Delivering Naomi
[Only two months later...The following (very long) post documents Naomi's emergence into this world. I tried to tone down the biology of the whole thing, but because I want to remember all of the little details,and because I really like its biology, the following story, and perhaps the pictures, too, might be a bit much for some. Feel free to skip straight to the cute, post-delivery elf-baby pictures at the end.]
After a really long day filled with many of the things rumored to bring on labor, my water broke just before 11:30pm. Some people apparently experience trickles, but I made it to the toilet just before releasing a movie-worthy gush of amniotic fluid. I called my doctor's on-call number from the comfort of the toilet, and just sat there, shaking uncontrollably (nerves, perhaps?) while I waited for the doctor or midwife to call back. When the phone rang and it was Julie on the other end, I was so relieved. My OB/GYN practice has four doctors and two midwives on staff, and births are handled by all six of them on a rotating basis. Together, the two midwives handle 50% of births, and I had all of my fingers and toes crossed throughout my entire pregnancy that it would be one of them delivering Naomi. The doctors in the practice are good doctors, but I really liked both midwives and knew that a midwife-assisted birth would be more in line with what I hoped our birth experience would be like. Knowing that I wanted to avoid as many interventions as possible, Julie recommended staying home and laboring as long as I felt comfortable doing so and until contractions started getting stronger and closer together or until 8am, whichever came first. After talking to her, I got in the shower and immediately started having strong, fairly regular contractions. Although we intended to stay at home much longer, around 12:30am we decided to head to the hospital so there would be no chance of Drew delivering this baby in our apartment or the car.
11:30pm was far from the ideal labor start time in most ways, but it did provide smooth, traffic-free driving conditions, especially down Capital Boulevard and I-540. We arrived at the hospital just after 1am and ran back through the arrival instructions we had been given in our childbirth class just a few weekends before. Ultimately, I think the information we received about where to go and where to park when we arrived at the hospital only confused us. We knew the normal Patient Registration doors were closed between 9pm and 5am and that we needed to use the Emergency Room entrance instead. But we had also been told not to park in ER parking because we would be asked to move our car. What we didn't realize is that the P1 parking deck for longer term stays was on the opposite corner of the very large medical campus... So, we parked in P1 and ended up walking what seemed like a mile through the winding, empty hospital hallways. Even though I was the one in labor, I think Drew had a tougher journey, since he was carrying all of our bags. Between our luggage and my contractions, our trip through the hospital was a slow one, but eventually, we walked through a door that put us back outside the hospital, in front of the ER doors. After a quick check-in, a very nice attendant put me in a wheelchair and wheeled me up to the Labor and Delivery triage.
Another friendly nurse met us in triage and asked me to lose my street clothes and don a hospital gown. Then, she hooked me up to two belts - a contraction monitor and a fetal heart rate monitor. Over the course of the next hour or so, the belts and the nurse monitored the activity in my belly, while I answered a bajillion questions about my pregnancy and preferences. Contractions were getting pretty strong by that time, so we started practicing the slow breathing techniques and focus we learned from our childbirth class and library books. After a while, Julie came in to check my progress; she did a pH test to confirm that my water was broken and also checked my cervix: I was 5cm dilated and mostly effaced, so we would be staying at the hospital whether the pH test indicated that my water had broken or not (it most definitely had...). The maternity wing of the hospital was really busy that night - in fact, I was the fifth woman from my OB/GYN practice whose water had broken that day, even though more often than not, your water doesn't break until sometime later in labor. Julie attributed it to the weather and large shifts in barometric pressure with recent storms. Sounded plausible to me. We stayed in triage for a little while longer, then I got back in a wheelchair and was taken to a Labor and Delivery room, where my mom and sister were already waiting. My mom took this picture on her phone just before the real business of labor began:
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Here are her birth stats:
After a really long day filled with many of the things rumored to bring on labor, my water broke just before 11:30pm. Some people apparently experience trickles, but I made it to the toilet just before releasing a movie-worthy gush of amniotic fluid. I called my doctor's on-call number from the comfort of the toilet, and just sat there, shaking uncontrollably (nerves, perhaps?) while I waited for the doctor or midwife to call back. When the phone rang and it was Julie on the other end, I was so relieved. My OB/GYN practice has four doctors and two midwives on staff, and births are handled by all six of them on a rotating basis. Together, the two midwives handle 50% of births, and I had all of my fingers and toes crossed throughout my entire pregnancy that it would be one of them delivering Naomi. The doctors in the practice are good doctors, but I really liked both midwives and knew that a midwife-assisted birth would be more in line with what I hoped our birth experience would be like. Knowing that I wanted to avoid as many interventions as possible, Julie recommended staying home and laboring as long as I felt comfortable doing so and until contractions started getting stronger and closer together or until 8am, whichever came first. After talking to her, I got in the shower and immediately started having strong, fairly regular contractions. Although we intended to stay at home much longer, around 12:30am we decided to head to the hospital so there would be no chance of Drew delivering this baby in our apartment or the car.
11:30pm was far from the ideal labor start time in most ways, but it did provide smooth, traffic-free driving conditions, especially down Capital Boulevard and I-540. We arrived at the hospital just after 1am and ran back through the arrival instructions we had been given in our childbirth class just a few weekends before. Ultimately, I think the information we received about where to go and where to park when we arrived at the hospital only confused us. We knew the normal Patient Registration doors were closed between 9pm and 5am and that we needed to use the Emergency Room entrance instead. But we had also been told not to park in ER parking because we would be asked to move our car. What we didn't realize is that the P1 parking deck for longer term stays was on the opposite corner of the very large medical campus... So, we parked in P1 and ended up walking what seemed like a mile through the winding, empty hospital hallways. Even though I was the one in labor, I think Drew had a tougher journey, since he was carrying all of our bags. Between our luggage and my contractions, our trip through the hospital was a slow one, but eventually, we walked through a door that put us back outside the hospital, in front of the ER doors. After a quick check-in, a very nice attendant put me in a wheelchair and wheeled me up to the Labor and Delivery triage.
Another friendly nurse met us in triage and asked me to lose my street clothes and don a hospital gown. Then, she hooked me up to two belts - a contraction monitor and a fetal heart rate monitor. Over the course of the next hour or so, the belts and the nurse monitored the activity in my belly, while I answered a bajillion questions about my pregnancy and preferences. Contractions were getting pretty strong by that time, so we started practicing the slow breathing techniques and focus we learned from our childbirth class and library books. After a while, Julie came in to check my progress; she did a pH test to confirm that my water was broken and also checked my cervix: I was 5cm dilated and mostly effaced, so we would be staying at the hospital whether the pH test indicated that my water had broken or not (it most definitely had...). The maternity wing of the hospital was really busy that night - in fact, I was the fifth woman from my OB/GYN practice whose water had broken that day, even though more often than not, your water doesn't break until sometime later in labor. Julie attributed it to the weather and large shifts in barometric pressure with recent storms. Sounded plausible to me. We stayed in triage for a little while longer, then I got back in a wheelchair and was taken to a Labor and Delivery room, where my mom and sister were already waiting. My mom took this picture on her phone just before the real business of labor began:
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Our nurse, Candy, was also waiting for us in the delivery room, ready and eager to make us comfortable. During the last few weeks of pregnancy, I had two strep B cultures done, both with inconclusive results - I was positive for strep, but negative for strep B, which is the strain that can cause pretty serious complications for newborns if they pick it up as they exit the birth canal. The doctor who I met with at my last appointment told me that because of the weird result (usually the lab sends back a simple positive or negative), I would be hooked up to antibiotics during delivery, just in case. Julie interpreted the results differently and didn't feel like antibiotics were necessary, since I was, after all, negative for strep B. While I certainly didn't want to risk Naomi's health, I wasn't keen on antibiotics, partly because I knew there would be side effects, but mostly because it would mean being at least partially bed-bound with an I.V. during delivery. So, I was really relieved to find out that I'd be a free bird, able to move around however my laboring body wanted to.
After getting to our delivery room, I knew immediately that sitting in a hot bath would be the ideal way to pass the earlier parts of labor, so Candy got the water started in the deep tub in the bathroom. I think I sat in that tub for over an hour, trying to stay as calm and relaxed as possible, letting each contraction do its thing. With each one, I tried to envision my cervix opening up, and I honestly think the combination of that mind game and feeling open and buoyant in the water really helped make it happen. Drew patiently sat next to the bathtub, talking me through and around the discomfort of it all and rubbing ice chips on my forehead. Eventually, I got too uncomfortable in the bathtub - too hot and too cold and already feeling the urge to push - so I got out and headed to the bed. My cervix was checked again at this point; I was 8cm dilated and almost completely effaced, so we were well on our way to birthing a baby. Contractions were getting really uncomfortable at that point; I think they may have felt particularly strong without the dulling influence of the hot water in the bathtub. Candy suggested kneeling and leaning over the back of the bed, a position that would keep my pelvis open, let me maintain eye contact with Drew, and give me something to squeeze through each contraction and rest against between them.
After getting to our delivery room, I knew immediately that sitting in a hot bath would be the ideal way to pass the earlier parts of labor, so Candy got the water started in the deep tub in the bathroom. I think I sat in that tub for over an hour, trying to stay as calm and relaxed as possible, letting each contraction do its thing. With each one, I tried to envision my cervix opening up, and I honestly think the combination of that mind game and feeling open and buoyant in the water really helped make it happen. Drew patiently sat next to the bathtub, talking me through and around the discomfort of it all and rubbing ice chips on my forehead. Eventually, I got too uncomfortable in the bathtub - too hot and too cold and already feeling the urge to push - so I got out and headed to the bed. My cervix was checked again at this point; I was 8cm dilated and almost completely effaced, so we were well on our way to birthing a baby. Contractions were getting really uncomfortable at that point; I think they may have felt particularly strong without the dulling influence of the hot water in the bathtub. Candy suggested kneeling and leaning over the back of the bed, a position that would keep my pelvis open, let me maintain eye contact with Drew, and give me something to squeeze through each contraction and rest against between them.
As time and labor went on, each contraction nearly took my breath away. I was trying to stay open to them so my cervix would open up, but I was also fighting unbelievable pressure in all of my lower sphincters and a really strong urge to push. I felt like I really needed to go to the bathroom, so I got out of bed, but I didn't get very far due to the growing intensity and frequency of my contractions. Candy said I needed to stay right where I was, or I'd be having a baby in the toilet. No gracias. The bed just wasn't cutting it anymore, though, and I needed to be closer to Drew, so he sat on the edge of the bed and I sat across his lap facing him - a birthing position I'm fairly certain none of the nurses had encountered before... It was certainly not something we would have learned from any childbirth class, but it felt right at the moment, so we went with it. Being close to Drew had a calming influence and straddling his legs directed all of the pressure in my back and hips to my birth canal. As the following pictures indicate, that was by far the most uncomfortable part of labor - transition, it's called. People say this is when women feel like giving up and going home - while that's ridiculous since quitting isn't at all an option, I definitely heard a few exhausted, defeated thoughts creeping out of the corners of my own mind at the time. I was prepared for them though, and, with Drew's help, I kept reminding myself that it - each contraction and the transition process - wouldn't last forever and it was bringing Naomi closer and closer to us; I can handle this. What nobody tells you, and what I wasn't quite prepared for, is that you feel labor in your behind as much as you do in your lady parts. In my opinion, that wretched feeling is what makes labor, and especially transition, so notoriously uncomfortable.
Julie reappeared at some point, determined that I was ready to start pushing, and encouraged me to get back in the bed so she could guide Naomi into the world slowly, preventing any unnecessary distress and damage to my lower parts. Although repositioning in any way or moving anywhere sounded like torture, I trusted that Julie knew what she was talking about and that she knew how to make this birth as gentle and smooth as possible for both me and Naomi. My fear of receiving an episiotomy or ripping badly was second only to my fear of having a C-section [I could stomach moving a baby through a small hole designed for that purpose; I didn't think I could handle being cut open...], so I willingly obliged. It took a few contractions, but I moved back to the bed and reclined, ready to start the final stage of this birthing business. I ended up pushing for about an hour; it's a miracle Naomi's head was still round when she finally emerged. In most ways, the pushing phase was a relief after transition, but that hour was definitely taxing in its own way. When I started pushing, it was around 6am; I had been performing some pretty strenuous physical activity for quite a while at that point and doing it with zero sleep. Aside from raw exhaustion, pushing has this close-but-not-there-yet element to it; every push feels like it could and should be the last one - please let this be the last one - but it's not. Naomi's little head would crown and recede, crown and recede, and each time Julie would tell me that the next contraction could be it. I think the fear of tearing or somehow hurting Naomi made me a sub-par pusher. Julie must have known that because she kept saying, "You're fine; Naomi's fine; you're doing great." She and Candy were both so calm and quiet during the whole thing; they were the perfect team for quelling my nagging fears.
Most of the final parts of labor are a bit of a blur. I remember my sister playing The Fray's song "Be Still" on repeat. I remember Drew saying "she has hair!" and then bringing a standing mirror over so I could see, too. I remember reaching down to touch the top of her head. I remember Candy reminding me over and over to hold my knees and push up. I remember checking the clock for one of the first times all night and feeling like it was taking forever to get her out. I remember the sting I felt as Naomi's head finally emerged. And then I just remember feeling relieved - thinking I'm not pregnant anymore and she's here - alive and healthy and perfectly unhappy with that telling little cry. Julie immediately put her on my belly, sticky and a little purple, and I just held her under a warm blanket for a while before my mom cut the umbilical cord with blurry, sleep-deprived eyes and no glasses. [Drew wasn't interested in severing our physical mother-daughter connection]. Naomi passed some tar-like meconium pretty quickly, so both of us were in need of a good cleaning [I vividly remember her little foot being stained from it until her first sponge bath]. Drew accompanied her to the warmer for a wipe-down, measurements, and an initial check-up while I delivered the placenta (which was neat to see and way bigger and heavier than I imagined) and the nurse cleaned my belly.
Most of the final parts of labor are a bit of a blur. I remember my sister playing The Fray's song "Be Still" on repeat. I remember Drew saying "she has hair!" and then bringing a standing mirror over so I could see, too. I remember reaching down to touch the top of her head. I remember Candy reminding me over and over to hold my knees and push up. I remember checking the clock for one of the first times all night and feeling like it was taking forever to get her out. I remember the sting I felt as Naomi's head finally emerged. And then I just remember feeling relieved - thinking I'm not pregnant anymore and she's here - alive and healthy and perfectly unhappy with that telling little cry. Julie immediately put her on my belly, sticky and a little purple, and I just held her under a warm blanket for a while before my mom cut the umbilical cord with blurry, sleep-deprived eyes and no glasses. [Drew wasn't interested in severing our physical mother-daughter connection]. Naomi passed some tar-like meconium pretty quickly, so both of us were in need of a good cleaning [I vividly remember her little foot being stained from it until her first sponge bath]. Drew accompanied her to the warmer for a wipe-down, measurements, and an initial check-up while I delivered the placenta (which was neat to see and way bigger and heavier than I imagined) and the nurse cleaned my belly.
Naomi was born at 6:57am on Sunday, April 27, 2014. When I initially called Julie, she told me that her rotation ended at 8am and one of the doctors from our practice would be taking over at that point; that information put me on a bit of a subconscious, internal clock - I wanted to have Naomi before she went home. Our timeline was shortened a little when we met Candy; her shift ended at 7am, and she wanted to see this baby be born. In the end, Naomi arrived just in time.
Here are her birth stats:
Weight: 7 pounds 10 ounces
Length: 20.5 inches
Length: 20.5 inches
Head circumference: 14 inches
After confirming that she was, as we already believed, practically perfect in every way, Drew brought Naomi back to me and I breastfed her for the first time. She was a nurser and a starer from the very beginning; she latched right on and looked deep into my soul with that intent newborn stare, solidifying my adoration of her right then and there. Looking in her eyes in that moment, and looking back at these pictures now, I feel a little more certain that human spirits aren't merely the product of biology, created spontaneously during gestation. Naomi seemed to be newly arrived from somewhere, a little dazed and confused by the bright lights and strange faces, but in no way a blank slate. Those eyes and her expressions indicate that while her experiences here are new, they aren't necessarily her first ones. There is so much we want to show her and teach her, but I'd trade just about anything for a glimpse inside her mind, both in her first minutes on Earth and in many moments since.
While Julie attended to a few tears in my derriere with a stitch here and there, Naomi got to know her dad, (as yet unnamed) grandma, and Aunt Jenn (I guess there isn't a picture of that because she was the one wielding the camera). Although my mom and sister were in the room the whole time, I don't remember exchanging more than just a few words with them. I was in such a zone, focused entirely on my own body and what Drew was saying for most of the time. In the end, I'm glad they were there to witness it all, although Jennifer may be permanently scarred...
My dad and Nannie arrived just as I got all put back together, less than an hour after Naomi was born. I texted him from triage to let him know he'd be having a granddaughter that night, and at that time, he was already on his way to North Carolina thanks to intel from my mom and sister. He stopped in Dunn to pick up Nannie and they made some pretty excellent time getting to Raleigh. The two of them took the second shift, letting my mom and sister go home and get some sleep after a long night. My dad and Nannie hung out with us through the morning, then left to get some sleep themselves after we moved to a post-partum room.
My dad and Nannie came back later that day and eventually acted as Naomi's very first babysitters, holding her while Drew and I went down to the hospital cafeteria for some pizza and pudding parfait. They and my mom and sister were in and out over the next few days, and Laura also came by for a visit. We spent all of Sunday and Monday in the hospital, holding and feeding Naomi, being checked regularly by a battery of nurses, and generally not sleeping - Drew because his couch bed was so uncomfortable and me because sleeping while taking care of Naomi on the outside was significantly more difficult than sleeping while taking care of her when she was on the inside. She hated that plastic tub of a bassinet at the hospital and only slept soundly when on top of me. There was big sign posted right in front of the bed in our room about the dangers of sleeping with your baby in the bed; they can roll off onto the tile floor or you can roll over onto them, after all. That, combined with the nurses coming in every few hours, kept me from sleeping well while holding her, and I was just about always holding her. In the end, I think I slept just a few scattered minutes in over 72 hours.
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Between the food and the lack of sleep, when Tuesday morning rolled around, we were so ready to take our little family home. An aide checked our car seat and rolled us all the way through the hospital to the car, while I covered Naomi's little body with a blanket and my hands, already so much more keenly aware of how scary and germy the world is. Someone told me that after their first baby was born, they instantly thought, "Oh, little one, you were so much safer on the inside," and it's true. You worry about them on the inside because you can't see them, but you worry so much more about them on the outside because you can see everyone else.
Pregnancy, labor, and delivery was an amazing, defining, and, at the end of the day, pretty indescribable experience. Most importantly, it was my experience, different from the pregnancy, labor, and delivery of any other woman. I was continually amazed by how being pregnant somehow appeared to the general public as an open invitation to question and provide advice about the activity of my womb or share both lovely and horrific stories about the activity that once went on in theirs. Nothing seems to evoke stronger, more freely flowing opinions than childbirth and child rearing; I was determined early on to smile and nod through it, taking what I found valuable and leaving the rest, and then to never be on the other end, providing unsolicited advice to worried mothers just trying to make the best choices for them and their house.
We had an unmedicated, zero intervention birth, and that was the right decision for us. It gave me a sense of ownership and control over an experience that drastically altered my life [and body] and could have been slightly traumatic. I wanted to be the captain of that ship, not a stowaway, just rolling on the waves of someone else's plans or a seasick passenger under the influence of numbing drugs. However one chooses to do birth, I think it's ultimately only important that they choose it (barring, of course, those circumstances in which choosing a healthy mother and baby precludes other birthing choices). Growing and birthing and becoming mama to a child is something extraordinary, something I didn't want to just happen to me; I wanted to do it actively, and I did. And Drew, in his oh-so-central encouraging, guiding, and reassuring role during labor, actively became the daddy of his baby girl. We were fully present in every moment of it, and because of that, I don't regret anything about how our experience unfolded. It was new and uncomfortable, messy and a little scary, but it was enlightening and empowering and beautiful, just like life always is, just like parenthood is bound to be. Naomi's birth was the perfect beginning to what has already been a beautiful life with her.
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