Immediately after being told that my waters had broken, the on-call doctor said “you’re having a baby this weekend.”
I was admitted to L&D right away since my waters had already been broken for 24 hours and contractions hadn’t started yet. The risk of infection becomes exponential once your waters rupture, so the doctor informed me that 1) they would put me on fetal monitoring overnight and hope contractions started on their own and 2) that they would induce with pitocin the following morning if contractions hadn’t started progressing on their own. They also refused to check my cervix to see how dilated I was for fear of further increasing the risk of infection; they would only do a manual check once I was in active labor.
With that news Kevin ran home to grab our hospital bag, which I had diligently put together several weeks prior when I my cervix started shortening. While he did that I sent off a flurry of work emails to close out some loose ends and officially start my maternity leave. When Kevin got back we settled in for the night, watching the Penn State vs. Wisconsin game (Penn State won!) and trying to get some rest. We went through our birth plan with our night nurse just in case things got moving soon. We wanted a natural, unmedicated birth, with the only intervention on our list of possibilities being nitrous oxide. We asked for as few interruptions from the nurses as possible, for delayed umbilical cord clamping, and for skin-to-skin time after birth if the baby’s condition allowed. Around midnight I was still wired for sound so I accepted the nurse’s offer to take an Ambien, with hopes that I’d get some sleep before active labor started.
By 8:00 AM the next morning no noticeable contractions had started, though the fetal monitor did pick up on some small, consistent ones throughout the early morning hours. Kevin and I were sent out walking. We roamed the hallways of the hospital for an hour and a half. No progression. At 10:00 AM I got my first dose of pitocin. I was wary about being induced medicinally but the clock was ticking and they really didn’t want me pregnant much longer. They started the pitocin drip at a “1,” assuring me that it would be a very slow increase until contractions started, then they would stop the increase. The maximum dosage they would go to was 20. Every hour they increased the drip by 1-2 points. All afternoon I sniffed jasmine essential oil and had Kevin massage reflexology points on my feet – both homeopathic methods known to induce labor. No cigar. By mid-afternoon I was still feeling next to nothing, so the doctor gave me permission to eat small amounts of food at a time so I wouldn’t get too famished.
By 5:00 PM, the pitocin was at a 16, and I still wasn’t feeling much of anything. It really felt as though active labor was eons away. I called the nurse and asked to be put on wireless fetal monitoring so I could walk around. Kevin and I zoomed in circles around the L&D hallways with my wheeled IV pole that I named Luigi (after the little Italian car in Disney’s Cars) in tow, giving me a constant pitocin drip. After an hour I decided to order dinner since contractions hadn’t started. Kevin left the hospital to take care of our dog, Boomer, and I called my Mom to touch base while I ate in my L&D room. By the time I was finished and Kevin got back it was closing in on 7:00 PM. “Let’s walk again,” I said, and we proceeded to wheel around L&D again.
We completed two laps around the floor and then, boom. Contraction. It felt like a really terrible menstrual cramp, but more sustained. I almost had to stop walking. It lasted about 40 seconds. “Let’s keep going.” One more lap and then, contraction again. We pushed through 2 more laps with one contraction hitting around the same place each time. I was too uncomfortable to walk anymore. We made our way back to our L&D room, where another contraction hit. Kevin asked, “Do you want to lay down?” “No. That sounds awful.” “Ok.” I stood, clutching Luigi and swaying purposefully through each contraction. I asked Kevin to come support my back. I leaned back into him during the worst of the contractions. This went on for about 45 minutes. My feet were tired, but the thought of laying down was still preposterous to me, so I asked for an exercise ball. I got down on my knees and leaned my forearms over the ball. I had Kevin sprinkle some lavender essential oil (which helps you to relax & stay calm) onto a washcloth for me, which I wound up clutching throughout the rest of labor. During most contractions I would fan the washcloth in front of my face and breathe in the lavender. It was amazing how helpful it was.
After 20 minutes or so on the ball I wanted to stand again. When I stood up I got nauseous, so I stood, leaning over the sink in the room, just in case. I continued swaying through contractions that were now lasting close to two minutes and were only separated by 30-40 seconds of rest. During a particularly long contraction I threw up my dinner but surprisingly felt much better. Leaning over the counter felt good, so I stayed put, and during each subsequent contraction I grounded down into a squat and had Kevin push with his full body weight against my lower back. This position greatly reduced the back labor pain. At around 2 hours into active labor, I had two back-to-back contractions so intense my vision blurred. “I need nitrous oxide right now,” I announced. Kevin knew I wouldn’t ask for it if I didn’t absolutely need it. He sprinted out to get the nurse. By the time they rolled the nitrous into the room and got it set up beside the bed nearly 15 more minutes had passed. In the middle of another vision-blurring contraction I stumbled across the room towards the bed. “Nitrous tends to make a lot of people nauseous or dizzy so you need to be beside the bed to use it” the nurse gently told me. You have to self-administer nitrous oxide, so I grabbed the mask and shoved it against my nose and mouth and inhaled way too deeply. I almost fell over I got so dizzy, so I had to lay down which I absolutely despised. I layed on my left side and reoriented myself with a peanut shaped exercise ball between my legs to take pressure off of my back. I tried using nitrous for the following two contractions and found I needed to inhale a lot less. It didn’t take away the pain, but I found it did help clear (or blur!) my headspace just enough that I was ever so slightly more relaxed during contractions. Then, all of sudden…I felt it. “I need to push.” “Now?” the nurse asked. “Now.”
The nurse’s eyes got super wide. My cervix dilation hadn’t been measured all day due to the infection risk, but they’d planned on measuring at some point during labor so they’d have a ballpark on timing. My nurse took a quick measurement, then frantically called over her shoulder to the second nurse, hovering in the back of the room, “She’s at 9 pushing 10, station 1. Go get the doctor, NOW!”
The next ten minutes were a blur as the contractions continued almost constantly. Then, the doctor whirled into the room, snapping gloves onto her hands as she positioned herself at the foot of my bed. I was still laying on my left side, clutching the bed rail. The nurses coaxed me onto my back and the doctor broke away the lower part of the bed. Kevin was on my right, a nurse was on my left, and both of them grabbed a leg. The doctor gazed steadily into my eyes from above her surgical mask. “Moriah, on your next contraction I need you to push.” I nodded.
With each contraction I held the nitrous oxide mask up to my face and took one breath, then I’d drop the mask and grab around the outsides of my legs, supporting some of my weight, while Kevin and my nurse helped. After a few pushes I could feel baby boy’s head crowning. Between contractions the doctor asked, “would you like to reach down and feel his head?” “NO!” I exclaimed, to which my nurse laughed. “Well that’s a definitive answer. Some women find it motivating. Some don’t.” Yeah, I was definitely in the no-thank-you camp.
With each push from then on out, the pain of the contractions wasn’t the worst part – the proverbial ring of fire was. I’m not going to explain it here, but Google “ring of fire in labor” if you want to know more. In between each of these doozies, Kevin said that I was quite chatty and kept making everyone laugh with my ridiculous commentary. A few choice things I said include: “man, giving birth is not glamorous!” and “I’m REALLY glad we took childbirth classes.” and “Can someone get me a mint? I need a mint.” After about a dozen of these contractions the doctor looked at me and with her calm command said, “Moriah, you need to push past the pain.” I knew what she was saying. On the next push, even after the contraction had ended, I kept going, screaming all the while. I felt this massive release and a sudden gush, and before I could fully take in what was happening, Berkeley Ford Royer was in the room with us, crying spiritedly. It was totally surreal.
The doctor looked up at the clock and started the one minute countdown for delayed cord clamping, and at the one minute mark turned to Kevin and asked if he’d like to cut the cord. “Sure!” (In hindsight it’s crazy to both of us that Kevin was right in the middle of all of the action. He’s normally not the best with blood and intense stimulation, but he was in the zone with me. We labored together, and he was THE best labor partner in the whole wide world.) He took the scissors and cut the cord, then Berkeley was passed off to the Nurse Practioner and NICU nurse who had come into the room with a warmer while I was pushing. They began doing his vital checks and APGAR scoring while the doctor tended to me.
Little did I know at the time, but after Berkeley was born I began hemorrhaging. The doctor worked quickly with my L&D nurse by her side and it took almost 45 minutes to stop the bleeding, which included the doctor going elbow deep into my uterus, doing uterine compressions from the inside and out, giving me several doses of medication to stop the bleeding, and several gentle tugs on the umbilical cord before I finally birthed the placenta. They were still working on me when Berkeley was whisked off to the NICU. I sent Kevin with him. Once the doctor was satisfied that the worst of my bleeding was over I was started on IV fluids and brought a wrap, chips, apple, and at my request, a cranberry juice & gingerale cocktail. I remember that I was violently shaking all over. “It’s the hormones” my nurse told me as she wrapped me in warm blankets and hung a second bag of IV fluids. Once the fluids were drained and I had eaten I was finally able to stand (with assistance) and make my way to the bathroom. After I passed the first-pee-post-labor test, I was put in a wheelchair and taken to the NICU to properly meet my sweet baby boy.