Asher's Birth Story

Asher's birth story started with contractions on Wednesday afternoon, March 18. As I left work, I noticed I was having them somewhat regularly and stronger than my usual Braxton Hicks. They got stronger as the night went on, and we called our friend Bonni to come spend the night so she could watch Ezra in case we needed to go in. Around 11:30 p.m., when contractions had been 5 minutes apart and 1 minute long for over an hour, I had a gush of bloody discharge and decided to go in. I was 3.5cm dilated, 70% effaced, and -2 station, an increase over the 2.5cm I'd been on Monday. Triage held me for 4 hours, during which I only dilated to 4cm despite some pretty painful contractions coming about 3 minutes apart. My doula, Liz, had met us there and she walked the halls with me for a while and then encouraged me to sleep.

By the time the 4 hours were up, it was 5 a.m. and I was so tired I couldn’t think straight, having been up all night and also not having slept well in several days due to getting over bronchitis. So when they offered to give me a combo of morphine and phenergan for what was called a "morphine sleep," there was no question that I wanted it. I got moved to a L&D room, got the shot, and 3 contractions later, I was blissfully asleep and pain-free. I got a good 8 hours of sleep, but contractions completely stopped and I hadn't progressed any more, so they sent me home on Thursday afternoon. I was impressed that nobody pushed to induce me, just that I go home and wait, but I was still extremely frustrated, still exhausted, and hoping I wouldn't go back into labor that night.

But I did. Starting around 4:45 p.m., I was having strong contractions about 10 minutes apart. Around 7 p.m., I broke down in tears because it hurt and I knew I wasn’t going to sleep again, but who knew if contractions were even doing anything? So I tried to ignore the contractions and went to bed around 9. I got about 3 hours of sleep before contractions woke me up. I was in and out of the bath tub and trying to rest on the couch until about 4 a.m., when contractions had been coming about 3 minutes apart, lasting about a minute each, and I couldn’t talk through them and had to be either on my side in the bath or kneeling with my head resting on the couch or birth ball. I woke up Ross and he went to pick up Bonni.

I had to ride to the hospital in the back seat so I could be on my hands and knees. Thankfully, I only had two contractions in the car, and then one right as we arrived to the hospital around 5 a.m. Ross dropped me off at the front, and I made my way up to L&D. He came in with all our stuff right as I was signing in. I was 5cm dilated and 80% effaced, and was admitted. I was encouraged that I'd dilated a little more, but felt like I’d see how things went and if I had to consent to pitocin, and maybe an epidural, I would. I was tired of painful sleepless nights and ready to be done.

TOLAC = trial of labor after cesarean

I got on the wireless monitor, asked for a saline IV because I knew I hadn’t been drinking enough water, and once I’d gotten about half a bag, got in the labor tub. My doula and birth photographer showed up, nursing shift changed to a super awesome 30-year L&D veteran nurse named Cindy, and my favorite MFM doctor popped in during his morning rounds to say hi. I was in a good mood, chatting with my birth team between contractions and glad to be in the tub. When a contraction came, I put my head down, gripped onto something, and breathed through it.

I forgot my birth plan, so we filled it out between contractions

I labored in the tub until about 9 a.m, when I mentioned that I felt like I had to poop. Cindy wanted to check me, so she did and I was 8cm and 100% effaced! I almost cried because suddenly my VBAC actually seemed within reach! I couldn’t believe I’d made so much progress in such a short time after being in early labor for so long. 

There was a big crane truck outside - we were talking about how Ezra would love it

Labor got even harder after that. Contractions were quite painful, and it was so hard not to push yet. I dilated to 9cm fairly quickly, but then got stuck for about 3 hours. My birth team all were very encouraging. At one point, Asher had a deceleration - I was only somewhat aware of this, but Cindy just had me stay out of the tub for a while and made sure the monitor was picking up reliably, and he was fine. Labor outside of the tub hurt a lot more, and contractions were coming right on top of one another, but I continued to just breathe and hang onto something - standing and hanging onto Ross felt best. My nurse and doula were worried about the lack of progress, but kept making good suggestions to move things along.

 Then the resident came in and said they were thinking pitocin would be a good idea. I really wanted to avoid it due to the increased risk of uterine rupture, so I suggested he break my water instead. Even though they'd been saying Asher's bag of waters was really tight around his head, I thought that would be worth a try before introducing pitocin into the equation. (Actually, it was so tight the resident didn’t realize it was still intact.) He agreed, and did the AROM. Even though not much fluid came out, contractions got more intense right away.  I asked my nurse if I could get back in the tub and she said that sounded great, so I did. Labor was so much more manageable in there, but contractions stayed really intense and right on top of each other.

This is the picture that exemplifies how labor felt to me.

 Then the OB attending came in and said she still wanted to do pitocin and thought I should strongly consider an epidural. I was so disappointed. It just didn't feel right to start pitocin or get an epi at that point. I knew I was close to my breaking point and couldn't take pitocin contractions without an epidural, but I really didn't want that epidural. I wanted to be able to feel pushing and to be able to get up and walk around, and I knew pitocin increases the risk of uterine rupture. And I think I told Ross that it was “just so mean” to suggest those things at that point. I was definitely in transition! So I said no and worked extra hard via positions (which I would not have thought of without Liz to suggest them) and tried not to actually push without holding back too much - I was trying to move the baby down a little. 

 I got out of the tub for a check, vomited four times, and was at 9.5cm, +2 station with just an anterior lip. The amazing Cindy had me do a "practice push" in bed and forced back that persistent bit of lip. Ross said it looked painful, but it was a relief to push and I didn't even notice any pain. 

Cindy getting me dilated to 10

Cindy went to get the doctors and said she didn't care if I pushed a little, so that's what I did! Squatted on the floor holding onto Ross and pushed. Lost some fluid. It felt amazing! Cindy came back in and asked me to get back in bed so I wouldn't have the baby onto the floor.  I wasn't crazy about pushing on my back, but Cindy had been so awesome at helping me achieve the birth I wanted that I went with her recommendation anyway. The “practice push” hadn’t felt like I expected, so I figured I could use some coaching after all.

 The whole entourage got ready - the OB came in grinning and said "Allison! You made me a liar - I love when that happens!" I pushed through 4 or 5 contractions and felt the “ring of fire” on the last one and Asher's head was most of the way out! 

I reached down and felt it, but honestly couldn't tell what was what - but Ross was right there telling me he could see his hair, and then "I see his face! He's cute!" Pushing felt incredibly satisfying after all that labor, and so did the breaks in between contractions. I couldn’t believe I was actually doing this! 

Then I did little controlled pushes through one more contraction, ring of fire still going strong, for the rest of his head and body, and he was on my chest, warm and tiny and slippery and perfect! It was amazing! I couldn’t believe I had actually just pushed a baby out of my body!

Asher came out screaming and went straight onto my chest. He seemed so little! He was breathing and responsive, but pretty blue (we asked later and his Apgars were 7 and 9). We delayed cord clamping and they just suctioned his mouth while he was on my chest and put warm blankets over him. When his cord stopped pulsing, they clamped it and I cut it myself because Ross didn't want to. 

Cutting the cord

I delivered the placenta while this was happening and was told I had one very minor tear that took 1 stitch to repair. Asher stayed on my chest the whole time. I had asked to see the placenta, so Ross held Asher skin to skin for a few minutes while Cindy brought the placenta over and showed me all the different parts - it looked healthy. 

Placenta

 Then Asher came right back to my chest for some nursing. It was about an hour and a half after Asher’s birth before some nurses came in to weigh and measure him and do newborn procedures. He was 7 pounds, 3 ounces, 19 inches long with a head circumference of 13 inches.

 All in all, I was in labor for 2 days, with about 14 hours of active labor. Everyone attending Asher's birth kept telling me they were so impressed with how calmly I dealt with contractions and how much control I seemed to be in, but being in control was the last thing on my mind - it was just that staying focused, in the moment, and breathing was what I needed to deal with the pain. Aside from being awake for so long, Asher’s birth was everything I had hoped for but couldn’t believe would really happen to me - healthy, full term, spontaneous labor, a baby who tolerated labor well, no drugs, and a VBAC!    

[All photography by Michelle Garey Photography. Do not reproduce or modify images.]