Miles’ Birth Story
First of all, because I’m sure that you all are as anal about grammar as I am — I spent the better part of 20 minutes researching the correct way to spell the possessive form of his name for the title of this post. It appears that both Miles’s and Miles’ are correct, but it depends on which style manual you adhere to (as I’m sure we all have one to live our lives by). THEREFORE, for simplicity’s sake and visual aesthetics, I opted for Miles’.
Going into the birth of our son, I made sure not to set any major expectations or outline any kind of detailed “birth plan.” When asked about it by others, my reply was simply that my plan was to go into labor, go to the hospital, and have a baby. I wasn’t attached to a natural childbirth, although the more I learned about birth, the more I could understand why someone might choose this option. Given my fear of physically having a child, I also considered that needing a c-section might be an easier option so that it was quick and over with. The only thing I knew was that I wanted an epidural and after it was all over, I’d have experienced all of the above and more.
My water broke around 4:30 pm on Tuesday, April 23rd, at 38 weeks. It wasn’t like they portray in movies, although it’s possible depending on where your amniotic sac ruptures. For me, the rupture must have been higher up, which led to a slow seepage of liquid several times over the evening. I knew it was different than other pregnancy-related liquids because it was clear and it was more abundant than normal. It didn’t smell like pee and I felt like I had little to no control over when it happened.
Typically, after your water breaks, contractions start not too long after. I didn’t experience any of this and was in voluntary denial because it was the final week that we had things scheduled — seeing The Avengers: Endgame on opening night (and the next day because we knew it would be amazing), a friend’s dance showcase, and another friend’s macaron pop-up. I had told him to wait until after Saturday because I had freed up my calendar for his arrival. My 38 week OB appointment was already scheduled for the next day, so I opted to wait until then barring any increase (or start) of contractions.
My appointment was at 1 pm, and when I showed up I told her that I thought my water had broken the evening before. I also told her that we had tickets to The Avengers (which you will hear referenced several times in this post), so he would need to please wait. She used a Q-tip that changes color in the presence of amniotic fluid, then proceeded to tell me that she hoped I could sell my tickets because I needed to go to the hospital. I felt a rush of heat and panic and in a classic procrastination move asked why I couldn’t just wait until labor started on its own. She told me that since it had already been almost 24 hours and labor hadn’t started, there was a risk of infection with my water broken. I needed to go home, pack a bag, and get this party started.
I left the appointment and called Neil at work as he was finishing up some meetings surrounding his paternity leave. I told him we needed to head to the hospital and he was home before I knew it. He was rushing around to get things packed and ready to go, while I decided to take my sweet time since I obviously wasn’t in active labor and knew we’d get there when we got there. We are only about 8 blocks from the hospital, so once we were packed and had set up boarding for Donut, we simply walked into triage and started the check-in procedure.
Rather than waiting in triage, we were sent directly to labor and delivery. Because I wasn’t having contractions and was 0 cm dilated, they would have to augment my labor to get it moving. It’s basically the same thing as an induction, but because my water had broken naturally, the technical term is an “augmentation.”
I was basically starting at ground zero. I was 0 cm dilated and not effaced at all, so before they could give me medication to dilate me, I first needed a medication to thin my cervix so that it would be able to open. Cytotec is a small pill that is inserted vaginally and I simply had to hang out in bed for four hours for it to start working. We had arrived and gotten settled in the delivery room at 3 pm, and the Cytotec was administered around 4 pm, meaning that we would have to wait until around 8 pm to even start the second medication, Pitocin.
Labor generally starts on its own after a large release of oxytocin. Pitocin is a synthetic form of oxytocin and mimics that release, causing the body to prepare for labor and increase contractions. The thing about Pitocin-induced labor, however, is that the body may not be prepared for it and the contractions that accompany it are generally stronger and closer together than those in a natural oxytocin-induced labor. Because of this, I decided that I wanted to have both the Pitocin and the epidural administered at the same time to get ahead of any serious pain.
While I was waiting in that four hour window, I was told by my nurses that I had actually been having contractions since I got there, but I wasn’t able to feel them. My stomach had been hooked up to two bands that monitored the baby’s heart rate and any contractions that I was having. I could, in fact, see that contractions were happening, but I honestly couldn’t feel anything really out of the ordinary when they did. I likely attribute this to the severity of cramps that used to accompany my period when I was younger — severe, illness-inducing pain that required I go home from school or work because I was on the verge of fainting or vomiting the entire first day, every month. Compared to those, these were nothing.
After waiting the four hours, I received my epidural. I had amazing experiences with every single nurse that worked during our time there (which ended up being five days by the end of it), and the only negative thing I have to say is that my anesthesiologist seemed to make it clear that she didn’t understand why I had asked for an epidural when I my contractions weren’t painful and I wasn’t even dilated. Make sure to advocate for your own comfort in any situation as I told her I simply wanted it preemptively to avoid chasing pain after it was too late. The experience wasn’t painful and it was one thing I could check off my list of things that made me anxious going into labor.
Note about pain management: I had informed the medical staff that I was in recovery, so they were aware of my apprehension around narcotic medications. The epidural consisted of two parts: an immediate spinal dose of pain medication and then the more long lasting medication that one commonly associates with an epidural. The epidural was continuous, but the pain medication (which I later found out was Fentanyl) could be administered by pressing a button and was limited to three doses per hour. I reserved use of this until absolutely necessary, which became so later on into labor when my epidural needed redosing.
Following the epidural, an IV was started with the Pitocin. They are able to increase the dosage every 15 minutes until contractions start progressing, so we started at a low dose and adjusted from there. Since I had been given an epidural, I was no longer able to get out of bed and a Foley catheter had to be inserted for the remainder of labor. I don’t know about anyone else, but the thought of catheters terrifies me, so I was just staring at that checkbox awaiting a terrible and horrible experience.Thankfully, I felt absolutely nothing and thought to myself that everything was progressing better than I thought it would. This labor would be a piece of cake.
Everything major had been checked off the list and at some time after 9 pm, they came back to check my progression. About 5 hours after the insertion of the Cytotec, I was only at 1 cm of dilation. The nurses suggested that we try and get some sleep and let things progress. Neil slept on a pull out couch in the room, which was actually really nice. I had trouble sleeping because a) I knew I was having a baby and b) the nurses came to check on me every hour, monitoring my vitals and checking in on me. Sometime in the middle of the night, as I stared at the monitor, I started feeling the contractions that I was watching rise and fall. I laid there and breathed through them until my nurse came and I asked her if I was supposed to be feeling each of them (rhetorical question really). She called anesthesiology back to my room and they redosed my epidural so that I could no longer feel them as they appeared on the monitor.
Sometime in the night, and as they increased the Pitocin dosage, the nurses started to appear concerned about the baby’s heart rate. As the contractions became stronger, his heart rate would drop. Because of this, they decided to stop the Pitocin in the early morning hours to regulate his heart rate. This caused my contractions to become more sporadic and less regulated, which slowed down labor progression, but after checking my cervix again I was now about four cm dilated. After his heart rate normalized, they started Pitocin again, with eventually similar results. I was put on oxygen and had to continuously change positions, rolling side to side to see if either position would help his heart rate, but it continued to drop with each contraction.
As the sun was coming up, sometime around 5 or 6 am, I started feeling the contractions again. They were stronger than before and I felt terrible. I ended up using the button on my epidural as they advised me that I needed to get ahead of the pain vs. waiting for it to become too much. Honestly, it didn’t help tremendously and I stopped using it after a few times. Anesthesiology finally made it to my room and realized I needed an increased dose, but until that time I was not a happy camper.
As the light shone through the window, my doctor was called to assess everything that was going on. She checked me and although I was finally 10 cm dilated and completely effaced, he hadn’t descended into the birth canal. She suggested we start pushing and go from there. I looked at Neil with apprehension and realized that when he had heard I was 10 cm and good to go, his eyes had filled with tears at the realization of what was happening.
I pushed as hard as I could for the better part of an hour. I had the doctor, nurse, and Neil holding my legs and encouraging me. My doctor said that my pushes were great, especially given that I had an epidural in. Unfortunately, he wasn’t moving down and passing my pubic bone. Every time I finished my series of pushes, I had two questions: “Did he move?” and “Did I poop?” HA. The answer to both was always no (yay for no poop). Because we were trying to get him to move down, I had to push with my doctor’s hand inside me so she could feel what was happening. It’s quite true that all modesty goes out the window in childbirth.
After about an hour, I started to feel really nauseous. Thankfully, I had the energy to say something, because almost right after voicing it and being given a cup, I started throwing up. I was currently in a kneeling position facing and hugging the back of the hospital bed, trying to push in more of a squat than on my back. I was dripping sweat and now throwing up into a cup and he still wasn’t moving down.
My doctor turned me around and told me that because he wasn’t descending and was in a sunny side up position (one notoriously hard to deliver in), we needed to consider a c-section. His heart rate was still dropping variably and given his heart concerns anyway, it was likely the best option. She spoke gently to me and stroked my legs as she told me that nothing was my fault and I did an amazing job. I agreed and once I had signed a consent form, things really started to pick up speed.
Anesthesiology came back and cranked up my medication level so that soon my legs were almost completely numb. I was rushed to an operating room, which contained a ton of people and was super bright. I could sense the urgency in the room, which I have to say increased my anxiety about what was happening. I had to transfer myself from one bed to another, which was not particularly easy given that my legs were now effectively dead weight (yay for fitness!). I laid on the table as I heard a cacophony of voices and was tested to make sure I couldn’t feel anything in my lower half. I was given injections in both shoulders, but I honestly have no idea what they were. By this time Neil had put on scrubs and was allowed to sit next to me as they raised a sheet to block viewing of the actual surgery.
At this point, I realized that I could barely keep my eyes open. I faded in and out as the voices around me blended into a hum. I found out I was still nauseous and a small container was placed next to my head for me to turn and vomit in. I struggled to stay awake and what started as mild shaking soon turned into more violent convulsions of my upper body. I tried controlling them until I couldn’t anymore, even as they placed warm blankets on my arms and chest. Neil stroked my head and one of the few things I remember hearing is to expect a lot of pressure. Although I couldn’t feel any type of cutting, I did feel the pressure of them pulling him out of my body and picked out bits and pieces of conversation including the fact that his umbilical cord was wrapped around him three times and was the main reason why he wasn’t able to descend into the birth canal. I also distinctly remember the doctor saying that he had “beautiful almond eyes.” Then my body went limp.
Because the cord was wrapped around him, he was immediately taken away and assessed for respiratory distress, which he exhibited. I wasn’t able to see him and Neil only caught a brief glimpse. I heard different doctors talking and when they realized I was in no place to comprehend anything, they filled Neil in on the situation. Miles was taken to the NICU and I was laid out on the table to be closed up without seeing my baby. Finishing surgery took longer than normal because apparently I had started bleeding a lot and to prevent hemorrhaging, they had to insert a balloon into my uterus. This works the same way as when you put pressure on a wound – by inflating the balloon, it put pressure on the bleed in my uterus and would hopefully prevent me from losing too much blood.
Once I was cleaned up and closed up, I was wheeled into a recovery room where I laid shaking for over an hour, something I was told was a completely normal side effect. I was freezing and bundled under blankets. Thankfully, they left my epidural in because of the balloon and I only pressed the medication button once before remembering that it didn’t really do much for me. That was the last time I used it.
I don’t know how long I was in the recovery room, but I do know that I couldn’t sleep. I was in and out, but never fully fell asleep. Neil sat next to me and was finally told that he could go visit our son in the NICU, which I fully encouraged him to do. From our arrival to the hospital at 3 pm on Wednesday to our son’s birth at 8:59 am the following Thursday, it had been a crazy experience. I took things as they came up because that’s really all there was to do. The fact that I went in with very few expectations really helped me have an open mind about everything that transpired.
Rather than going to a recovery room on another floor, we had to spend another night in a labor and delivery room because the balloon needed to stay in for about 12 hours. If you’re keeping track, that means I now had an epidural catheter in my spine, a regular catheter for urine, and a tube connected to the balloon in my uterus that collected blood. I was back to hourly nurse checks throughout the night which consisted of monitoring my vitals and pressing firmly on my stomach to check if my bleeding was controlled. Needless to say, my sleep wasn’t great that night either.
Neil was able to visit Miles whenever he wanted and he made sure to take pictures and FaceTime me from his visits. I wasn’t able to actually meet him until Friday morning when my epidural, catheter, and balloon were finally removed and we were moved upstairs to a recovery room. During our room transition, we made a stop in the NICU for me to meet Miles, but our stay was brief as I had to get checked into my room.
Once we were settled, the nurse visits slowed down and we were left with more time to ourselves. All I wanted to do was take a shower after the previous days of sweat and blood, but I wasn’t permitted to until the bandage came off my incision, which wasn’t until two days after the c-section. I was told what my medication protocol was following surgery: Motrin, Tylenol, and oxycodone. I declined the oxycodone unless I decided it was absolutely necessary at some point (it never was), and recovered with Motrin and Tylenol.
I wanted to visit Miles, but my body was exhausted from the work it put into having him. I fell in and out of sleep as Neil went to visit and took care of things. Once I finally felt rested, later Friday afternoon, I finally met my son.
His respiration had already started improving, but he still had IVs and was hooked up to a respirator. The nurse placed him on my chest to do skin-to-skin, something I had missed out on immediately after he was born. Honestly, I was worried about how attached I would feel to my child, but it was such a heartwarming moment. I knew I likely wouldn’t experience it as THE GREATEST LOVE I NEVER KNEW UNTIL THEN, simply because I’m not that type of person, but I immediately felt connected to him and knew that I absolutely loved him.
Because I had had a c-section, I had to stay in the hospital until Sunday. That meant we were in the hospital from Wednesday until Sunday, and I wasn’t able to take a shower until Saturday (these are the important things to note 🙂 ). We visited Miles when we could and each day he continued to improve. We were initially told that while we would be going home on Sunday, he would likely have to stay a little longer to monitor his respiration and his heart. He improved so much, however, that by Sunday we were all able to go home as a family.
I am so thankful to the amazing staff at the hospital for helping us through this process and for bringing such a beautiful boy into the world. I’m thankful to everyone who checked in on us and supported us, and I’m especially thankful to Neil for helping me make him and for already being an amazing father.
And don’t worry, thanks to my sister in law, we did get to see the Avengers.