Our beautiful baby boy, Jasper David, was born on October 21st at 6:28pm at 7lbs 20z, 19 inches long, and a head full of dark, straight hair. The story of how he came into the world was both everything we wanted and many things we didn't want, but now that we're after the fact, I'm thankful for every part of our labor and birth process. If you want to hear all of the details, pull up a comfy chair and let's get to it!
Matt and I wanted a midwife model of childbirth for our prenatal care and labor and delivery. I am a patient at Lisa Ross Birth & Women's Center , a freestanding natural birth center. We feel extremely fortunate that a place like Lisa Ross exists in Knoxville, because not all cities have the luxury of such a place. I know some women seek a birth center or home birth looking for some specific or ideal "birth experience", but for me, I just wanted things to be as peaceful as possible. I have pretty severe medical anxiety and knew I would end up working against what my body needed to do during birth if I was distracted by beeping monitors, hustle and bustle, bright lights, and the threat of augmented labor or interventions. I certainly wasn't trying to prove some kind of point nor was I trying to be superwoman by attempting a totally unmedicated birth - I just wanted peace and I wanted my body to be left alone to do what it knows how to do. That's all. I don't judge women who choose a medical model of childbirth or who choose to give birth in a hospital. Heck, more power to women who choose to opt for a scheduled C-section right from the get go.
I'm saying all of this as kind of a disclaimer that I am not saying that my way of doing things is better than any other, I just knew that when dealing with something as profound as labor and delivery, a hospital would not allow me to have the mental focus needed to get through it. My prenatal care did not differ much than what I would receive from an OB... I was offered/given all the yucky tests like the glucose challenge, I had my anatomy scan at 20 weeks, and I had the same routine blood tests. What I appreciated was that most of my visits were focused on how we were feeling mentally and not just the numbers that the blood pressure cuff or fetal doppler were giving them. I felt like I was surrounded by kind, sympathetic women who could absolutely help coach me through a natural birth. The loving midwives and personal care that we received at Lisa Ross was exactly what I needed, and exactly what I got.
Anyway! On with the story...
In the days leading up to the birth, at almost 39 weeks gestation, I was feeling pretty crappy. Jasper had been wedged into my rib cage in two places - butt on one side and feet on the other - for a solid 6 weeks and I was extremely uncomfortable unless I was sitting board straight in a chair with my legs bent at a 90 degree angle. Two days before I went into labor I remained immobile on the couch because the pain in my ribs, legs, and sciatic nerve rendered me useless.
Before going to bed on the night of October 20th, a random attack of hunger hit me at 9:30pm as we were coming downstairs to get ready for bed. I stood in the kitchen with a spoon in one hand and a jar of Peanut Butter & Co.Dark Chocolate Peanut Butter in the other. I stood there digging the spoon into the jar and whining to Matt about how ready I was to not be pregnant anymore. Matt snapped a photo of me with his phone because he thought it was a funny sight, but little did we know that random picture would be the last one taken of me while pregnant, because just 4 hours later I was in active labor.
I woke up at 1:50 am and got out of bed for one of my many overnight bathroom visits. When I got back into bed I noticed a very mild pain similar to a menstrual cramp. I ignored it, because I'd been feeling similar pains off and on for the week prior. I closed my eyes to go back to sleep, and less than 10 minutes later I had another pain. Then another one. Then another one. I started paying attention to the clock and realized they were coming at regular intervals. About half an hour later a sudden shift occurred and the pain stopped feeling like a menstrual cramp and settled into my hips, wrapping around my torso and radiating down into my thighs... and it was starting to hurt.
I finally woke Matt up and said, "Don't get too excited, but I think things might be getting started here." He sat upright and said, "Are you serious?" I filled him in on what I had been feeling, and he stayed awake with me to time what I was sure now were full blown contractions. I was shocked at how strong they got so fast. By 4am I was in a lot of pain, the contractions were coming anywhere from 4-6 minutes apart, and I could barely talk during each one. I found that standing up and bending over with my hands on the bed while Matt applied strong pressure to both hips was the best way to cope. Even though I was sure I was in full on labor, everything just seemed so surreal. Were we really going to get to meet our baby now? Was I ready to face this labor and delivery? Was I completely and totally nuts for choosing to do this without a drop of pain medication?
At 5am I picked up the phone and dialed Lisa Ross's main line, hitting the menu option that transferred me to the after hours Hey-I'm-In-Labor call center. The operator told me the on-call midwife would be notified and I would be receiving a call from her within 10 minutes.
Less than 10 minutes later, Ellen, one of the 5 wonderful midwives currently on staff, called me back and I gave her the details of what was happening. She gave me some options based on what she heard. I could meet her at the birth center immediately to be checked to see if/how much my cervix was changing, or I could just hang out and see how things go for a little longer. The thought of getting into a car once in as much pain as I was in sounded horrible, but the thought of being in the car twice was out of the question (though one does have the option of staying - they will never send you home if you don't feel comfortable doing so, even if you're still in early labor). I told Ellen that I would see how things changed or progressed over the next couple or few hours and I would check in again.
I sent a quick email to our best friends, Kara and Remington, letting them know that I was in labor. Matt and I agreed that they would be the only ones told and we'd make the phone calls to family and other friends once the little guy actually arrived. However, I stay in close contact with my family on a day-to-day basis, and when calls to my cell phone went unanswered, Matt said I got a text from my sister later in the day that read, "We are on to you!!!" So that actually got a laugh out of me.
Next, I got into the shower with Matt and let the hot water beat against my hips. It was a massive relief. Every few minutes a contraction would build and I would lean against the wall and Matt would squeeze my hips together using all of his strength, because I was convinced the contractions were trying to rip them apart. It felt like I couldn't get enough counter pressure. I was starting to make a lot of noise at that point, groaning low and loud through every contraction. When I got out of the shower I sat on our birth ball (basically a yoga ball we've had for years) and did hip circles, which was a very comfortable position in which to ride through some of the pain.
At 8am the contractions were stronger and closer together. I was beyond holding a steady conversation at that point, so Matt called Ellen back. We learned that her on-call shift was ending soon and Chris, another amazing midwife, would be the one taking over. Matt talked to Chris on the phone and we agreed to meet at the center just after 9am.
I crawled into the car and we started the miserable ride to the birth center. I had several contractions on the way there and I groaned my way through every one. I was surprised at how much noise I was making. I'm a very quiet person usually, and didn't think I would be one of those women who vocalize during labor. I guess I was wrong!
We pulled into the Lisa Ross parking lot at around 9:15. The building is set into a hill, and the 2nd floor clinic area is completely separate from the lower level, which is where the three birth suites are housed. I think it's a pretty smart design, so the laboring women down below can make as much noise as they want without horrifying the pregnant women in the clinic above. Each birth suite contains a full bath with a tub and shower, a normal bed large enough for you and your partner, a chair or couch, a private exit with a patio with a high fence and gated access to outdoors if you want to walk around, and one of them has a Jacuzzi tub for water births (though you have the option of using an inflatable tub in the other rooms).
Usually, a woman would be taken into a triage room to assess whether or not she is in active labor before being taken into one of the birth suites. Since it was obvious by the state I was in that there was no question that this baby was coming, Chris skipped triage, reaffirmed that I wanted the water birth room, and we headed right for it. Halfway there I had to lean against a door frame to ride a contraction, and in the middle of it I managed to actually feel embarrassed that I was definitely going to vocalize my way through this entire process... and that Chris and the nurse, Emily, were going to hear every bit of it. As if reading my mind, Chris started encouraging the noises I was making, saying they were low and productive and telling me, "Good job." That was very reassuring to hear.
When we got into the room, Matt saw a birth ball and rolled it over next to the bed while Chris made a big pile of pillows. I sat on the ball and leaned over onto the pillows while she and Emily got some things set up. A few minutes later Chris asked if she could check my progress, and I agreed. I find those checks pretty painful, but because my labor was so blissfully hands-off, that one check was the only one I had to grit my teeth through the entire day. I was expecting to hear a disappointing number like 3cm or something, so my jaw dropped wide open when Chris announced that I was already at 6cm and 90% effaced. Say what? Now realistically, I had already been laboring over 7 hours so I guess it wasn't as fast as it seemed at the time, but I still had to stifle the urge to pump my fist in celebration.
Since I had already progressed significantly, Chris recommended that I go ahead and get into the tub. She and Emily filled the tub, checked the temperature, and turned on the jets. Matt helped me climb in and I settled into the water and breathed a huge sigh of relief. Water labor is sometimes referred to as the Midwife's Epidural, and I can (almost) believe it. I felt SO much better in the water, supporting myself with one hand while I let the rest of my body float. The buoyancy the water created allowed for there to be zero pressure on any part of my body and made the contractions, which were still growing stronger, so much easier to deal with.
The next few hours are a blur. I completely zoned out, still in the same floating position with my head resting on a folded towel Chris placed on the edge of the tub. Matt sat in an armchair right next to me and kept one hand on my arm (that was the only touch I could tolerate... if he started rubbing me I shoved his hand away!) Chris had a bowl of ice water that she used to constantly refresh freezing cold cloths across my forehead and the top of my back. There was something about the stark contrast between the freezing cloths and the hot water that was almost a distraction from the pain. The lights were kept dim and Chris and Emily spoke in low calming voices. It was the perfect, peaceful labor that I always wanted. Most of the time the only sound in the room was the burbling of the tub jets. Chris checked vitals regularly, but since their fetal dopplers can be used underwater, I didn't even have to move. I barely noticed whenever she reached into the water to hold the monitor to my stomach.
After a couple of hours (Matt was the one who gave me the actual timeline, as I have no memory of exactly how much time passed between the phases of labor) I passed into what I was able to recognize as the dreaded "transition", when your cervix dilates the last couple of centimeters and makes way for the baby to drop into the birth canal. Transition is the most intense phase of labor, but thankfully, also the shortest. The contractions were as long as 90 seconds to 2 minutes, and the breaks in between couldn't even be described as such, since my contractions never seemed to fully let go... it was just a brutal assault of peaks and valleys of pain. I admit, I almost lost it during this phase... I started braying like a donkey, sometimes forgetting to keep my sounds "low and productive". After about an hour of that ridiculousness I asked, "Is this transition?!" I already knew it was, but I needed verbal reassurance that I was going through the worst of it and that I was very close to pushing! From behind me, I heard Chris say with a smile in her voice, "I think you've transitioned already."
As if on cue, with the next few contractions there was an obvious shift in what I was feeling. Like a freight train, my body started bearing down all by itself... I couldn't stop it even if I used all the strength I have. I felt an immense pressure in my pelvis that wasn't there before. I told Matt later, after the birth, that it felt like I was trying to "poop out a couch." My body had started to push the baby down with every contraction. I didn't even need to tell Chris that things had changed, because at the end of each contraction I started to let out a powerful grunt that I couldn't control. When Chris heard the first grunt, she said, "Yes! Do you feel that change? You can go ahead and push with these contractions now." I had done a massive amount of reading and research regarding how midwife-led births are conducted and I knew all about that all-telling grunt. I knew immediately that the end was in sight (or so I thought!).
I heard the sound of Chris and Emily putting on gloves and moving closer to the tub. The sudden springing into action was at first a little alarming, because that was my clue that stuff just got real and I could very well be giving birth right here and right now.
I let my body push for several more contractions, adding whatever I could on top of the natural bearing down my body was doing. Chris gently suggested that I shift my position to standing on my knees and leaning over the tub, just to shake things up a bit. It took me a minute to muster up the ability to move, but I finally twisted around and got into the position she suggested, and pushed for another little while before I realized that something felt "not right" about being in the tub. I don't know what it was, I just felt the need to "get out".
We moved to the bed and alternated pushing on my back, Matt holding one leg and Emily holding the other, and then on my side. I pushed and pushed and pushed. At Lisa Ross, there are several safety timelines in place to make sure that you and the baby do not go into distress before a hospital transfer is needed. Once you start pushing, you have 3 hours to get the baby out. I was already past the 2 hour mark and had made very little progress. I cried a lot, but frequent vital checks revealed that Jasper was handling the prolonged pushing like a champion... his heart rate was fast and strong, no signs of distress.
Soon after entering the last hour in the 3-hour deadline, my water finally started to break... not at all once, just a slow trickle. I used that as encouragement that something was happening at least, and got another small burst of energy. Chris and Emily hauled me into several different positions... squatting on the bed while Matt held me up, squatting on the birth stool, back to the bed, into the bathroom sitting on the toilet (which was covered with towels), back to squatting, etc etc. Chris was working her butt off to give Jasper every chance in the world to dislodge himself and finally come out. Close to the deadline, she asked if she could break the rest of my water manually, because they could see the rest of the water bag bulging against what little bit of his head was visible and she thought it was worth a shot to see if that would help. I told her to go for it, a moment later felt a huge gush of fluid, and we resumed the pushing and alternating of positions.
Finally, it was time to make the first call to UT Hospital. UT's OB department maintains a very close relationship with the Lisa Ross center, and Chris spoke directly to the doctor and filled her in on everything that was happening. Because Jasper's and my vitals were perfect and I was still in relatively good spirits, the doctor gave us the okay to continue pushing for an additional hour. Chris told me that it was going to take "a lot of effort" in that last hour to get the baby out. I kept asking her if I was doing anything wrong... was I pushing hard enough? What else could I be doing differently? She reassured me that I was working my butt off and couldn't be doing any more than I was, his head just needed to make "that last little turn" to finally allow him to come out.
Well, we gave it our all in that last hour, but after 4 hours of exhausting pushing, it was time to be transferred to UT... what I previously considered to be my worst nightmare, but at that point, I didn't care anymore. I wanted the baby out, however that had to happen. The doctor told Chris that as soon as I got there they were going to try a vacuum extraction. Chris had a similar situation happen to her when she gave birth to her own baby and also ended up with an assisted vacuum delivery at UT at the very end. She gently recommended that because of the additional tearing and pain involved with an assisted delivery, I should consider an epidural. I heartily agreed. Though I had been hell bent on an unmedicated birth, there is nothing natural about an instrumental birth, and I wasn't about to go through that without help. Chris passed that information along to the doctor.
Now it was time to be transferred to the hospital. Depending on where you are in the delivery process, you will either be allowed to drive your own car or you will be required to transfer via ambulance. Because Jasper was so close already, I obviously had to use the ambulance. The thought of transferring in the middle of pushing contractions slamming into my body and the involuntary bearing down was absolutely terrifying. Chris was realistic with me and agreed that the transfer was going to be intense - she had firsthand knowledge of that - but she kept holding my hand and telling me that I could handle it and everything was going to be okay. She was amazing at keeping me calm.
Matt couldn't go with me because he had to drive our car, and even if he did ride in the ambulance he would have to be up front anyway and I wouldn't be able to see him. So Chris came with me and never left my side. The EMT was a little spooked and though I'm pretty sure he was told that the baby wasn't going to come out, he kept shouting to the driver that if he says the baby is coming, that he is to pull over to the side ASAP. I had one leg curled up under me to help resist the bearing down, but he kept grabbing my ankles and pulling my legs straight, telling me that "I couldn't deliver" in that position. I wanted to kick him in the face. The baby was not going to come out right now, so leave me alone! It was obvious that I was now leaving the comfortable peaceful setting of a midwife-led birth and being transferred into the more mainstream medical model, so I was already well aware that I was going to be yelled at and messed with beyond my control from here on out. Again, in the moment, I didn't really care. Get the baby out get the baby out get the baby out was all that was going through my head.
We finally got to the hospital and I was wheeled through the halls and rode in a couple of elevators. Again, Chris never left my side, and never stopped reassuring me. I had the blanket crammed into my mouth because even though I was in a right state, I was still self-conscious enough to not want to be wheeled through the halls of UT drawing attention from everyone we passed, so I was able to keep mostly quiet until we arrived in the delivery room.
I was so very thankful for the close communication that Chris had with the doctor, because when I scooted over to the bed in the delivery room, the anesthesiologist was already right there and joking about how he heard someone would like an epidural. Meanwhile, I was hurriedly being hooked up to tubes and wires and monitors, my left wrist was pierced with an IV, and I was told not to move from lying on my back. I ignored that request... lying on my side felt better so I kept naturally rolling over when a contraction would hit.
Minutes before the anesthesiologist wanted to begin, Matt arrived. I was allowed to curl up on my side for the epidural instead of having to sit up on the side of the bed. I could have kissed him for that. The epidural itself was a walk in the park. I'd heard horror stories, but all I felt was a mild bee sting followed by a few weird electrical jolts down one of my legs. Then my back was covered in what felt like half a roll of masking tape. The next contraction hit and I felt every bit of it. I was reassured that the next one would feel better, and then the next one I shouldn't be able to feel at all. He was right... by the time a couple more hit, the nurse said, "Hey, you're having a contraction." And I felt nothing at all. Okay, time to have the baby.
I remember looking over at Matt, who had been given a chair next to my bed, and I saw that he looked miserable and was fighting back tears. He later told me that he was upset because he knew that a bustling, loud hospital birth was "my worst nightmare" and he hated seeing me literally having to live out exactly what I didn't want. I reassured him over and over (after the birth) that at that moment, I was happy to be there because I had already been able to have a perfect, peaceful labor experience and had accepted that Jasper needed some extra help right there at the end. I just wanted to meet our baby!
Matt moved closer to the bed and what seemed like an army of people in scrubs flooded the room with an infant warmer - the special pediatric team. Since the vacuum was being used, Jasper would need to be taken from me immediately after the birth to be checked for any injuries sustained.
The OB showed me the vacuum, which was a small round disk attached to a tiny plastic tube... way less scary than I envisioned. She explained that she was going to attach it to the top of his head and as I pushed, she would gently pull. She attached the disk to the top of Jasper's head and a few seconds later the nurse told me I was having a contraction and to hold my breath and push. I pushed and not 10 seconds later heard Matt say excitedly, "He has a full head of hair!!" The rest of him came out immediately after. One contraction, that's all it took. I caught a glimpse of perfectly smooth, healthy pink skin. I couldn't see much because there were so many people and my belly was still blocking most of my view. Immediately, he started screaming. Everything happened so fast that my brain struggled to keep up, though I do remember having one clear thought: "Holy sh**, I just had a baby."
Now came the only part of the delivery at the hospital that sucked (aside from the annoyance of the 24-hour hospital stay and constant stream of nurses in our room). Most of you know that my husband is hearing impaired and uses a cochlear implant. He does extremely well, but in a room full of hustle and bustle and lots of overlapping voices, it's difficult for him to keep track. As soon as Jasper was born, a nurse started shouting excitedly, "Is dad cutting the cord? If he is he has to move now! Dad, do it now do it now!" Matt obviously heard none of this over the sea of voices, so I held his arm and told him what was going on. I was afraid they would get impatient and cut the cord themselves. Matt hurried over to the nurse and doctor and a pair of scissors was shoved into his hand. He tried to ask what he was supposed to do, but the only response he got was "Cut! Cut Cut! Hurry!" It was a totally ruined moment. As soon as he cut the cord, looking bewildered and confused and I'm not even sure he got to fully take in what he just did, Jasper was whisked away and I never caught more than just that glimpse of pink skin right when he was delivered. They didn't stop at my bedside for even a second to let me get one look at him. I tried contorting my body to see over my shoulder to the infant warmer, but there were just too many people surrounding him to see anything but blue scrubs. The doctor asked me to be still (I tore pretty badly as a result of the vacuum pulling Jasper out so quickly, so there was a bit of repair work going on down below) and I finally just relaxed and waited.
Several minutes later a bundle was carried over and Matt announced, "Oh my God, he has a butt-chin!!" Cleft chins run in both of our families and while speculating what Jasper might look like, we agreed that he would most definitely have a cleft so deep that he would have two entirely separate chins. We were pretty much right.
Then, finally, our gorgeous baby boy, who scored a whopping 9/10 on both APGARs despite a prolonged pushing phase and vacuum delivery, was placed into my arms. Chris took our camera and got a few precious photos of us as we stared at him and cried. He was incredibly awake and alert, rolling his little eyes around to take in what little he was able to see. He pushed against my chest with a surprising amount of strength, able to fully lift his upper body away from mine. Whatever else was still happening in the room kind of melted away and we stared at Jasper and ignored the rest of the world.
So, why wasn't I able to get him out on my own? Right before a baby is born, assuming he is already in the ideal birthing position (which Jasper was), his head needs to make one last little turn after dropping through the cervix and into the birth canal in order to slip under the pubic bone and make his grand entrance. Jasper was just a stubborn little guy and his head never managed to make that last little maneuver on his own so he was trying to be born with his head at a tilt. Thankfully it was not a dangerous complication, though it did cause me to have to endure a transfer to the hospital. Though I wasn't able to deliver at Lisa Ross this time, I'll make the same choices should we ever choose to have another baby. I had a blissful 7 hours of labor at home followed by another 8 hours of peaceful, quiet, and hands-off labor and pushing at the birth center. It was the hardest physical thing I've ever done in my life, but now experiencing for myself the difference between a hospital and birth center experience, I believe that, for me, the peace is worth the pain.
We still love our sweet corgi boys. It took them a day or two to realize that Jasper is a human and not a toy, but they have chilled out around him now and we are trying to give them as much love as we can. They were here first, after all!
All of the grandparents at our house when Jasper was 5 days old. Matt's parents live across the country and had planned an extended visit surrounding our due date to be sure they could be present for his first days!
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