© Amber Therrien 2011. Amber provides perspective on how assistants can be unhelpful and abusive, even when birthing outside the hospital. She gives insight on back labor and prolonged labor. This account may be triggering. In two parts due to length. Part two:
Despite being exhausted in every sense of the word, I pushed with all I had in me. I have no idea what order they went in, but the positions I tried ranged from lying down, squatting, and standing, kneeling, and being on a birthing stool. John was my constant support, often literally, and Cari was always within reach and giving me water. Thirst was a constant thorn. At some point while I sort of hung off the end of the bed between John’s legs, my midwife began giving me little cliff bar energy packets that tasted awful but I forced them down. I kept thinking that this was the home stretch and I wanted to be alert when my baby arrived.
We were back in the bedroom when she did yet another check and told me that the anterior lip (the part of my cervix that wasn’t fully open) had swollen and was blocking my daughter from descending. I didn’t have energy to get upset; I just asked what to do now. Her solution was for me to continue pushing while she attempted to move the lip back and around the baby’s head. I thought I knew pain before this and I was wrong. I screamed now.
There was no attempting to maintain dignity. There was no desire to impress her, or anyone else. I screamed and I begged her to stop. I tried to wiggle away and may have even tried to kick her. It was torture. I have no other word to describe it. I begged her to stop, to get out of my body and she refused, saying it was for my own good.
I couldn’t see how this was good. Even in the now dense fog of pain relievers my body was attempting to give me I knew something wasn’t right and felt there had to be a better way. John, who had been awake with me for most of the past 30 hours or so without food said he wasn’t feeling well. I didn’t think of it until later, but I imagine seeing his wife in that state may have led to his stomach upset. When he asked me if he looked pale the midwife snapped, “It’s not about you right now!”
Cari spoke up that he didn’t look well, and hadn’t eaten and convinced him to go get something to eat. I was too tired to speak or argue and thankful that someone was looking out for him as well. It may have been me birthing, but it was his child as well and I wanted him ready to receive her happy and healthy.
After the midwife tried to move the lip back by force some more, and got very annoyed with me screaming and pleading with her to stop, I was allowed to return to the tub to try to stop my pushing. I had moved the baby down just enough that now every contraction forced me to push. The only way to describe it would be vomiting in reverse. I had no more control over my body trying to push the baby out than you do over not blinking if someone claps in your face.
My doula had hung a quote up for me that said, ‘the power and intensity of your contractions cannot be stronger than you, because it is you.‘ It had helped in the middle of my labor, but now I felt like the power might tear me to shreds. I refused to take Unisom so we opened a bottle of mead I had been saving for after the baby was born and I drank a glass. It was delicious but I had to choke it back and I can’t say it did anything to calm me. I figured everyone else in the house was most likely frayed at this point and offered for them to each have a glass as well. I may not have been very coherent, but I still had some manners left.
When it was clear nothing was going to stop my body from trying to move the baby down we went back to trying every position we could think of to wiggle her around the edge of my cervix. I could hear my voice, far far away, roaring. For a moment I was proud of myself for being able to make such a noise. While I was pushing on the bed the midwife announced she could finally see my daughters head and had Cari take a look.
Her beaming smile gave me hope and a small measure of strength to keep pushing. I would find out later that the amount of head she could see was the size of a dime and largely obscured by my cervix, which resembled a bloody sausage. The midwife’s assistant suggested we try stairs and lunges to open me and move my hips around. Few things are as annoying as trying to remember how the hell to do a lunge after thirty something hours of labor. We decided I should put some pants on and try walking up and down the stairs outside my apartment. When she tried to convince me to put a depends on for any bleeding I flat out refused. I had to hold on to some part of my dignity and that would be it.
We went out to the stairs and a small part of me hoped someone would come out of their apartment. I was beginning to wonder if the outside world still existed at all. I lunged up and down the stairs with John by my side. When a contraction would come, forcing me to push, I would practically climb up him trying to escape the pain. There were scratches and bruises on him for days afterwards to attest to the strength with which I tried to escape.
When my legs felt as if they could not carry me any further we went back inside. I was on the birthing stool again, and still roaring. I had been pleading for hours now for someone to let me go. Something didn’t feel right, but I couldn’t seem to get anyone to hear me and help me leave. I knew Cari couldn’t, it is outside of what we’re allowed to do as doulas [give medical advice or opinion.] And I don’t think John had realized I was serious. Finally my midwife looked at me and said, “I can’t watch you do this anymore.”
It was what I needed. I had wanted a homebirth more than anything, and I believed in natural birth and my ability to birth, but something had gone wrong and I did not believe it was going to happen with this child. Someone saying it, and finally saying it was okay for me not to do this, was a relief. The feeling of failure set in immediately and I just wanted this all to be over. While everyone scurried to get things together, find a hospital, and alert the hospital that we were coming I was lost in my failure. The ride to the hospital was the worst of my life, but I think I was able to get a bit of rest.
When we got to the hospital everything went into fast forward. I was put into a wheel chair, which I was too tired to refuse, and rushed up to somewhere. I was told I could only have two people in the room with me and momentarily became frantic. I wanted Cari, but I knew the laws and knew she couldn’t speak for me the way a midwife could, so I chose John and my midwife.
I instantly regretted my decision but didn’t know what else to do at the time. John and the midwife stayed out to talk to the doctor while I was taken into the room. I went into the bathroom even though I knew I didn’t have to go and when I came out a nurse was there. I asked her what we could do to stop me pushing and she held up a hospital gown and told me “we can’t do anything until you’re wearing this.” I knew she was full of shit, and I knew my rights, but I could feel a contraction coming on so I quickly pulled my shirt over my head and my pants and shoes off just in time to fall to my knees and yell “There! Now DO something!” as another contraction took hold.
She was shocked for just a moment before handing over the gown. She said there was paper work, and fluids, and blah blah blah before anything could be done. I forced myself to pay attention and only signed papers I was 100% sure about. I asked for my water and she told me I wasn’t allowed to have it; my fluids bag would give me all I needed. I told her if I was going to aspirate something I would rather water than bile and ordered John to give me my water bottle, daring her to take it from me. She left the room in a hissy fit and never came back.
The doctor came in and checked me and said she couldn’t see how the baby would get past the lip. She asked a lot of questions about how long I had been pushing, how long my water had been broken, and about my midwife. Eventually I was told I was becoming exhausted and would need a c-section. My midwife briefly came in to see what the doctor said, and that was the last I saw of her. She had given up on me and again I regretted not choosing Cari.
My next nurse was lovely. I told her right away that I wanted to go to the bathroom, and even though she knew I didn’t really have to go she said that whatever made me comfortable was just fine with her. She told me that the woman in the room next to me needed an emergency c-section so I was going to have to wait for the anesthesiologist to come give me an epidural.
Before helping me walk my I.V pole over she told me she wished she could give me something to help me stop pushing, but she knew I wanted a natural labor. I didn’t remember saying this until John told me the next day, but I replied, “that’s pretty much out the fucking window now isn’t it! Please…just make it stop.” She helped me to the bathroom and left to get me drugs.
It was at this point I told John I wanted to die. He laughed it off a bit saying, “of course you don’t honey.” But at the time the pain coupled with failure was more than I thought I could handle and I meant it. We were in a hospital and the baby would survive, but I didn’t know how much more I had in me. And at that point the baby seemed like an impossible dream.
The nurse gave me a shot of Stadol and the pushing stopped. I was asleep nearly instantly. I woke up once and saw my mother standing over me. I asked how she had gotten there and if she was okay, then apologized for not being able to keep my eyes open. She brushed my hair back from my face while staring at me with a look I didn’t recognize and told me it was okay and I should get some rest.
I said I was sorry one more time and slipped back into sleep. I woke up about half an hour later dully aware of my body beginning to push again and became very alert. I saw John sleeping on the desk in the corner and called out to him. A minute later I was back to full on pushing, writhing in my bed without the blessed oxytocin to help me.
John must have done something because people were quickly back in the room. My nurse was checking my machines to see how I was doing, John was putting on his scrubs, and the doctor was explaining what would happen next. She told me she wanted to check me one more time before letting me get an epidural. I told her I appreciated it, but I did not want another check.
I was amazed when she told me that it was important to her that I had wanted a natural birth and she wasn’t comfortable giving me an epidural until she knew I couldn’t have one. I trusted her because of this and allowed her to check me. A huge smile crossed her face and she told me “I can see the head!” John and I simultaneously responded that we’ve been able to see the head for hours and it didn’t matter. She made John turn and look and I’ve never seen such happiness on his face as I did then.
The little bit of rest from the Stadol had allowed me to relax my muscles and stop forcing the babies head the wrong way, she had shifted while I slept and was now much further down the birth canal. That was all I needed to start really enjoying my pushing. I could feel her making slow and steady progress now and it was exhilarating! I could feel her head about to come out, but something was stopping her.
I heard the doctor say to a nurse that she hates episiotomies (a cut to widen the opening for the baby), but thought she would have to do one on me. I told her I didn’t want one and she was okay with this. But a few minutes later I could feel that I wasn’t making progress. Something wasn’t moving correctly and I told her it was okay. I trusted my instincts this time. I felt the ‘ring of fire’ when her head began to crown and heard the lovely nurse telling me to ‘push through the pain honey’ but I smiled and told her it didn’t hurt. I could feel it yes, but I was too happy to care.
My daughter was coming and I would see her soon and nothing else mattered. I remember the feeling of her head coming out being intense, but I wouldn’t call it bad. After her body came out I heard the doctor ask for something to clamp the cord and I yelled, “No, don’t!“ I told her I wanted them to wait until it stopped pulsing and she looked bemused, but not annoyed. The man waiting to weigh and score my baby was clearly impatient and told her he had to leave. She told him I had been through enough and deserved this so he could wait.
The placenta came quickly and I was handed my beautiful and bruised baby girl. The video of her birth shows me asking, “Did anyone even check to make sure she’s a girl?“ and then lifting her leg to be sure. Very soon after I began holding her I could hear frantic noises next to me. I listened and heard someone ask where all the blood was coming from.
The doctor ordered Pitocin and a nervous voice said that they had already given me some. Two women began frantically pressing on my belly. I knew they were trying to get my uterus to contract, and I knew I was hemorrhaging. There were snippets, “I don’t know where it’s coming from,“ “there’s so much,“ “can we give her more.“ All I could think was there was no way I was leaving this beautiful girl now that I finally had her and then I heard, “okay…she’s okay.“
The cord eventually stopped pulsing and my husband cut it, then my not-wrapped or cleaned baby was allowed to lay on my chest with clear eyes.We were still in triage. I quickly went into the bathroom to shower and rinse off and came out to a dimly lit room full of my family and loved ones, and saw my father holding my sweet girl with tears in his eyes. I laid down with her and luxuriated in her scent and feel and felt deeply connected to everyone in the room. I birthed my daughter at 6:05 pm, after 37 hours of labor, 23 hours of active labor, and 12 hours of pushing, to the cheers and smiles of a hospital room full of strangers who believed in me, with my husband still in surgical scrubs and an IV in my arm, and it was perfect.
I would later learn that my midwife had lied to the doctors and that is why there were so many questions when I arrived. I had also become big news in the hospital and everyone seemed to want to meet us and talk to the woman who transferred from home. I am still struggling with what happened and with my feelings of inadequacy, but I realize how much worse things could have been, and I know we were saved in the end and amazingly lucky.
I think Mama Birth said it perfectly when she said, “No, I don't need to see the world to know that I am both strong and weak, powerful and frail; labor has taught me that already.”