I Had a Baby, and It Was Different Than My Birth Plan

Two weeks ago, I delivered a healthy baby girl that weighed in at 8 pounds and 11 ounces. My original plan for delivery was very different than how my delivery actually went, which I feel is pretty common. However, for a lot of people, sticking to the birth plan they have in mind is extremely important, as if it was an ancient ritual carved in stone that could not be adjusted at all. As an L&D nurse, it is important to me to give my patients the birth experience they desire, as closely as I can, while also educating on specific events that could warrant adjusting of their plan. And because of the knowledge I have as a nurse, it was easier for me to not feel bad about changing my birth plan for myself in the middle of my own labor and delivery experience.

I have witnessed some amazing women bring their new babies into this world in captivating unmedicated deliveries. The term “unmedicated” purely means without an epidural. Some patients who have unmedicated deliveries do utilize the option for IV pain medication that has shorter effects than an epidural, while some labor and deliver without any pain medication at all. These are some of the most special deliveries to be apart of because it is amazing to see what women can do when they set their mind, body, and soul on something.

And I wanted to be like them.

I had hopes of going into labor on my own, laboring upright, in whatever position felt comfortable to me. And delivering unmedicated, also in whatever position I found myself in. Whether that be hands and knees, squatting, kneeling, on my side. I had hopes that I would be able to cope with the pain well and put all my energy into getting my sweet baby girl here.

But. I caved.

On Wednesday, February 21st, after I had published my previous blog post about dilation not having correlation on when labor will start, I went into labor on my own. I spent a couple hours walking around Walmart with my mother, running errands, and getting some groceries. I arrived home around 2 PM and noticed I was having a few contractions. These felt a little different than my normal Braxton Hicks contractions and they were accompanied by a lower back ache. I was slightly suspicious of them being the real thing, but I also told myself that my lower back could have been aching due to all the walking I did.

I did my regular routine of ball circles and hands and knees. I took a couple breaks to lay down on the couch because of my back being so achy. My boyfriend arrived home around 3-ish, and noticed I was breathing through a couple of my contractions. He made a joke saying, “Do we need to go to the hospital?” I laughed and told him not just yet but that I was having irregular contractions ever since I got home from the store. However, I was still unconvinced they were the real thing.

Because my plan for delivery was to go unmedicated, I wanted to remain home for as long as I could, but with already being dilated so far (I was a 5 for a week prior to this), I also didn’t want to take a chance on being one of those people that has a precipitous birth (less than 3 hours) and end up delivering in my vehicle on the way to the hospital. So I decided to wait it out and see if my contractions got more regular or if my water broke.

After a few more hours of these contractions and my achy back, I decided to lay on the couch and use a cushion to open my hips. My back was so achy and I just wanted to lay down. I had only been on the couch for about 10 minutes when I felt a change.

It was 7:10 PM, and I felt leaking that I thought was just going to be discharge, but quickly realized it was much more than discharge. I used my hand to press my panty liner into myself and jumped off the couch as fast as I could, so I would not get fluid all over it.

I ran to the bathroom, and it was very apparent that my water had broken based on my panty liner being soaked, and more fluid audibly falling into the toilet. I also could tell that my contractions got a little more intense. Which is expected when your water breaks, as that fluid cushion is no longer there. Because I was still able to tolerate these new, more intense contractions, I was still confident that I could have an unmedicated delivery and not want an epidural.

Oh I was very wrong.

After letting my boyfriend know that it was, in fact, go time, and not just a joke anymore, we began the last bit of packing and headed off to the hospital. At about 8:30-8:45 PM, we arrived to the hospital and my doctor checked my cervix. There was still a “buldgy bag” which just meant that my amniotic sac was broken, but higher up and what was still intact was keeping the rest of my fluid inside. This is why my contractions only became a little bit more intense and still manageable. I was also dilated to a 6, and completely thinned out.

All throughout the night, I labored on my own. My contractions were still irregular and some were extremely intense while others were not as bad. I labored on the floor in hands and knees with the peanut ball. I got in the shower a couple times. And I even used the back of the bed to lean over in a kneeling position. I did everything I knew to do to encourage my labor to pick up, even walking in the hallway. I continued to lose a lot of fluid as well.

However, at midnight, I had only dilated to a 7, and by 3:30 AM, I was still about a 7-8. I got in the shower again around 4 AM. My contractions were more intense, I was losing energy and was exhausted. I had only dozed a couple of times between contractions and was starting to lose patience with the process.

I was beginning to feel intense pressure with pain in my butt and lower belly during contractions. It was worse in some positions, like the hands and knees, but was better in others.

My doctor came and rechecked my cervix at about 8 or 9 AM. She stated that I was still only dilated to an 8 and she wanted to recheck me again in an hour. With the next cervical check, I had not made any change and she said she could still feel that buldgy bag. I consented to letting her break my water the rest of the way, which was something I was open to, but did not want it to happen too early.

After she broke my water completely, my contractions hit full force. I could not find a position that was comfortable enough to sit in. The bed was uncomfortable, the ball was uncomfortable, being in hands and knees was EXTREMELY uncomfortable. The only thing that was semi comfy, was sitting on the toilet. And even then, I could not sit still.

I was losing my focus and could not even open my eyes. I had to keep moving, was on the verge of crying. My lovely coworkers and friends were trying to keep me calm and encourage me to keep going. But I was starting to think that I was not in the right mindset to continue without the drugs.

I knew that if I lost my control, began crying, was super tense and could not relax into the contractions, that it was likely my body would not allow for further progression in labor. I also knew that because I was so tired and physically exhausted that I needed rest or I would not be able to push effectively.

Around 11, I requested an epidural. I caved on my dream of an unmedicated delivery and got the drugs.

The first epidural only worked on my right side. I was so numb and tingly on that side but could still feel my body on the other side. I was coping a little better but still had not opened my eyes and couldn’t feel my body relaxing. I was still so tense.

My doctor and nurses advocated for me to get my epidural replaced. The second one took to both sides of my body and the CRNA gave me an extra small dose to get me numb really quick.

So roughly around 12 PM, I was finally comfy and warm and tingly from my belly down. I finally took a nap, sitting straight up to allow gravity to pull the medication down as well as to help my baby move further into the pelvis. I also consented to getting IV Pitocin to help regulate and strengthen my contractions, now that I was comfy. Which was also something I originally did not want.

About an hour later, my doctor rechecked my cervix and said that I was complete and had me start pushing. Being able to relax my body, muscles, ligaments, and pelvis helped me through the transition period from 8 cm dilated to complete. This is what I knew would happen and one of the reasons I decided an epidural was needed.

I pushed for 2 hours, on my back, in the bed, in lithotomy position. This is another thing that I absolutely did not want to do. I wanted to deliver more upright, or on my side, definitely not on my back. However, even though we tried different positions to push in, the only one I felt like I was actually moving the baby during pushes, was on my back. I also was not able to open my eyes during pushing or else I lost the push. It just didn’t feel affective.

Towards the end of the 2 hours of pushing, my baby had been crowing for a handful of pushes. I was starting to lose my momentum again. I kept saying “I can’t do it.” “I can’t get her any farther.” “Get her out of me!” I felt like I had gotten her as far as I could, but was unable to get her any further.

I was worried about a couple of things. I knew my baby had been estimated to be on the larger side. So I was worried I was going to tear through my butthole. And I was worried she would get stuck in what we call a shoulder dystocia. When the shoulder gets stuck on the pubic bone and it can cause serious complications. This was another reason I decided I wanted an epidural last minute.

I knew if she was large, I did not want to feel myself tear that bad, and I didn’t want to feel everything if she got stuck and they had to use certain maneuvers to get her out.

So because I felt like I could not get her any farther than crowning, I was beginning to worry that we were going to have some complications. My doctor then suggested an episiotomy.

These are not something that providers do routinely anymore, or even frequently. However, even though I did not want to be cut originally, I found myself saying “That is fine, whatever gets her out faster.” I was feeling so much pressure from her crowning for so long, I just wanted her out.

So my doctor made a small cut, and I pushed some more. And she didn’t budge. My doctor extended the cut some, I pushed some more. And she still didn’t budge. So after another extension of the cut, I finally was able to push once more and my daughter finally came out, at 2:52 PM on February 22nd.

My doctor stated later that my tissue was so swollen and tight from how long I was pushing, that it was not wanting to give way to my daughter’s head. That it is possible that I would have eventually torn but that she thought it would have ended worse, with possibly extending through my booty like I was worried about. The episiotomy has been a bitch with healing, but I am glad that it was an option and helped get my daughter here when she did.

So, although I ended up with an epidural (technically 2), got Pitocin, pushed and delivered on my back, got my hoo-ha cut open, I feel as though my delivery went very smoothly for what it could have been. I was happy that I was able to progress as far as I did on my own without the epidural. I was happy that my daughter came out happy and healthy. I was happy that I had such amazing support from my boyfriend, my mother, my coworkers and my doctor.

Many of them tried to encourage me to keep going without the epidural but I knew I needed it, and I was okay with changing my plan. Labor and delivery is never something you can predict or know how you will experience it, even if you have done it before. It is different every time.

Maybe next time I will be able to stick it out and get that unmedicated delivery. Or maybe I’ll decide it isn’t worth it for me anymore. Maybe I will still get the epidural. But being open minded to the plan changing is what I know I will stick to. Because as important as it is for me to have the delivery I dream of, it is also important to me to go with what I am feeling in that moment and what I know will be better for myself, my body, and my baby.

And sometimes that’s the damn drugs.

*Emma