icons, and bullet points. It even had a big, bold box around a note about pharmaceutical pain management, stating that any suggestion to go that route had to come from me. (Our doula had discussed a code word with us ahead of time, so she would know whether I was truly changing my mind about an epidural. Seeing as my memory can fail me in moments of extreme stress, the code word was simply "code word.")
Anyway, the time had come to start marking up that pristine birth plan with a big red pen. Michele was convinced that my labor wasn't going to progress without intervention. I conceded. I flashed back to the exercise we'd gone through in our birth class, where we decided which goals we'd be willing to part with, and which were non-negotiable. I don't remember which of our plans we parted with first in our hypothetical birth, but in the real world, we'd start with induction. We took an hour to process our options and decided to start by having my water broken. Tonight.
Lest we get cocky thinking we can make any kind of plans at all, the midwife on call at the hospital phoned a few minutes after we'd reached a decision to tell us that she didn't think it was safe to break my water given how much fluid there was and the possibility of cord prolapse.
Oh, and there were no Labor & Delivery beds available for an "elective induction." Naturally.
I'm not proud of how I took that news. It all just felt like sand in my eyes at this point. So I buried my feelings in a box of Polpette from Scratch's Pizza Night and watched the season finale of Law & Order: SVU with my butt in the air. (One last half-hearted effort at getting that tiny hand out of the way.)
Contractions picked up overnight so much that I took two long, therapeutic showers before the sun rose. We got word first thing in the morning that a bed was now available at the hospital, so we headed in for the induction at 7:30 AM. I felt good knowing that this time, we wouldn't be coming home without a baby.
We checked into Labor & Delivery, Room 7 and I sat hooked to a fetal monitor for over an hour waiting for those three precious "accels." Andrea was with us again, setting up the room and sneaking me bites of a granola bar when the nurses weren't looking.
Around 9 AM, Jualeah Early burst into the room with her extra-large coffee and false eyelashes and a smile as wide as the day is long. She would be our midwife today. She checked me and declared that I was 5-6 cm. Perhaps just as important, the baby's hand was out of the way.
Jualeah: I'm super excited about your cervix! How do you feel?
Me: So super.
There was one catch. Instead of an arm, the presenting part was a nose. It's better than an arm, but it would make for a hard delivery. Jualeah was confident she could reposition him, so I gave her the go ahead and braced myself.
With me on hands and knees alternating between low tones and raspy screams, she reoriented his head back where it belonged. All totally sober and unmedicated, without breaking my "bulging bag of waters." I can't decide who is more of a badass for that: me or her. I'll call it a draw.
And so there would be no Pitocin — no "elective induction" — this morning. I was progressing on my own. Hallelujah.
After all the morning's festivities, I was still hooked to the monitors. I could move around so long as I didn't stray too far. So I spent a couple of hours alternating between a birthing ball and the plastic covered rocking chair until a blessed nurse came in to remove them. Free at last.
I took a seat on a stool in the shower and let the water ease the intensity of each rush. Mercifully, the hospital doesn't meter water usage, so I won't be seeing the bill for however many hundreds of gallons I used that afternoon.
For hours I moved between the shower, the bed, and the halls of the labor and delivery floor, my support team following dutifully close by. It was, for all of us, exhausting.
By 4 PM Vance needed a rest, so Andrea took over. We did some work with a rebozo, syncing abdominal lifts with contractions. (While this may sound lovely, it intensified each contraction mightily.)
Jualeah returned about an hour later to discover that I was still 5-6 cm. Zero progress. Damn the zero; it was time for a change of plans.
We didn't take long to decide that she would break my bag of waters. Andrea cautioned that the nature of my contractions would change afterwards, that there was no going back. All the better, since I was only interested in moving forward.
Jualeah took an instrument not unlike a crochet hook and tugged at the bag until it finally acquiesced. She'd told me to expect a trickle, but it. Was. A. Gusher. Eyes wide, I watched my girth shrink as the fluid drained. I laid there on my side for thirty minutes as the contractions intensified. This was supposed to get the baby moving down into the pelvis.
Andrea wasn't kidding. I had opened the door to a whole new level of pain. If this was a test, I was just barely passing. This was surely the limit of what I am capable of enduring.
I labored for six hours this way, contractions nearly running into one another. Each time I'd decide I couldn't take it any longer, I'd change positions or move around the room — from the tub to the bed to the ball and back again. By midnight, I had gone to a special place. I heard myself say things like, "this is why certain species eat their babies," and "nothing feels good, everything is horrible." I asked Vance repeatedly, "When does baby come out?" Surely this was transition.
Jualeah returned. Still 5-6 cm. I sat there in disbelief as she talked me through our options: start an epidural and get some sleep while the baby continued to labor down, or go in for a C-section.
I raised the white flag; I had no fight left. "Let's just go in for the C-section." Jualeah balked. Maybe she knew that, somewhere, I had some fight left. Or maybe she knew that what I needed most was a few hours of good sleep. She coached me away from a C-section, at least for now. I looked at Vance, then at Andrea.
I agreed to the epidural.
The next hour was excruciating. And I'm not just referring to the paperwork. (Here are all the risks, and by the way one of them is that you might die. Sign right here.) The contractions weren't waiting for the anesthesiologist. They were wicked. Punishing. Relentless.
And then the doctor came with his big beautiful needle, which he shoved into my spine as I gripped the bedsheets with balled fists. When it was over, my ears were ringing louder than usual. I casually asked if that was normal, and the anesthesiologist replied that he'd have to start over. Surely this was just some 2 AM humor.
We did the whole thing over again, and after spraying me down with a can of cold air to test its efficacy, I drifted off to sleep. It was the best rest I'd gotten in five days.
I awoke a little before 5 am to Jualeah coming in to check me. The baby was presenting face-first, posterior. Face presentation occurs in about 1 in every 500-600 deliveries, but the figure is closer to 1 in 1,250 for deliveries of babies that have made it to term. It's possible to have a normal delivery of a baby presenting face-first, but not the direction he was turned. It was time for that C-section.
Everyone moved quickly. Before I knew it I was covered in wires: an IV line, blood pressure cuff, heart rate monitor, catheter, epidural. I remember griping at the nurses about my low blood sugar; I could feel myself shaking, sweating, having whiteout spells. Someone told me it was too late to have any sugar water, but I was later told that they'd given it to me via IV. I was too much in shock to know what happened.
Vance suited up in translucent white coveralls and we caravanned toward the OR. It was so bright in there. Too bright for 6 AM. A team of people moved me to a smaller table and strapped my shaking arms out wide. Vance was still scrubbing in, so the anesthesiologist stood by my head as tears rolled down my cheeks. He tried halfheartedly to comfort me, but he knew better. I asked for Andrea again. (Before we went in, they'd insisted there wouldn't be room for her.) He must have relented, as a few minutes later I was flanked by Andrea and Vance on either side.
Dr. Gunter and Jualeah got to work. From my side of the curtain I could see her head and shoulders heaving against my belly, pushing Misha down and out. After 130 hours of labor, they delivered our son in less than ten minutes. He was bruised and swollen and took several agonizing seconds to breathe his first breath, but he was perfect in every way.
And that's the end of our epic birth adventure. Seven days and six nights we labored, each one testing us more than the one before. There was no world news on those days; no thought about what day it was or how long we'd been at it. There was only labor, and love. This was the hardest thing we've ever done, and I wouldn't change a thing about it.
The days that followed would test us further — Misha's adjustment to this world was a difficult one. But he was here. He made us a family. He made me a mother and Vance a father, and all the work it took to get him here sort of falls away when compared to the magnitude of the job that is still before us.