When I became pregnant with Judah in 2010 there was an increasing awareness of birth culture and choices in childbirth in the United States. With unnecessary interventions on the rise, documentaries like The Business of Being Born, books like Ina May Gaskin’s Guide to Childbirth, and January Harshe’s Birth Without Fear movement aimed to restore childbirth as a natural human experience versus a medical emergency.
Idealistically I wanted to birth with the midwives at Ina May’s Farm in Tennessee, but realistically I wanted to have a natural, or physiological childbirth in the hospital. I quickly realized the importance of having a good birth team in place. I wasn’t a doula at the time, but knew what a doula was and that I wanted one. I interviewed one who came highly recommended by a friend who used her. She was training to become a midwife and also taught private childbirth classes. We immediately connected and I felt confident.
My pregnancy started out with unrelenting nausea which made commuting an hour each way to and from my corporate job very unpleasant. Nevermind the guy in the cube next to me who ate tuna fish sandwiches for lunch everyday. Around the time the nausea subsided, I found out I was a carrier of an Ashkenazi (Eastern European Jewish) genetic disease and that my husband Jeff would also need to be tested. He was adopted so we didn’t know exactly what his biological background was. I asked my doctor if I was a carrier for any of the other diseases I was tested for so I wouldn’t have anything to worry about and she said no. Whew. Jeff’s results came back negative and we breathed another sigh of relief. Two weeks later, I was on traveling on business and she left me a voicemail saying that I was a carrier for another disease and that Jeff would have to be tested again. I remember crying in my hotel room feeling upset because she told me everything else came back negative and now we had to go through another two weeks waiting for Jeff’s results. People make mistakes but trust was broken and I had doubts about her. I requested my medical records and scheduled an appointment with a highly recommended doctor who was affiliated with the same hospital I was born at. My sisters and their children were born there as well.
The night before my appointment with the new doctor, I read through my medical records folder. There it was in plain English. She missed a third genetic disease I was a carrier for. This confirmed that I needed to transfer care. The next day we went to our appointment with the new doctor and handed the receptionist my records. She squeezed us in before office hours and it was early so we didn’t think the doctor would have time to read through them. She introduced herself and immediately asked why I was a carrier for this third genetic disease and that Jeff hadn’t been tested for it. We knew right then that this was our doctor. She was also very supportive of our birth preferences.
The rest of my pregnancy was uneventful except for small amounts of fluid that seemed to be leaking. I mentioned it to my new doctor but she didn’t make much of it. Then at 38 weeks and 3 days, my usually very active baby stopped moving. It was around lunch time so I drank a big cold fruit smoothie and layed down on my left side to do some kick counts. There wasn’t a whole lot to count. Later that evening he still wasn’t moving very much so I called my doctor. She sent me to the hospital for monitoring. There wasn’t much activity so they did what’s called a biophysical profile. It revealed that my amniotic fluid was low, my baby’s fetal breathing was absent and his movements for non-reactive. I wasn’t dilated and was barely effaced. My doctor sent me home, told me to drink water and lay on my left side, and scheduled a another test at the hospital the following day.
She called me first thing in the morning and told me to come right to her office. I knew by the tone of her voice that I probably wasn’t coming back home that day so I called my husband and doula, took a quick shower and head to her office. Jeff left work to meet me there. She reviewed the report taken the night before and said that pockets of amniotic fluid that the umbilical cord was in were counted, meaning that my fluid was lower than we previously thought. She checked my levels herself and my fluid was even lower and he still wasn’t moving. We discussed the situation and my options and I consented to an induction. It was one of the things I really wanted to avoid but I felt like my baby was asking for help.
By the time I was admitted to the hospital and my IV was started I was tired and hungry. My doctor told Jeff he could grab me a half of a sandwich and some fruit before starting the (dreaded) Pitocin. Most doctors wouldn’t allow eating before an induction so I was grateful. I gave my doula an update and that I would call when I wanted her to come. In the meantime, my sister who birthed twins vaginally at the same hospital 5 months prior within two hours came to offer additional support.
Once the Pitocin was started, the doctor instructed the nurse to keep me sitting upright on the birth ball and not to lay down. A few hours later, she came to check on me and nothing much was happening aside for some pressure in my lower back. I was getting uncomfortable and asked my doula to come. When she arrived I told her I wanted to get into a hot shower. My doctor was okay with that so she stopped the Pitocin and taped up my line. I was able to get some relief in the shower but my contractions were starting to space out, so back on the Pitocin I went.
As more time passed and the Pitocin increased, I still wasn’t dilating so my doctor performed an amniotomy (broke the bag of waters). That kickstarted my contractions and the pressure I was feeling in my back intensified. At this point nobody had to tell me my baby was posterior (face up) – I just knew. We tried a few things including changing positions. By now we were 15 hours into the induction and I was still 1 cm dilated and experiencing horrible back labor. I told my doula I wanted an epidural and she knew I was serious. The mean anesthesiologist kept yelling at me not to move, which I understood the extreme importance of, but being on Pitocin at the high dose of 18, I had no relief. I was having tetanic contractions. No start, no end – in addition to my baby being in the posterior position. Could he try to be just a little nicer about it? He had me curl up in a ball but the sensation made me want to arch my back. I dug my nails into my poor doula’s arm and screamed, “FUUUUCKK” at the top of my lungs, convinced I woke up the entire floor, but I didn’t care. Once the epidural was finally placed, I got some relief and took a short nap. When I woke up, I had finally progressed and my doctor said that soon it would be time to push and meet my baby. Bless her for being by my side for the majority of my labor.
I started off pushing pretty well, but after a couple of hours I was nearing exhaustion and my baby wasn’t budging from his position. We were nearing the third hour of pushing and my baby kept getting stuck under my pelvic bone. I needed help. My doctor explained why she wanted to use the vacuum along with the risks to which I consented. She instructed me to push but to stop when the baby’s head came out. Well the flipping vacuum popped off and she said, “Lacey, we need to get this baby out. I’m going to have to do an episiotomy.” Tears started streaming down my face. This is not what I wanted to hear. I had been through so much at this point and was feeling defeated. She told me we could give it one last chance but that she would be doing the episiotomy if we weren’t successful.
The next contraction took its sweet time but when it finally came, my doctor, the nurse, my husband, my sister and my doula cheered me on. “Push Lacey push,” they said. “Go on, you can get a little angry” said the nurse. I gave it everything I had and Judah’s little head popped out facing up to greet everyone. I was completely exhausted and the doctor helped assist him the rest of the way out. The NICU team was there just in case, but his Apgar scores were strong. He weighed 6 lbs, 13 ounces and measured 19.5 inches. His head, face and body were very bruised from his challenging journey into the world, but it was in that moment that I realized how symbiotic our relationship was, and that we did it together.