August 5, 2011

My (42 hour labor) Birth Story

I am a very good example that prenatal yoga will not necessarily guarantee you a shorter labor, but can offer you tools to get through whatever your labor turns out to be. I could not have gotten through my labor without the support of all I have learned about myself through my years of practicing yoga.

I grew up hearing from my mother about the fast, easy labors she had with my brother and me. Naively, I was expecting to follow in her footsteps since our body structures are so similar. I never would have predicted that my labor would be about 42 hours long with 5 hours of pushing.

The story starts, July 9th- my due date!- early in the morning. My husband and I were trying some “natural methods” to get labor started. About an hour and a half later, dressed and ready to head out to the gym, I noticed that I was starting to experience strong cramping feelings- like intense menstrual cramps. I decided to hold off on my gym excursion and see where things would lead. After a bit of time, I realized that these cramps were not going away and were becoming a regular pattern of every 5 minutes. The sensation was still quite manageable, but I called my labor support doula and my midwife just to give them the heads up that something was brewing. My husband had a prep class that morning for his Social Work licensing exam, and since I was certain that I was still at the beginning of the process, I insisted he go to the class. I also felt like I needed some time alone to wrap my head around what was to come. I took a bath and spent some time to relax and breathe through the rise and fall of the contractions.

Terry, our doula, arrived around 3pm that afternoon. I knew I had not “turned the corner” into active labor, but did believe I was on the brink of it. Things slowly progressed through the day. I alternated between laboring in the birth tub- which brought my contractions on to every 3 minutes- (this as painful as it was, made me hopeful that things were progressing) and moving around the house and resting. Terry had been in contact with our (AMAZING!) midwife, Stacey Rees, through out the day and was informing her of my progress. By late Saturday night, I was aware that things were moving along very slowly and was concerned about a disfunctional labor. At this moment, being a professional in the birthing community proved to be a double edge sword. I knew enough to realize that something was not quite right in the progression of my labor, and suspected it was the baby’s position. After a night of moving between resting – I did actually fall asleep between contractions- and trying different exercises to adjust the baby’s position- I was reinvigorated by the rising of the sun.

Joey, Terry and I went to the roof of our building to get some fresh air and change of scenery… and, continue with lunges and stair climbing to encourage the baby to rotate forward. Our midwife arrived a little after 9am and did an internal exam to see how far along I was. I was terrified she would say that I was only 1-2cm along. It is typical that with a malpositioned baby, the mother could experience quite strong contractions but have made little progress in dilation. To my great delight- and surprise to all involved- I was 80% effaced and 5 cm dilated! This news gave me renewed hope and a second wind to keep truckin’ forward. Stacey checked my vitals signs, continued to listen to the baby’s heart rate every 15 minutes and declared that my labor was “methodically” progressing. She then put me to work to try to disengage the baby from my pelvic in hopes to re-rotate him into a more optimal birthing position. For almost an hour I did “butt up” child’s pose. The “big guns” came out when Stacey said she wanted to do a method Guatemalan midwives use with a rebozo sling. This technique involved the help of my husband, Terry and Stacey. I laid on my back and Stacey placed the rebozo sling (a big piece of fabric) under my hips. Joey lifted my feet while my head and shoulders remained on the floor, and Terry took one end of the rebozo and Stacey held the other end. They then rocked my hips from side to side trying to use gravity and the swinging motion to disengage the baby’s head from my pelvis and help him re-engage in a better manner.

At this point, our midwife headed home for a few hours and I was then instructed to alternate between resting and being active to try to turn the baby. This went on for a while, which brings us to late Sunday afternoon when Stacey returned to check in on me. To my great delight I had progressed to 8 cm and almost 100% effaced. This progress helped me regain confidence and hope that labor was nearing an end. I continued to follow the same routine I was doing before, resting and moving. About 3 hours later- convinced I had to be close to full dilation, considering the intensity of the contractions, I was still at 8 cm.

In my mind, I started to fall into despair. I was tired and had been at this game of labor for about 34 hours. The contractions were definitely challenging and took over my whole body. I often counted my breathes, knowing that at a certain number, I was hitting my halfway point in the contraction, and soon the pain would subside. I also allowed my body to move however it needed to move. And, I talked myself through the wave of intense sensation with mantras like “the breath is the path through the contraction.” I had to dig deep to keep going and started to question if I should transfer to the hospital to get an epidural so I could rest. I felt that I had the capability to deal with the pain, but I was so tired, I just wanted to sleep.

I started to doubt myself and my choices and mentioned the idea of transferring. Everyone agreed we could do that if I really wanted to, but they all believed I still had the strength to complete my labor at home. Stacey suggested that I try to push and see if she could stretch me open the last couple of centimeters. She also wanted to see what kind of room I had in my pelvis and if the baby would easily descend. After a “practice” push, she believed I could push the baby out. So for about an hour, I pushed as she had her hand in me trying to stretch my cervix open. I made some progress and pushed the baby down a bit. My water spontaneously broke at this point and Stacey wanted to see if this new development of ruptured membranes would bring on strong enough contractions to push me through transition (moving from 8 cm to fully dilated at 10cm) and help rotate the baby into an anterior position.

Intense does not even begin to describe the sensation of the contractions at this point. I was curled on my side in bed actually sleeping between the 3 minute apart contractions. As the contractions started, I moved onto an all 4 position, rocked, moaned, counted, breathed to get through them. An hour and a half later, I begged to start pushing. I was still only 8 cm. UGH!! But, I was not going to stop until my baby was born. As I pushed, Stacey again, stretched my cervix open and finally I was 10 cm and the baby stayed down. After an hour, he rotated into the anterior position- a position that allowed him to continue to descend and fit through the pelvis easier. We tried a myriad of pushing positions; supported squat, pushing on the toilet, “tug of war” pushing and finally side lying (the easiest position on the perineum).

Second stage of labor – the pushing stage- held it’s own challenges. I liked that I was more actively involved instead of just tolerating the experience. But the act of pushing was exhausting. I wanted to give up and be done with the whole thing. Luckily, my baby tolerated this lengthy labor with ease. Stacey checked his heart rate with every contraction and he was never showed any sign of distress. The midwife and doula even joked that his heart rate was so strong, the baby didn’t even seem to know he was in the birth canal. But I certainly knew he was!!! I will be honest- the pain near the end of pushing was a pain that I did not know could exist. I mustered strength- both mental and physical- in a way I didn’t know I was capable of. I would start the contraction and say to myself- “Just finish this off and get the baby out” and then proceed to push with everything I had. Once the baby was crowning- which lasted an eternal 45 minutes- I had to shift into an even more serious mode. (There is a reason this stage of pushing is called “The Ring of Fire”) I wanted to give up, I just wanted this all to end. I looked down at my big belly and wondered, “How is this baby ever going to get out?!” I knew with each push I would have to deal with excruciating pain of my pelvic floor muscles stretching as his head continue to emerge, but I also knew that if I didn’t meet the pain and go through it, labor would continue to drag on. So I faced the obstacle and just plowed forward until he was finally out.

Relief, joy, exhilaration, exhaustion, disbelief all came flooding over me at once as my baby was placed on my chest. He was so alert as he looked around taking in this new, dry world. My hard work paid off, and my beautiful baby boy was finally in my arms. The placenta came out soon enough and much to my incredible surprise, I only had a minor tear on the side of my vagina, my perineum stayed intact. After Stacey skillfully repaired the small tear, Joey and I stayed in bed and took in the wonder of our new son. Terry was busy cleaning up the birth tub, reorganizing the living room and she cooking us breakfast – it was about 4am on Monday morning at this point! Stacey was conducting her newborn procedures and assessment. Her final task was weighing our boy and measuring him. 8 pounds and 20 inches long! WOW! That was a surprise!

After telling my story to some friends and family, I am often asked if I regret doing a home birth where pain medication was not available. No, I don’t regret that choice at all. I will admit that towards the end, an epidural sounded like a fantastic idea. However, I can see with the labor that I had- slow and methodical – as my midwife called it, I would have likely experienced a very medicalized birth in a hospital setting. Having a career in the birth community, I have a good sense of the time table that births need to run on in a typical hospital. I likely would have had pitocin to help move my slow labor along and an epidural. This would have made the chances of my son rotating from posterior to anterior even slimmer. Since I never progressed past 8 cm on my own (remember, Stacey helped stretch me to full dilation) I likely would have been declared “a failure to progress.” If I did dilate to 10 cm on my own, the 5 hours it took to push him out would have been too long for the protocols of most hospitals and I would have been told my baby was too big for my pelvis and ended up delivering via cesarean section. So, yes, it was painful, but for me and my little family, it was the right choice.

As for how my yoga practice helped me. There is a term in the study of yoga, svadhyaya, which means “self study.” Through my years of yoga, I have encountered asanas (poses) that were challenging and took years for me to uncover how to fit them into my body. From the poses that did not come easily to me, I learned how to deal with discomfort, find patience and surrender my ego. Those tools were invaluable to me during my long, arduous labor.

Shay Henry was born in our bed, in the warmth of our small apartment on July 11th. We could not be happier, prouder, (tired!) parents.

Me doing

Me doing “butt up child’s pose” hoping to turn the baby forward

Shay, Mom and Dad just moments after the birth
Shay, Mom and Dad just moments after the birth




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