His birth story picks up right where I left off in my update from last week. (Notice: this being a story of childbirth, there are some details toward the end that aren't for the squeamish.) Five days overdue, we went to the midwife for our 41-week appointment, bags in tow just in case. I knew they would strip my membranes if I wanted, to help urge things along, and Peg had told me they might want me to stay close in that case, since it could happen quickly. My labor with Claire started about seven hours after getting my membranes stripped, but third babies can come especially quickly.
So, she checked me—80% effaced and 3.5 cm dilated—and did the stripping. We had some trouble when she put the heart and contraction monitors on, though. Jonah had been very active that morning, even before I was out of bed, and in the midwife's office, he was going nuts! My placenta being in front and a super-wiggly baby made it hard to get a steady read on his heart rate. So, we stayed a while to get a good trace on his heart, and at one point it went up to 170-173 bpm, a bit over the desirable range. Peg decided to send us on to the hospital for further monitoring and possible induction. (We used the Vanderbilt Nurse Midwives practice, and while they did open a birthing center a couple months ago, we'd still planned to deliver in the hospital.)
She didn't make a big deal of it, just wanted to be on the safe side. My main midwife was the one on call, so Peg called Margaret and told her we were coming. As we quickly drove through Wendy's and updated the grandparents, I told Matt not to use "the I-word." Induction. I hate the idea of having a crazy-specific "birth plan," (shocking for a planner like me, but I also hate the idea of being high-maintenance) but since I did want to go natural, drug-free this time, getting Pitocin would derail my hopes right from the start. Surely they wouldn't have to induce.
It was strange going up to Labor & Delivery not already in labor, pulling my own suitcase and waiting (semi-)patiently in the waiting area. The check-in person told us no need for triage, we were being admitted already. When the nurse, Ann, showed us to our room, I commented there was no laboring tub, and she said we couldn't use one "because you're an induction." I started to debate her, so she went to get Margaret the midwife. As we waited, my face crumpled to an angry cry. I did learn that the tub didn't get extremely hot, though, so I didn't really care about that anymore, since I like to practically boil myself in the bath or shower! The bottom line for me was that I wanted to be up and about during labor, not confined to the bed. They assured me this would still be possible.
We started monitoring and Jonah's heart rate was totally normal, but Margaret thought we should go ahead and try to start labor if we could, since I was already near 41 weeks and his heart rate had gotten so high earlier. She explained the options: 1) have her break my water and see if that got contractions going, or 2) start a Pitocin IV. I didn't want to have an IV in and be tethered to a pole, even if I could walk around with it, plus I worried that Pitocin would make contractions so strong I'd end up wanting an epidural. I felt disappointed and confused and had another face-crumpled angry cry before deciding to have her break my water. At least then there would be a chance of not needing Pitocin, if contractions got started without it. My membranes (bag of waters) had been artificially ruptured with the girls, so I was hoping to let that happen naturally too, but it wasn't too big a concession. She did that around 2:30 in the afternoon (no meconium this time—go Jonah!) and Matt and I settled in, had a visit from a friend, watched a little TV, and took a walk around the halls.
I was planning to use Vanderbilt's volunteer doula program, and though none of the volunteers had signed up for that on-call slot, we were going to call the main number and see if someone could be found. Instead, Ali, the student midwife I'd seen that morning and the week before with Peg, volunteered to doula for me. As it turned out, she was also a graduate of Vanderbilt Divinity School (where Matt and I met) and we knew a lot of the same people. She'd been at div school after our time, planning to go into ministry, and done a chaplaincy internship alongside a traditional midwife in Mexico. There, she discovered a passion for midwifery, and after graduating the divinity school, enrolled in the nursing school!
We chatted and got to know Ali and my contractions began around 3:30--hooray! The water-breaking worked! Contractions were about 4-7 minutes apart and only mildly uncomfortable. I paced around our room in circles, watching my guilty-pleasure show, "Say Yes to the Dress," and then having Matt hook up his iPod speakers and turn on the soundtrack to "Rent." Strangely, this was something I'd thought about way back when birthing Kate, feeling like singing along to some really driving songs would help me in labor. But I don't really feel like I "labored" then, I just endured contractions lying down until I could get my epidural. Instincts were pretty much forgotten.
At 4:45, I had my first contraction that was remotely painful. So I kept pacing around in circles like a lion and Matt and I sang along to Jonathan Larson's brilliant music. (The nurse told me she's seen lots of things, but never a couple singing show tunes in labor!) As contractions got more painful, I put the birthing ball up on the bed, kneeled behind it, and rocked forward and back. It felt so good to be moving around at this point. At one point, I sat back in the bed to test my theory of whether contractions really hurt more when reclining (my rationale for this "I think I can do it without drugs if I'm able to move around). It didn't really hurt more, but made me feel helpless against the pain because there was nothing I could really do about it.
Sometime around 6:00, contractions got MUCH more painful, and only 2-3 minutes apart. I had Matt turn off the music and I got in the shower for a bit. The water wasn't near hot enough for me and brought little relief. The pain was getting really bad. I sat on the toilet and threw up. Ali checked me, and I was 90% effaced, 7 cm dilated, and baby's head was at zero station (i.e. right at the cervix). She coached Matt on supporting me through the contractions (the dancing pose really didn't work for me, though), and she and Matt switched off pressing firmly on my hips while I stood at the end of the bed with my torso laying across it.
Around 7:00, Margaret's shift was over, so she introduced me to Tania, a midwife I'd never met. Given that Ali and I had a good thing going, Tania pretty much stayed in a background or advisory role. Margaret might have stayed if they'd known how soon it would all be over, but who knew? I was seriously laboring, practically in tears, leaning onto the bed with one contraction coming right on top of the next with no break. This was the one point where I asked "Why did I think this was a good idea?" and wondered how long I could take pain at that level before wanting an epidural. Whatever that point might have ended up being, it was thankfully a moot point, because at 7:15 or so, I said hesitantly, "I think I need to push out a BM . . . and maybe a baby?"
Ali checked me again. Couldn't have been more than an hour since checking me before, but there I was, 100% effaced, 10 cm dilated, head at +1. It was go time!
Perched awkwardly on the end of the bed, we prepared for me to push. I'd envisioned myself squatting to push, but someone said gravity might help a little too much and he'd come shooting out too quickly. Plus, it hurt so bad to change positions in this state, I just wanted to push him out ASAP. I did have a BM, and then got a little reprieve as contractions eased up. I'd read about that in one of the birth books—what an amazing gift our bodies give us, a rest right before the big job of pushing out Baby!
I had Matt take a picture of the clock, as we had at the girls' births. 7:23 when we started pushing. I asked for the mirror to be brought over so I could watch. As contractions began again, I screamed from my gut as I pushed Jonah out. A bunch of dark hair became visible and then retreated until the next push. When I reached down to feel it, I thought it was the cord because it was just a puffy, soft line of flesh, but it was the skin of his head squeezing through the opening. Pushing hurt so bad, I thought again at this point, "Why did I want to do this?" He crowned with the next contraction, but retreated again and I pushed ever harder to get him out with the next one. His head popping out brought a burst of excitement, followed a split second later by the realization that his shoulders weren't going to just slide out—I'd have to push them too. Ow. But one more contraction and push and it was done. There was Jonah!
He was born at 7:45, just over five hours from getting my water broken and only three hours from the first twinge of pain! They laid him on my chest as they helped the placenta out and stitched up a first degree tear. Once that was done and I could get into a better position, we nursed. It was nearly an hour before they took him from my chest to weigh him and do other checks. He weighed 9 pounds, 4 ounces, 21.25 inches long. More than a pound heavier than my girls, but he still seems tiny to me. Precious babe. He didn't leave my presence until a short bit Sunday morning before we went home.
I don't know if I could have done it with a longer labor, but I'm glad I had the experience of laboring and birthing my sweet third child naturally. My parents were there even before he left my chest, and Matt's parents brought the girls the next morning. They were so excited to meet him and just adore him. We've had a good week getting to know each other. He's such a sweet baby!