By Amy Wood, contributing writer
Most people probably don’t envision high-risk pregnancy and natural birth as being compatible, but if you have been reading my posts about different aspects of high-risk pregnancy you know that I was planning to have a natural birth with my first child, even though I have a chronic health condition that will always make me a candidate for high-risk pregnancy. So what ended up happening?
High-Risk Pregnancy and Natural Birth: Isaiah’s Story
It was October, and as I neared the end of my pregnancy, everything was progressing normally. My blood sugar was under good control, and my baby always looked great during biweekly non-stress tests. My husband and I were finishing up our natural birth classes. We had met with our doula, Amanda, a few times, and now we were all just waiting. My doctor offered induction at all of my appointments in the last weeks of my pregnancy and I always declined.
At 37 weeks, I felt my first contractions. I was confused at first; I thought I would feel a tightening around my entire belly, but the sensation I was feeling was only in my lower abdomen and was similar to the monthly cramping I was used to. I had a few hours of these contractions one night, and then they stopped.
This occurred three other times during my 39th week. The contractions were increasingly intense and I tried to put into practice all of the techniques we had learned in our classes: relaxation, breathing, trying different positions and moving around, etc. I was getting a little frustrated and I wondered how I would ever know when I was really in labor. Amanda encouraged me by telling me that these contractions could be helping the baby turn from being posterior into a better birthing position, so I just tried to go about my day without spending too much time wondering when the baby would come.
An Unexpectedly Fast Labor
On Sunday the 19th, a few days before my due date, I wasn’t feeling well- after my last bout of contractions the previous day I felt a sharp, continuous pain in my lower back, as if I had a pinched nerve, and was trying to treat the pain by sitting with a heating pad.
I emailed my Bradley instructor (and friend!), Rachel, to ask her to pray for me. She called later in the afternoon and we chatted for awhile. I said to her “wouldn’t it be nice if the baby was born by the end of the day…well, it’s already 4pm, so I guess that won’t be happening”. Rachel told me that the local midwife apprentice who helped connect me with my doula had offered to meet with me the next morning before my appointment to check my cervix and I agreed to call her the next morning.
That evening at 7:08pm I felt a contraction, I thought about just brushing it off since I knew by now that it might not lead to anything, but decided instead to write the time down on the dry-erase board in our kitchen. In the meantime, Adam had just put a caramel apple pie in the oven (which we now refer to as “Isaiah’s birthday pie”) and I made myself a sandwich to eat for dinner. My next contraction came 20 minutes later and I thought how odd this was compared to the other times when my contractions began very close together.
The contractions were intense and I had to focus and relax through them, but in between I was checking my email and chatting with Adam. Then a few more contractions came, but now at 12 minutes apart- they were still intense enough that I did not want to talk during them. I called Amanda to let her know what was going on and agreed to call back with updates. I also talked to Rachel and told her that I was having contractions again and it might be the real thing. While talking with Rachel my contractions began coming every 8 minutes and I really felt like I needed to get off the phone and concentrate- the contractions were becoming very intense.
From about 8:30- 9:20pm my contractions were about 6-8 minutes apart and very strong. I also went to the bathroom at some point and realized that I was losing my mucous plug. At that point I really began to believe that this was going to be the real thing! I decided to lie down, relax, and try my favorite relaxing position that we had been practicing. My doctor was in agreement with us that we should labor at home for awhile before coming in to the hospital because labor usually takes a long time and I would be more comfortable at home and wouldn’t have to worry about fending off unnecessary interventions at the hospital.
I figured that we would be hanging out for awhile at home and that I had better get comfortable. But I couldn’t. I tried a few positions before finally deciding to take a warm bath. The bath was nice in between contractions, but during them I found it very hard to relax. By this time I had told Adam that he needed to stay with me at all times.
I got out of the bathtub and felt like I was doing a terrible job handling the contractions- they were still about 5-7 minutes apart, but they were extremely intense and I felt like I could not relax. I began to wonder how I would do this for so many more hours and I felt like such a wimp- why did I think that I could have a natural birth?! I thought that Adam and Amanda would think I was the wimpiest person ever since I couldn’t even handle what I assumed then to be early labor. I even started to cry and I couldn’t even think straight.
The Surprise of Transition
I kept telling Adam “I can’t do this…this is too hard…this is too painful…it’s just too much…I think I really need some medication or better yet just take me to the hospital, put me under, and get the baby out!” This was around 9:30pm, and looking back, based on my emotional signs, we believe that I was already in transition. At the time, because I had only been in labor for a little over 2 hours we didn’t think I could be in transition so quickly, so I thought I was in early labor and I couldn’t imagine going on for hours or the intensity increasing (which it didn’t really after that point), but in fact I was in hard labor. At this point I was also feeling very nauseous so I decided that it would be a good idea to stay in the bathroom. I got down on my hands and knees, which seemed to be the best position for me, so I stayed that way and leaned over the toilet.
Adam called Amanda to give her an update and she asked what we wanted her to do- check back in a little bit, come over, meet us at the hospital? I couldn’t think and so I just kept telling Adam, “I don’t know what I want her to do”. Adam asked her to come over. Around 9:50pm contractions were coming every 3-4 minutes and I felt like I couldn’t handle it anymore. I was still on my hands and knees over the toilet and with each contraction I focused on breathing normally, deeply and it felt natural and somewhat more comfortable to sway my hips. Adam rubbed my back, encouraged me, and tried to do what he could to comfort and support me, though I was quite out of sorts by that time!
I thought that maybe we should go to the hospital, but then I also thought about how I did not want to ride in a car for 30 minutes feeling like THIS. I also still thought that my labor would last many more hours and I did not want to get to the hospital too soon (clearly I actually have the opposite issue!).
Amanda arrived around 10:15 and just observed us in the bathroom for a few minutes. My contractions were close together and very intense- we stopped recording their timing at about 10:30. I still doubted myself, told them that I was scared and that I thought I could not do this. Amanda suggested that I try some different positions so we moved out of the bathroom and I tried standing with my arms around Adam, being on my hands and knees on the floor, and also having Amanda apply counter pressure to my back. I was still very uncomfortable and didn’t know what to do. Soon after this I threw up. We decided to call my doctor and let him know that we were coming to the hospital, it was about 11:00pm.
As soon as Adam got off the phone with him I felt tremendous pressure and thought I needed to go to the bathroom, but realized that I was actually feeling the urge to push. I stayed down on the floor on my hands and knees and Amanda showed me how to breathe through my contractions and not push myself, although my body was. I began to get nervous at this point because the hospital was not exactly close by.
Adam took all of our things out to the car and covered the backseat with towels as my water had not yet broken. Amanda helped me get dressed and get down the stairs, then left to get into her car and follow us. Before Adam and I could get out the door I had another contraction and once again needed to get down on my hands and knees and focus on breathing through it. We grabbed a blanket before we walked out because I told Adam that I was cold. I got onto my hands and knees in the car and draped myself over the backseat, with one knee on the floor. I was no longer cold so I balled up the blanket, placed it up against the inside of the door and laid my head into it. We left our house around 11:20pm.
“The Baby is Coming Right Now!”
During the car ride my contractions began to space out a little bit, but with each one I called out to Adam “I need to push, the baby is coming right now!” Adam, being ever calm as he is, just kept telling me, “no, you don’t have to push…just breathe, you’re doing great”. With every contraction I swayed back and forth, tried to breathe, and continued to pray, “Lord please help me”. I braced myself with every turn, and having been to the hospital many times over the previous few weeks for non-stress tests I knew exactly where we were without even seeing out the window- and I felt like we would never get there!
Adam called my doctor when we were very close to the hospital to let him know that I was fighting the urge to push. When we parked, Amanda told Adam to go in and get a wheelchair and she helped me out of the car. As Amanda and I were walking in I felt another contraction coming on and dropped down onto my hands and knees in the parking lot. Adam and a man from the ER came out with a wheelchair during my contraction and the man said, “I don’t think you should be doing this out here”. Of course, I had no intention of standing up and walking into the hospital at that moment!
When the contraction was over I sat down in the wheelchair and was wheeled up to labor and delivery- a room was ready for me, and our nurse, Amy, was waiting. I felt another contraction coming on so I climbed up into the bed and got onto my hands and knees. Adam and Amanda helped to take off my clothes and soon after that my water broke all over the bed. The nurse wanted to check me and asked me to roll over and lay on my back, but I said that I couldn’t, so she waited for my doctor to come and in the meantime found the baby’s heartbeat with the monitor- baby was doing great! My doctor came into the room, checked me, and found that I was completely dilated. He left the room to change his clothes and when he came back it was about 12am and I was finally able to push.
Our nurse moved the head of the bed up which put me in a kneeling position, holding onto the top of the bed. Adam was right next to me and Amanda and my doctor were behind me. I began to push whenever I had a contraction, though not very effectively at first. I was relieved to be able to push, but still a little scared and I wasn’t concentrating very well.
Someone reminded me of what to do while pushing and then I think I was much more effective. I was making a lot of noise during contractions and pushing, but I actually felt so much better than when I was going through hard labor at home. Between contractions I asked how the baby was doing (the nurse was still holding the monitor on me) and my doctor kept telling me that the baby was doing great.
An Empowering Natural Birth
Amanda continued encouraging me, though I can’t remember exactly what she said. After I had pushed for a few contractions, my doctor said that if I turned around into a squatting position he thought that the baby would come very soon, so I slowly turned around and grabbed onto Adam’s arms and the side of the bed to steady myself and hold me up as I pushed.
When the baby was close to crowning, my doctor took my hand and let me touch my baby’s head for the first time, I could hardly believe it- my baby was almost here! After a few more pushes the baby’s head was out, and then the rest of his body! It was 12:33am. He had been presenting with both of his hands up by his head and my doctor was able to move one out of the way. I did suffer a tear, probably from a combination of things, including how fast the baby came out.
I heard the nurse say, “we have a boy!” and I saw him laying on the bed below me. I had almost forgotten that we didn’t know the sex until that moment- I hadn’t even asked if it was a boy or girl! He was handed to me immediately and our nurse wrapped a blanket around the two of us.
I felt such a sense of relief that the baby was finally born and I couldn’t believe that I had just done that! I felt so amazed and empowered. That “birth high” you may have heard people talk about? Absolutely! I was overjoyed to finally be holding my baby. I was so proud of myself for working hard to achieve the natural birth that I desired to have and felt was best for myself and my baby. I did it! I had stood my ground, found a respectful care provider, and demanded evidence-based and individualized care. Despite having a high-risk pregnancy, I proved several doctors wrong: I had a healthy pregnancy, healthy baby, and uncomplicated birth.
Adam and I did everything in our power to ensure that I continued to be healthy and that my blood sugar was well-controlled throughout the pregnancy. We did all that we could to give our son a healthy beginning to his life, and we prepared ourselves in every way we could for a natural birth- and we did it. I remained healthy throughout my pregnancy, my baby was healthy, and I found that high-risk pregnancy and natural birth are not mutually exclusive.
My first labor was also very fast, and I remember being at home going through contractions thinking the same thing you did, “how am I going to get through labor if I can’t even handle the early part?” Of course, it WASN’T the early part. I was 8 cm when I got to the hospital.