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The Short Version
Tyler Alexander was born on 12/13/12 at 6:36am, after 20.5 hours of labor and over 2 hours of pushing. He was 7 lb 6 oz, 19.5 inches long & presented with a with nuchal hand. The labor was all natural, with no interventions, although I did receive pitocin after delivering the placenta. I received a few stitches for a first degree tear, most likely due to the hand.
I began consistently contracting at around 11am on Dec 12th. They were always between 1-1.5 min long - and were spaced apart initially by 8-10 min. By 8pm, they were 4-5 min apart, and never became any closer than this. I did experience “aftershocks,” where after the initial contraction, my uterus remained cramped for another 30sec-1min. I progressed steadily from 2, 3, 4, 6, to 8cm dilated over the course of 14 hours. I ended up pushing for over two hours, most likely because of the hand.
I was able to achieve all my birthing goals thanks to Joey, Dorel, Ira & Hannif. I labored at home until active labor, I continued to eat and drink, I was able to move around, I was able to use a tub for comfort. I did not have pitocin or an epidural, I had a saline lock instead of continuous IV (even that made my hand sore and fingers numb however). I was able to do intermittent external fetal monitoring, self directed pushing with encouragement not counting, no episiotomy (although I did tear slightly), and no time limits were placed on me. I was able to keep my placenta, Joey cut the cord, I had hours of uninterrupted skin to skin contact, exclusively breastfed, was never separated from my baby, and was able to room in. I was so well prepared due to Tanya Will's Bradley course that I confidently knew what to say and ask for during my labor. Although I could have been a bit more graceful, and yelled a bit less, it really was a wonderful birth and I couldn’t ask for more.
The Super Extended Version
Monday - Dec 10th
I was a bit sluggish this morning - but not sure if it was me or the rainy weather. Decided to take a long bath while listening to the Les Mis soundtrack. After the bath, noticed some lower back pain and abdominal cramping. Put on hypnobabies and took a nap. When Joey returned from work, we walked from our apartment (36th & 1st Ave) to Cafe Mogador (St. Marks & 1st) for dinner (I had chicken cous cous - so good!). We then walked to Veniero’s and I had a chocolate lobster tail and a decaf cappuccino. Dorel called while we were eating dessert and I called her back during our walk home. She discussed all the ways I could bring on labor (sex, nipple stimulation, walking, castor oil, an enema). Since by ovulation, today was my actual due date, we decided not to do anything drastic for another couple of days (to me an enema sounds awful!!!). So Joey and I finished walking back and I was suddenly inspired to walk up the 35 flights of stairs. We did it in about 15-20 minutes - and only stopped on the 10th, 20th & 27th floor. I felt amazing!! I took a little shower to rinse off and we headed to bed. I couldn’t sleep all night - I’m not sure if it was the endorphins from walking up the stairs, if the cappuccino actually was caffeinated, or if this was the beginning of labor.
Tues - Dec 11th
Awoke and felt some cramping in my lower abs and lower back pain. I headed over to Momoko Uno for acupuncture (which I’ve actually never done before). I was urinating quite frequently at this point (maybe every 10 min) and wasn’t sure how I would make it through an entire session. Momoko used needles in the webbing of my hands, ankles, and sacrum to try to start/intensify contractions (she also put some in my sinuses since I was a bit stuffy). She palpated my abdomen for a while and said that I was having contractions (even if I couldn’t really distinguish them). By the end of the session, I did feel “something” and was pretty excited that things were happening. I took a taxi to meet Joey for lunch at Smorgas - and was famished. I ate a parsnip soup and full entree of swedish meatballs with a lingonberry soda and was still hungry. We were a bit early for my appointment with Dr. Jaffe, so we stopped at Starbucks first, where I had a caramel macchiato and peppermint brownie pop. So hungry.
I went to Jaffe’s office - weighed 183lbs - up 35 lbs overall and my blood pressure was 110/70. Dorel met us in the office and came into the ultrasound. Tyler was measuring 7lb 9oz and his heart rate was 131. The most concern was for his amniotic fluid - the AFI was still 10.6 which was still ok. Ira then came in to do the vaginal exam - it was quite a party in this tiny little room, with Joey, Dorel, the ultrasound tech and Ira all gathered around my vagina. Last week I was 1cm dilated, 60% effaced and he was in 0 station. This week I was 2cm dilated and 90% effaced. I think Ira and I were both a little disappointed - especially after all the evening primrose oil, walking, climbing, and acupuncture. He said I would need to return on Fri if I did not go into labor. When we were walking out, Dorel said we should have a bag packed before our appointment on Friday, because depending on the fluid levels, they might need to kick start the process. It was only one scenario, but so completely depressing to think I might get this far and end up induced.
We left Jaffe’s office and I sat outside on a bench for a bit. I was cramping pretty bad and bleeding a bit - combined with being depressed. I was just miserable. We walked 2 blocks and 1.5 avenues to Banana Republic and all I wanted was to sit down. The walk back home was absolute torture - but it was 4:30pm and there were no cabs in sight. Besides, I still would rather walk than be induced. We stopped at Jamba Juice (for a Banana Berry) and Duane Reade (for more Evening Primrose Oil) on the way home. By the time I got back, I was a complete mess. I warmed up Dorel’s sock, wrapped it around my lower back, and slept for 3 hours. I woke up slightly less crampy and Joey really wanted us to eat dinner. In a complete turnaround from lunch, I wasn’t hungry at all and had to force myself to eat some Thai food. I climbed back into bed with the sock and started feeling pretty strong contractions. This lasted for around an hour and at some point I finally drifted off to sleep. When I woke up, the contractions had died down, although I was still having red bloody mucus. After previous exams, I had bled but within hours had stopped. This was different.
Wed - Dec 12th
I woke up feeling a little off but well enough to work out with Marsha. So at 9am, I walked up the flight of stairs to the gym (which was a bit harder than usual) and proceeded with my training session. There was walking lunges, squats, pull ups - I thought for a second she was going to take it easy on me but no such luck. I felt pretty good and strong - and was satisfied in the end. I came back to the apartment, made some breakfast (two waffles w/ PB&J, red raspberry leaf tea), and set to work on buying some Christmas presents for Joey. In a span of a half hour, I used the restroom twice, which is not unheard of for me but made me wonder.
11am - I decided this was a good time to take a bath - to try to ease some of the tension in my back and the cramping I was feeling. I was completely paranoid of dropping my phone in the tub and being left in the apartment without a way to contact anyone - so when the “cramping” started becoming worse at regular intervals, I didn’t think to start timing them. I also was nervous about calling Joey back from work (he had a client meeting in the afternoon) and summoning Dorel, if the cramping was nothing and would go away.
12:30pm - I finally decide to let Joey and Dorel know what I’m feeling. I still felt very much in control at this point and knew I had a few hours before the real fireworks were going to start. Dorel listened to my symptoms and said she was going to get herself together and head over. She then said - would Joey be more upset if he came home unnecessarily or if he missed your labor? I knew at that point, he had to come home. This was around 1pm. By piecing together when contractions were coming based on my conversations with Dorel and Joey, they were about 8 minutes apart at this point and lasting for about a minute. I was going to start timing them, when Joey’s mom called to chat about what Joey would want for Christmas. I tried to play off how I was feeling as just cramps, but when the contraction hit, I was unable to really talk through it. I hurried off the phone knowing this was it, the beginnings of labor. I finally started using the contraction timer app on my phone.
So until Joey arrived, I tried to put on some makeup and get dressed while timing my contractions. I timed them myself from 1:30 until 3:30, and they were consistently 1-1.5 min long, and around 7-8 min apart. Interestingly enough, when Joey arrived at 2pm, and then again when Dorel arrived at 3pm, the contractions slowed down to about 10min apart until I became comfortable with them there. I had ordered rice and beans burritos for Joey and I (one of my favorite foods - although I didn’t consider the gas factor that would come into play later...) and we were eating when Dorel arrived. I could not remain seated through contractions, even at this point, however. When one started, I needed to stand up and move - and found the most comfortable spot was leaning on the couch or in a modified child’s pose on the bed. I tried both sitting and leaning on the birthing ball - and neither were comfortable. I didn’t really want anyone touching me at this point either. I was still firmly in control, laughing, and chatting - just mildly annoyed by these spaced out contractions.
3:30 - I finally had finished eating lunch and Dorel said she would like to check me and then possibly we could get in the tub. She said I was about 3 cm dilated and fully effaced. She then tried to listen to the baby’s heartbeat using a stethoscope, since she didn’t have a doppler and Ira said she should be able to hear it. Although she tried for quite some time, she could not hear it - but I was not concerned because he was still moving around at this point. She texted Ira to see if he had any helpful ideas about listening to the baby and my status, and off I went to the bath (around 5pm). We sat for a while just chatting and the warm water really did feel pretty good. She had brought an almond scented soap from Lush and some lavender oil that she put in the bath. I smelled amazing and so soft. At some point she even washed my back - which no one has done since I was a little kid. I was pretty relaxed and only decided to get out because I was turning pruney. I rinsed off, got dressed, and laid down for a little while. As before, the contractions seemed to intensify after I left the bath.
At some point (around 7pm), the party moved to the living room where we began to watch Castle. I was pretty relaxed, with a water bottle on my back and the heated sock on my lower abs. Again, the heat seemed to intensify the contractions, and soon I found myself on my knees, leaning over the arm of the couch. I stayed in that position for quite some time as we decided to order some dinner from 2nd Ave Deli.
8pm - Still leaned over on the couch - the 12/12/12 Sandy Relief concert started. Seeing as the hurricane/post tropical cyclone had completely upended my world (both with us being displaced to a midtown hotel for almost 2 weeks and closing NYU hospital, it was super fitting to watch during labor. All the pics of the shore, Bruce, and Bon Jovi also made me think of home. I was still on the couch with the water bottle and warm sock - but at this point the contractions had become a bit more strong and were more like 5 min apart. Dorel decided it was time to check me again and try again to find the baby’s heartbeat. I was around 3-4 cm, but she still could not find the heartbeat. I was a bit more concerned this time, since he wasn’t moving quite as much, but still didn’t want to arrive at the hospital too early. Dorel said this might be the last time for me to bathe, and seeing as I was already half undressed I figured why not. While sitting in the bath, our dinner from 2nd Ave Deli arrived - so mid-labor I ate matzo ball soup, naked in the bath, while hanging out with Dorel. I can only imagine what I looked like.
I could still hear the concert from the bath, and around the time Roger Waters was singing The Wall, the contractions began to get a bit more intense. I remember saying to Dorel when listening to Comfortably Numb that I couldn’t believe I picked this moment to say no to drugs. Soon after, there were three contractions in a row that I could not find a good position for that made me start vocalizing. Dorel said it was time to get out of the bath and head to the hospital. I showered off, but before leaving the bathroom realized I needed to sit on the toilet. Being well prepared, I thought the feeling of needing to poop was just a part of labor - but in actuality, I really needed to go! While sitting on the toilet, a really painful contraction came which made me question if I should remain seated or stand up - all the contractions were so much more painful when sitting down. I finally got myself together and got dressed while Dorel and Joey finished packing up their things. As we walked down to the elevator, I remember thinking - I don’t know how I will make it in the cab all the way to the hospital, I’m not even sure I’m going to make it down this elevator without a contraction. Luckily we made it to the lobby without stopping.
10pm - The doormen were very excited when we arrived downstairs. Suad immediately ran to 1st Ave to try to get a cab. Fortunately enough, as we walked outside Jesse was arriving home from work in a taxi. This comforting site made gave me the confidence that I could survive the cab ride. We all piled in the backseat of this Prius- first me, then Joey, then Dorel. Joey told the driver that I was in labor, but ok, and to get to Beth Israel as quickly and safely as possible. I was functional enough to send out a mass text telling everyone I was on my way to the hospital. I’m pretty sure we took the FDR and made it mostly there before a contraction started. Not being able to sit, I kind of twisted to the side and dove over Joey’s lap while beginning to yell. Funny enough, the cab driver seemed more put out by the loud man who got in the cab after us - he was actually excited to drive us! We finally arrived at the ER entrance, and now I was posed with the task of getting upstairs.
When we arrived to the 4th floor, they wanted us to check in even though Ira had told Dorel he would do a direct admit. So I stood in the hallway while they checked my pre-admit paper work, asked me a couple of questions, and waited for a free triage room. I survived two contractions standing up in that hallway - and by this point I was yelling with each one. They finally brought me and Joey back into triage and a nurse went through the basics. There should be constant fetal monitoring and I was not allowed to eat or drink anything from this point forward. She asked when the last time my cervix was checked - which was about an hour prior and Dorel said I was 4-5cm dilated. As soon as she left, I took a giant gulp of water - don’t tell me I can’t drink anything! At this point, a resident came in to check my cervix. Laying on my back was next to impossible, and her exam was super painful. She then said she couldn’t feel my cervix because I was moving too much, and that I couldn’t be admitted without her checking me. I told her the baby was going to come regardless of whether or not she could feel my cervix and to get away from me. Eventually I let her check me one more time, which was again super painful, and she announced that I was only 3 cm. I heard her outside the room, saying that they thought I should be sent home since my contractions were still 4 min apart and I wasn’t dilated that far. The nurse came back in to hook me up to the fetal and contraction monitors, which are ridiculously uncomfortable, but she allowed me to remain standing instead of making me lie down. While hooked up, Jaffe came in the room and apologized for the resident. He told Joey there are more signs of active labor than just how dilated I am and that I was definitely on my way to having our baby.
When the nurse returned, she said that I would need to be monitored for 20 minutes every hour - not continuous, and that she would put in a saline lock instead of starting an IV. I also was cleared to drink fluids and eat if I wanted. Jaffe rocks! We moved to L&D room 12 - which was an inferno. The nurse called maintenance and said if the room didn’t cool down they would move me - I unfortunately was there until around 2pm the next day. At some point, Ira came in and checked my cervix and I was at least 4cm dilated. He directed the nurse that during pushing, the room should remain exactly as it was now. No lights, no breaking down the bed. He apologized again for the resident and said he would come back to check on me. The next five hours were a combination of me on all fours on the bed or standing leaning on the bed (necessary when being monitored). My legs eventually fatigued to the point that they were shaking - I’m so happy that Marsha had me do so many squats and lunges throughout my pregnancy! I would try to use the restroom every once in awhile, but if a contraction came while I was sitting, it was super painful. I tried to squat or lie on my side at some point, but both of those positions were unbearable too. All I wanted was to be on all fours and have Dorel squeeze my hips during contractions - if Joey was on hip squeeze duty the contractions were so much worse. Because I was moving around so much, and so ridiculously sweaty from labor and the super hot room, there was a lot of trouble keeping the monitor in the right position for the baby. Every once in awhile there was some concern about his heartrate, but it always ended up being that the monitor had slipped. My blood pressure did elevate a bit - but Tyler always remained super steady. Joey stayed by my side the entire time.
I steadily progressed from 4cm to 6cm to 8cm over those 5 hours, even though my contractions never came closer than 4 min apart. Ever since the beginning, my contractions had an “aftershock” - the main contraction would die down after 1-2min but I would remain contracted for a while afterward. I never did turn on music or use my hypnobabies training. Instead, I yelled. With every contraction. I’m not sure how Dorel or Joey could stand it. (Dorel was so unphased, she even was able to put her head down and sleep for about 15 minutes). I yelled “no, no, no, no, no” or “ow, ow, ow, ow, ow.” Sometimes I yelled “I can’t” or when the very few double peak contractions came “why?” I pleaded for it to be over, for someone to make it stop. A couple of times I let out primal screams that I didn’t even know my body could make. Sometimes I was loud enough for a resident or nurse to come in, but for the most part I was left alone to scream as much and as loud as I wanted. Dorel even got me to yell, “I want to see my baby,” which was helpful in reminded me what I was doing this for. My nurse, Haniff, was from and trained in Guyana, and said this is how women labored there. That after 22 years at Beth Isreal, she still thought this was the way labor should happen. I would not have had the birth I wanted if not for her support and patience.
Some time after they announced I was 6cm, I was standing and leaning on the bed, when I believe my water broke. Dorel doubted this at the time, because there was not that much fluid pooled around my legs. Although it did continue to trickle out, and I did use the restroom at this point, there was no big gush of water. I wonder now if I really had been leaking fluid for days. Possibly what saved me was the 3-4 liters of water I was drinking daily.
Although my mouth was saying no - my head was racing with plenty of positive thoughts. I had prepared for this. I was strong. I wanted everyone to know how capable my body was and that they shouldn’t doubt me. I thought of John during spin - saying there is no substitute for experience. Of Marsha making me do those stupid down/down, up/up things even though I hated them - and knowing that I never once copped out of finishing my sets. Although the pain was intense, I knew I could finish this.
4:30am - Ira and Dorel conferred after he checked me. I believe at this point I was a little more than 8cm and the baby was in +2 station. For a reason I’m not sure of, they decided that I should try to push a bit to see if I could help Tyler to come down. Jaffe convinced me that to push I had to lay on my side and that all the energy that I was expelling through my mouth now had to “come out my ***.” It took a couple of pushes to get the hang of things, and with each push Ira was guiding the baby’s head. After a while, he left me to Dorel, Joey and Haniff, who continued to help me push. I’m positive at this point that I was pooping a bit with each push - but I honestly could not have cared less. After each push, I found it increasingly more challenging to lower my leg - and yet could not just leave my leg in the air. This part was particularly torturous. Dorel made me turn over to my right side, which was super painful, but did result in the baby coming down further. I’m not sure when, but she eventually made me turn back to the left side and I wanted to physically harm her it hurt so much. But again she was right, and the baby was crowning. They had me reach down and I could feel the baby’s head. This was really happening!!!
Although there was much excitement with the baby crowning, this phase lasted forever. I crowned for over an hour - and everyone subsequently said they would see the baby’s head and then it would retreat. It was very frustrating. Ira had been checking in and out at some point decided it was time to stay. They began to get the birthing tray together and Ira sat on the bed positioning my legs, directing my pushes, or pushing on a combination of my perineum, clitorus, or anus during contractions. I could hear him telling me to push past the point of fear, to keep pushing longer. There was no counting, however, and when another resident came in and started directing me, Ira quickly told her I only needed one voice to listen to. He is so amazing!! There was some concern for the baby’s heart rate at this point, because I had been pushing for so long. Either Haniff or Ira was now physically holding the monitor to my abdomen, but the baby’s heart rate remained constant around 135 - to which Ira said “I love this heart rate.” I really think all those hours of spin and training helped the baby cope with me physically exerting myself.
I pushed for what felt like forever - but at least the pain was somehow more manageable now. I did have moments where I wondered what would happen if I was too tired to get him out. What if I just gave up? I also wished that I had that hour I spent at the gym with Marsha back. Somehow, between pushes, I began to fall asleep. The contractions always woke me and the pushing resumed. I can remember just wishing for it to be over. I began to will contractions to come just so I could push. I think I even pushed without contractions once or twice.
And then the ring of fire began. Ira was super energetic in his “commands” at this point. Keep going, slow down, don’t push - everything he said I followed. After all this time, he finally said, “We can see the tops of his ears. One more push and he’ll be out.” I think it was actually two or three more pushes when his head was finally out. I heard him say something about a hand, and how he would have put money on a cord being there but it wasn’t. Ira told me that I had to concentrate and get him out on the next push, that this was very important. So with all my might I pushed, and he maneuvered Tyler’s shoulders out.
6:36am - My initial response was to say - “It’s a baby!! It’s my baby!!” Ira handed him right to me and I held him tight. Suddenly I was not quite as tired and so grateful that it was over. Tyler promptly pooped in my hand and then peed all over me. Even this was endearing.
Ira let the cord stop pulsing and then clamped it. Joey was able to cut the cord. Ira then said I had to push one more time to get the placenta out which I didn’t really want to do - but he was right, it did feel good once it was out. The placenta was packaged for Dorel to take back to the apartment for Martina the encapsulator (who I had only contacted two days before). Ira debated whether I needed the pitocin, but in the end I had two bags of it. He then proceeded to stitch me up, which felt like went on forever. I’m not sure how many stitches I have, but Dorel said it was only a small first degree tear due most likely to the nuchal hand. Ira kept wanting me to “put my butt down” while he was stitching, but everything felt so mangled that it was so hard.
I was able to hold the baby uninterrupted for almost 2 hours. He did not nurse, but only slept in my arms. It wasn’t until around 1pm that a nurse finally came in to help me nurse him since I was still on L&D and not the postpartum floor. If I could complain about anything, it was that I was stuck in that inferno of a room forever because there were no rooms upstairs. At first, they also told me there were no private rooms available and that I would be in a semi-private and Joey would have to leave at 10pm. When we arrived upstairs, however, there were plenty of privates - although I had to share a bathroom. It didn’t matter - Joey didn’t have to leave my side.
I was never separated from Tyler. The did the Vit K shot, eye ointment, and footprinting while he laid on my chest. The did take him to be weighed (7lb 6oz) but gave him right back. Upstairs, they never brought him to the nursery. I watched as they bathed him in the room and checked his apgar scores (9/9) - and was encouraged to warm him by skin to skin afterward. I can’t imagine how I would have felt if I was forced to send him to the nursery.
There is no way I could thank Ira, Dorel, Haniff, and of course, Joey enough. With their support and encouragement, I was able to give birth just the way I had planned - although with a bit more yelling than I thought was possible. It could have been more graceful - but really it was perfect!