A Mighty River

Over the course of the last 9 months or so, I have written one post after another about preparing for the arrival of our son.  Even though this would be my third time laboring and birthing a baby, I put forth just as much effort as the first time around ensuring that everything was in place and that we would be ready when the day finally came.  On Thursday, August 22, 2013: that day indeed came.  It was everything we had hoped and planned for it to be while simultaneously surprising us and knocking us off our feet.  Here is the story of how our mighty River entered this world.

We knew from the beginning that a scheduled induction could possibly be a part of our birth plan.  Due to her large size (9 lbs 11 oz) and very broad shoulders, Brees was born in distress with shoulder dystocia.  Basically, her shoulders were stuck under my pubic bone and my doctor had to use a special maneuver to get her out.  She had a mild case of hip dysplasia as a result and we had to see a pediatric orthopedic doctor for several months after her birth.  Because of all of this, my OBGYN discussed, from the very beginning, the possibility of inducing me early to ensure that this baby didn't get TOO big, thus resulting in the same scenario.  We knew from our 36 week ultrasound that he was larger than average and that I was carrying around an extra large amount of amniotic fluid.  Shawn and I both agreed that if a scheduled induction was the best plan for our baby, we were on board.  At my 38 week appointment, my doctor confirmed that I was 3 cm dilated, 50 % effaced.  I was having contractions off and on throughout the day and the baby was nice and low.  We agreed that if I didn't go into labor on my own before Thursday, 39 weeks and 1 day pregnant, we would move forward with the induction.

We spent the next few days calling friends and family, making last minute preparations, and spending as much time together as possible.  My mother came over on Wednesday night and stayed with us so that she could be with the girls in the morning.  Shawn and I tried to get some rest but between the contractions coming and going and my frequent bathroom trips, sleep never really came.

We woke up very early on Thursday morning and got dressed and ready to head to the hospital for the induction.  Though we were both a bit nervous about the procedure, we were almost bursting at the seams with excitement that today was the day: today we would finally get to meet our son!  It was very surreal to kiss our sleeping girls goodbye, hug my mother, and leave my house knowing that next time I returned, it would be with an infant in my arms.  We made the 40 minute drive to the hospital talking and laughing the whole way, praying and holding hands as we mentally prepared ourselves for the day ahead.

We arrived at the hospital at 4 am as we had been instructed to.  Because I had preregistered at the hospital (OCD over-prepared nurse that I am), all of my paperwork was already in place.  We were led to our room by a sweet nurse named Christy who had me change into a hospital gown, started my IV, and put me on the fetal monitor.  The hospital where I gave birth supports low intervention childbirth and I was not required to wear the monitor throughout my labor, only intermittently to monitor the baby.  She set me up with a big glass of ice water, reviewed the plan for the day, and then started me on the lowest dose of Pitocin.  The plan was to put me on Pitocin until my contractions became steady and regular.  At that point, my doctor would break my water and allow my body to finish the job on its own.

Christy left the room, dimming the lights and urging Shawn and I to get some rest.  We both napped on and off for the next several hours, waking when my doctor made her rounds at 7 am.  Dr. Ingalls is a mother of 3 herself and has the most calming, soothing energy of any doctor I have ever worked with.  She has always made me feel so comfortable and strong and capable, encouraging me to believe in the process and enjoy it for the miracle that it is.  Seeing her that morning and hearing her reassuring words: it soothed any anxiety I had previously had.  I knew that we were in the best hands.

My mother arrived shortly after 8 am after putting Isabelle on the school bus and dropping Brees off with the babysitter.  She brought coffee and her trademark sense of humor, helping me to the bathroom when I needed and keeping Shawn entertained.  I am so thankful that my mother has been present during all three of our children's births: she is an essential part of our support system.

The morning proceeded with relative ease: our day nurse, Shanny, arrived and came in periodically to check on us.  The labor and delivery nurses at our hospital have only one patient each when a woman is in labor, allowing them to give you unlimited care and support.  Shanny was a very knowledgeable nurse and always seemed one step ahead, knowing what I needed before I even asked.  It's not easy to nurse a nurse as most of us make terrible patients but Shanny and I had a great connection from the start.  The Pitocin was doing its job and forcing my contractions to pick up in intensity and frequency.  They were coming about 4-5 minutes apart but were extremely manageable.  I declined the epidural each time Shanny asked me if I was ready, not wanting to get it too early and not feeling like I needed it at that moment anyway.  I concentrated on breathing through the contractions and resting as much as possible.

At 10:30 am, Dr. Ingalls came in to break my water.  She informed me that I was still only 3 cm dilated, patting me gently when she saw the disappointment on my face.  "Don't worry", she reassured me.  "Your contractions are regular now and things are about to really pick up.  I have a meeting at noon so if you want to have the baby around that time to get me out of it, I would really appreciate it" she said jokingly.  I laughed and assured her that I would do my best although I was very doubtful that I would be giving birth in the next 2 hours.

My contractions quickly picked up, just as Dr. Ingalls had predicted, and within 5 minutes of having my water broken I was having contractions 2 minutes apart.  My pain level went from "Breath, you've got this" to "Holy hell that hurts!" in minutes.  Shanny watched me breath through a few contractions and then offered the epidural again.  This time, I took her up on it without pausing.  I've had an epidural for both of the girls and knew that I wanted one for this birth as well.  I have big babies and had no desire to birth a nearly 10 pound baby naturally.  Taking the edge off with the use of medication was always part of my plan.

At 11 am, the anesthesiologist came in to administer my epidural.  Shanny checked my progress and I was now 5 cm dilated and my contractions were 2 minutes apart.  I was in a pretty significant amount of pain and just the sight of that doctor and the promise of relief he brought with him comforted me.  Shawn stood in front of me and I wrapped my arms around him, his arms around me.  He held me close and whispered words of encouragement to me as the doctor got the epidural in place.  I could feel the tension in his arms as he felt my body shake through the pain of the contractions.  He was trying to stay calm and comfort me as much as possible but I could feel how much it hurt him to see me in so much pain.

Within minutes, the epidural was in place and Shawn and Shanny helped me get comfortable and settled in bed.  I felt the medicine begin to descend into my lower body and breathed a sigh of relief.  I could still feel the contractions but my pain level had definitely been dialed down a notch.  I looked up at the clock: 11:15 am.  When Shanny asked if I needed anything, I told her that I was going to close my eyes and attempt to get a little rest as I was sure we would be at this for most of the afternoon.

I closed my eyes and attempted to relax but felt the intensity of my contractions begin to pick up again.  I thought that perhaps the medicine was not fully in my system yet and resolved to breath through each contraction while the epidural did its magic.  Shawn could see the pain begin to show on my face again and reached for my hand, asking if I was okay. With each contraction that passed over me, I began to feel more and more pain.  The numbness that had previously begun to spread through my legs was now subsiding and I realized that I could move them freely.  I could move my entire body freely, actually, something that's not usually possible with an epidural nerve block.  I asked Shawn to call Shanny back in, knowing that something was wrong.

By the time Shanny came back into the room, I could not only feel my contractions growing stronger, I could also feel the baby pressing down on my back and moving deeper into the birth canal.  Shanny assured me that, because the epidural is a nerve block that uses gravity to work, it was probably just a positional problem.  She turned me onto my left side, the side where I was feeling the most pain, and reassured me that the medicine just needed to travel down the nerves to reach those areas.  After being on my left side for about 10 minutes, I felt no relief.  The pain continued to intensify and I now felt absolutely no effects of the medication.  I could feel the baby surge with each contraction and could feel my body begin to open up.  By this point, it was about 11:45 and I was feeling significantly different.  The contractions were now coming around 1 minute apart and they were very intense.  The Pitocin had been turned off over an hour ago but it had already done its job of taking labor up a notch.  I started humming loudly during each contraction, a low, deep sound I couldn't keep quiet any longer.

I realized that things were happening in the room that I was not really aware of.  I had moved inside myself and was so focused on what was happening to my body that I was no longer participating in what was going on around me.  I heard Shanny report that she was trying to get the anesthesiologist back into the room to assess why the epidural wasn't working but he was now stuck in a C-section and wouldn't be available for a while.  I heard Shawn and my mother worrying over me as they watched me completely change from the calm, smiling, laughing Liv to this whole other laboring person.  I heard Shanny say that she thought I was in transition, felt her checking my cervix, and felt encouraged when she announced that I was now 7 cm dilated and almost completely effaced.  I had gone from 3 cm to 7 cm in less than an hour.

I resolved myself, from that moment on, that there would be no pain medication helping me through the rest of this labor.  There was no time.  I didn't care whether or not anyone called the doctor back in, I wasn't interested in any other medicinal options.  I was going to labor and birth this baby on my own, using the strength and power I was born with.  I was going to do this and I would kick ass at it whether I had planned on it or not.  I continued to lay on my left side because that was the most comfortable position for me to be in.  I held onto the bed rail with my left hand and Shawn's hand with my right.  I looked up at Shawn and whispered, "I've got this.  Don't worry.  I can do this".  He smiled down at me, told me to squeeze his hand as hard I needed to, and agreed that I could no doubt do this.

I began to imagine myself in the ocean, each contraction was a wave that took me closer to shore.  They came every minute, one on top of the other, giving me just enough time to catch my breathe before another one took me up again.  I told myself that I just had to get to the top of the wave, I had to make it to the crest.  After that, I would begin to descend down and I would be one step closer to shore.  The low humming sound that was involuntarily leaving my body was now a groan, that sound was like a vocal release that took some of the pain and pressure off of my back.  I didn't fight the contractions, I let them roll over me from the top of my head down to the tips of my toes, imagining them leaving my body and taking the pain with them.  I could feel the baby moving down with each one, our bodies so in tune with one another as we worked together to bring him into the world.  One by one, breathe by breathe, he was coming hard and fast.

It felt like time was standing still yet moving very fast all at once.  Shawn and my mother stood at my side, my mother rubbing my head as Shawn held my hand and steadied me.  I suddenly felt a deep urge to push, felt my body bare down.  I couldn't control it, it was just happening and I trusted my body enough to just go with it.  Shawn called Shanny back into the room, she checked my cervix and announced that I was now 9 cm and the baby was at +2 station.  My groans were now escalating to full on guttural cries.  I lifted my right leg into the air and pulled it up to my chest, baring down and letting the contractions roll through me.  I felt my entire being wrapped up inside itself, my mind and heart completely enveloped in this experience that had taken complete control.  I could feel the baby moving down, felt my body responding to him, heard myself scream a loud and forceful shriek.  With an epidural, you can feel pressure and your body responds without you knowing exactly what it is responding to.  This time, however, I felt every single fiber of my being. This time, I knew exactly what was happening.  It was raw and intense and powerful.  My body has never felt more alive.

I looked up in time to see my doctor running into the room, putting on gloves and a gown and talking to me softly.  "I need to push!  I am going to push now!" I told her.

"Listen to your body, Liv.  Whenever you are ready, you push that baby out.  We are ready for him".

I lifted me legs into the stirrups that had suddenly appeared as the nurses prepared the room for our son's birth.  The room was now filled with people: several labor and delivery nurses, two baby nurses, the energy was palpable.  As the next contraction began to wash over me, I dug my heels into the stirrups and pushed with everything in me, Shawn's hand still holding mine, his presence at my bedside keeping me grounded and focused.

As I began pushing, the entire room started counting, "1,2,3,4", their voices filling the air, encouraging me as I did this most beautiful work.  I've read so many birth stories from women who find the noise of counting to be distracting but, for me, it was exactly what I needed.  It reminded me that there was indeed a means to an end, it reassured me that I was on the right track.

After pushing through that contraction, Dr. Ingalls informed us that the baby was crowning, one more contraction and he would be here.  I didn't need her to tell me that he was crowning: I could feel him there.  The mythical "ring of fire" was in full force and I let out the loudest scream yet.  That moment, the moment right before my son and I became two separate beings, was the most intense yet beautiful pain I have ever experienced.  I could feel my body shaking from the pain, heard myself scream from deep down inside myself, but I knew that we were almost there.  I could do this.

And as the next contraction came, I felt a sense of energy and strength surge through me.  As the nurses and Shawn and my mother counted and cheered, I pushed deep down through my bottom.  I suddenly felt an intense release, his head was out, I felt myself stop pushing for a second, and then bared down again.  And during the last half of that contraction I felt the amazing rush of my newborn son entering this world.  Relief washed over me as I opened my eyes, looked down, and saw his angelic face right in front of me. I could hear Shawn next to me, crying loud sobs of joy.  He cut the umbilical cord with steady hands, tears streaming down his face. Dr. Ingalls placed our son, River Scott, on my chest as he let out his first cry.

And the tears washed over me.  This was the moment we had been waiting for, the baby we have dreamed about was finally here.  After once of the most difficult years of our lives, after almost losing Shawn to his accident, almost losing everything we have worked so hard for, we were now experiencing our full circle moment.  Shawn didn't die in that accident.  Instead, we were given a son to carry on Shawn's name.  We were given a boy to continue our family for generations to come.  That moment, holding our son, my husband holding both of us: that moment will continue to define me for the rest of my life.

The nurses brought River over to the incubator next to my bed to examine him while Dr. Ingalls finished up with me.  She thanked me for keeping to my word and getting her out of her meeting after all.  I looked up at the clock to see what she meant: it was 12:30 pm.  Exactly 2 hours since she had broke my water.  From 3 cm to 10, from feeling like nothing was happening to birthing full throttle, River made his way into this world in a mighty way.

We all speculated about the great epidural debacle, deciding that, in the end, River came too hard and fast for the epidural to have time to work.  The fact that I was in back labor may have interfered with the medicine's ability to work properly.  Whatever, the reason, I didn't care.  I loved the experience for what it was, I loved the raw energy of natural childbirth.  My body completely took over and did exactly what it was supposed to do and I felt like a warrior afterwards.  Shawn can still be heard, one week later, complimenting me to anyone who will listen on my superhuman strength.  It was not something I had planned for or even knew I wanted but it was exactly right regardless.  After all the pain we have endured this last year, it seems only right that our son would be born in such a real and intense manner.

After the nurses declared our son a healthy 9 lbs 10 oz, he was placed on my chest for skin to skin time and his first breastfeeding session.  I cried huge tears of joy as I held him close to me, felt my heart expand yet again as I welcomed another child into my heart.  He opened his eyes and peeked out at Shawn, my mother, and I, his fingers forming a peace sign as he assessed his new surroundings.  I loved him so much already, felt like we had known each other for several lifetimes.  I kept him on my chest, nursing him off and on for the next two hours, the two of us hiding out under the warm blanket someone had wrapped us both in.  Shawn hugged and kissed us, thanked me for blessing him yet again, his smile so deep and full he was literally glowing.  We did it, babe.  Our son is here.

Later on that afternoon, after I had showered and finally given Shawn and my mother a chance to hold River (I've been deemed the baby hog), visitors started to filter into our room.  My dad, aunt, cousins, and then the much anticipated sisters all arrived to greet baby River.  Isabelle was over the moon, carefully kissing him on his forehead and whispering, "I love him so much already, Mommy".  Brees peaked in at him curiously but preferred to sit in the hospital bed with me, asking a million questions while rubbing my arm.  I felt amazing: though an epidural feels great DURING labor, the after effects have always been hard on me.  I usually get nauseated, have a severe headache, and suffer with leg and back pain for days.  This time, however, I was up and walking right after delivery.  The endorphin high was out of this world and my body felt strong and good.  It is true that no two birth experiences are alike and I am so thankful for the way my third evolved into something so inspiring and empowering.  Having experienced both medicated and now an unmedicated birth, I will never say that one way is better than the other.  All three of my experiences were beautiful and unique exactly for what they were.  I will say, however, that I am in complete wonder over what my body did that day.  The process was so powerful and has brought me closer to myself and the woman I have become.

We said goodbye to our visitors shortly after 6 pm, reluctantly kissing the girls and promising them that we would see them soon.  And then, it was just the three of us: Mommy, Daddy, and River.  We spent the next 24 hours bonding with our son, resting, and loving each other and our time together.  By the next afternoon, we were on our way home. We made our way down the long driveway lined with crepe myrtles and a place that was so familiar was suddenly something new as we carried our son into his home for the first time.  And just like that, we began a new chapter.

Welcome home, River Scott.  We will always and forever love you, our strong and mighty son.