I had just completed my DONA doula training when one of my nearest, dearest and oldest friends, Bethany, asked me to be her doula. As with most relationships, we've had our ups-and-downs, but we've also been through some of the most painful (the passing of friends and family members) and joyful (love, marriage and career achievements) moments of each others lives together. And so, there was no question that I would attend the birth of her beautiful cookie to be.
Morgane and Bethany in Cambodia.
When we began talking about Bethany's hopes for her birth, she was a tad skeptical of epidurals and hospitals but certainly felt like it was the best option for her. Being a doula, I don't judge how and where people give birth and so I supported her throughout every decision she made. However, as Bethany's due date came closer - and after an amazing birth education course with Tanya Willis - she realized just how much she wanted to avoid having a medicated birth and decided to switch to a midwifery practice in Princeton, New Jersey.
Sadly, the hospital was a bit too far for me to guarantee my presence at her birth and so we set her up with another doula. But, Bethany took control of her birth experience and gave birth to her cookie just as she wanted - surrounded by love and support, in a peaceful environment and without an epidural.
Bethany allowed me to share her beautiful story with you all. So here it is:
A number of people have asked me to share my birth story, so I decided it would make for a great blog post to send to folks that are interested in my experience.
For all first time mothers, childbirth can be a really scary experience – we’ve heard so much about it and watched so many movies, but we just have no idea what it will be like. Every woman remembers their childbirth experiences and unfortunately, most of the women who have negative experiences are much more likely to share them with pregnant women than ones who have positive ones. Before I gave birth (yesterday!) a lot of women shared their horror stories, but few shared anything remotely positive.
When we first found out we were pregnant back in January or February, I assumed I would go for the standard U.S. childbirth experience: an epidural, a hospital stay, an OB and none of that hippy shit. My high school best friend became a doula and I warned her that was the experience I wanted, so if she wasn’t on board, I would try to find another doula. I’m not sure I even understood why I wanted a doula, perhaps because I had read up on what they did when she told me she was becoming one. I began seeing an OB practice in SoHo and everything was going swimmingly – the pregnancy, while miserable thanks to extreme morning sickness that never really abated, was going perfectly. Around 20 weeks one of the OBs in the practice pushed me, hard, to take some sort of childbirth class, something Seth and I weren’t in the mood for and certainly didn’t want to pay for. I asked around on Facebook for recommendations and on a local listserve in my neighbourhood for recommendations and via the listserve, over and over moms raved about a particular instructor, Tanya Wills, who taught Bradley Method classes. I had heard of Bradley from a friend, Abby, who is a huge advocate of it and actually began teaching classes after her childbirth experience. Abby was so gung-ho, though, I was kind of convinced she had joined a childbirth cult (sorry Abby!), so I didn’t take her recommendation as seriously as I should have. No other women seemed to have opinions nearly as informed as she did.
Our first class with Tanya I warned Seth not to join the Bradley cult. We were still going to get an epidural, even though the Bradley Method focuses on natural childbirth. I had heard there was enough good information for medicated mothers that it was still worth it, which was the only reason we took the class. After the first class, we were members of the Bradley cult, and halfway through the cycle of classes we were 100% committed to having a natural birth.
What made us join the Bradley cult? In our first class we talked a great deal about medicine in the United States and how warped it’s all become. Doctors practice as much CYA (cover your ass) as they do medicine these days – they have to thanks to lawsuits and schedule constraints. We discussed skyrocketing c-section rates and how childbirth has evolved in society over the last hundred years. By midcycle, we were discussing why that is – how one intervention (medication of any kind to speed up labour, an epidural, etc) often cascades, leading to increased chances of more interventions, each more drastic than the next, ultimately leading to major surgery: a c-section. Even when these interventions don’t lead to a c-section, many of the methods used to assist in delivery can be extremely unpleasant, to say the least. Our instructor brought props with her, most notably a vacuum extractor, a device secured onto the top of a baby’s head while s/he’s inside the birth canal which is then pulled by the OB in order to drag the baby out of the cervix. The chances of a doctor having to use one of these devices skyrockets when women have an epidural. Seth absentmindely grabbed it and affixed it to the inside of my calf and started pumping. While our instructor was talking, I suddenly screamed out in pain as Seth secured the suction cup around my skin. Panicked by my yell, he began to pull, trying to get it off my leg. WIth every pull, I yelled more, something I would never do in public or in private, and with each yell, Seth got more apologetic and frenzied in his attempts to get it off. Finally, the air seal was broken after about three or four tugs. Our instructor laughed and thanked us for the demonstration. That, she said, is what the baby feels on the top of their very soft skull as they emerge from the womb. That is their first experience with the outside world. From that moment, Seth and I looked at each other and wordlessly decided we were on the natural childbirth boat full-on. I barely paid attention the rest of that class, I was googling alternative care providers. We were determined not to deliver with my OB practice in Manhattan. For my last several appointments, I had expressed my desire to at least try for a natural childbirth. Every time I did so, my OBs said “sure, but how do you feel about an epidural?” A very worrisome sign that they weren’t as on board with the experience I wanted.
We quickly settled on Princeton Midwifery, as we had just moved to New Jersey somewhat unexpectedly. Their offices were inconvenient from our apartment and especially from our office. We decided to try to switch as late as possible so that we would only have to go to a handful of appointments before my delivery. We had gone so far onto the natural childbirth boat that we were looking for home birth midwives that were covered by our insurance, but had no luck finding any that had openings and our insurance absolutely refused to budge on covering their services anyway. Princeton Midwifery delivers at Princeton Medical Center at Plainsboro (yes, Dr. House’s hospital), and the facilities are brand new: the hospital was built a year ago. We would have a private room for post-partum, Seth would have a place to sleep and there was even two jacuzzis for labouring women to use. From our first meeting with Peggy, one of the midwives, we knew we had made the right decision. She was totally on board with the kind of birth experience we wanted, and we spent over an hour chatting with her and got the best vibe from the office and from Peggy.
On Friday night, October 11th, I went to bed early after Seth and I finished Shabbat dinner. At 11:15 I woke up to go to the bathroom and thought on my way back into our bedroom that I had peed more then than I had in months, thinking it strange my bladder could be so full while pregnant and just two hours after I had gone last. When I got into bed I realized that I was still leaking and so I ran into the bathroom. As I did so I thought “I can’t stop this leaking. I don’t think this is pee. Oh my G-d this is my bag of waters.” I came back into the bedroom and woke Seth to tell him – he didn’t necessarily need to know, I wasn’t having contractions, but how many times in life can a woman have that dramatic “my water just broke” moment with her husband? Seth, bleary eyed, said “oh okay. so what now?” I told him “I guess we wait for contractions to start.” And with that, he was back to sleep. I went outside into the parking lot and got a random elderly neighbour who was coming home from work to turn my cell phone on (it was Shabbat) and he called my doula. My doula told me to sit tight, get some sleep, and keep her updated. At about midnight I started to have contractions and at 1am, I woke Seth and he packed a bag for the hospital while I puttered around, mostly freaking out. At 3am we went back to sleep and at 8am I was disappointed to realize that while my water was still leaking, the contractions I experienced overnight had ceased. I called my midwives in the morning and they told me that the hospital’s policy was to let me stay home with a broken water for about 18 hours – if contractions didn’t start by 5pm we would have to come into the hospital to try to medically induce them, something we desperately didn’t want. The midwife on call, Grace, suggested we walk around to try to inspire my body to go into labour and to call back in the late afternoon to update her. Seth and I walked for over two hours over Shabbat, all over our town, and while I was having contractions, they weren’t strong and were totally irregular. At 2pm I called Grace back and negotiated to come into the hospital after Shabbat was over around 7pm. At 5pm, our doula arrived and tried using natural ways to induce labour, none seemed to work. After Shabbat ended Seth and I got in one car and our doula got into another and we were off to Princeton hospital. The mood in the car was extremely dejected. Seth and I had this picture in our minds of what the birth would be like, and even before it began it was going wrong. We had imagined this car ride to the hospital so many times, me in transition, screaming like a madwoman, and instead, we were calming discussing the situation as if we were going to the movies. It was a surreal experience and we kept having to remind ourselves that we were on the hospital to have our baby.
We walked into the delivery room and calmly set down our bags and met the nurse who would labour with us all night long, Ellen. She was incredibly warm and to our shock and delight, had already read our birth plan and was totally on board with trying to help us maintain as much of our birth plan as possible, despite the circumstances. Grace arrived a few minutes later and we discussed our options. She told us that she would be putting a chemical on my cervix called Cervadil which would hopefully ripen my cervix and kickstart labour. She was honest though: it almost never worked for first-time moms. It would, however, buy us an extra 12 hours before hospital policy mandated the use of pitocin, a chemical which makes contractions come on, but at a price: it amplifies the pain and intensity of contractions to the point where most women can’t function without the use of medication. Using pitocin, to us, meant that the likelihood of using an epidural was greatly increased. Grace inserted the Cervadil, told us to go to sleep and wake up at 7am to order breakfast. She would be starting the pitocin at 9am. We sent our doula home. I put on my face mask and rolled over to go to sleep. This picture is of me right before I “went to sleep.”
Bethany at Princeton
Around 10pm, I woke up to go to the bathroom, about 30 minutes after the Cervadil went in. I experienced several contractions in the next 30 minutes. By 10:30 our nurse Ellen came racing in the room: her monitors told her that my contractions were 2 minutes apart and a minute in duration. How could I already be in active labour, less than an hour after I wasn’t in labour at all? She told us she had never seen such a thing. She called Grace who immediately told her to take the Cervadil off of my cervix so that it wouldn’t be hyperstimulated. We called our doula back and by the time she arrived, around 11:30pm, I was in the shower, hysterically crying with Seth pressing on my back. As I got out of the shower the power of one contraction rocked me so hard I fell on the floor of the bathroom, naked, on my hands and knees grabbing Seth’s pant legs, screaming. Ellen came into the room and suggested that I sit on the birthing ball our doula brought and try a few positions to figure out a way to manage the pain better. I moved into the delivery room, sat on the ball, and propped myself up onto the bed and asked Seth to try accupressure points on my back, a coping mechanism our birthing teacher Tanya taught us, a technique I had decided would be utterly useless to me in labour. The pressure points brought immediate relief, and so I thought of the other utterly ridiculous things Tanya told us about. What else was she right about that I doubted at the time? I began to picture myself somewhere else while trying the best I could to relax my entire body, every single muscle, especially in my face. I sat on the birthing ball next to the bed, rocked back and forth, and kept my energy totally focused on total muscle relaxation. I pictured myself in random other places in my life: teaching fractions to my students in Cambodia, on the Maid of the Mist boat in Niagara Falls with my mother and step-father, anywhere but where I was. Incredibly, it worked. I managed the pain so well through my contractions that Seth and our doula noted that they didn’t even know when I was contracting after Ellen removed the monitors. I sat in a totally calm state, rocking back and forth, sometimes humming my way through contractions from about midnight to 4am, with Seth and our doula (but mostly Seth) alternating using pressure points on my back. To my shock and delight I was still able to be polite even while in labour, saying thank you to Seth over and over for being such an incredible, supportive rock. At around 4am, our doula noticed that my face was starting to scrunch, as if I was pushing. I told her that I was pressing down, not to push the baby out, but that when I did so, I felt amniotic fluid flow out, which felt incredibly relieving and so I was pushing that out during contractions. She ran to get our nurse who suggested to change positions. They were worried I was pushing too early and that the birthing ball position had done the most it could to help my labour along. I was only 5cm dilated (I was 3cm dilated when the Cervadil came out at 10:30 and barely 1cm dilated when it went in an hour before) and Ellen predicted I would dilate 1cm an hour until I hit that magic 10cm number, at which point I could start pushing.
I moved onto the delivery bed, which was propped up all the way. I went onto my knees and was upright, leaning against the bed for support. I spent about half an hour in that position, which moved me back into uncontrollable agony-mode. Between contractions I was experiencing more relief than I had on the birthing ball and even fell asleep during one break for all of 45 seconds, but the contractions themselves were almost unmanageable in their fury. I got it into my head that everyone had become convinced that I couldn’t manage and that someone would order an epidural, if they hadn’t already. I kept crying, begging not to have a needle in my spine, telling them I didn’t want any drugs. As bad as the contractions were, I was still petrified of a needle in my spine. Seth and our doula were pretty confused about why I was begging not to get drugs, but for some reason, I was convinced they thought I was at a breaking point.
I got out of bed and began to slow dance with Seth, a technique that had been working for us in the very initial stages of labour. In retrospect, this was transition, not that any of us realized it at the time, because it came on so suddenly. I was warned by everyone, every book, every birthing expert, that transition was when women really lose it. I spent transition hugging Seth, kissing and smelling his neck, telling him how much I loved him. He was absolutely incredible and I was so thankful in that moment to know that even though I was in agony, he was right there with me.
By 4:45am, I was grunting. Ellen came running into the room, heard the sounds of pushing, and ran back out to call Grace to tell her that I was bearing down. We spent the next twenty minutes with three people telling me not to push as we waited for Grace to arrive. This was probably the hardest part of my labour, fighting the urge to push, which actually felt like the urge to poop. It felt like I had explosive diarrhea and someone was telling me to hold it in – an impossible request. Grace walked into the room at 5am to the sounds of me screaming “I just want to poooooooooooop.” She walked us all over to the delivery bed and I begged her to let me push when the next contractions came on. I knew that only an hour had passed since I was 5cm and was frightened that she would think I hadn’t dilated 5cm in the last hour, a highly improbable scenario. To my sheer delight she told me to do whatever I wanted, to listen to my body and if it was telling me it was ready to push, to listen. I stood next to the bed and pushed through a contraction, which was the best feeling in the world. As soon as it was over I jumped into bed and Grace arranged Seth next to me so that he was holding my right leg high in the air as I laid on my left side. The next contraction she also told me I could push and amazingly, she agreed that we were ready to deliver the baby. Soon, nurses were in and out of the room and people were setting up warming trays and equipment for the baby. Seth and I couldn’t believe it. We did it, we were at the pushing stage and at the end of the road. The next hour I pushed and felt our daughter move forward while I pushed through contractions and then recede back inside of me as contractions subsided. It was incredibly frustrating knowing I was stepping forward two inches with every contraction just to step back one step afterwards. During one contraction, noticing I was starting to feel dejected, Grace took my hand and put it down to feel our daughter’s hair as she came forward while I pushed. It was enough to inspire me to keep pushing. I felt a full head of hair and I really wanted to just see it already. Soon, she was crowning and the phrase “ring of fire” passed through my mind. This is the terminology everyone uses to describe the feeling as the head emerges from the birth canal. During our birthing classes I was most afraid of the pushing and ring of fire stage, but strangely, it was the absolute best part of the entire labour. It was such a relief to push and even the burning sensation that accompanied crowning was a relief. It felt like when you’re getting a good burn on at the gym (which, let’s get real here, a feeling I’m barely familiar with). All while pushing I was talking, telling jokes and laughing. I shared the story of the circumstances of how she was conceived with the entire room, which made Seth tense up with total discomfort, which I felt as he held my leg. Everyone laughed and soon, another contraction stopped me from telling further details, to Seth’s utter delight.
For the next few minutes, Grace helped me slowly ease her out of me, telling me to push a little, then stop, push a little, then stop. She was applying ointment and trying to help naturally stretch my muscles to prevent any tearing (and it worked, I had none, I didn’t get a single stitch, which is rare for first-time mothers). Before I knew it, I felt her head and almost immediately after, her shoulders emerge from me and in an instant, I saw a nurse struggling to pull this slippery, squirming little purple creature onto my chest. I immediately started screaming “I have a daughter!” and just like that, I did. She was born at 6:35am. She was on my chest, still connected to me through the umbilical cord, which was still pulsating. She stayed on my chest for the next hour and when we initiated breast feeding she, incredibly, immediately latched on. Grace cut the cord (after offering to let me or Seth do so) after it stopped pulsating, something that isn’t standard in most hospitals but absolutely should be. In doing research into best practices for childbirth, delayed cord clamping came up time and again. Standard hospital policy (to immediately cut the cord, while still pulsating) was once again not always the best policy.
During this time I naturally delivered the placenta as well. Most doctors administer pitocin to do so, even if moms hadn’t received it at all during the labour, however Grace told me her policy is to just let it come out naturally. I kept asking Grace how and when I should push it out, if I would feel the urge or if it would just slide out without my pushing. I didn’t feel anything else inside of me and as intuitive as delivering my daughter had been, delivering the placenta was equally unintuitive. I’m not sure how I ended up doing it, I think I gave a slight push, but soon, an enormous organ passed out of me and I yelled “that was the biggest dump I’ve ever had to take and I didn’t even know I had to take it!” It was an incredible relief to deliver the placenta, which was strange, considering I hadn’t even felt it inside me moments before.
From during the pushing stage to the next hour afterwards, I was crying, already thanking Grace and Ellen for helping Seth and I achieve the birthing experience we wanted. I texted Tanya, our Bradley instructor within hours to thank her for teaching us the techniques to achieve it as well. In less than an hour after birth our daughter was awake and aware enough to breastfeed successfully, something most babies during medicated labours are not able to do. I was able to step out of bed on my own and go to the bathroom within an hour as well. No IVs had to be brought along and I walked there on my own two feet. We were able to leave the hospital a day earlier than hospital policy. During my postpartum recovery period I took extra-strength Motrin three times to help ease the cramps in my uterus as it receded. When Seth’s parents came to visit less than 12 hours after she was born, I was up, walking around, laughing and talking. I felt fantastic and still do 50 hours later (which is how long it’s been since I gave birth as I write this). I credit our unmedicated birth for that completely.
And that is the long answer to the question “How was your birth?” My answer is: incredibly difficult but ultimately absolutely incredible.