A Curvy Gal's fight for a Natural Childbirth

My due date had come and gone without incident. And after a week had past, I became serious about trying every trick I had heard of to bring on labor. A little castor oil in my eggs (gross, but not unbearably so), sex (which seemed like the worst idea in the world to me when I was super pregnant), climbing the many stairs in my apartment to do laundry, scrubbing the floors, walking around the park, more sex, primrose oil capsules, blue cohosh, black cohosh, pineapple, hot as hell thai food, gnawing on basil leaves, eggplant Parmesan sandwiches, and acupuncture…I would try just about anything because I really did not want to be induced. I had an appointment for a foly catheter induction scheduled (followed by a pitocin induction if that didn’t throw me into labor) and I was intent on MISSING this appointment.

I was scheduled to get induced initially two days before my due date, but thankfully, I rescheduled. I made this induction appointment after a midwife (one of many at my OB practice) told me that going beyond my due date might put my baby at higher risk of stillbirth. The literature does point to pregnancies that go beyond the 42 week mark as being at higher risk, but I wasn’t even at 41 weeks yet. Of course if a medical professional says, "if you don’t do what I am saying, you may hurt your baby", you listen. She explained my options: I could have a mechanically induced labor to ripen the cervix (“but who wants to have a catheter inside them?” she added) or I could have a “Miso” induction—which she presented as if it were as harmless as having a cup of Miso soup -- “you come into the hospital, we give you a small dose of medicine to ripen the cervix overnight, and you’ll probably sleep through it and go into labor the next morning”.

Thank god for the internet. This “Miso” induction she spoke of is Misopropil— also known as Cytotec, is a cheap and widely used induction agent—not formulated or intended for the use in labor (it is an ulcer medication!!!). Cytotec’s manufacturer, Searle, has repudiated its use for induction and cervical ripening because of Cytotec’s potential risks. The FDA states that Cytotec’s major adverse effects include uterine hyperstimulation, which can be severe and result in serious fetal distress; amniotic fluid embolism (carrying a high maternal and infant mortality rate); uterine rupture; severe genital bleeding; fetal death; and maternal death. Other adverse effects include retained placenta and passage of meconium (the baby’s first stool) into the amniotic fluid. Aside from these risks, first-time mothers have approximately twice the likelihood of cesarean section with induction compared with natural onset of labor. This risk is due to the drug induction itself, not any reason that might have led to inducing the labor in the first place.

So how could she justify scheduling me for an induction that posed so many risks for myself and my baby? This midwife clearly did not believe in my body's ability to birth. She probably assumed I would have a failed induction and need a cesarean. After some research, I called my midwife to say that I did not want a Miso induction, and that I wanted to wait and go into labor spontaneously. She said, “Well, in my experience, women with BMIs higher that 26 tend to have cervixes that won’t dilate without chemical induction.” Okay—first I was being pressured into induction because of the increased risks of a long gestation to m y baby and NOW she’s saying that because I am a curvier gal, my body is somehow clueless about giving birth (by the way, I had NO other risk factors in this pregnancy—no gestational diabetes, no elevated blood pressure, etc) I have since searched high and low for ANY medical study that supports her belief and have come up with nothing. I argued with her that I’d like to give my body the chance to go into labor on its own—at least through the weekend (agreeing to the postponed induction with the foly catheter instead). She was condescending and doubtful, but ultimately said it was up to me.

I wrote an email to Henci Goer, author of wonderful book The Thinking Woman’s Guide to a Better Birth in hopes for some insight. Henci was so encouraging about my body knowing exactly how to birth. She also sent me links to research about induction—particularly the dangers of Cytotec. Luckily, I also had the support of my wonderful doula, Rachel, who encouraged me to wait it out--reminding me that most first time moms average a gestation of 41 weeks and a day. The day I went into labor naturally marked that average--I was pregnant 41 weeks and a day when I had my baby!

I went into spontaneous labor in the wee morning hours during a rainstorm. My contractions started waking me up at 2am, so I got out of bed and started cleaning. I had a feeling that my labor was starting, so I cleaned the cat box because I knew It might not get done for a couple days (my kitties don’t have toxoplasmosis—though finding this out cost 300$ and it only cleared my partner Brian from having cat box duty as his sole responsibility). I did some organization around the apartment for a bit and then took a wonderful bath in our Jacuzzi tub. I deep conditioned my hair and carefully shaved my legs, knowing that I might not have the luxury to do these things in the busy weeks to come.

I told Brian at around 4am that I was starting labor. We snuggled in bed and he put on "Kill Bill 2" for me (a movie I love and find oddly soothing). I held on to him tightly through my contractions, which were not that close together yet. I called Melissa, my nearest and dearest who lives north of Boston. She was one of my labor support team. She would head down right away, driving too fast in the rain to help me through this.

The sensations of labor are difficult for me to describe. I liken it to the feeling of riding an amusement park ride—like you are calmly being pulled up a steep incline and you suddenly drop—stomach in your throat, feeling20out of control (for a full minute!). And as suddenly as it comes on, the free-fall is over. You regain control. And you try not to be too freaked out that that same feeling is going to happen again in a few short minutes. At first the contractions were not all that painful—just intense. At times they felt primal and out of this world--but not painful at all. They built up slowly and at times I found myself wanting to escape the waves of pressure. Surrendering to the feeling was the only way for me to get through. I found myself saying “release, relax, and surrender” to myself during the contractions. It helped.

Melissa arrived shortly after "Kill Bill" ended. We timed contractions on her iphone using the “Contraction Master” application (highly recommended and fun!). A couple hours later I called Rachel and she came over to help me as I labored at home through the morning. Her calming presence really helped me through hours of contractions. I intended on staying home to labor as long as I could.

We kept the mood light and peaceful. Rachel baked some brownies for the nurses with me (although I contracted through most of the process, and blamed the brownies). At one point I wanted to be alone, so I went to my bedroom and quietly labored with my eyes closed , listening to my hypnobabies tracks on my earphones (also recommended—although my birth was not pain-free, the relaxation techniques were very helpful) . I had no concept of how much time was passing…We watched episodes of Desperate Housewives when I joined everyone again. I felt like I would have a contraction every time I moved, so I tried to remain still.

We went to the hospital only when I felt it was absolutely time to have my baby (thanks to my doula's gentle distractions and encouragement). At the hospital I was chastised for forgetting to call my practice to notify them I was in labor (oops!). When I arrived, I was 8cm dilated, and a wonderful midwife was on call to deliver me. She and the team of nurses were kind, encouraging, and simply perfect. I was not offered any drugs at any point during the birth. I thought I would have wanted to move around more during labor. I did labor on the birth ball for a while, but I found the hospital bed most comfortable—whenever I moved, I felt terrible pressure.

I had read so many horror stories about hospital births, and had fully expected to come into my hospital birthing process kicking and screaming for a natural experience. I had imagined a candy cart of painkillers being pushed on me by the hour. I thought the person delivering me20might break my bag of waters or give me an episiotomy without asking. I thought I would have to make a fuss to hold my baby immediately after birth. But I am happy to report that none of these things happened. And I attribute this experience to the fact that I stayed home laboring as long as I could. I had been warned by one midwive at my practice to "stay home as long as you can while you're laboring--because if you hang around the hospital to long, we'll want to play with you". I knew I didn't want anyone "playing" with my birth pocess.

I regret that before the birth I had made Brian promise to stay near my head during my labor—above my waist—so he wouldn’t be traumatized by seeing the whole messy process. Sure it’s messy, but it’s also beautiful, and next time I plan on inviting him to witness the entire event. He was a very calming and encouraging presence for me during the birth, even though he felt that he didn’t do much at the time. I also know that if I have another child, I will choose to have a homebirth. But this choice is not because my hospital birth was unpleasant--I just think it would be a much more beautiful experience (and besides, the most unpleasant part of my labor byfar was the 3 block car ride to the hospital) .

One hospital procedure that wasn’t planned on was an episiotomy. The midwife later told me that the baby’s umbilical cord was quite short—and that probably was what made the procedure necessary. When she told me I needed one, I asked if I could try two more pushes without it. She said, “Absolutely,” and I gave it my best shot (to no avail). Luckily, it caused me very little discomfort and healed quickly.

I went to the hospital at 2:00 pm and my 7lb 9oz son, Nathaniel Hayden Lima, was placed in my arms just two and a half hours later. This birth was the most incredible experience of my life so far. I was truly blessed with a beautiful and merciful birth.