When I became pregnant with Judah in early 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 the Birth Without Fear movement aimed to restore childbirth as a natural human experience instead of a medical emergency.
I debated between wanting a natural, or physiological childbirth at home or in the in the hospital. I decided I felt more comfortable at the hospital and quickly realized the importance of taking a good childbirth class and having a strong, supportive birth team in place. A friend recommended a childbirth instructor who was also a birth doula and midwifery student. We signed up for her childbirth classes and eventually hired her as our doula.
My pregnancy started out with relentless nausea which made commuting an hour to and from my corporate job very unpleasant. Around the time the nausea subsided, I found out I was a carrier of an Ashkenazi (Eastern European Jewish) genetic disease and my husband Jeff would also need to be tested. Since he was adopted we didn’t know his background. I asked my doctor if I was a carrier for any of the other diseases I was tested for so I wouldn’t have to worry about anything else and she said no. Whew. Jeff’s results came back negative and we breathed a sigh of relief. Two weeks later, I was traveling for work and my doctor left me a voicemail saying that I was a carrier for another genetic disease and Jeff needed to be tested again. I was so upset because she told me everything else came back negative and now we had to wait another two weeks for Jeff’s results. People make mistakes but trust was broken and I was already having my doubts about this doctor. I requested my medical records and scheduled an appointment with a different doctor who was sought-after by women who desired a natural childbirth. She was also affiliated with the same hospital I was born at. My sisters and their children were born there as well.
The night before our appointment with the new doctor, I opened my medical file and read through my records. 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 morning I handed my medical file to the receptionist. Since we were being squeezed in before office hours it was early and we didn’t think the new doctor would have time to read through my chart. She introduced herself and led us into her office. The first thing she asked why I was a carrier for this third genetic disease and why Jeff wasn’t tested for it. We knew right then that this was our doctor. She was also warm, friendly and supportive of our birth preferences.
The rest of my pregnancy was uneventful except for small amounts of fluid that slowly seemed to be leaking. I mentioned it but should have insisted on having it tested for amniotic fluid. Then at 38 weeks and 3 days, my usually very active baby became very inactive. I drank a cold fruit smoothie and laid 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 much so I called my doctor. She sent me to the hospital for monitoring. There still wasn’t much activity so they did a biophysical profile (BPP). It revealed that the amniotic fluid was low, the fetal breathing reflex was absent and the movements were non-reactive. My doctor sent me home, told me to drink some water, sleep on my left side and come back to repeat the BPP at the hospital the next day.
When my doctor called me first thing in the morning and told me to come right to her office, I knew there was a good chance I wasn’t coming back home. 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 BPP 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 even lower than we previously thought. She did an ultrasound to check my fluid herself and it was indeed lower and my baby still wasn’t moving very much. We discussed the situation and my options and I consented to an induction. It was one of the things I really wanted to avoid, especially because I wasn’t dilated and was barely effaced, but I trusted my intuition which was telling me Judah was asking for help.
By the time I was admitted to the hospital and the IV was started I was tired and hungry. My doctor suggested I eat a half of a sandwich and some fruit before starting me on Pitocin. Most doctors wouldn’t allow eating before an induction so I was grateful for that. I updated my doula and told her I would call her when I felt like I needed her support. In the meantime, my sister who had birthed twins vaginally at the same hospital 5 months before came to be with me.
Once the Pitocin was started, my doctor instructed the nurse to keep me sitting upright on the birth ball. When she came back to check on me nothing much was happening aside for some pressure in my lower back. I was getting anxious and uncomfortable so I 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 started to space out, so back on the Pitocin I went.
As more time passed and the Pitocin increased, I still wasn’t dilating so I consented to an amniotomy (break the bag of waters). That seemed to kickstart my labor and the pressure in my back intensified. I had a feeling my baby was posterior (facing up) so we tried changing positions. 15 hours into the induction I was 1 cm dilated and experiencing horrible back labor. When I told my doula I wanted an epidural, she knew I was serious. The anesthesiologist yelled at me not to move, which I understood the importance of, but being on a high dose of Pitocin (18), I had no relief from the tetanic contractions that seemingly had no start and no end. He asked me to curl up in a ball but it was such an odd sensation and I couldn’t help but arch my back. I dug my nails into my doula’s arm and screamed, “FUUUUCKK” at the top of my lungs. I’m sure it reverberated throughout the entire labor and delivery unit, but I didn’t care. I needed to let that out. Once the epidural was finally placed, I got some relief and took a short nap. When I woke up, I was relieved to find that I progressed a good deal and my doctor said that soon it would be time for me to meet my baby!
I started off pushing pretty well, but Judah wouldn’t budge from his posterior position. We were nearing the third hour of pushing and he kept getting stuck under my pelvic bone. I was nearing exhaustion and needed help. My doctor explained why she wanted to use the vacuum extractor along with its risks and I consented. She instructed me to push but to stop when Judah’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.” Noooooo! This is not what I wanted to hear. I had been through so much at this point and was feeling defeated. Tears streamed down my face. She told me not to cry and that we would give it one more chance.
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. I gave it everything I had and Judah’s little head popped out facing up to greet everyone. The NICU team was there just in case, but his Apgar scores were strong. He weighed just 6 lbs, 13 ounces and measured 19.5 inches long. Although things did not go as planned, I was heard, I was treated with respect and I was supported. Judah was quite bruised from his challenging journey into the world, but he was healthy. In that moment, I realized how symbiotic our relationship was. We did it, together.
Click below to read Benjamin’s (very different) birth story.