Rushing to the bathroom, the soaked maxi revealed the confirmation. I called out for my husband, Alan. He grunted a half-asleep, "what?" 

"You were right. He's coming early. My water broke."

 

I showed him the pink-tinged pad as proof, and he claimed to smell the tang of amniotic fluid. He got up to make coffee and oatmeal. I finished up my work, emailed all my clients, ate breakfast. Alan did the same. 

We jumped in the shower. Contractions came in irregular waves. I laid down, catching a short catnap. Contractions stronger, but manageable and irregular. At 10am we bundled up to walk around the neighborhood. After one block in snow flurries, husband insisted we go to the mall. We walked around for two hours, munched on a Auntie Ann's, tried the Windows Oculus for Xbox, bought Lush conditioner. Contractions stopped. At home I returned to lying down and watching YouTube videos. We watched an Amy Schumer comedy special while I sat on the birthing ball. By 3pm it became clear nothing was picking up. I finished off a protein smoothie, wrapped up the house, and we headed towards the hospital, checking in at 5pm.

We secured the last available room on the L&D floor. Busy night for babies! Unfortunately neither of our two midwives were available. Our favorite was on call, but she was sick. We had to use an OBGYN affiliated with the practice that I'd never met. The first L&D nurse was very upfront and honest, especially after checking my cervix and declaring it 3cm, 70% and 2 station. "Over 12 hours, little progress, broken water: You're going to need pitocin." The news was a bummer, but at this point not unexpected.  I was more bummed that I wouldn't be able to move around or use the in-room birthing tub thanks to the constant monitoring requirement. 

The L&D nurse started the pitocin before the OBGYN stopped in. She talked with us about the drip, and inserted the internal monitor. That hurt! It took her three tries and boy, did I bleed!

The pitocin contractions were easy to handle at first. I sat next to the bed on the birthing ball. As the dosage slowly ramped up, I moved through various positions: squatting, hands and knees, standing, hip rocking. It seemed to be working, but after an hour the new on duty L&D nurse checked and said I'd only dilated 4cm.

Up went the dose again. The contractions finally became intense, reaching 2-4 minutes apart. I rocked constantly on hands and knees. Side-lying was excruciatingly painful. I remember yelling at my husband, "It hurts! It hurts so much! I can't do this!" At varying intervals. Hands and knees was the only position that wasn't scream worthy, and my knees and back were killing me. Alan asked if the L&D nurse would check me, but she refused saying with my water broken, they didn't want to check too much. Maybe half an hour later, my resolve broke. 

"Alan, I can't do this anymore. I can't."

To his credit, he did everything right. Super encouraging, saying yes I could, that I was doing it. The L&D nurse--lets call her Tia-- came in. I remember sitting naked on the edge of the bed, Alan and Tia kneeling in front of me, and me confessing I was throwing in the towel.

"I just can't, Alan. I can't relax. And if I can't relax, I can't dilate."

Tia was very soothing. "It's up to you honey. Whatever you want."

I took a few breaths. "Lets check and I'll decide."

Laying back flat took serious effort. I squeezed Alan's hand as she rummaged around downstairs. 

"You've got no cervix left," she said. "Yeah, it's all gone."

"What?" I was mentally prepared for her to say 5 cm. "I'm all dilated?"

"Yes. Are you feeling the need to push?"

"No."

"Well, that's okay. Let's get you off that Pitocin and get you moving. His head his still high, so let's get him to drop and wait for the urge to come on."

Off went the monitors--I'd taken to yanking them off during contractions at the end anyway, unable to tolerate them any longer--and I went straight,  for the shower, collapsing into a puddle on my hands and knees. It felt so much better sitting in the floor, kneeling, hot water dripping. Mentally I could handle the contractions, knowing soon the pitocin would be out of my system and the sensations would change soon to be more productive. I was expecting them to space out, too, and give me time to recoup.

Tia had us try a few things as we waited for the contractions to shift from dilating to pushing: toilet sitting, birth ball in the shower, the tub, leaning against the peanut. I actually found kneeling in the tub irritating, with the ripples against my skin. I didn't expect that. I also couldn't lay back into the seat. Hands and knees again was the only comfortable position. In all, it took about an hour to start feeling a difference in the contractions.

Around 1am I moved back to the bed to start trying positions to push. My initial efforts were less than stellar. We began with hands and knees, but I wasn't pushing effectively. Tia had me move to the right side-lying. Again, not effective. Tia felt me out and brought in another nurse--let's call her Bea--to consult. I could tell something was up from their conversing. Bea moved me to the left side lying and coached me through pushing by pressing on points on my cervix. Pushes became more effective. We stayed here for a while, but a new problem emerged: my contractions were spacing out too much, making my pushing efforts wasted. As much as 6-10 minutes were passing. We started moving through new positions: kneeling, squatting, toilet sitting. Back to hands and knees. I complained of pressure in my back--as if I was having back labor. Tia again checked his position. She seemed vexed. Bea came back and again they consulted mysteriously.

"We need to try nipple stimulation," Tia said. "We have to get your contractions closer together."

I rubbed and rubbed until they were raw. No changes. 

Tia delivered the bad news. "Dr is recommending we return to pitocin. We have the get your contractions closer, otherwise all your pushing is for nothing. The good news is we shouldn't need very much this time, and you'll be able to work with them."

In went the IV, on the monitor. Luckily the internal monitor stayed out. The pitocin initially did very little. Tia was surprised. She had to up the dose twice before the contractions picked up at all, and even then they remained inconsistent for the remainder of labor.

Occasionally I glanced to the clock and it's glaring red numerals. I knew I was on a timer, with my broken water. Mentally I kept telling myself he'd arrive by 430am. 24 hours.

Tia left to eat her lunch, promising to be quick. Bea filled in and was a superstar at coaching me to push correctly. I finally started making progress.  

Bea stepped out, but kept coming back to check and confer with Tia. They were trying to decide his position. Based on his sutures he seemed sideways. Progress continued but slow. Even with nipple stimuli my contractions remained weak and far apart. Still, I managed to get him far enough that they started to see his hair in the birth canal. Dad and Tia got excited, but he never seemed to move further.  She kept pressing on my belly, which hurt like hell. I would yell and tell her so. After each push I screamed from the pain in my hip.

The nurses grew more concerned. I heard them whispering he was stuck behind a bone and that his head had a top knot. 

Around 330am Bea gave us a truth bomb. "Here's what's going on. Dr. OBGYN is going to advise if he is not here by 430, that you have a c-section. But I'm telling you it's okay to push back. You don't have to take the recommendation."

"But I thought you said I birthed hair!"

"You have, he's very close. He is stuck though, you have to push him through it."

Bea left and Tia returned, telling the same story but she was even more direct. "You're so close. Don't give in to the csection. I would exhaust every other option first, like getting an epidural."

The real work began. There was no way I was getting a csection, not with him so close and doing fine. He wasn't in distress. Bea went to town stretching my perineum and giving me focus points. I won't lie; it was excruciating to have her do that but it worked. Alan held one leg and I held the other. The pressure and pain of trying to shove him through my birth canal was intense. I knew from my studies I should have been breathing calmly and deeply, but the emotions in the room were intense. It was all I could to do to gasp two shallow breaths between pushing, with Tia and Bea encouraging me to push harder and harder. 

Finally the pressure reached a new intensity and Bea and Tia got excited. "He's free! He's almost here!" Tia gave me oxygen to suck on between pushes. The pressure and pain intensified. Alan kept saying he could see him--he had a dark curl on his head. 

"You are a bad a--," Alan kept saying. " isn't my wife a beast?"

"Yes, she is." Tia said. 

I kept wondering when he was crowning, or if i would burst a blood vessel from pushing so hard. The clock passed 430, 500.

"That's it, you're finally getting it! Keep going!"

With each push I grasped hard into the hand rail. They wanted me to relax my legs, but it was tough to focus on pushing like a poop and staying limp in my legs. I didn't like that I kept rolling onto my back, which I know is not ideal for pushing. I said all sorts of things--I want it over, I want him out, I'm done. I would cry out during pushing, despite rationally knowing not to, but would get it back together and focus that yelling back into pushing. Alan started giving me sips of apple juice. For some reason, that seemed to perk up my contractions. We alternated between sips of water and sips of apple juice. 

Suddenly things happened very fast. I felt the bed move. I didn't feel like I could drop my leg. They took away my hand rail and I grasped for Alan's hand. The bed rose. The OBGYN was standing there in her green and someone else was in the room. Lights flicked on. 

They told me to push. I could see my reflection in the lamp over the bed. They moved me into the sitting position, feet in stirrups, which I knew was I was too tired to sit upright. Legs spread, someone helped me curl up on the contraction.

Wow. The pressure and stretching was unlike what I expected. No ring of fire, just a bowling ball sitting down there. In the reflection a crown of hair came out several inches.

"Breathe, breathe," someone said. "You can hold it if you want."

Holding back was a challenge. I wanted nothing more than to get it out. To shove and be done. But the rational part of my brain knew I didn't want to tear. I sobbed through the pain. I tried holding off as long as I could, waiting to feel the next contraction that never came. With a deep breath, I gave up on waiting and curled up again. He slowly moved, and to everyone's surprised I popped him out in one big final push, all at once in a huge rush. Even I was surprised at how fast his entire body flew out. 

I never tore and no hemorrhoids.

"Wow. I can't believe he came out right side up," Tia said as they were delivering postpartum care. 

"Me neither," Bea agreed. "He must've turned at some point. His sutures were not aligned that way."

They both said I did awesome. Alan and I thanked them profusely. I'm confident I couldn't have done it without them, especially with Bea's pushing coaching. And I'm super impressed they advocated against the csection. I'm not sure if the OBGYN said anything, but the NICU nurse said, "I can't believe you did all that without pain meds. You are a beast!" 

Caelan was officially born at 5:49am. Tia and Bea went off shift at 7, and the next nurse that came in said, "The whole floor knows about your labor and delivery and we are all super impressed."