Christine's Birth Story

There were two things I wanted for my daughter's birth. I wanted her to be able to choose her own birthday (no induction) and I longed for a non-traumatic birthing experience. I knew delivering in a hospital could have the odds increased of unwanted medical interventions, so I prepared the best I could. That meant hiring a doula team my husband and I loved, prenatal yoga, taking birth prep classes and re-reading the wisdom of Ina May Gaskin. 

My due date of 5/31 came and passed. I kept going out to brunch and walking a ton to pass the time. I made a big batch of laboraide and froze some into popsicles. As my next OB appointment and talk of a scheduled induction approached, I set up an acupuncture session 1 day past my estimated due date to stimulate the points that could kickstart labor. The very next evening bloody show made an appearance. It was followed by the loss of my mucus plug about 12 hours later. Very irregular contractions started around this time and lasted for 24 hours.

On the evening of 40 weeks, 4 days my contractions kicked in at a more regular frequency around 1am. I remember my doula advised me to relax and go to bed early that night and I decided to stay up and watch the series finale of a television show I watched over the past few years. I now regret this as I couldn't focus on the show and I could have used all the rest I could get. My husband and I didn't sleep at all that evening and when we woke up at 40 weeks, 5 days, the contractions were more frequent and intense at around 4 minutes apart. That morning we asked that one of our doulas join us at home.

When our doula arrived around 11am I was halfway into the shower thinking it would help with my contractions. It did help me take my mind off of things. I was glad the doula joined us as my breath was veering off into hyperventilation territory and I had lost my mindful breath. She got me back on track.  My doula, husband and I breathed through so many contractions mainly with me leaning over an exercise ball.

As we approached 3-1-1 (3 minutes apart, 1 minute in length, for 1 hour) and I started to wonder when we should go to the hospital. Our doula mentioned there was still some work to be done at home. She was right. I was still talking in between contractions, trying to make jokes. It didn't take long for me to go to a deeper place where I was in my own zone. 

This helped when we called a car to drive us from Brooklyn to our hospital in Manhattan. I labored so loudly in that car. I was on my knees, with my body facing the rear of the car holding on the car seat headrest. As we drove over the Williamsburg Bridge I remember opening my eyes at one point and looking out the back seat window to make eye contact with a driver right behind us. I didn't even care at that point.

We finally made it to the hospital around 1pm. I remember I had two contractions (with me moaning very loudly) before I could even make it to the check-in desk upstairs. In triage I learned I was already 8cm dilated and fully effaced. This didn't mean I would get to my labor and delivery room anytime soon. 

I was still stuck in triage for about two hours. While there I had two medical inventions I didn't initially plan on (my water being artificially broken and internal fetal heart monitoring being attached to my daughter). I also was initially feeling an urge to push when an anesthesiologist showed up and wanted to discuss options with me. I remember it was so easy to block him out and sign whatever paperwork he wanted so I could focus on my contractions.

At one point I started crying because I thought I'd be giving birth in triage it was taking so long. My doctor, who was also in her 3rd trimester of pregnancy, advocated for me to get into my labor and delivery room. When we finally moved to the room, I remember complaining as to why so many fans were blowing as it was distracting and making me cold. Turns out they were frantically trying to dry the floors as they had just finished cleaning the room. I'm glad I was too deep in my contractions to notice how close we were to not getting a room to deliver in at all.

Once we were in the room it felt like things moved rather quickly. I waited for my daughter to get to the proper station while on my knees in the bed, leaning over the back of it. When it finally came time to push, my doctor convinced me to get on my back with my feet in stirrups and they "broke the bed" and encouraged me to push when I felt the urge with each contraction. 

Pushing was the hardest part of labor for me and I ended up doing so for 50 minutes. The whole idea of pushing extremely hard without expelling any breath was foreign to me and I wasn't prepared for the sensation and intensity. The doctor asked if I wanted to reach down and feel her head while she was crowning and I surprised myself by doing so. I don't think I realized how close I was to being finished at that point.

A few last pushes and Adeline was born at 4:10pm, approximately 15 hours after my regular contractions started. The doctor let me naturally tear which was fine except for the fact a resident did the repair afterwards and I felt the teaching moment took what felt like forever. It also made me so uncomfortable that Adeline was eventually taken from me and given to my husband while they finished up.

Looking back, my labor and delivery experience makes me so proud of myself. I had told myself beforehand that the sensations associated with labor are normal. It's not pain. It's my body doing what it naturally knows to do. Accomplishing the birth I wanted was due to my prep work, but I know it was also up to a little luck as there are often circumstances out of one's control.

If I decide to have another child, I've already decided to look to do so at home given it's a low-risk pregnancy. Even though my labor and delivery was what I had in mind, the postpartum period in the hospital setting was uncomfortable and unsettling. The hospital room I had was shared and if I stuck my arm out into the curtain right next to me, I'd be in my neighbor's bed. Not really the best environment to rest and get your bearings. I was so happy when it was time to leave and return back to our safe haven at home to start recovery and spend time alone as a new family.

What Do I Need To Know About Getting An Epidural?

What can you expect from the procedure should you choose to undergo an epidural for pain relief during labor? When is the best time to ask for it? What positions can you be in? How long does it take to work? How long will it last?

I’m also introducing a concept called the Gate Control Theory of Pain, which explains how we can most effectively manage pain in childbirth with natural alternatives. This goes hand in hand with the idea that rather than fearing the pain of labor and delivery, by being informed and prepared, we can embrace the physical challenge for better experiences and outcomes.

• An Epidural is spinal anesthesia offered to you at the Birth Center or Hospital.
• Epidural medications fall into a class of drugs called local anesthetics, which includes bupivacaine, chloroprocaine, and lidocaine among others. They are often delivered in combination with opioids or narcotics such as fentanyl and sufentanil in order to decrease the required dose of local anesthetic. This produces pain relief with minimal effects. These medications may be used in combination with epinephrine, fentanyl, morphine, or clonidine to prolong the epidural’s effect or to stabilize the mother’s blood pressure. 1
• An epidural can take time to be administered depending on the availability of the anesthesiologist. Just keep in mind that you may not get it the minute you ask for it; there can be a bit of a wait–anywhere from 15 min to 2 hours. Plan to cope with a potential wait using breathing, massage and relaxation techniques.
• After a local anesthetic is administered, a catheter delivering the medication is placed in your lower spine.
• You’ll start to feel the effects of the medication in 15 minutes or so. After it’s turned off, these effects will wear off in an hour or two.
• You will not be allowed to leave the bed; however, you will be able turn on your side and use a peanut ball between your legs. 2
• Since you won’t be able to get up to go to the bathroom, a urinary catheter will be inserted as well. They’ll put it in once you’re numb and take it out before you push.
• Whether you have an epidural or not, most hospitals and birth centers will require you to have an IV, usually inserted in your non-dominant arm. If you choose not to have an epidural, you can ask for a hep-lock instead so you don’t have to carry the IV bag around with you. However, if you get an epidural, a continuous IV will be placed.
• The fetal monitor is essentially two discs that are placed on your belly to help record the baby’s heart rate and monitor your contractions. It significantly limits your mobility. If you choose not to have an epidural, you may ask for intermittent fetal monitoring. However, in the case of an epidural, continuous electronic fetal monitoring is necessary. Studies have shown that there is no difference in birth outcomes between continuous and intermittent fetal monitoring and continuous fetal monitoring is associated with a greater chance of cesarian section. 3
• You can ask for the button to control your own epidural medication. Studies have shown that when self-medicated, women give themselves smaller dosages! 4
• Labor will likely slow down when you get an epidural. If labor does not progress, pitocin may be introduced to augment labor. 1
• Occasionally, the epidural will be uneven, with more feeling in one leg or the other. Let your care provider know as soon as possible if that is the case. 5
• Our recommendation si to wait until you are 6- 7cm dilated to get the epidural. Getting the epidural too early can stall labor. Once you’re at 8cm, you’re so close that it may not make sense unless it's been a really long labor and you're looking to rest. 
• Occasionally, some women are allergic to the medication. There isn’t a good way to test for this allergy, but you can ask for it to be administered in small test doses to start. 6
• Studies have shown that epidurals can cause maternal fevers and in turn affect the baby. If you have a fever after birth, often the baby is taken to the NICU for 48 hours to ensure that they haven't developed any infections. 7
• There is a risk for pelvic and hip injuries caused when pushing. Injury can occur both with an epidural and without but not being able to fully feel your internal musculature can put you at a greater risk. 
• The medications in an epidural are the same as those used for anesthesia in Cesarian sections. In case of a C-section, the epidural is left in for about a day to help numb the pain after surgery. You will be given pain meds after the epidural is taken out, and the scar from the incision will be kept numb for a few weeks.

The Gate Control Theory of Pain–A natural alternative to relieve pain

Have you ever burned your finger and immediately run it under cold water for relief? The Gate Control Theory of Pain explains that there are two types of fibers that transmit messages to the brain–slow-acting fibers, and fast-acting fibers. However, before the pain signals reach the brain, they encounter neurological “gates” along the spinal cord. These gates filter pain signals to determine which ones reach the brain. Pain is perceived when the gates give way to these signals, and is less intense when the gates close. If the fast fibers are stimulated more than the slow fibers, the gates close, inhibiting transmission of pain impulses and reducing pain perception. So when we pour cold water over a burn, the water activates the fast acting fibers which closes the gates, which results in fewer pain impulses reaching the brain and reduces our perception of the pain from the burn.

When we apply sensory stimulation–such as heat, cold, water in a bath/shower, firm pressure, intradermal water blocks, Transcutaneous electrical Nerve Stimulation (TENS) and massage–the fast fibers are activated, endorphins are released, and the transmission of pain never reaches the brain, preventing us from perceiving it.

So while waiting for the epidural (if you choose to have one), to manage your pain most effectively use methods that take advantage of the Gate Control Theory of Pain. For example, place a heat pack on your low back in the same spot where an epidural would be administered, or have someone massage you in that same spot. You can see exactly where on your lower back an epidural is administered at this link.