In birth, a woman often comes up against a wall that is either going to change the course of her labor, or she’s going to scale it.
At our first prenatal meeting, Colleen shared two potential walls she hoped to scale on the day of her baby’s arrival: she wanted to labor at home for as long as she could in order to arrive at the hospital already in active labor, and she wanted to deliver her baby without needing to rely on pain medication. She acknowledged that some people who had known her for a long time questioned her second goal. They worried she would set her heart too firmly on one outcome and then be disappointed if her history of having a low pain tolerance prevailed. Colleen approached that issue with such wisdom. She was not determined that her birth had to go a certain way, and she felt comfortable with the possibility that the pain might be more than she could handle. I admired her confidence as she asserted that she would not be riddled with guilt if she opted to get an epidural. I was impressed with her level-headedness, as I’ve known many mothers (myself among them, at one time) who set their sights on natural birth with such certitude that it devastates them to discover they need anything different.
As Colleen’s pregnancy unfolded, she read books and watched videos, attended classes and had many discussions with her provider, her doula (yours truly), and her family. A teacher herself, she was an excellent student of birth and was well-prepared before her labor began. She knew what to expect of a textbook labor, and she knew that it’s somewhat foolish to expect a textbook labor—birth is too unpredictable. So, she also became familiar with many common variations within the broad category of “normal.” In one conversation about having realistic expectations, I remember talking with her about how unusual it is for a woman’s labor to begin with her water breaking like in the movies (only about 15% of births start that way). We also talked about mentally preparing to wait until past her estimated due date to have her baby and for labor to take a long time, as she knew that only about 5% of babies arrive on their due date and that the average first-time mom labors for at least 15 hours.
So how did the big day go for Colleen? In many ways, it was not like what she had mentally prepared for! And in many ways, it was exactly the “textbook” birth she was both ready for and not expecting. Birth can be a weirdly paradoxical experience like that.
To kick things off, Colleen’s water broke in the middle of the night! That’s right. She’s one of those rare mamas in the 15%. Contractions started on their own right away, and Colleen handled things well at home while her boyfriend Marcus slept in preparation for the anticipated long day ahead of them. Both parents breathed a sigh of relief that Marcus was at home that night, as his job takes him out of town on a regular basis. Throughout the night, Colleen’s labor pattern gradually gained speed and intensity, but she continued to manage well on her own, making use of various labor positions we had practiced and trying to rest as much as she could. Around 7:30am, she called me.
Colleen sounded quite calm on the phone, so I thought she might still be in early labor. However, she described her contractions as painful and said they had been less than five minutes apart for a while. Those are both active labor guideposts, so I wondered if instead of early labor she was instead coping really well and had already made into active labor on her own like she intended. She called her doctor to seek advice on whether to go to the hospital or not while I got myself and my kids ready to leave our house. She and Marcus were soon on their way to the hospital. Meanwhile, I criss-crossed town a couple of times in order to take my kids to a sitter, swap vehicles with my husband, and double back almost to where I had started to meet the happy couple at the hospital.
Only they weren’t so happy at that point. At least, Colleen wasn’t. While I was en route, I received a text from Marcus that Colleen was saying she felt like she was dying. I felt bad for the pain she was in, but I also somewhat excitedly wondered if there was some way she could be in transition already. Women have been known to say all sorts of drastic things (like, “Let’s go home! I don’t want to do this today.”) when they reach transition—the point in labor at which dilation finishes those last couple of centimeters and the woman’s body prepares to push.
It wasn’t transition, but her progress was still worth celebrating! Upon her arrival at the hospital, Colleen had received the excellent report that she was 5cm dilated. This meant she had leapt right over her first wall of getting into active labor before changing spaces! But there is also a mini “transition” of sorts that occurs as a woman turns the corner from early labor into active labor. Her body is gaining momentum, and sometimes it takes her mind a little time to get back on top of things. She may feel physically out of control and mentally off-balance until she regains her rhythm and begins to cope again.
That “mini transition” seemed to be exactly the wall Colleen had run into at about the point that I made it to her side. She was in bed, tense, and one of the first things she said to me was “I just want medicine.” Not being sure exactly how things had been going before this, and knowing she had no desire to be upset with herself if she decided to get an epidural, I didn’t want to argue with her if she asked for medicine. I said, “Okay,” and started trying out some techniques to help her cope in the meantime. We tried position changes, light massage, counterpressure, heat, cold, softly speaking affirmations, guided breathing, and guided relaxation. For that first half-hour of searching for some sort of groove together, nothing seemed to be helping her cope. Most modes of touch that I tried seemed to actually make things worse, as Colleen would say, “No,” or “Ow!” It was hard to tell whether she was talking to me or Marcus or simply her own body. At one point, trying to encourage her, I said, “The good news is, you only have to do this for one day, and then it’s over.” Her response was very transition-like: “Nope. I’m not doing this today.”
But then, she scaled the wall.
It was the simplest and seemingly most miraculous thing: she got up to pee. While she was out of bed, I heard Colleen beginning to lightly grunt and say, “Ow” at the end of a grunting sound. These were definite involuntary-pushing sounds. I asked if she was feeling like pushing, and she said yes. The nurse called for a doctor to come in and check her, and we were all pleasantly surprised to hear that in only one hour of being at the hospital, Colleen had progressed 3cm. She was already dilated to 8cm. No wonder that last hour had been so intense for her and made her say she felt like she was dying. Her body was moving through the active labor phase like a freight train.
Over the next hour, on the far side of her wall, Colleen was like a different woman. She alternated lying on both sides in the bed, breathed deeply and slowly through each contraction with her eyes closed, still occasionally said “Ow,” but the only real show of physical tension that she still showed was sometimes raising her left hand in the air or covering her face with it. I stroked her hair during this hour and told her how beautifully she was handling every contraction, and just one hour after hearing she had reached 8cm, she was ready to push.
Remaining calm, collected, and staying on top of every labor wave that moved through her, she pushed her daughter out without ever having asked for medicine again since the first time. It was as if she forgot all about it and just got the job done. Her stamina and strength and ability to be “in the zone” were astounding! I’ve never seen such a dynamic change in a laboring woman like Colleen displayed that day. As I stood nearby and admired the new family while they got to know each other, I noticed a perfect summary of what Colleen had just accomplished:
With her toes perfectly pedicured for the big day, and her foot resting in the stirrup now that the birth was complete, her tattoo proclaimed exactly what she had done that day. She had lived more fearlessly. Maybe more fearlessly than she had truly expected of herself. There had been a moment of wavering when it seemed that fear of the pain would overcome her, but then she pulled herself up and climbed over the wall in front of her, and she fearlessly took on the remainder of her task of giving birth to her daughter.
Carrigan was born just ten hours after the bag of water around her broke. An unusually short labor for a first-time mom. And her birthday just happens to be in the 5%. She was born at 12:06pm, right on her due date.
Way to take all of the norms and odds and shatter them, Colleen. Your birth was spectacular, and you have so much to be proud of in the new life you and Marcus have created.
Happy birthday, Carrigan!
Shared with permission.