Wren was born August 22, 2020 (which just so happens to be our 5 year wedding anniversary!) at 1:48am. I went into labor at 37+2, was in super painful labor for about 3 hours before she was born (starting around 10:30pm), and was able to have a completely unmedicated labor without any labor complications (but I did have a tear and some post-labor complications) – details are below.

Background

By way of a little background / setting the stage for her birth story, the last few weeks of my pregnancy I was extremely swollen and had borderline high blood pressure – it seemed like preeclampsia was setting in. So I had to be very inactive, on slight bedrest, trying to keep my swelling and blood pressure down. When they did a blood test for preeclampsia, they found that my iron levels were very, very low – so I had anemia and needed to get iron infusions. (I had been on iron supplements but they weren’t doing enough, apparently.)

Tuesday: I was trying to get my iron infusion scheduled with the infusion office for DAYS and it was a bureaucratic nightmare (as things are with the horrible health care system we have in the US). The doctor said it was medically urgent in the order for the transfusion, so the fact that bureaucratic bullshit held it up for DAYS is really insane. Basically, the infusion office was saying they needed a prior authorization from my insurance, but my insurance was saying they didn’t need to give one … and they were at a standstill.

Wednesday Night/Thursday: In the middle of the night when I got up to pee, there was a tiny bit of leakage. I didn’t think much of it and went back to sleep. There were a few more instances of leakage that I felt Thursday throughout the day, especially when I moved after being in one position for a long time. I read a bunch online that said this can happen as you get to the end of pregnancy, and that its nothing to worry about, so I didn’t worry.

Friday: I finally got my infusion scheduled for Friday afternoon. The leakage was still happening in small amounts, and Cory and I decided to just call the midwife to talk about it so I wasn’t worrying about it all weekend. The midwife said it was probably nothing to worry about (and probably not my water breaking), but asked me to come in on my way to my iron infusion just so she could check it out. Well, she used a test strip and determined that my water HAD in fact broken! And since it had been over 24 hours and I didn’t go into labor, I had to get things moving. Unfortunately, I was high risk due to my STUPID IRON LEVELS since I never got the infusion (thanks US healthcare), combined with the fact that my water had broken over 24 hours ago. So, sadly, I had to give birth at the hospital instead of the birth center (this turned out to be a really good thing, though – read on).

So the midwife made me the “midwife cocktail” which consisted of castor oil, champagne and nut butter and told me to drink that and meet her at the hospital at 8pm. The hope was that this would be enough to get my labor going and that they wouldn’t have to do any medical induction / intervention once I was at the hospital. I drank it around 3pm and headed home to shower, speed pack, and generally get ready for baby girl!

Labor

Contractions started getting noticeable (but not painful) around 6pm, and slowly increased in strength and frequency for the next few hours. I was hanging around the hospital room watching legally blonde with some painful contractions that I couldn’t talk through at 10:24pm, but still having a “good time.”

The next 3 or so hours was a complete blur. I was prepared for labor to be more painful than I could ever imagine, but somehow it was even worse than that. Even though I was at the hospital, since my midwife was in charge of my labor, I was able to move around and try various positions to make things comfortable and try to progress labor. Nothing really seemed to help except getting in the shower, which slightly alleviated the pain. I remember I was crying from the pain at various times and really, truly didn’t think I could do it.

Cory said at one point I looked over at him, crying, and just said “I want to go home” – and he says he will never forget the look in my eyes and how helpless he felt. I remember another point in the shower really thinking I couldn’t do it. I asked the midwife how much longer – thinking that if she could at least tell I was almost done then maybe I could muster up the courage. But she said she had no idea, and since it was my first child, things tend to be longer. I asked her then if it was too late for an epidural or some sort of drug. She said it wasn’t too late, but to try a few more contractions.

At some point after that I was WAY TOO HOT in the shower and thought I was going to pass out so we got out quickly and back to the hospital bed. Then it was time to push! This was probably the most painful part, but at least there was an efforts-based outcome: i.e., the harder I push, the faster the pain would be over and I’d have my baby girl in my arms!

So I pushed as hard as I could with each contraction. I pushed again with each contraction as I felt it fading out. NOTE – I think this was a bad idea, but I was trying to get in as much pushing as possible during the contractions. But I think if I had waited and not added in another little push at the end it would have allowed things to stretch out and maybe it would have hurt less and maybe I wouldn’t have had a 2nd degree tear/stitches.

I had no idea how long the pushing phase was, but Cory said it was maybe 15 minutes long. Then she was here! They handed her to me while she was still attached. We opted for delayed cord cutting to get her all the extra nutrients and blood, etc. They cut the cord when it stops pulsing – which is normally 1 to 2 minutes. Mine pulsed for 5 whole minutes – so she got a TON of extra blood and nutrients. Then they cut the cord, and then I delivered the placenta. The placenta delivery really was nothing – I barely noticed it since I was over the really painful part and paying attention only to my baby.

Afterward, the midwife had to stitch up my 2nd degree tear. She also had the nurse give me a very small dose of pitocin. I was only barely paying attention and heard her order this. No one asked me and it was DEF. against my birth plan. This was really frustrating, and I thought about objecting but at that point I was so tired and out of it, and I had my baby in my arms already, so I decided I just didn’t care.

After Labor in the Hospital

Saturday: The next morning, I was losing a lot of blood but didn’t know whether that was normal or not. Eventually I decided it was probably more than normal, so I said something to the nurse. She took a look and said it was DEFINITELY not normal. And she ordered a hemorrhage cart and we monitored the bleeding, which wasn’t slowing down. The most likely (and least scary) reason would be that there was lots of clotting still in my uterus and/or some bits of the placenta left in there. We didn’t have any indication that my placenta broke at all, but it was still possible. The nurse did a ton of the *lovely* (read: painful) uterus massages and was able to push out a GIANT blood clot the size of a softball. We were hoping that this was the cause of my bleeding, but in order to be sure, the doctor did an ultrasound and didn’t see any remaining clots. She also did a VERY PAINFUL manual sweep of my cervix and got a few more small clots out. After this, luckily, my bleeding slowed down.

On Saturday, I was very weak and exhausted from labor, losing so much blood, and not being allowed to eat (I hadn’t eaten since an afternoon snack before we went to the hospital on Friday). I didn’t realize at the time how “out of it” I was – but looking back I was very out of it.

I was relying on the nurses to tell me whether I was breastfeeding enough, whether Wren was getting enough to eat, etc. The main way the nurses can tell whether the baby is getting enough is based on how many pees and poops the baby has. Wren did 5 poops and a ton of pees, which is WAY more than normal, so everyone assumed she was eating plenty. The problem is, she wasn’t. I think she peed and pooped a ton because of all the extra blood she got from the delayed cord clamping.

In any event, I didn’t feed her enough but no one realized until Sunday, partially because everyone was really focused on me since I was losing so much blood, and partially because she peed and pooped a ton.

Sunday:

At Wren’s 24 hour check, her bilirubin levels came back high and she had to go under the light (which they brought in our room). One crucial factor in getting bilirubin levels back down is making sure she is eating enough. She was pretty lethargic at this point, and I was struggling to get her to latch because she kept falling asleep. A few of the nurses were able to help one-off after I asked a bunch of times for some help, and I asked to see a lactation consultant (we hadn’t seen one yet). Unfortunately, there aren’t any on the weekends. I was really struggling and felt really helpless.

They did another bilirubin test and the results came back in the middle of the night. Her bilirubin had gotten even higher. It was around 2 am, I was still really delirious from losing so much blood, and really, really frustrated with not getting help breastfeeding. The nurse came in and was going to give her formula. This made me SO UPSET – I knew there were all sorts of things to do in the interim before just giving her a ton of formula. No one ever told us things were getting concerning and I should, for example, try manual expression of the colostrum. Or try harder to get her to eat. Or anything. So when the nurse came in about to give her a whole thing of formula, I got really upset and asked to see a doctor (who wasn’t readily available at 2am on a Sunday night / Monday morning). The doctor basically said that at this point, we had to give her formula. I was so upset that we were “at this point” without ever being given any warning, and urgency or any help with feeding her. Then the nurse gave her a whole thing of formula in about 15 seconds, which also made me extremely frustrated because the better thing to do would have been to give it to her slowly at the same speed as it would come out of my boob so as to not stretch her stomach and potentially make her averse to breastfeeding.

I was still pretty upset, but the doctor made me feel a bit better by telling us that she had to give her first child formula in the hospital, but had no issues breastfeeding after. (Spoiler alert: as of the time I’m writing this post 6 weeks after her birth, we have been breastfeeding exclusively ever since that one injection of formula in the hospital. So let that be reassuring to anyone who may have to give formula in the hospital!)

Monday: She had another bilirubin test Monday morning, and this time her levels were down to safe and it was looking like she could go home! Hooray! At this point I was so glad we’d given her formula overnight, and haven’t regretted that since!

Finally, it was looking like we’d get to go home. Wren was discharged, but they had decided to test some of my blood, and found that my iron levels were low (which shouldn’t have been a surprise to anyone). AND THEY ALMOST WERE GOING TO MAKE ME STAY LONGER TO GET MY IRON LEVELS UP! I said “absolutely not. My iron levels have been low for weeks and you could have given me iron any time over the last 2 days.” So they gave me a super quick infusion and WE FINALLY GOT TO GO HOME!

Overall, I got the unmedicated birth I wanted, but a lot of other parts of my “birth plan” didn’t play out as perfectly as I would have wanted. But everything turned out okay – I remember at the hospital after she was born saying to Cory, “nothing really matters as long as we both can go home healthy.” And that’s what I got, albeit 3 days later than when I would have gone home per my “birth plan.” But, in retrospect, I am VERY glad we had to give birth at the hospital because of my subsequent blood loss and Wren’s bilirubin. I couldn’t imagine having to call the midwife from home to say “I’m losing a lot of blood, but I don’t know if its too much or not” and then having to figure that out, then pack up everything and go to the hospital.

I hope Wren’s (very long) birth story is helpful to anyone who just wants some of the mystery taken out of labor, or may be struggling with any of the same issues I struggled with. I remember reading somewhere that its more of a birth “wish list” than a “birth plan” – and I think that’s a great mentality to have going into labor. Things don’t always go perfectly. The best thing you can do is be a strong advocate for yourself and ask questions. I should have said something about my bleeding much sooner than I did, and I shouldn’t have assumed the nurses were making sure I was feeding Wren enough. And when I started to realize I needed help breastfeeding, I should have been much more forceful and demanded a lot more help than I did.